What Does a Periodontist Treat?
A periodontist treats conditions that affect the gums and the bone surrounding your natural teeth. These supporting structures, called the periodontium, include the gingiva (gums), the periodontal ligament, the cementum covering the tooth root, and the alveolar bone. When bacteria cause infection in these tissues, a periodontist is the specialist trained to stop the disease and restore gum health. Your first step toward healthy gums is understanding what does a periodontist do and when their expertise matters most.
Gum disease, also called periodontal disease, is the most common reason patients see a periodontist. It starts as gingivitis, a mild inflammation of the gums that causes redness and bleeding gums during brushing. If left untreated, gingivitis can progress to advanced periodontal disease, where the infection spreads below the gum line, destroys bone, and eventually loosens natural teeth. A periodontist treats every stage of this process and works to preserve your gum health long term.
Common Periodontal Procedures
Periodontists perform a range of surgical and nonsurgical procedures to treat gum disease, rebuild lost tissue, and replace missing teeth. During your first visit, the periodontist will evaluate your gum health and discuss which treatment options are most appropriate for your case.
- Scaling and root planing (deep cleaning): A nonsurgical procedure where the periodontist removes plaque and tartar from below the gum line and smooths the root surfaces so the gums can reattach to the tooth. This is often the first step in treating gum disease.
- Gum graft surgery: When gum recession has exposed the tooth root, a periodontist can take tissue from the roof of the mouth or a donor source and graft it over the exposed area. This protects the root, reduces sensitivity, and restores gum health around your natural teeth.
- Pocket reduction surgery (flap surgery): The periodontist folds back the gum tissue, removes bacteria and diseased tissue from deep pockets around the teeth, then repositions the gums to fit more tightly around the tooth. This procedure is common for advanced periodontal disease.
- Bone grafting: When periodontal disease has destroyed the bone supporting a tooth, a periodontist can place bone graft material to encourage new bone growth and stabilize the tooth.
- Dental implant placement: Periodontists are one of two dental specialties trained to surgically place dental implants. Their expertise in bone and soft tissue makes them well-suited for implant cases, especially those requiring bone or gum grafting first.
- Tooth extraction: When a tooth cannot be saved due to advanced periodontal disease or severe bone loss, a periodontist may perform the extraction and prepare the site for a dental implant to replace the missing tooth.
- Crown lengthening: A surgical procedure to expose more of the tooth structure by reshaping the gum line and bone. This is done for restorative purposes (such as fitting a crown on a broken tooth) or for cosmetic improvement of a gummy smile.
Conditions a Periodontist Diagnoses
Gum disease often develops without pain in its early stages, which is why many patients do not realize they have it until they notice bleeding gums or gum recession. A periodontist is trained to detect subtle signs that your regular dentist may refer for further evaluation. Identifying advanced periodontal disease early is the first step toward preserving your natural teeth.
- Gingivitis: Early-stage gum inflammation. Gums appear red, swollen, and bleed easily. Reversible with proper treatment and a commitment to gum health.
- Chronic periodontitis: The most common form of gum disease in adults. Causes slow, progressive bone loss around the teeth and threatens your oral health if untreated.
- Aggressive periodontitis: A less common form that causes rapid bone destruction, often in younger patients with otherwise healthy gums and good oral health.
- Gum recession: The gum tissue pulls away from the tooth along the gum line, exposing the root surface. This increases sensitivity, raises the risk of root decay, and compromises the stability of natural teeth.
- Peri-implantitis: Infection and bone loss around a dental implant. Similar to periodontitis but occurring around implant hardware rather than a natural tooth.
- Mucogingival defects: Problems with the amount, position, or quality of gum tissue around the teeth. These conditions often require surgical correction to restore healthy gums.
Periodontist Training: What Sets Them Apart
Every periodontist is a dentist first. After completing four years of dental school and earning a DDS or DMD degree, a periodontist completes an additional 3 years of full-time residency training accredited by the Commission on Dental Accreditation (CODA). This residency focuses on the biology of the periodontium, surgical techniques for treating gum disease, bone regeneration, implant placement, and soft tissue management.
During residency, periodontists gain extensive hands-on experience in both surgical and nonsurgical periodontal therapy. They study the relationship between periodontal disease and systemic health conditions such as diabetes, heart disease, and pregnancy complications. This training gives them a deeper understanding of how gum disease affects your oral health and your overall well-being. Your regular dentist may identify gum disease during a routine visit, but a periodontist has the advanced training to manage complex cases.
Many periodontists also pursue board certification through the American Board of Periodontology (ABP). Board-certified periodontists have passed written and oral examinations and demonstrated ongoing commitment to continuing education. Board certification is voluntary, but it represents an additional level of verified expertise.
Technology Periodontists Use
Periodontal treatment has advanced significantly over the past two decades. Modern periodontists use specialized equipment that allows for more precise diagnosis and less invasive treatment than was possible in the past.
Cone-Beam Computed Tomography (CBCT)
CBCT provides a three-dimensional view of the jawbone, tooth roots, and surrounding structures. This is especially important for planning dental implant placement, where the periodontist needs to know the exact height, width, and density of the available bone. Standard two-dimensional X-rays cannot provide this level of detail.
Laser-Assisted Periodontal Therapy
Some periodontists use dental lasers to remove diseased gum tissue, reduce bacteria in periodontal pockets, and promote healing. Laser-assisted procedures such as LANAP (Laser-Assisted New Attachment Procedure) can treat gum disease with less cutting, less suturing, and faster recovery compared to traditional surgery. However, laser therapy is not appropriate for every case, and your periodontist will recommend the best approach for your situation.
Microsurgical Instruments and Growth Factors
Periodontists performing gum graft surgery or regenerative procedures often use microsurgical techniques with magnification loupes or microscopes. Smaller instruments and finer sutures result in better healing and more predictable outcomes. Many periodontists also use biologic growth factors, such as platelet-rich fibrin (PRF) derived from your own blood, to accelerate tissue healing after surgery.
When to See a Periodontist vs. a General Dentist
Your regular dentist diagnoses and treats mild gum disease (gingivitis) as part of routine dental care. Scaling and root planing for mild-to-moderate cases can often be done at a general dental office. However, there are situations where a periodontist's specialized training makes a meaningful difference in treatment options and outcomes. Understanding what does a periodontist do differently from your regular dentist can help you make an informed decision.
See a Periodontist When
- You have been diagnosed with moderate or advanced periodontal disease, especially with significant bone loss
- You have bleeding gums that continue despite regular cleanings at your regular dentist
- You have deep periodontal pockets (4mm or greater) that have not responded to nonsurgical treatment
- You need gum graft surgery to address gum recession and cover exposed tooth roots
- You are planning to get dental implants, particularly if bone grafting is needed first
- You have peri-implantitis (infection around an existing dental implant)
- You have a medical condition such as diabetes that increases your risk for gum disease complications and need a personalized treatment plan
A General Dentist May Be Fine When
- You have gingivitis or mild gum inflammation that responds to improved brushing, flossing, and professional cleaning
- Your dental exam shows shallow pockets (3mm or less) with no bone loss
- You need routine periodontal maintenance cleanings after completing active treatment with a periodontist
- Your gums are healthy and you are getting a standard dental cleaning
What to Expect at a Periodontist Appointment
If your regular dentist refers you to a periodontist, or you schedule an appointment on your own, the first visit typically focuses on evaluation and diagnosis. Most periodontists can see new patients within one to two weeks. Your first visit is an important first step toward understanding your gum health and creating a personalized treatment plan.
The periodontist will review your dental and medical history, examine your gums, and measure the depth of the pockets around each tooth using a small probe. They will also take X-rays, and in many cases a CBCT scan, to evaluate the bone levels around your teeth. This full assessment takes about 45 to 60 minutes.
After the evaluation, the periodontist will explain your diagnosis, show you the imaging, and discuss your treatment options. For mild-to-moderate gum disease, treatment may begin with scaling and root planing. For advanced periodontal disease, the periodontist will outline a surgical plan and develop a personalized treatment plan that includes the expected timeline, recovery, and cost.
If you are being evaluated for dental implants, the periodontist will assess your bone volume and density, discuss whether bone grafting is needed, and review the full implant process from surgery through final restoration. The goal is to preserve or replace your natural teeth in the way that best supports long-term gum health and oral health.
Find a Periodontist Near You
Every periodontist on My Specialty Dentist has verified specialty credentials. Search by location to find board-certified periodontists in your area, compare their experience, and schedule a first visit. Whether you need help with bleeding gums, gum recession, dental implants, or tooth extraction, a periodontist can develop a personalized treatment plan to protect your gum health and preserve your natural teeth.
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