There are a variety of ways periodontists can treat periodontal disease. Following dental school, periodontists receive up to three additional years of specialized training in both surgical and non-surgical periodontal procedures to treat gum disease. Periodontists are also experts in replacing missing teeth with dental implants.

1/- Surgical Periodontal procedures:

Sometimes a periodontist may need to perform a surgical procedure to treat periodontal disease and any damage it may have caused. Because they receive three years of specialized training following dental school, periodontists are experts in performing gum surgery and are trained in administering the appropriate comfort measures such as sedation or anesthesia during treatment.

• Gum Graft Surgery
  Exposed tooth roots are the result of gum recession. Gum graft surgery will cover the exposed root and help prevent additional recession and bone loss.
  During gum graft surgery, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. Gum graft surgery can be performed on one tooth or multiple teeth, and may help reduce tooth sensitivity and improve the aesthetics of your smile.
• Regenerative Procedures
  Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. These procedures can reverse some of the damage by regenerating lost bone and tissue.
  During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body’s natural ability to regenerate bone and tissue.
• Dental Crown Lengthening
  Some individuals may have a “gummy” smile because the teeth appear short. In fact, the teeth may actually be the proper lengths, but they’re covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure.
  During the dental crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile. Your dentist or periodontist may also recommend dental crown lengthening to make a restorative or cosmetic dental procedure possible. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.
• Periodontal Pocket Procedures
  Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth. Over time, these pockets become deeper, providing a larger space for bacteria to live accumulate and advance under the gum tissue. These pockets can result in bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted. During a periodontal pocket procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone

2/- Non Surgical treatments

Depending on your unique case, you may be a candidate for non-surgical periodontal treatment. However, these procedures do have limitations. When non-surgical treatment does not achieve optimal periodontal health, your periodontist may recommend gum surgery.

• Scaling and Root Planing
  In scaling and root planing, your periodontist will perform a deep cleaning of your tooth root surfaces. First, your periodontist will scale beneath the gumline to remove plaque and other bacterial toxins from periodontal pockets. Root planing allows your periodontist to smooth the tooth root to prevent future plaque or toxins from adhering.
  Many patients do not require additional treatment after scaling and root planing. However, the majority of patients will require ongoing maintenance therapy to sustain periodontal health.
• Laser Treatment
  Lasers can be used to treat periodontal disease. Current controlled studies have shown that similar results have been found with laser treatment compared to specific other non-surgical treatment options, including scaling and root planing alone.
  Each laser has different wavelengths and power levels that can be used safely during different periodontal procedures. However, damage to periodontal tissues can result if a laser with an inappropriate wavelength and/or power level is used during a periodontal procedure.
• Tray Delivery Systems
  A tray delivery system consists of a custom-fit tray made from impressions of the patient’s mouth. Patients use the tray at home to deliver medications that have been prescribed by their dental professional. Tray delivery systems were cleared by the Food and Drug Administration (FDA) since they are similar to fluoride trays traditionally used to prevent tooth decay. However, the FDA clearance process did not determine that any specific medication delivered via tray delivery systems has been proven to be a safe or effective way to treat gum disease. When determining the best course of treatment for your specific case, be sure to discuss the pros and cons of all available treatment options with your dental professional.

3/- Dental Implants procedures

Technically, a dental implant is an artificial tooth root that’s placed into your jaw to hold a prosthetic tooth or bridge. However, when most people use the term “dental implants,” they’re talking about the combination of the implant (the artificial tooth root) and the prosthetic tooth. Dental implants may be an option for people who have lost one or more teeth due to periodontal disease, an injury, or some other reason and who prefer not to wear dentures.

Types of Dental Implants

• Endosteal (in the bone): This is the most common type of implant. Its various forms include screws, cylinders or blades surgically placed into the jawbone. Each implant holds one or more prosthetic teeth. This type of implant is generally an alternative for patients who are now wearing bridges or removable dentures.
• Subperiosteal (on the bone): This type of implant is placed on top of the jaw with metal framework’s posts that protrude through the gum to hold the implant in place. Subperiosteal implants are generally used for patients who are unable to wear conventional dentures and don’t have adequate bone height to hold an endosteal implant.

Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs. Here are some of the possible treatment plans depending on your situation:

• Single Tooth Dental Implants – If you’re missing a single tooth, one dental implant can replace it.
• Multiple Tooth Dental Implants – If you’re missing several teeth, they can be replaced by multiple dental implants.
• Full Mouth Dental Implants – If you’re missing all of your teeth, they can be replaced by full mouth dental implants.
• Sinus Augmentation – A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
• Ridge Modification – Deformities in the upper or lower jaw can leave you with and inadequate amount of bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the void where bone is missing. The void is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve the jaw’s appearance and increase the chances of successful implants.

4/-Cosmetic procedures

Periodontists are often considered the plastic surgeons of dentistry. If you are looking to improve your smile, a periodontist may be able to help.

• Gummy Smile or Uneven Gum Line
  Do you feel your smile is too gummy or your gums cover too much of some teeth while leaving the others the right length? If so, dental crown lengthening might be the solution for you. During this procedure, excess gum tissue is removed to expose more of the crown of the tooth. Then your gumline is sculpted to give your new smile just the right look.
• Long Teeth or Exposed Roots
  Sometimes gum recession as a result of periodontal disease causes the tooth root to become exposed, which makes your teeth look long. Gum graft surgery and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession, protect vulnerable tooth roots from decay, and improve your smile.
• Indentations in the Gums and Jawbone
  Tooth loss can cause an indentation in the gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indention unnatural looking, it can also impact the success of a replacement tooth, such as a dental implant.Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw. A dental implant can then be placed that is natural looking, easy to maintain, and functions like a real tooth.