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What is Periodontics: Definition and Overview

Definition and Overview

Periodontics is a dental specialty involving different oral structures especially the gums, teeth, and bones. A person who specializes in this field is called a periodontist.

A periodontist is often confused with endodontist and a general dentist. A general dentist is expected to have certain skills and knowledge similar to a periodontist, especially since gums, teeth, and bones are interrelated and interdependent. However, when the problem has progressed and becomes more complex, a dentist often refers the patient to the periodontist.

On the other hand, an endodontist works with roots and pulp chamber of teeth. One of their most popular services is root canal therapy. It is carried out when the pulp, which contains the nerves of a tooth, becomes inflamed. To avoid causing further damage to dental health, the pulp is removed from its chamber while the chamber is disinfected and filled. The tooth can continue to survive without the nerves.

To become a periodontist, one must complete a four-year undergraduate course and proceed to obtain a degree either in medical dentistry or dental surgery. He or she must also complete a residency programme, which can take more than five years. It is only after the residency programme is completed that the dentist can obtain a board certification to practice periodontics. A periodontist has to go through continuing education since the certification needs to be renewed every six years.

Although several periodontists are in private practice, some are also in other health care settings such as community clinics and hospitals. They may also be found in schools and non-profit organizations.

Periodontists work closely with radiology technicians, general dentists, and other specialists such as endodontists to help patients achieve a beautiful smile and optimum oral health.

When to see a Periodontist

Patients have to see a periodontist if:

  • They are referred by their dentists – Often, patients see a periodontist since they have been referred by their general dentists. It could be because the problem such as a gum disease has already become too severe or too technical.

  • They are looking for a second opinion – Many general dentists are trained to diagnose gum diseases, which also fall within the scope of periodontists. However, if the patient does not agree with the diagnosis and treatment program of the general dentist or if he or she requires more information, he or she may directly approach a periodontist.

  • They need thorough cleaning – Gum disease often develops due to the regular buildup of plaque on teeth. Plaque forms when deposits have become calcified. They can damage the teeth, causing the bacteria to penetrate that may lead to tooth decay. In deep cleaning, the periodontist carry out scaling and root planing procedures. In scaling, the deposits are removed from the teeth. In root planing, the periodontal pockets, which can be a sign of a worsening gum disease, are also cleaned to avoid bacteria development.

  • They need to have dental implant – A dental implant is one of the best ways to offer support to the tooth structure. A patient can suffer from bone loss when the bone does not have anything to support, such as when the tooth is already extracted. To prevent that, a dental implant, usually made of titanium, is added and allowed to meld with the bone.

  • They have been diagnosed with periodontitis – Periodontitis is the inflammation of the gingiva or the gums. It develops when the gums become irritated by the consistent buildup of tartar and plaque on the teeth. When this happens, the gums become inflamed and infected. If this does not get treated very soon, the gum problems can affect the bones and the tooth may become loose. Although many factors can cause or trigger periodontitis, it usually occurs when the patient has poor dental hygiene such as not flossing every day or not seeing a dentist at least once a year.

  • They are a transplant recipient – Organ transplants have saved thousands of lives, but they can also be risky even after the patients have already received the donated organs. Anytime, the body can just attack and damage the newly transplanted organ. To decrease the risk, doctors give immunosuppressant drugs to patients. Because of the suppression of the body's immunity, however, different dental problems can occur. Usually, dentists refer transplant patients to periodontists before and after the procedure to ensure the mouth is healthy.

    References:

  • Amsterdam JT. Oral medicine. In Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 70.

  • Kawar N, Gajendrareddy PK, Hart T. Periodontal disease for the primary care physician. Dis Mon. 2011;57(4):174-183.

  • Chow AW. Infections of the oral cavity, neck, and head. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 60.