A periodontist is a dentist specializing in the prevention, diagnosis and treatment of infections and diseases in the soft tissues surrounding the teeth, and the jawbone to which the teeth are anchored.  Periodontists have to train an additional three years beyond the four years of regular dental school, and are familiar with the most advanced techniques necessary to treat periodontal disease.  Periodontists also perform a vast range of cosmetic procedures to enhance the smile to its fullest extent.

Periodontal disease begins when the toxins found in plaque bacteria attack the gums surrounding the teeth.  The bacteria become embedded in the gums and rapidly breed, causing an infection.  If no treatment is sought, the jawbones recede and teeth loosen and fall out.

Referrals from General Dentists and Self Referral

There are several ways treatment from a periodontist may be sought.   If your general dentist or hygienist finds signs of gingivitis or periodontal disease during your routine check up, a consultation with a periodontist may be recommended.  However, a referral is not necessary for a periodontal consultation.

If you experience any of these signs and symptoms, it is important to schedule an appointment with a periodontist without delay:

• Bleeding while eating or brushing – Unexplained bleeding while eating or brushing is one of the most common signs of periodontal infection.
  
  
• Bad breath – Halitosis (bad breath) which persists even when a rigorous oral hygiene program is in place can be indicative of an infection in the gum tissues.
  
  
• Loose teeth and gum recession – Longer looking teeth can signal recession of the gums and bone loss due to periodontal disease.  As this disease progresses and attacks the jawbone, the teeth may become loose or be lost all together.

Diagnosis and Treatment

Before initiating any dental treatment, the periodontist must extensively examine the gums, jawbone and general condition of the teeth.  When gingivitis or periodontal disease is officially diagnosed, the periodontist has a number of surgical and nonsurgical options available to treat the underlying infection, halt the recession of the soft tissue and restructure or replace teeth which may be missing.

• Mild to Moderate periodontal disease – If the gum pockets reach 4-6mm in depth, extensive scaling and root planing is required.  This procedure is performed under local anesthetic.  Patients receive education on advanced oral hygiene techniques to use daily.   
  
  
• Advanced periodontal disease – Gum pockets in excess of 6-7mm are usually accompanied by bone loss and gum recession.  Scaling and root planing will usually be performed as the initial nonsurgical treatment.  In addition, the periodontist may recommend surgical treatment to further reduce pocket depth.
  
  
• Tooth loss – Where one or several teeth are missing or require extraction due to periodontal disease, dental implants are often an effective option.  If the bone is strong enough to provide a suitable anchor for the prosthetic tooth, an implant may be placed.  However, if the bone is severely eroded, bone grafts may be placed  to provide a suitable anchor for the new tooth/teeth.

Ask your periodontist if you have questions about periodontal disease, periodontal treatment or dental implants.