Learn

What

does a Periodontist do?

A periodontist is dentist that has completed an additional 2-3 year university specialist program in the field of Periodontology. Periodontology is the study of supporting structures of the teeth, or all the tissues that surround ( “peri” ) the tooth. A periodontist is a dental specialist trained in the diagnosis, and treatment of the diseases and conditions that affect the supporting structures of the teeth, which includes the bone and the gums. A periodontist is also trained in the placement of dental implants, bone grafting and gum grafting.

Click here to meet our periodontist Dr. Nancy Baldan and her team of dental professionals below.

When

should you see a Periodontist?

Typically, patients will be referred to a periodontist by their dentist however it is possible to request a consultation and examination if you suspect you are experiencing symptoms affecting your teeth or gums. Additionally, if you require a dental implant, visiting a periodontist is a good option.

Visit our “learn more about periodontics” section to understand the types of services we provide and whether the symptoms you are experiencing could be related. For patients who have been referred to our practice already, this section will give you an overview of what will be involved during your visit with us.

Periodontal Disease

Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

Periodontal disease is often silent, meaning symptoms may not appear until an advanced state of the disease.

Gingivitis

Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Periodontitis

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

There are many forms of periodontitis. Dr. Baldan will discuss them with you at your new patient appointment.

The Four Stages of Periodontal Disease

Stage 1 - Healthy Gums

Healthy Gums

Stage 1

At this stage, gum colour is normal and the probe depth of the gingival sulcus—the area where the gums meet the tooth— is minimal (approximately 2mm). Inflammation and bleeding are absent on contact.

Stage 2 - Gingivitis

Gingivitus

Stage 2

As plaque builds within the gingival sulcus, an inflammatory reaction occurs. The bacteria within the plaque biofilm emit toxins that prime the immune system, leading to sore, swollen gums that sometimes bleed easily on contact. At this stage, the gums are commonly bright red or purple. Despite visible inflammation, however, probe depth is still minimal (approximately 3mm). Bad breath, or a bad taste in the mouth, is common.

Stage 3 - Mild Periodontal Disease

Mild Periodontal Disease

Stage 3

As periodontitis progresses, further separation of the gums and teeth occur which leads to deeper gingival pockets. At this point, a probe depth of up to 6mm is not uncommon making it difficult for the patient to properly clean the tooth. Calculus forms in the deeper recesses of the pocket and damage to connective tissue that holds the tooth in place. Attachment loss can occur. More aggressive cleaning options, such as root planing, are sometimes necessary to halt disease progression. Antibiotics, that help disrupt bacterial deposits and slow support-tissue-destroying enzymes are commonly used to stop tissue loss.

Stage 4 - Advanced Periodontitis

Advanced Periodontitis

Stage 4

This is the final stage of periodontal disease where significant damage to ligaments i.e. attachment loss, has occurred; varying levels of bone loss may also be present. Probe depth is often excessive. Loose, migrating teeth with increasing gaps are not uncommon—not to mention significant infection. Often, at this point, diseased teeth require extraction and surgical grafts may be required to compensate for bone loss.