Periodontists and Information on Periodontology

Every dentist has knowledge in this field, but periodontists have completed specialized additional training.

In Germany, the University of Münster offers a three-year continuing education program to become a specialist in periodontology. Equivalent to this is the training to become a DGParo Specialist in Periodontology®. In addition, there is a master’s degree program in this field and specialized courses—known as curricula—offered by the state dental associations and various institutions.

The periodontium consists of

• the gums,
• the periodontal ligament,
• the cementum, and
• the alveolar socket.

Healthy gums fit snugly against the tooth and are pink in color. However, the gums are often red, swollen, and bleed easily. They pull away from the tooth, forming pockets. This inflammation of the gums—which dentists refer to as gingivitis—is very common.

At this stage, there is no severe pain yet, but treatment should begin as early as possible. Otherwise, the inflammation could spread to the jawbone, the periodontal ligament, and the cementum.

At that point, the dentist diagnoses periodontitis; the term “periodontosis” has also become commonly used.

If periodontitis progresses untreated, deep gum pockets form and the necks of the teeth become exposed. This results in sensitivity to hot and cold stimuli. As the condition progresses, the jawbone is also affected; the teeth become loose and can no longer be saved without extensive treatment.

However, even in such severe cases, periodontology—in collaboration with oral surgery and implantology—can preserve or restore the functionality of the masticatory system.

The periodontist will first determine the severity of the disease. He or she checks the teeth for plaque and tartar and uses a probe to measure the depth of the gum pockets. An X-ray examination provides information about the position of the teeth and the condition of the jawbone.

The actual treatment may consist of several steps.

First, during a professional teeth cleaning, the dentist removes plaque and tartar. To do this, he uses a curette, which allows him to reach tartar even in deep gum pockets. They often use sonic or ultrasonic devices or a laser device as well. While this is more comfortable for the patient, it may not remove all plaque from deep gum pockets. This thorough cleaning is sometimes sufficient on its own to remove harmful bacteria and allow the gums to heal.

If the pockets are very deep, a minor surgical procedure—known as open treatment—is necessary. The dentist detaches the gum margins to gain better access and removes diseased tissue.

In some cases, targeted medication is necessary. To determine the appropriate treatment, a sample can be sent to a laboratory to identify the pathogens. Appropriate antibiotics support healing without destroying the oral flora. They are administered orally or placed directly into the pockets.

With these treatment steps, the chances of a complete recovery and tooth preservation are very high, even in cases of advanced periodontitis.

A film of plaque builds up on the teeth, which contains various microorganisms, among other things. Over 700 types of bacteria colonize the oral cavity; they are either beneficial or harmless. If this plaque is not regularly removed through careful oral hygiene, it hardens due to the deposition of minerals, resulting in tartar.

Tartar also leads to the formation of gum pockets, where bacteria can multiply beyond normal levels. The body’s immune system attempts to combat these bacteria. The resulting inflammation releases substances that destroy the fibers of the periodontal ligament. Regular and thorough dental cleaning is therefore an important prerequisite for healthy gums.

However, there are other risk factors that contribute to the development of periodontitis. These include

• smoking,
• stress,
• an unbalanced diet,
• a weakened immune system,
• and diabetes.

In addition to using dental floss and interdental brushes as part of your oral care routine, regular checkups and professional cleanings by a dentist are effective ways to prevent periodontitis.