NORTHEAST TEXAS PERIODONTAL SPECIALISTS
Nathan E. Hodges, DDS, MS
Kimberly D. Sheppard, DDS, MS

How to Choose a Periodontist

A periodontist is a dentist who specializes in diagnosis, prevention, and periodontal disease treatments, which can be surgical or non-surgical. Periodontists also specialize in tooth-implant placements, as well as specialized procedures such as cosmetic oral plastic surgery.

If you have experienced, or are currently experiencing any symptoms associated with gum disease, it is particularly important to visit a periodontist. Ideally regular periodontal exams should be included in everyone’s oral health routine. Sometimes periodontal exams are the only way for gum disease to be detected. It is also especially important to see a periodontist if you have heart or respiratory disease, malnutrition, diabetes, osteoporosis, and/or if you use tobacco or smoke, since all of these conditions have been shown to be linked with periodontal disease.

Periodontal Education

Beyond completing a four-year undergraduate college degree program, periodontists must also graduate from a dental school (that is accredited) with a Doctor of Medical Dentistry (DMD) degree or a Doctor of Dental Surgery (DDS). In addition, three to seven more years of further training in a periodontology residency program must also be completed. After the residency in periodontics, dentists specializing in periodontics must also earn board certification (national), which is an extensive process. Every six years periodontists must also get re-certified. Like the initial board certification, re-recertification is extensive, which is important for keeping periodontists up to date on technological advancements and advancements in practice. There are many ways periodontist can practice - and many environments in which periodontics can apply. In choosing the right periodontist it is important to take a look at his or her background and any relevant patient reviews.

Periodontal Procedures

In considering a periodontist it can be helpful to understand what kind of procedures or treatments he or she may specialize in.

  • Non-surgical Periodontal Treatments: In treating gum disease in its early stages, deep cleanings (scaling and root planning) are common treatment options. Scaling and root planing, as well as consistent daily flossing and brushing will typically ameliorate gingivitis.
  • Dental Implant Placements: Periodontists often deal with dental implant procedures. In an implant procedure, a fixture (also known as an artificial tooth root) is fixed into your jaw and fuses with the jawbone through a binding process known as osseointegration. Eventually, after the initial implant heals, a prosthetic tooth can be attached to the implant.
  • Periodontal Surgeries: There are various periodontal surgery treatments including regeneration, pocket reduction and gingivectomy. In regeneration, a periodontist will fold the gum tissues back for bacteria removal. To encourage natural regeneration bone grafting, membranes, or proteins (tissue-stimulating) are used in this surgical treatment. With pocket reduction, a periodontist folds gum tissues back for removal of bacteria that can be disease causing. The tissue is then secured into place. Sometimes damaged bone or irregular surfaces get smoothed to prevent more bacteria from spreading. This process allows for better reattachment of the gum tissues to heathy bones. A gingivectomy is a surgery for the removal of excess tissue. Usually only local anesthesia is needed and gums are able to heal in about a week, which allows for teeth contours to be restored.
  • Plastic Surgeries (Periodontal): There are a few common types of periodontal plastic surgery. Gingival Sculpting (also known as Crown Lengthening) is a plastic surgery where excess bone and gum tissue can be reshaped, which allows for more exposure of the natural tooth or teeth. Often used to even the gum line or create a broader appearing smile. Soft Tissue Grafting is periodontal plastic surgery in which gum tissue is taken from the palate (or sometimes another source) and is used to for covering a root that has been exposed. This procedure can be used for one tooth or multiple teeth and is usually used to even a gum line and/or to reduce gum sensitivity. Ridge Augmentation is another plastic surgical procedure in which jawbone and gum indentations are corrected to recapture a person’s natural contouring of the jaws and gums, and can make prosthetic teeth appear to emerge from the gum tissue much more naturally.

What to Expect During a Periodontal Visit

During your initial visit with a periodontist a general health and oral-health evaluation will be made. In this evaluation your general medical and dental history will be reviewed. If you have any current (or a history of) specific medical issues it is important to discuss these with your periodontist, because many diseases can also affect the gums and general oral health. It is important to let your periodontist know of any medications you use or take regularly, as some medications can negatively affect your gums, and/or have contraindications for any antibiotics that might get prescribed by the periodontist. Smoking is also a serious issue for any periodontal issues, especially if any periodontal surgery is being advised or considered.

In an initial visit a periodontist will likely examine your mouth, throat, teeth, gums, head, neck and jaw joints. And X-rays are usually taken. An X-ray known as a peri-apical X-ray is able to show the pattern and amount of any bone loss around the teeth. In addition a panoramic radiograph - which an X-ray of the entire mouth - can show other significant skull structures. Once the full exam has been completed, the periodontist can determine an ideal treatment plan for your specific needs and wants.

Important Considerations in Choosing a Periodontist

The most common and effective way to find a good periodontist is to ask for a referral from your dentist. Once you get a referral there are several important considerations:

  • How long has the periodontist been practicing? And how long in their current location?
  • Has the periodontist recently completed any recertification or continuing educations courses?
  • After the first visit consider the treatment proposal offered by the periodontist. Were you comfortable with your communications and exchanges? Did you understand the periodontist’s recommendations and treatment proposals? Did you feel like the periodontist understood your treatment concerns and goals?
  • Does the periodontist have extensive training and/or experience in the treatment you need?
  • What are the costs associated with the treatment plan offered? Will your insurance pay for any or all of the treatments? If not, did the periodontist give you any information about other available financing?
  • What kinds of equipment and or technology does the practice offer?
  • What kinds of medications or pain relief were suggested in association with any treatment suggestions?
  • Do you truly feel comfortable with the manner and communication style of the periodontist and the staff?
  • Does the periodontist have any partners? Or does he/she practice alone? Is it a specialty-specific practice? Or more of a one-stop multi-specialty practice? Make sure you know if the periodontist specializes specifically in the treatment you need.
  • Have you researched the periodontist’s referral network? If the periodontist will be working collaboratively with any other dentists or health practitioner on your treatment, you must feel confident in everyone’s professionalism and expertise. It is also very important to make sure that your insurance will cover everyone and all care involved if your treatment is multi-faceted or will involved other practitioners.
  • Do you know which lab your periodontist uses for any fabricated restorations? It is important to make sure the periodontist thinks highly of the work done by the lab technicians.
  • Do you feel comfortable with the office, location and office hours of your periodontist?
  • Do you know what kind of emergency care is offered in the event that that would be needed?

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