Who is a periodontist?
Periodontists specialize in preventing and treating periodontal disease and other oral health issues. They care for the gums, jawbone, and other structures supporting the teeth. In other words, periodontists are experts in treating hard tissue problems, including ones in the teeth and bones, and soft tissue related issues, such as those in the gums and cheeks. Periodontists specialize in dental implants (structures that replace lost teeth), cosmetic periodontal procedures, root surface debridement, scaling, and root planing. They also treat conditions like periodontitis, gingival recession, gingivitis, and oral inflammation.
Periodontists can help reverse bone and tissue loss with regenerative procedures (that is why they are called 'tooth savers'), clean infected root surfaces, and treat severe gum disease. Dentists generally refer those patients to periodontists who require more specialized treatment that the dentist may be unable to provide.
For example, a dentist may refer a patient to a periodontist if they suspect a patient suffers from gum disease. The symptoms of gum disease include pain around the gums, receding, bleeding, or swollen gums, loose teeth, or a change in how the upper teeth meet the lower teeth (also called 'the bite'). Periodontal diseases are also related to chronic conditions such as cardiovascular disease (CVD), diabetes, high blood pressure (hypertension), cancer, respiratory disease, and osteoporosis. Further, if one has a family history of these conditions, one is at a higher risk of periodontal disease. Smoking also increases the risk of periodontal problems.
What kind of education and training do periodontists receive?
After graduation, aspiring periodontists must attend dental school to study how to diagnose and treat oral health problems. After four years of study and training in dental school, they need to specialize in periodontics by taking up a residency. The residency continues for three years, during which they learn to diagnose and treat diseases of the gums, tooth root, and the tissue surrounding the tooth. Periodontists can get board certification upon clearing an American Board of Periodontology examination.
What are some procedures a periodontist can perform?
Periodontists carry out various surgical procedures to address periodontal diseases and their associated complications. Below are some of the surgical interventions that a board-certified periodontist near you might perform:
- Gum graft surgery: Gum recession exposes tooth roots, leading to potential bone loss. The periodontist performs gum graft surgery to prevent further recession and bone damage. During this procedure, the periodontist covers the exposed root using the gum tissue from the patient's palate or a donor. Gum grafts can be done for single or multiple teeth, reducing tooth sensitivity and improving the smile's overall appearance.
- Regenerative techniques: The periodontist may recommend regenerative procedures when a periodontal disease causes bone loss around the teeth. These techniques aim to reverse the damage by promoting the regeneration of lost bone and tissue. In this procedure, the periodontist retracts the gum tissue, removes disease-causing bacteria, and employs membranes, bone grafts, or tissue-stimulating proteins to encourage the natural regeneration of bone and tissue.
- Frenectomy: This involves releasing a frenum, a band of connective tissue that joins different body parts. In the mouth, two types of frena exist: lingual and labial. The labial frenum enjoins the lip to the gums, while the lingual frenum connects the tongue to the gums, situated just behind the lower front teeth. The frenum may sometimes be excessively tight, leading to problems such as tongue tie or gum recession. To address this issue, the periodontist performs a frenectomy by making an incision to free the frenum and alleviate the tightness.
- Periodontal pocket management: Healthy gum and bone should fit around the teeth like a turtleneck collar. However, periodontal disease can destroy supporting tissues, forming "pockets" around the teeth. Over time, these pockets deepen, allowing bacteria to accumulate and further damage the bone and tissue. To prevent tooth loss, the periodontist performs a periodontal pocket operation. It involves folding the tissue back, removing disease-causing bacteria, and securing the tissue. Sometimes, the periodontist may smooth down uneven bone surfaces to reduce the spaces where harmful bacteria can reside.
- Smile lift: Some may have excessive gum tissue that covers a portion of their teeth, affecting the appearance of their smile. This procedure helps enhance your smile's aesthetics. In this process, the periodontist eliminates the excess gum tissue and some amount of bone around the affected teeth. The periodontist can perform a smile lift as a standalone procedure or, if necessary, may suggest combining it with veneers for optimal results.
Why should one see a periodontist?
A dentist often refers patients to a periodontist if they think they are suffering from periodontal issues. It is crucial to understand the symptoms of gum disease so that early treatment can happen. The most common symptoms include bleeding or swollen gums. Inflammation causes swollen gums, a sign of gingivitis (an early stage of gum disease).
If you notice that your brush is pink after brushing or that you are spitting out blood while flossing or brushing your teeth, it could mean your gums are susceptible, and you could suffer from periodontal issues. Other symptoms of periodontitis include persistent bad breath, pain while chewing, loose teeth, and gums pulling away from your teeth. You must not delay visiting a periodontist if you observe these symptoms. You must not ignore gum disease. Chronic periodontitis, if left untreated, can cause other health issues.
Four stages of Periodontal disease
Periodontal disease can cause gums to become swollen, discolored (red or purple), and prone to bleeding. If left untreated, it may lead to the destruction of the jawbone beneath the gums, potentially resulting in tooth loss.
Gum tissue damage occurs progressively and often without pain, particularly in the early stages. This makes recognizing warning signs crucial. Periodontal disease develops in four stages:
- Gingivitis: The first stage of gum disease is marked by red, swollen gums that can also bleed during brushing or flossing. At this point, no bone damage has occurred, making gingivitis completely reversible with proper care.
- Mild periodontitis: Bacteria begin to invade below the gumline, affecting the supporting bone. Gums may recede from the teeth, forming pockets where bacteria and plaque accumulate, which are difficult to clean with regular brushing and flossing.
- Moderate periodontitis: If untreated, bacteria start damaging the ligaments, soft tissue, and bone supporting the teeth. Symptoms may include persistent bad breath, pus near the gumline, and occasional pain.
- Advanced periodontitis: In the most severe stage, continued bone loss can loosen teeth, potentially leading to tooth loss.
While early-stage gum disease is reversible, advanced cases involving bone loss cannot be completely reversed. However, with appropriate treatment and consistent oral hygiene, it is possible to control the disease and prevent further progression.
What will happen during the first consultation with a periodontist near you?
Meeting a dental specialist, such as a periodontist, may cause stress and anxiety when you don't know what to expect. Educating yourself about periodontal visits is one of the ways you can feel at ease. So, here's a detailed overview of how your first consultation with a periodontist will pan out:
- First, you will complete certain formalities, including filling out paperwork and submitting necessary documents, such as the dentist's referral, photo ID, and insurance card.
- Afterward, the staff will direct you to the periodontist's office. Then, the periodontist will discuss your reasons for visiting. You can share details about your symptoms, including when they started and how they affect your quality of life. They will also ask about your dental history, medical history, allergies, medications, lifestyle habits, and oral hygiene.
- Once they have gathered all the required information, they will perform a comprehensive oral exam to check the status of your teeth, gums, mouth, throat, neck, and jaw. They may also take X-rays or other diagnostic tests if necessary.
- Next, they will discuss the findings with you, explaining the type of periodontal disease you have and its severity. The periodontist will prepare an individualized treatment plan and discuss it with you.
- You should also clear any queries you may have regarding your condition and treatment. How long will the surgery take? Will I experience pain during or after the procedure? Are there any risks or complications involved? When will I recover? Are there any alternative treatments? The periodontist will answer all your questions thoroughly and ensure you understand everything before leaving their office.
- Lastly, they may offer at-home instructions and schedule a follow-up appointment.
How do you find a board-certified periodontist near you in Brooklyn, NY?
Visit Zocdoc.com to schedule a consultation with a periodontist in Brooklyn, New York. Based on your unique demands, Zocdoc will compile a list of the best board-certified periodontists near you. Enter your details in the search bar, such as your address, the time of your preferred appointment, and your symptoms, to find the most relevant results. Zocdoc can filter the results of your search based on your insurance status. If you have multiple insurance plans, Zocdoc allows you to add medical, dental, and vision plans to your account. However, you can only search for and schedule appointments using one insurance plan at a time. To share details about a secondary insurance plan, you can include the information in the notes section during the final step of booking. Additionally, if your provider uses Zocdoc’s Intake forms, you can include your secondary insurance details while completing the forms online.
Each physician's profile on Zocdoc includes information on their training, areas of expertise, affiliations, awards, certifications, and years of practice. Zocdoc also strives to improve the patient experience by providing verified patient comments.
Apart from setting up virtual sessions, Zocdoc also lets you schedule appointments on the weekends and in the evening after 5 p.m. You may also check if the periodontist works with children and what languages they speak. Additionally, if you have any questions about the process of finding a periodontist near you, you can refer to the Zocdoc patient help center.
All reservations made through Zocdoc are free, safe, and effective.
Statistics on periodontitis and chronic diseases in New York
Finding a periodontist can be a difficult task. Periodontitis is related to chronic conditions such as diabetes, cardiovascular disease (CVD), and high blood pressure. A journal article published in ScienceDirect reveals how studies have shown that people suffering from periodontal diseases have an approximately 1.14 times higher risk of developing cardiovascular issues.
According to America's Health Rankings, around 10.3% of New York State's adult population (excluding those with prediabetes and gestational diabetes) were diagnosed with diabetes in 2020. Diabetes mellitus and periodontal issues form a two-way association that affects each other. Chronic periodontitis leads to inflammation that interferes with blood sugar control. On the other hand, diabetes leads to poor wound healing and periodontitis.
Some studies have also reported a link between periodontitis and cancer. High levels of the periodontal pathogen P. gingivalis were discovered in patients suffering from oral squamous cell carcinoma and esophagus squamous cell carcinoma. The report also mentions how prolonged exposure to this P. gingivalis increases the aggressiveness of the oral cancer cells.
The habit of smoking is a strong predictor of gum disease. In 2020, in New York, about 12% of the adult population reported smoking daily or on some days, and they had smoked about 100 cigarettes in their lifetime. Men (around 14.2%) were more likely to fall into this category than women (nearly 10%). Similarly, about 15.3% of those between the ages of 45 and 64 were in this category, compared to almost 6.8% of those 65 and above and roughly 12.2% of those aged between 18 and 44.
The Centers for Disease Control and Prevention states that the risk of developing periodontal diseases increases with age. Over 70% of adults above 65 years suffer from periodontal disease in the US.
Sources
MouthHealthy
American Academy of Periodontology[1]
American Academy of Periodontology[2]
Penn Dental Medicine
WebMD
The Oral Health Specialists
America's Health Rankings[1]
America's Health Rankings[2]
America's Health Rankings[3]
America's Health Rankings[4]
ScienceDirect
Centers for Disease Control and Prevention
Cleveland Clinic[1]
Cleveland Clinic[2]
ROOT™ Periodontal & Implant Center
DocDoc
Dental Products Report
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