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When to See a Periodontist

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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 and place dental implants.  Periodontists also perform a vast range of cosmetic procedures to enhance the smile to its fullest extent.

Periodontal disease begins when the bacteria found in plaque starts to build up around the teeth and attack the gingival tissue surrounding the teeth.  This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial infection.  As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums, causing the gums to appear red and bleed easily.  The resulting pockets between the teeth deepen and if no treatment is sought, the bacteria destroys the bone around the teeth and leads to less support for the teeth. This ultimately leads to unstable teeth and tooth loss.

Referrals from General Dentists and Self Referral

There are several ways treatment from a periodontist may be sought.   In the course of a regular dental check up, if the general dentist or hygienist finds symptoms of gingivitis or rapidly progressing periodontal disease, 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 that you schedule an appointment with a periodontist without delay:

  • Bleeding while eating or brushing – Unexplained bleeding while consuming food or during the course of daily cleaning is one of the most common signs of periodontal infection.
  • Bad breath – Continued halitosis (bad breath) which persists even when a rigorous oral hygiene program is in place, can be indicative of periodontitis, gingivitis or the beginnings 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 anchor holding the teeth in place) the teeth may become loose or be lost altogether.

Diagnosis and Treatment

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

  • Gingivitis/mild periodontal disease – When the gum pockets exceed 4mm in depth, the periodontist or hygienist may perform scaling and root planing to remove debris from the pockets and allow them to heal.  Education and advice will be provided on an effective cleaning regime thereafter.
  • Moderate periodontal disease – If the gum pockets reach 4-6mm in length, a more extensive scaling and root planing cleaning might be required.  This cleaning is usually performed under local anesthetic.
  • Advanced periodontal disease – Gum pockets in excess of 6-7mm are usually accompanied by bone loss and the periodontist may recommend surgical treatment to reduce pocket depth and prevent further bone loss. 
  • Tooth loss – Where one or several teeth are missing due to periodontal disease, dental implants are an effective option.  If the bone is strong enough to provide a suitable anchor for the prosthetic tooth, the implant can be placed.  However, if the bone is severely eroded, bone grafts may be performed by the periodontist 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.

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