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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.   As the disease progresses, the gums become inflamed and a deepening pocket develops between the gum tissue and tooth.  Gradually the health of the gum tissue worsens and subsequently the hard jawbone support will weaken.   Left untreated, the teeth will become loose due to inadequate bone and gum support.  Ultimately, if the tooth becomes too loose it will need to be extracted.   In addition,  it is widely believed that there exists a direct link between the health of the periodontal tissues and the overall systemic health of the patient.  Many systemic health conditions are affected by how healthy the gum tissues are kept.

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 dentist:

  • 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 gum disease.
  • 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 all together.
  • Related health conditions – Heart disease, diabetes, and osteoporosis are highly correlated with periodontitis and periodontal infections.  The bacterial 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 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 3mm 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 for 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 usually be performed as the initial nonsurgical treatment.  In addition to those  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.

Dr. John H. Ko is proud to bring his patients leading-edge dentistry. Dr. Ko and his entire team are dedicated to providing you with excellent, personalized care and service to make your visits as comfortable and pleasant as possible. Dr. Ko is dedicated to excellence in general, family & cosmetic dentistry, offering quality and gentle dental care in a stress free environment for adults, teens, and children in Pleasanton, Livermore, Dublin, San Ramon, Danville, Castro Valley and the surrounding Alameda County communities.

Our beautiful office is conveniently located at 5720 Stoneridge Mall Road, Suite 200, Pleasanton, CA 94588.


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