We will talk about what a periodontist is and what procedures they perform. Some of you are probably wondering what a
periodontist is. A periodontist specializes in treating the gum tissue and supporting bone around the teeth. They focus on the prevention, diagnosis, and treatment of periodontal disease. They also do some pretty cool stuff that we will discuss shortly. All periodontists attend three years of residency training after they have finished their four
years of dental school.
What is a PERIODONTAL DISEASE?
Since a periodontist specializes in treating periodontal disease it only seems appropriate that we at least discuss what periodontal disease is. When you see your regular dentists, they should check the health of your gums to do this they take an instrument called a periodontal probe and place it between the gums and the teeth used. The periodontal probe measure how deep the probe goes between the gums and the teeth. They will proceed to measure every tooth in your mouth. An average healthy measurement is one to three millimeters deep, and patients who have normal healthy gum tissue typically only require a dental cleaning. If however, a patient has measurements greater than four millimetres deep they will require a deep cleaning or what we refer to as scaling and root planing.
Here’s the thing we all have bacteria in our mouths, and some people have bacteria that can be very aggressive and cause inflammation within the gum tissue. If this bacteria is not controlled by regular brushing and flossing it can migrate down into the gum tissue and cause inflammation within the gums.
In some individuals, this inflammation can cause an immune response where the body attempts to attack the vaiting bacteria. When the immune system tries to remove the bacteria, sometimes bone can be lost from around the teeth as well. When a patient has measurements around the teeth that are greater than four millimetres this means that it is highly likely that inflammation has caused a loss of attachment and bone from around the teeth.
When you start to lose attachment and bone from around your teeth, the bacteria can then propagate even deeper into the gum tissue. This becomes a problem because once the measurements around the teeth become deeper it becomes virtually impossible for you to keep the teeth adequately cleaned with at-home brushing and flossing. It is just too difficult to clean that deep underneath the gum tissue. In these situations, your dentist may recommend deep cleaning or scaling and root planing to help clean those deeper areas underneath the gums. In some cases, all the treatment and follow-up care for scaling and root planning can be done by general dentists. However, in some cases, they may elect to refer you to a period on us who can not only offer to scale a root planing but also consider potential surgical procedures to treat this as well. We are trained to perform surgical procedures that can eliminate the deeper measurements around the tooth by either lowering the gum tissue making it easier for you to clean or by bone grafting which will also reduce the depth around the teeth and make it easier for you to clean as well.
What Does a PERIODONTIST DO?
We’ve already touched on how periodontists can diagnose and treat periodontal disease, and again ways they treat periodontal disease is by non-surgical therapy or scaling and root planing aka the deep clean. They can also treat periodontal disease by surgical approaches. All these surgeries are designed to decrease the depths between the teeth and the gum tissue. They can reduce these deeper areas by doing a surgery that removes excess tissue or they can decrease steps by doing bone grafting that adds tissue around the teeth. Another procedure that periodontists perform is the placement maintenance and repair of dental implants.
Not only do periodontist place implants but they can also maintain them dental implants are subject to the same issues as natural teeth and can also have a loss of bone from around the implant. A periodontist is trained to treat these complications and can try to save an implant from failure. They have a good understanding of the soft tissue or the gum tissue around the teeth. When the gum tissue is not in an ideal location or if it has a pathology, the periodontist can diagnose and treat these complications. For example a periodontist can treat gum recession where the gum tissue has actually migrated lower on the tooth exposing some of the root surfaces of the tooth. Exposed root surfaces can cause sensitivity to the teeth and make it harder to keep the teeth clean. In cases of recession, the periodontist can perform gum grafting procedures that can cover the exposed root surface improve the appearance of the gum tissue around the teeth and make it easier for you to keep things clean and healthy. Another procedure that periodontists commonly perform is aesthetic crown lengthening. Some patients show a lot of gum tissue when they smile, and there are a lot of reasons why a patient may have a gummy smile. Keep in mind that treatment of a gummy smile is an elective procedure meaning that it’s entirely optional. Some gummy smiles are treated with aesthetic crown lengthening procedures that make short teeth appear longer. This procedure can really change the appearance of a smile and make someone smile way more full and pleasing to look at. A periodontist may also do what’s called functional crown lengthening where a tooth that is severely broken down or short needs to be lengthened by exposing more teeth through the removal of gum tissue and supporting tissue from around the tooth. A crown lengthening like this usually is necessary so a tooth can be adequately restored with either a filling or a crown.
Who Should See the PERIODONTIST?
As We mentioned earlier many general dentists can diagnose and manage periodontal disease. However periodontal disease is more complicated than we once stopped, and more and more we are discovering relationships between periodontal disease and other chronic diseases such as diabetes, and cardiovascular disease. Patients with moderate or severe cases of periodontal disease may be better managed through a partnership between general dentists and the periodontist. If you have gum recession or are a candidate for crown lengthening, or are looking for a dental implant you may want to see a periodontist for evaluation and treatment. Typically your general dentists will identify any treatment needs, and they will refer you to see a periodontist. Your dentists most likely have a periodontist who they work with or refer to regularly. Your dentists should be familiar with the types of services and procedures that periodontist performs.