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. This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial infection. As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums. The response of the body is to destroy the infected tissue, which is why the gums appear to recede. The resulting pockets between the teeth deepen and if no treatment is sought, the tissue which makes up the jawbone also recedes causing unstable teeth and tooth loss.

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 periodontist without delay:

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 periodontal infection.
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 altogether.
Gangrene in the tissues – Gangrene is hard to self diagnose but the general dentist and periodontist will check for its presence in the soft tissues, alveolar bone and periodontal ligament.
Related health conditions – Heart disease, diabetes, osteopenia and osteoporosis are highly correlated with periodontitis and periodontal infections. The bacteria 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 officially 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 4mm 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 on 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 always be performed as the initial nonsurgical treatment. In addition to tose 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.

Testimonials

Dr. Wetzel is an absolutely incredible gem of a dental surgeon. In every manner of incredible he and his lovely assistant deserves major props.

I am or was a big chicken of the procedure, but based on a small Asian jaw, awful bite and one horizontally impacted wisdom tooth that was causing bone loss, and another slanted and also impacted I had to do something. Due to difficulty taking time off work I got 7 teeth taken out for braces, bite and health. I was terrified to be honest but the office is beautiful, a great place to drool all over yourself ( more on that later) and the pain is minimal considering 2 impacted wisdom teeth are difficult to manage.

I only remember talking to him and joking with him when all of a sudden my memory lapsed and I woke up feeling no pain and they were almost done. I was in disbelief but I remembered hearing about that. There is super slight soreness now 12 hours post op but it actually is better than the soreness from braces! Isn't that crazy? Lastly as someone who only had dentists aged 55 and older I can tell you don't worry. His youthful appearance belies his ability and incredible expertise. :)

Oh and a Warning! You will drool everywhere and I wish I bought a towel for that. Lol. In any case definitely come see him. The drive is worth his ability and he and his assistant is honest, intelligent, kind and super duper skilled!
Tracy is also super kind and the entire staff is great!

I will trust him not only for my first surgery but every one thereafter!

Miss W.

Great periodontist. Very professional and competent. Prices are reasonable compared to similar services elsewhere. Reception staff and nurses are very kind and takes time to explain everything and address all concerns. I highly recommend this office.

Sara G.

Dr. Wetzel is a real professional as well as a likeable person. You don't always get that in an oral surgeon. LOL. His staff is super friendly and you really feel that the whole office cares about your well being. Also, Dr. Wetzel instills me with confidence. I trust him with any procedure. So far I have had a bone graft, an extraction, and a large gum graft. I am looking toward to two dental implants and another gum graft and bone graft. You can tell he is really focused on the task at hand when he is doing a procedure and he takes surgery to the level of an art. Clearly, he has the experience and skills to improvise when he runs into snafus. I had a question about my pain after my last surgery and called his after-hours emergency number, and he called me back within 2 minutes. You can't ask for more than that. Also, if you have Delta Dental, then Tracy will lay out your whole plan for all of your work and tell you how much is covered by Delta and how much you will have left to pay. No surprises. Plus, Dr. Wetzel's new office is super cool. The design is tres chic;) I wish he did regular dentistry too.

Dr. Felicia D.