Periodontics / Periodontist

What is periodontics?

Periodontics is a dental specialty. The word “periodontics” comes from two Greek words: “peri”, which means “around” and “odont”, which means “tooth”. So, the field of periodontics treats conditions that affect the tissues around your teeth, such as bone loss, gum recession and periodontal (gum) disease.

What’s the difference between a dentist and a periodontist?

A general or family dentist focuses on preventative and restorative treatments. For instance, if you need a routine dental cleaning, you see your dentist. A dentist also fills cavities and places restorations such as dental crowns or dental bridges. In the U.S., a general dentist must graduate from a four-year dental school before receiving their license to practice.

A periodontist is a gum specialist. They focus on treating conditions that affect the tissues that support your teeth (such as your gums and jawbone). In addition to graduating from a four-year dental school, a periodontist receives three years of additional training before earning their license to practice periodontics in the U.S.

Why would you see a periodontist?

There are several reasons why someone would need to see a periodontist. Some people only need to see a periodontist temporarily. In other words, they may need to undergo treatment that’s outside the scope of practice for a general dentist. For example, maybe you need a gum graft, bone graft or frenectomy. A periodontist can perform your surgical treatment, then refer you back to your general dentist when your recovery is complete.

Other people may need to see a periodontist long term. This includes people who are prone to gum disease. Those who are genetically predisposed to gum disease usually need periodontal cleanings in addition to routine cleanings at their dentist’s office. In these cases, your periodontist will work closely alongside of your general dentist. You’ll continue to receive care from both of them in order to maintain optimal oral health.

What exactly does a periodontist do?

A periodontist treats oral health issues that affect your periodontium (the tissues around your teeth). This includes your:

• Gingiva: Your gums.
• Periodontal ligament: A group of connective tissue fibers that attach your teeth to your jawbone.
• Cementum: A hard layer of calcified tissue that covers your teeth roots.
• Alveolar bone: The part of your jawbone that has tooth sockets.

What type of procedures does a periodontist perform?

A periodontist can perform a wide range of periodontal treatments, including periodontal maintenance, scaling and root planing, and several types of periodontal surgery.

Periodontal maintenance

Periodontal maintenance refers to a type of teeth cleaning. It’s similar to a regular cleaning at your dentist’s office. But in addition to cleaning your teeth, your periodontist or hygienist checks your gum health and measures the pockets around your teeth. (When you lose bone around your teeth, the pockets get deeper.) Many people who need periodontal maintenance should have these cleanings every three to four months. Your periodontist can recommend a cleaning schedule that’s right for you.

Scaling and root planing (periodontal cleaning)

“Scaling and root planing" (SRP) is another term for a deep dental cleaning. The main difference is that SRP requires local anesthesia to numb your gums. This allows your hygienist to clean deep underneath your gum line, where harmful bacteria hide. They’ll also smooth the surfaces of your teeth roots to discourage plaque and bacteria from building up.

Periodontists typically recommend scaling and root planing for people with early-stage (mild) gum disease.

Periodontal surgery

A periodontist routinely performs gum surgeries. There are several different types of surgical periodontal treatments, including:

• Gingival flap surgery: Also called pocket reduction surgery, this procedure treats moderate to severe periodontitis (gum disease). During this procedure, your periodontist makes incisions and gently moves your gums away from your teeth. This allows them to see the infection that’s deep under your gum line. After thoroughly cleaning your teeth roots, your periodontist repositions your gum tissue and stitches it into place.
• Gum grafts: This procedure treats gum recession. People with gum recession don’t have enough healthy gum tissue around their teeth. During a gum graft procedure, your periodontist adds tissue to the area where your gums are thin. The graft might come from the roof of your mouth, or your periodontist might purchase the grafting material from a licensed bone and tissue bank.
• Tooth extractions: Periodontists routinely extract hard-to-remove teeth, especially ones that have broken off at the gum line.
• Dental bone grafts: Periodontal infection can erode the bone that supports your teeth. When this happens, your periodontist can place a bone graft to regenerate bone in that area. Periodontists often purchase the bone grafting material from a bone and tissue bank. But your periodontist might use some of your own bone from another area of your mouth.
• Surgical crown lengthening: Sometimes when a tooth breaks off near the gum line, there isn’t enough room to place a dental crown. When this happens, your periodontist can remove a few millimeters of gum and bone tissue around that tooth so the crown can fit properly.
• Smile lift: Some people have excess gum tissue that covers part of their teeth when they smile. People who want to improve the appearance of their smile can have a smile lift. During this procedure, your periodontist removes gum — and usually a small amount of bone — from around the affected teeth. Your periodontist can perform a smile lift as a stand-alone procedure or they may recommend it in combination with veneers.
• Frenectomy: A frenum is a band of connective tissue that joins one part of your body to another. In your mouth, you have two types of frena: lingual and labial. Your labial frenum connects your lip to your gums. Your lingual frenum connects your tongue to your gums, just behind your lower front teeth. Sometimes, a frenum is too tight. This can cause issues like tongue-tie or gum recession. During a frenectomy, your periodontist makes an incision to free the frenum so it’s not too tight.

Many periodontists also place dental implants, though the procedure isn’t exclusive to the field of periodontics. Oral surgeons and some general dentists place dental implants as well.

Most periodontists offer sedation dentistry to keep you comfortable during your procedure. These options may include nitrous oxide, oral sedation or IV (intravenous) sedation.

A note from Cleveland Clinic

Healthy gums are just as important as healthy teeth. Periodontists are dental specialists who care for your gums and other tissues around your teeth. It might be scary if your dentist refers you to a periodontist, especially if you’ve never been to one. But if you have gum disease, a periodontist has the knowledge, training and experience to treat the problem and help you maintain good oral health.