Periodontal Services

A periodontist is a dental specialist who has successfully completed at least two academic years of continuous advanced studies in an periodontic program of a dental school or institution approved by the American Dental Association. Only dentists with this advanced education and with their practices limited to this specialty can claim to be Periodontists.

What Is Periodontics?
Periodontics is dentistry involving the diagnosis, prevention and treatment of diseases and conditions of the support structure of the teeth. Most people don’t know they have periodontal (gum) disease, until their dentist brings it to their attention. One of the reasons is that periodontal disease (also known as periodontitis, gum disease, or pyorrhea) is a silent disease, with few obvious symptoms in its early stages. Periodontitis is a chronic disease. It takes a long time to develop and can be characterized by short periods of rapid tissue breakdown, followed by long periods of quiescence. With treatment, a periodontal condition can be controlled and maintained, however like diabetes never cured. How do you know you have periodontal disease? The signs are subtle at first, and often can only be detected by a dentist or hygienist. These professionals are trained to look for:

• Pockets: Pockets occur when the collar of gum becomes infected and detaches from the tooth - creating a space. This space is a "pocket." The pocket is measured with instrument called a periodontal probe. The hygienists and dentists use this measurement to determine the degree of periodontal disease.
  
  
• Bleeding: Bleeding gums are not normal. When gums bleed, at the very least, a minor, reversible problem exists. Sometimes the bleeding is a sign that there are deeper problems, and without some kind of treatment, pockets and bone loss will continue to occur.
  
  
• Bone loss: Dental x-rays, taken at regular intervals, show bone levels surrounding the teeth. Subtle changes can be seen, and when they are observed, they are symptoms that periodontal breakdown is occurring. Bone loss left untreated, progresses until teeth are compromised. Fact: seventy percent of all teeth removed from adults is from bone loss due to periodontal disease…not decay.
  
  
• Loose teeth: Often early signs of loose teeth are detected by the dentist or hygienist, not by the person. Looseness in teeth is a sign that something is wrong. When discovered, the cause needs to be determined and corrected.
  
  
• Spaces forming between front teeth: In general, teeth don’t shift their position, though crowding of the lower (mandibular) front incisors does occur as we age. However, when spaces form between some of the upper (maxillary) front teeth, it could be a sign that the bone and gum tissue is breaking down in these areas.
  
  
• Halitosis: Bad breath may be a sign that significant periodontal problems exist in someone’s mouth. Once the periodontal problems are under control, bad breath often goes away.
  
  
• Abscess: Occasionally, the first time a person knows they have a gum problem is when they get a periodontal abscess. An abscess occurs when bacteria are trapped in a gum pocket. They have no way of escaping and the pocket expands, forming an abscess. If treated in time, little damage is done to the surrounding bone and tooth. Not treating an abscess in time, can lead to rapid and severe bone. When this happens, additional periodontal treatment is needed.

Like all chronic diseases, periodontal disease doesn’t go away. It won’t get better by itself. It can remain silent and in remission, only to act up at a later date. As the condition worsens, it’s harder to successfully treat. That’s why once gum problems are noticed or diagnosed, it’s best to initiate treatment as soon as possible.

Who Treats Periodontal Disease?
Your dentist should be the first line of defense in treating your gum condition. Once he or she discovers that you have periodontal disease, a program to return your gums to good health should be initiated. Many dentists employ dental hygienists. Hygienists are specially trained to recognize and treat the early stages of periodontal disease. (However there are limits as to what hygienists can do for patients).

In advanced cases, thorough dental cleanings and scalings (sometimes curettage) and improved oral hygiene techniques, are not enough to treat periodontal problems. More has to be done to the pockets and bone. This is where a periodontist referral is necessary. The periodontist will evaluate the supporting bone and gum tissue and determine the necessary treatment which may involve surgery to reduce the pockets and improve the bone and tissue architecture.