A periodontist is a dentist who specializes in procedures related to the supporting structures of the teeth and mouth – such as the bone and gum tissues. Most of the procedures a periodontist performs are focused on repairing the damage done by periodontal disease (a.k.a. “periodontitis” or “gum disease” – read much more here).
Diagnosing and Treating Gum Problems
Periodontal disease is a complicated process of gum tissue breakdown. This process is affected by a person’s health history, medications and diet as well as professional and home dental care. A periodontist will take all of these factors into account. However, the standard of care for detection of gum disease requires current full mouth radiographs (X-rays) as well as a 6-point measurement of the sulcus (gum pocket) surrounding each individual tooth.
Once periodontal disease has been diagnosed, a patient may be referred to a periodontist for any of the following treatments:
- Specialty x-rays and evaluations (i.e. cephalogram, 3-D cone beam scan)
- Non-surgical periodontal treatment (commonly called “deep cleaning” – usually involves scaling and root planing the teeth)
- Surgical periodontal treatment (a.k.a. “pocket reduction surgery”)
- Simple and complicated tooth extraction
- Gum and bone grafts
- Sinus lift
- Implant placement
This is certainly not an exhaustive list of periodontal treatments and it should be noted that many patients who walk into a periodontal office are NOT destined for surgery. Nevertheless, a typical day in the life of a periodontist will involve surgery of some kind; from simple extractions and suture removal to complicated sinus lifts, bone grafts and implant placements.
Sometimes surgical procedures are carried out for cosmetic reasons by the periodontist. Procedures like gingival recontouring/resculpting, crown lengthening, root coverage procedures, gum grafting, and ridge augmentation can be undertaken to improve appearance, ie not just to treat disease.
The periodontist and their team (which often includes hygienists and/or therapists) also has a responsibility to guide and educate patients about correct brushing techniques, flossing techniques and the importance of regular scaling and polishing (maintenance).
Roles, responsibilities and training
The primary responsibilities of a periodontist are to prevent, diagnose and treat periodontal diseases. Not only are they experts at this but, in general, they are known for their thorough evaluations and fastidious record keeping before, during and after treatment. This should be very encouraging and comforting to a patient in need of their services!
As with general dentists, periodontists are required by law to attend continuing education. This is more than just a perfunctory requirement since new treatments and technologies are constantly advancing in this field. In addition, many periodontists have elected to augment their career through advanced training in analgesics (pain reducing medicines), sedation (anxiety reducing medicines), anesthesia (total loss of sensation) and other technologies, each of which often require special certification/licensing as well as continued education.
As you can see from the above description, a periodontist is a highly trained expert. As such, they are required to have education that goes beyond that of a general dentist. Typically, this would include an additional 3 years of post-doctorate education specific to the field of periodontics and possibly a hospital internship as well.
As a result of this extensive education and training, periodontists are the preferred clinician to treat periodontal diseases (it should be noted that mild to moderate periodontal problems can be aptly managed by a general dentist). The monetary compensation of a periodontist is typically commensurate with their advanced degrees and expertise. It is not uncommon for periodontal fees to be higher in comparison to those of a general dentist.
Periodontists also need to be good team players as, in most cases, the general dentist and the periodontist will work together in managing the oral health of the patient.
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