Periodontics

Periodontics is the field of dentistry that focuses on the periodontium. The periodontium is made up of the bone and tissue that buttress and fortify the teeth, holding them in place and protecting them. This tissue, which we know as gum tissue, is technically called “gingiva.” The primary components of the periodontium are the gingiva and the underlying alveolar bone that supports each individual tooth in its socket, but there are also ligaments and other tissues in the periodontium. Periodontists diagnose and treat diseases of the gingiva and of the larger periodontium; some of the more commonly known diseases are gingivitis and periodontitis.

Gingivitis is a common affliction characterized by swelling, inflammation, redness, and possible bleeding of the gum tissue. It is usually a result of the accumulation of plaque on the teeth and gums, which most often results from inadequate oral hygiene. Gingivitis can be reversed with improved hygiene and professional plaque removal. However, if it is not addressed properly, gingivitis may develop into periodontitis or other periodontal diseases. These periodontal diseases may lead to damage of the bone that supports the teeth, eventually causing the teeth themselves to fall out. Symptoms of periodontal disease include bleeding from the gums, receded gums, bad breath, loose teeth, and a visible buildup of plaque and tartar.

The best way to prevent diseases of the gingiva and periodontium is through consistent and correct oral hygiene practices, including brushing properly and consistently with fluoride toothpaste and cleaning between the teeth with floss or other dental tools. Professional examinations and twice-yearly professional cleanings are also important parts of the care that can stave off gingivitis and more serious periodontal conditions. When plaque does accumulate excessively and gingivitis appears, dentists can perform a routine root scaling and cleaning procedure, also known as a “dental deep clean,” to remove built-up plaque and tartar and reduce inflammation in the gums, possibly reversing gingivitis and restoring the periodontium to health. This is considered a periodontal treatment. Periodontists also place and maintain dental implants and treat any issues that may arise from dental implants.

While oral hygiene practices are the primary determinant of gingival and periodontal diseases, other risk factors exist. These risk factors may contribute to the severity of gingival and periodontal diseases. Smoking tobacco is considered a primary risk factor, as exposure to smoke is strongly correlated to the destruction of periodontal tissue. Smoking hinders the mouth’s own ability to clean itself with saliva and beneficial bacteria, and it destroys blood vessels and blood supply, making it much easier for the harmful bacteria found in plaque to destroy tissues of the periodontium. There is no way to continue smoking tobacco and prevent this destruction; for this reason, smoking cessation is the recommended treatment to help restore the periodontium to health. Alcohol consumption is also believed to be a risk factor for diseases of the periodontal tissues, though current studies indicate only that it may accelerate the risk of progression of periodontal disease. Other risk factors include diabetes, obesity, vitamin D deficiency, cardiovascular disease, and stress. While these risk factors may be modified, some uncontrollable diseases and disorders, as well as genetics and even pregnancy, can contribute to gingival and periodontal diseases.

Periodontists are specialists who treat people with diseases and conditions that arise in the periodontium, like gingivitis and periodontitis. They work to diagnose and treat periodontal diseases while also educating and treating patients to prevent the progression of such diseases. Periodontists can perform both simple and complex periodontal procedures, ranging from dental deep cleaning to periodontal or implant surgery. Periodontists must obtain additional training in their specialty after completing their dental degree. In the United States, this periodontal training lasts a minimum of three years and is completed with a board examination. Periodontists strive to provide non-surgical therapy whenever possible, though much of the success of periodontal treatment lies in the habits of the patient; periodontists make recommendations that must be carried out by the patient in order to be effective. For this reason, periodontists are also often trained in techniques that encourage behavioral change, such as motivational interviewing and other counseling approaches.