A periodontist is a dentist who specializes in the gums, the bone that supports your teeth, and dental implants. After completing four years of dental school, periodontists train for an additional three years in a residency focused on surgical techniques, tissue regeneration, and implant dentistry. They treat everything from early gum disease to severe bone loss, and they’re often the specialist your general dentist refers you to when a problem goes beyond a routine cleaning.
About 42% of U.S. adults aged 30 and older have some form of periodontal disease, so periodontists stay busy. Roughly 8% of those cases are severe, meaning significant bone and tissue damage has already occurred.
Deep Cleanings for Early Gum Disease
The most common starting point with a periodontist is a deep cleaning, formally called scaling and root planing. It works like a regular dental cleaning but reaches beneath the gumline to remove tartar and bacteria that have built up around the roots of your teeth. Your periodontist uses specialized instruments to scrape away hardened deposits from the root surfaces and smooth them down so the gums can reattach more tightly.
This is a nonsurgical treatment and typically the first option for mild to moderate gum disease. For many patients, deep cleaning alone can halt the progression of gum disease and avoid surgery entirely. You’ll usually need a follow-up visit a few weeks later so the periodontist can check whether your gum pockets have started to shrink.
Gum Surgery and Pocket Reduction
When deep cleaning isn’t enough, a periodontist may recommend surgery to reduce the pockets that have formed between your gums and teeth. In a pocket reduction procedure (sometimes called osseous surgery), the periodontist folds back the gum tissue, removes bacteria hiding underneath, and reshapes the bone around your teeth to eliminate the deep crevices where bacteria thrive. The tissue is then stitched back into place so it fits more snugly against the tooth.
Recovery from this type of surgery typically takes two to four weeks, depending on how many teeth were treated and how advanced the disease was. You can expect some swelling and tenderness in the first few days, and you’ll be on a soft-food diet for a while. Most patients return to normal activities within a week, though full healing of the tissue takes longer.
Gum Grafting for Receding Gums
When gums recede and expose the roots of your teeth, a periodontist can rebuild that tissue using grafts. There are two main types, and which one you get depends on how much gum tissue you still have and where the recession is in your mouth.
- Connective tissue grafts are the more common choice. The periodontist takes a thin layer of tissue from beneath the skin on the roof of your mouth and stitches it over the exposed root. This approach covers 70 to 86% of the exposed root on average and works well in visible areas where appearance matters.
- Free gingival grafts take tissue directly from the surface of the palate rather than from underneath it. They’re highly effective at building up a thicker band of gum tissue, adding 2 to 6 mm of new tissue. However, the grafted tissue can look slightly different in color from the surrounding gums, so periodontists typically reserve this technique for areas that aren’t easily seen, like the lower front teeth.
Dental Implant Placement
Periodontists are one of the main specialists who place dental implants. Their three years of training in both hard and soft tissue makes them particularly well suited for cases where the jawbone needs preparation before an implant can go in.
If you’ve lost bone in your jaw from missing teeth or gum disease, a periodontist can build it back up. In the upper jaw, where the sinus cavity sits close to the tooth roots, they perform a procedure called sinus augmentation, raising the sinus floor and packing bone material underneath to create a solid foundation. For areas where the jawbone ridge has shrunk or developed deformities, they can lift the gum away, fill the gap with bone or a bone substitute, and reshape the ridge so it’s ready for an implant.
After placing the implant itself, your periodontist coordinates with your general dentist on the final crown and ongoing care. The implant needs several months to fuse with the bone before it can support a permanent tooth.
Laser Treatments
Some periodontists offer laser-based alternatives to traditional surgery. The most well-known is LANAP (laser-assisted new attachment procedure), which uses a laser fiber thinner than a pencil tip to target and destroy bacteria inside periodontal pockets. The laser removes diseased tissue while leaving healthy tissue intact, then stimulates a blood clot that seals the pocket and encourages new connective tissue to attach to the root surface.
Studies show LANAP reduces pocket depth, bleeding, and plaque buildup, with somewhat better overall outcomes than deep cleaning alone. The appeal for patients is that it avoids the scalpel and stitches of traditional surgery, which generally means less discomfort and a faster recovery.
The Link Between Gum Disease and Overall Health
Periodontists treat more than just your mouth. Gum disease shares the same chronic inflammatory pathway as cardiovascular disease, and research has found that people with periodontitis have a meaningfully higher risk of heart attack, stroke, heart failure, and peripheral artery disease. The connection to diabetes is even more direct: people with diabetes are more susceptible to gum infections, and those who have both diabetes and periodontitis tend to have worse blood sugar control. Treating the gum disease has been shown to reduce levels of glycated hemoglobin, a key marker of long-term blood sugar management.
These links are still being studied, and not every piece of research agrees on how strong the connection is. The American Heart Association, for instance, has noted that there isn’t enough evidence yet to say that periodontal treatment prevents heart attacks. Still, the relationship between inflamed gums and systemic inflammation gives periodontists a role that extends beyond dental health alone.
Training and Board Certification
Every periodontist completes dental school before entering a three-year residency in periodontics. During that residency, they train extensively in surgical techniques, regenerative procedures, implant placement, and complex treatment planning. After residency, periodontists can pursue board certification through the American Board of Periodontology, which requires passing both a written qualifying exam and an in-person oral exam. Board-certified periodontists have met the highest standard of verified competency in the specialty, though all licensed periodontists have completed the same core residency training.