I remember a patient, let’s call him Mark, who came into the clinic looking a bit worried. “Doc,” he said, “my gums have been bleeding when I brush, and one of my teeth even feels a little…wobbly. My regular dentist mentioned I might need to see someone else?” Mark’s concern is something I hear quite often, and it often leads us to a conversation about a special area of dental care called periodontics. It sounds like a mouthful, doesn’t it? But it’s all about keeping the foundations of your smile strong and healthy.
So, What Exactly is Periodontics?
Let’s break it down. Periodontics is a branch of dentistry that focuses specifically on the gums and the other structures that support your teeth. Think of your teeth like houses; periodontics is all about making sure the ground they’re built on is solid. The word itself actually comes from Greek: “peri” meaning “around,” and “odont” meaning “tooth.” So, it’s literally the study and care of everything around your tooth.
This field tackles issues like:
- Gum disease (periodontal disease)
- Gum recession (where your gums pull away from your teeth)
- Bone loss around your teeth
If you’re dealing with these kinds of problems, that’s where a periodontist comes in.
Your Dentist and a Periodontist: What’s the Difference?
You might be wondering, “Don’t I already see a dentist for my teeth?” And you’re absolutely right!
Your general or family dentist is your go-to for routine care. They handle things like:
They’re fantastic at preventative care and common restorative treatments. To become a dentist in the U.S., they complete four years of dental school.
A periodontist, on the other hand, is a specialist. They’re like the gum expert. After finishing dental school, they go on to complete another three years of specialized training focused just on gum health and the supporting structures of your teeth. So, while your dentist looks after your overall oral health, a periodontist has that extra, in-depth knowledge for more complex gum issues.
When Might You Need to See a Periodontist?
There are a couple of main reasons why your dentist might suggest a visit to a periodontist, or why you might seek one out yourself.
Sometimes, it’s for a specific, often temporary, treatment that’s a bit beyond what a general dentist typically handles. Maybe you need:
- A gum graft if your gums have receded.
- A bone graft if there’s been some bone loss around a tooth.
- A frenectomy (we’ll touch on what that is in a bit).
In these cases, the periodontist performs the necessary procedure, and once you’ve healed up, you’ll usually go back to your regular dentist for ongoing care.
Other times, people might need to see a periodontist more regularly, especially if they’re prone to gum disease. Some folks are just genetically more susceptible, unfortunately. If that’s you, you might need special cleanings with a periodontist in addition to your usual dental visits. It’s all about teamwork – your dentist and periodontist will work together to keep your mouth in the best possible shape.
What Does a Periodontist Actually Do?
A periodontist is focused on the health of your periodontium. That’s the fancy term for all the tissues that hold your teeth in place. This includes:
- Gingiva: This is simply your gums – the pink tissue that surrounds your teeth.
- Periodontal ligament: Think of this as a group of tiny fibers, like little bungee cords, that attach your teeth to your jawbone.
- Cementum: This is a hard, calcified layer that covers the roots of your teeth, kind of like enamel but for the roots.
- Alveolar bone: This is the part of your jawbone that actually holds your teeth in their sockets.
If any of these areas are having trouble, a periodontist is the specialist to see.
Common Procedures a Periodontist Performs
Periodontists have a range of tools and techniques to help get your gums and supporting structures healthy again. Here are some of the common ones:
Periodontal Maintenance
This is a bit like a regular dental cleaning, but with an extra focus on your gum health. Your periodontist or their hygienist will clean your teeth, but they’ll also carefully check the health of your gums and measure the “pockets” around your teeth. These pockets are the tiny spaces between your teeth and gums. If you’ve lost bone around your teeth, these pockets can get deeper, which can be a sign of trouble. For many people needing this, we recommend these cleanings every three to four months.
Scaling and Root Planing (SRP)
You might hear this called a “deep cleaning.” And that’s a pretty good description! For scaling and root planing (SRP), your gums will be numbed with local anesthesia. This allows the hygienist to clean thoroughly beneath your gum line, getting rid of harmful bacteria that can hide there. They’ll also smooth out the surfaces of your teeth roots. Why? Because a smoother surface makes it harder for plaque and bacteria to stick around. We often suggest SRP for folks with early-stage gum disease.
Periodontal Surgery
Sometimes, non-surgical treatments aren’t enough, and that’s when we might talk about periodontal surgery. Don’t let the word “surgery” scare you too much; periodontists are highly skilled in these procedures, and they’re done with your comfort in mind.
Here are a few types:
- Gingival Flap Surgery (Pocket Reduction Surgery): If gum disease is more advanced (moderate to severe), this procedure can help. The periodontist makes small incisions to gently move your gums away from your teeth. This gives them a clear view to clean out the infection deep below the gumline. Afterward, they’ll carefully reposition your gums and stitch them.
- Gum Grafts: This is for when your gums have receded, leaving your tooth roots exposed. A gum graft adds tissue to those thin areas. Sometimes, the tissue comes from the roof of your own mouth, or it might be sourced from a special, licensed tissue bank.
- Tooth Extractions: While your general dentist can do extractions, periodontists often handle more complex ones, especially if a tooth has broken off at the gum line or is tricky to remove.
- Dental Bone Grafts: If gum disease has eaten away at the bone that supports your teeth, a dental bone graft can help rebuild it. The grafting material can come from a tissue bank, or sometimes a tiny bit of your own bone from another spot in your mouth is used.
- Surgical Crown Lengthening: Imagine a tooth breaks, and there’s not enough of it showing above the gum line to securely place a crown. In this situation, a periodontist can perform surgical crown lengthening. They’ll carefully remove a small amount of gum and bone tissue from around that tooth, creating enough space for the crown to fit properly.
- Smile Lift (Gingivectomy/Gingivoplasty): Some people have what’s often called a “gummy smile,” where more gum tissue shows than they’d like. A smile lift can reshape the gum line by removing excess gum tissue (and sometimes a tiny bit of bone) to reveal more of your teeth. This can be done on its own or sometimes with other cosmetic work like veneers.
- Frenectomy: A frenum is a small band of tissue that connects one part of your mouth to another. You have one connecting your upper lip to your gums, and another connecting your tongue to the floor of your mouth (the lingual frenum). If a frenum is too tight, it can cause problems like tongue-tie or contribute to gum recession. A frenectomy is a simple procedure where the periodontist makes a small incision to loosen that tight band.
Many periodontists also place dental implants, which are a fantastic way to replace missing teeth. Oral surgeons and some specially trained general dentists can place implants too.
And please know, if you’re feeling anxious about any procedure, most periodontists offer different types of sedation dentistry to help you relax. This could be nitrous oxide (laughing gas), oral sedation (a pill you take beforehand), or IV (intravenous) sedation for deeper relaxation. We’ll always discuss the options to make sure you’re comfortable.
Take-Home Message on Periodontics
Alright, that was a lot of information, I know! Here are the key things I’d like you to remember about periodontics:
- It’s all about your gums: Periodontics focuses on the health of your gums and the structures supporting your teeth.
- Periodontists are specialists: They have extra training beyond dental school to treat complex gum issues.
- Bleeding or receding gums? Loose teeth? These are signs you might need to see a periodontist.
- Teamwork makes the dream work: Your general dentist and a periodontist can work together for your best oral health.
- Many treatments are available: From deep cleanings to specialized surgeries, there are ways to manage and treat periodontal problems. Don’t delay if you have concerns about your periodontics health.
It’s so important to pay attention to your gum health. It’s truly the foundation of a healthy smile. If you ever have any worries, even small ones, it’s always best to chat with your dentist. They can guide you on whether seeing a periodontist is the right next step for you.
You’re not alone in this, and we’re here to help you keep that smile bright and strong.