Periodontists: Gum Disease Experts

Key Takeaways

• A periodontist is a dentist who focuses on the gums, bones, oral inflammation, and other tissues surrounding the teeth.
• General dentists can perform some periodontal treatments. But for more challenging procedures, you may be referred to a periodontist.
• You might see a periodontist if you need specialized treatment for gum disease or a dental implant.
• Periodontists can also provide cosmetic improvements to the shape of your gums.

What is a Periodontist?

Periodontists are dentists who specialize in treating the periodontium, the group of tissues surrounding and supporting your teeth. These include your gums and the surrounding bone.

The most common disease periodontists treat is periodontal disease (PD or periodontitis), which is an advanced form of gum disease. As PD progresses, it can cause severe bone tissue damage and, eventually, tooth loss.

Periodontists are also experts in placing artificial tooth roots, also known as dental implants. Implants replace missing or extracted natural teeth due to periodontal disease, injury, or tooth decay.

What’s the Difference Between Periodontists and Dentists?

There are several types of dentists who specialize in different aspects of oral and dental health. Periodontists are dentists with expertise in treating the gums and other structures that support your teeth.

However, when people use the word dentist, they’re likely referring to general dentists. These are the dentists you see for regular checkups and cleanings. General dentists also perform many common dental procedures, such as:

• Cavity fillings
• Root canals
• Crowns and bridges
• Tooth extractions

Sometimes, people need treatment that general dentists don’t offer. If you need treatment from a specialist (such as a periodontist or an oral surgeon), your general dentist may refer you to one.

Why Would You See a Periodontist?

You might see a periodontist if you have symptoms of advancing PD, such as:

• Gum recession
• Red, swollen, or bleeding gums
• Deep periodontal pockets
• Bad breath (halitosis)
• Bone loss (this can also simply be due to prior tooth loss)

Other reasons you might see a periodontist include:

• You’ve had a tooth removed and need a dental implant to replace it
• You need a bone graft (this may be required before implant surgery)
• You want cosmetic treatment for a “gummy smile”
• You need a soft tissue graft to treat gum recession

Qualifications of Periodontists

To become a periodontist, these dental specialists must complete several years of education, including:

• A bachelor’s degree.
• At least four years of dental school.
• Three additional years of residency training.

In addition, periodontists must stay up to date on developments in the field of dental health to get recertified. They are also highly trained in performing cosmetic procedures.

Dr. Nandita Lilly, one of NewMouth’s in-house dentists, states, “General dentists often refer patients to periodontists for complex procedures since they have at least 3 years of advanced training in periodontal dentistry.”

What Services Do Periodontists Provide?

Periodontists provide treatments like:

• Scaling and root planing (a deep cleaning to treat gum disease)
• Dental implant placement
• Dental crown lengthening
• Gum grafts
• Pocket reduction (reducing the spaces between your teeth and gums)
• Certain cosmetic surgeries, such as gum contouring

These treatments may overlap with what your general dentist or another specialist offers. For example, both periodontists and oral surgeons can offer dental implants.

What Does Periodontal Treatment Look Like?

Here are the most common procedures a periodontist might perform:

Scaling and Root Planing

Scaling and root planing is a deep cleaning of the teeth and gums. It’s more challenging than routine oral cleaning, so your general dentist may send you to a periodontist.

• Scaling: Removes plaque and calculus (tartar) that have built up over time.
• Root planing: Smooths out the roots of the teeth to help keep tartar from coming back.

This procedure is a common treatment for gum disease because it disrupts the tartar and oral bacteria that inflame the gums. It can help prevent mild gum disease (gingivitis) from progressing to more advanced PD.

Dental Implants

Dental implants are a permanent solution for missing teeth. A crown is fitted on the end of the implant to serve as a replacement tooth.

An implant can be placed by a general dentist, a periodontist, or an oral surgeon. Usually made from titanium, it forms a bond with the surrounding bone, providing strong support for the new crown.

Implant surgery requires several months to fully heal and comes with some risks. But unlike dentures or bridges, dental implants are integrated into your jawbone and can last a lifetime.

Dental Crown Lengthening

Sometimes, dental crowns or fillings can’t be placed because there’s not enough tooth structure to support the restoration. Crown lengthening exposes more of your tooth structure to improve "biological width."

This procedure involves reducing some of the surrounding bone. Occasionally, gum tissue is reduced for cosmetic reasons, which is often referred to as gum contouring (see below).

Gum Grafts

Gum grafting refers to the placement of new tissue over areas where the gumline has receded. You may be given a gum graft if you have exposed tooth roots.

The new tissue will protect and support your gums. The tissue for the procedure may come from the roof of your mouth or from an area of your gums that is already in good shape.

Pocket Reduction

Pocket reduction surgery, or gum flap surgery, is a treatment for periodontitis. It addresses the deep spaces between the teeth and gums (periodontal pockets) where tartar and bacteria can accumulate. Gum tissue is lifted away from the teeth, tartar and infected tissue are removed, and the healthy tissue is reattached.

Gingivectomy

A gingivectomy, also known as gum contouring, is usually a cosmetic procedure. Like crown lengthening, it reduces gum tissue to expose more of the surface of the teeth. This procedure is intended to address a “gummy smile.”

Bone Grafting and Ridge Augmentation

These procedures often go together:

• Bone grafting — Replaces lost bone tissue. You may need a bone graft to prepare for a dental implant or if you have bone loss due to advanced gum disease.
• Ridge augmentation — Reshapes the newly grafted bone for improved function and appearance.