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General information about Periodontist Specialist

Periodontics is a specialty of dentistry that deals with the tissues that surround the tooth and anchor it in the jaw: the gums, the supporting bone and the fibers that connect them. A periodontist diagnoses and treats diseases affecting these tissues, including diseases around dental implants. The specialty also covers implants and bone rehabilitation - bone grafts, sinus lifts and treatment of bony defects.

Gum disease is far more common than people tend to think: about 4 in 10 adults aged 30 and over in the United States suffer from advanced gum disease, periodontitis. Gum disease and tooth decay are the leading causes of tooth loss.

The disease usually progresses without pain. Bleeding when brushing or red, swollen gums are often dismissed as a minor issue, while the process continues to deepen below the gum line.

The disease begins with bacteria that accumulate on the teeth and penetrate below the gums. When they remain there over time, layers of plaque and tartar form, and the result is superficial gum inflammation — gingivitis. As the disease worsens, the gums pull away from the teeth, and pockets form between them that fill with infection. This is the periodontitis stage.

The difference between the stages is fundamental: superficial gum inflammation can be reversed through professional cleaning and diligent oral hygiene, whereas periodontitis cannot be fully cured — but it can be controlled and its progression halted with appropriate treatment.

Who is at risk of developing periodontitis?

Smoking is a major factor in severe gum disease. Diabetes is also linked to the disease in a two-way relationship: gum disease can worsen blood sugar control.

Frequently asked questions about Periodontist Specialist

What's the difference between a general dentist and a periodontist (gum specialist)?

The main difference between a general dentist and a periodontist lies in professional training and areas of treatment. While a general dentist is qualified to provide routine dental care, a periodontist is a dentist who has completed an additional, dedicated residency program focused on gum disease, dental implants and bone grafting. The training path and responsibilities of a periodontist include several key components: * **Extended academic and clinical training**: After completing general dental studies, the dentist undergoes about four years of practical and theoretical residency at a university institution or a recognized hospital. * **Certification and government licensing**: The title is granted only after successfully passing the Scientific Council exams. The specialist license is issued by the Ministry of Health, as with any other medical specialty in Israel. * **Specialized areas of treatment**: The residency provides in-depth knowledge in diagnosing and treating all types of gum disease – both around natural teeth and around existing implants. In addition, the specialist is responsible for periodontal surgery, dental implant placement, and jawbone restoration or grafting.

How can I verify that my dentist is a certified specialist?

In Israel, the use of the title "specialist" is defined by law and reserved solely for doctors holding a specialist license from the Ministry of Health. It is recommended to check and verify the doctor's license classification [in the official registry of licensed practitioners on the Ministry of Health website](https://registries.health.gov.il/Practitioners) before booking an appointment.

Is it normal for gums to bleed when brushing?

Bleeding from the gums when brushing your teeth or flossing is not normal. Healthy gums shouldn't bleed with routine contact, and the appearance of blood is usually an early warning sign of developing gum disease that requires attention and treatment. The causes of the bleeding and its implications include several key aspects: * **Bacterial plaque buildup:** The main cause of bleeding is the buildup of a layer of bacteria and tartar on the teeth and below the gumline. These bacteria trigger a local inflammatory response that makes the gums sensitive, red, swollen and prone to bleeding easily. * **Early gum inflammation:** Bleeding while brushing is the most prominent symptom of the first stage of gum disease. At this stage, the damage is limited to the soft tissue only. This is a fully reversible condition that can be resolved with professional cleaning at the clinic and consistent daily oral hygiene. * **Risk of the disease worsening:** Ignoring the bleeding and leaving it untreated can lead to the inflammation and infection spreading deep into the tissues that support the tooth. At this advanced stage, deep gum pockets form, the gums recede, and irreversible loss of jawbone occurs, which can lead to loose teeth and even tooth loss.

How is gum disease treated?

Treating gum disease is not a one-time procedure, but a process that progresses in four stages. Between stages, the dentist checks how the gums have responded and decides on the next step accordingly. * **Stage one: Building the foundation** — personalized oral hygiene instruction, removal of plaque and tartar above the gumline, and management of risk factors such as smoking and uncontrolled diabetes. * **Stage two: Treating the root of the problem** — thorough cleaning of plaque and tartar in the pockets below the gumline, also known as root planing or deep scaling. * **Stage three: Treating stubborn areas** — in areas where the pockets remain deep, the cleaning is repeated or gum surgery is performed. Some procedures are designed to regenerate lost tissue and bone. * **Stage four: Maintaining the results** — regular maintenance visits, from once every three months to once a year, depending on your individual risk level. Keeping up with them reduces the risk of losing teeth over the years. Throughout the process, your oral hygiene at home is an integral part of the treatment - and to a large extent, it is what determines its success.

Can dental implants also "get" gum disease?

Yes. The tissues around an implant can also become inflamed, and at an advanced stage, called peri-implantitis, the bone supporting the implant is also lost. About 22% of patients with implants developed peri-implantitis after 20 years of use. A history of gum disease increases the risk: patients with a background of periodontitis were found to be at 2.2 times higher risk of developing peri-implantitis. Therefore, before implant placement it's advisable to diagnose and treat gum disease, and afterwards — to maintain good hygiene and regular maintenance visits.

When is root planing not enough, and gum surgery needed?

Root planing (deep cleaning) is the first line of treatment for gum disease. However, when deep areas of infection remain after conservative treatment, a periodontist needs to step in and perform gum surgery. The decision is made at a re-evaluation appointment, several weeks after the cleaning is completed. The main situations that require moving to surgical treatment: * **Deep gum pockets (over 5–6 mm):** When deep pockets continue to bleed after cleaning, standard instruments can't reach their base. Surgery allows direct access for thorough cleaning of the root surface and reduction of pocket depth. * **Root furcation involvement:** In multi-rooted molars, the inflammation can penetrate narrow, winding areas that can't be cleaned without surgical access under direct vision. * **Need for bone grafting:** Root planing halts the inflammation but doesn't restore bone that has been resorbed. Deep bone defects require surgery combining bone substitutes and proteins that encourage regrowth of the supporting tissues. * **Reshaping the bone and gums:** Correcting craters and irregularities in the jawbone allows the gums to reattach firmly to the tooth and creates a structure that is easy to maintain. The goal of surgery is to create a healthy environment that is accessible for home brushing and for maintenance treatments with a dental hygienist, thereby preventing the disease from recurring and saving teeth from extraction.

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