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When to See a Periodontist

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 toxins found in plaque start to attack the soft or 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.  The response of the body is to destroy the infected tissue, which is why the gums appear to recede.  The resulting pockets between the teeth deepen and if no treatment is sought, the tissue which makes up the jawbone also recedes causing 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.
  • Gangrene in the tissues – Gangrene is hard to self diagnose but the general dentist and periodontist will check for its presence in the soft tissues, alveolar bone and periodontal ligament.
  • Related health conditions – Heart disease, diabetes, osteopenia and osteoporosis are highly correlated with periodontitis and periodontal infections.  The bacteria infection can spread through the blood stream and affect other parts of the body.

Diagnosis and Treatment

Before initiating any dental treatment, the periodontist must extensively examine the gums, jawbone and general condition of 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 gum recession.  Scaling and root planing will always be performed as the initial nonsurgical treatment.  In addition to tose nonsurgical treatments, the periodontist may recommend surgical treatment to reduce pocket depth.
  • 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.

Testimonials.

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Testimonials

I am 42 years old. All of my life I was self conscious about my smile
because of the dark tetracycline stain on my teeth. When I was 37 I
decided to do something about it. I had braces for four years to prepare
me for orthognathic surgery. My maxillofacial surgeon moved my jaw
forward so my overbite would be corrected. After that healed, the braces
came off and I went to see Dr. Stewart. She said I was a perfect
candidate for porcelain veneers. After talking with her and seeing her
portfolio, she installed them.

Almost over night I went from not smiling at all to grinning like a
fool. I can tell you the exact moment I knew I had made the right
decision to do what I had done. About a month after Dr. Stewart had
finished with me, a complete stranger said, "You have a nice smile." It
was the first time in my life I had ever heard those words...ever. My
limited vocabulary prevents me from describing what those words meant to
me but my whole world was changed.

I am 42 years old and I have a nice smile. Would I do it all again?
Absolutely! Do I have any regrets? Absolutely not!

Thanks Dr. Stewart!


Stephen...with a PH!

"Whenever people complain about their dentist or say they haven't been for a checkup in years, I tell them about Dr. Nancy Stewart and her great team. They're all friendly and professional, and the work they do is top-notch. For the past nine years, they have done both 'yearly maintenance' and cosmetic procedures on my teeth, and I get regular compliments on my smile! Leave your excuses at home and go see Dr. Nancy."

Kate Y. February 2007

"Dr. Stewart may be the only dentist I have never been afraid to go to.
Everyone on her staff is informative, friendly and professional, and so is
she. Check out the photo board on your way out, too - she's the only dentist
I've ever met who gets flossing photos from her patients' vacations!"

J. Handler

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