When to See a Periodontist

A periodontist is a dentist specializing in the prevention, diagnosis and treatment of infections and diseases in the soft tissues surrounding the teeth, and the jawbone to which the teeth are anchored.  Periodontists have to train an additional three years beyond the four years of regular dental school, and are familiar with the most advanced techniques necessary to treat periodontal disease and place dental implants.  Periodontists also perform a vast range of cosmetic procedures to enhance the smile to its fullest extent.

Periodontal disease begins when the toxins found in plaque start to attack the soft or gingival tissue surrounding the teeth.  This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial infection.  As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums.  The response of the body is to destroy the infected tissue, which is why the gums appear to recede.  The resulting pockets between the teeth deepen and if no treatment is sought, the tissue which makes up the jawbone also recedes causing unstable teeth and tooth loss.

Referrals from General Dentists and Self Referral

There are several ways treatment from a periodontist may be sought.   In the course of a regular dental check up, if the general dentist or hygienist finds symptoms of gingivitis or rapidly progressing periodontal disease, a consultation with a periodontist may be recommended.  However, a referral is not necessary for a periodontal consultation.

If you experience any of these signs and symptoms, it is important that you schedule an appointment with a periodontist without delay:

  • Bleeding while eating or brushing – Unexplained bleeding while consuming food or during the course of daily cleaning is one of the most common signs of periodontal infection.

  • Bad breath – Continued halitosis (bad breath) which persists even when a rigorous oral hygiene program is in place, can be indicative of periodontitis, gingivitis or the beginnings of an infection in the gum tissues.

  • Loose teeth and gum recession – Longer looking teeth can signal recession of the gums and bone loss due to periodontal disease.  As this disease progresses and attacks the jawbone, (the anchor holding the teeth in place) the teeth may become loose or be lost alltogher.

  • Gangrene in the tissues – Gangrene is hard to self diagnose but the general dentist and periodontist will check for its presence in the soft tissues, alveolar bone and periodontal ligament.

  • Related health conditions – Heart disease, diabetes, osteopenia and osteoporosis are highly correlated with periodontitis and periodontal infections.  The bacteria infection can spread through the blood stream and affect other parts of the body.

Diagnosis and Treatment

Before initiating any dental treatment, the periodontist must extensively examine the gums, jawbone and general condition of the teeth.  When gingivitis or periodontal disease is officially diagnosed, the periodontist has a number of surgical and non surgical options available to treat the underlying infection, halt the recession of the soft tissue, and restructure or replace teeth which may be missing.

  • Gingivitis/mild periodontal disease – When the gum pockets exceed 4mm in depth, the periodontist or hygienist may perform scaling and root planing to remove debris from the pockets and allow them to heal.  Education and advice will be provided on an effective cleaning regime thereafter.

  • Moderate periodontal disease – If the gum pockets reach 4-6mm in length a more extensive scaling and root planning cleaning might be required.  This cleaning is usually performed under local anesthetic.

  • Advanced periodontal disease – Gum pockets in excess of 6-7mm are usually accompanied by bone loss and gum recession.  Scaling and root planning will always be performed as the initial nonsurgical treatment.  In addition to tose nonsurgical treatments, the periodontist may recommend surgical treatment to reduce pocket depth.

  • Tooth loss – Where one or several teeth are missing due to periodontal disease, dental implants are an effective option.  If the bone is strong enough to provide a suitable anchor for the prosthetic tooth, the implant can be placed.  However, if the bone is severely eroded, bone grafts may be performed by the periodontist to provide a suitable anchor for the new tooth/teeth.

Ask your periodontist if you have questions about periodontal disease, periodontal treatment or dental implants.

Testimonials.

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Testimonials

I've had the privilege of going to Dr. Howard since young (decades). Now my entire family has chosen Dr. Howard and Dr. Alan Igasaki as our dentists. Both are calm, soothing, gentle and amazing dentists. Dr. Alan also specializes in periodontics which helped the extensive gum work we had to do over the years. The entire staff is super friendly and fun. There wasn't one visit I didn't leave laughing or encouraged by some one on the staff.

The doctors work well together and often seek each other's opinion. I appreciate that they're always educating themselves and using the latest technology. Dr. Alan used the laser on my son's gum procedure with no bleeding and minimal pain. They also allow you to bring your own music in and can play movies on a special eyeglass video screen. We often didn't want to leave since the "movie wasn't over." I get pretty anxious with any dental work. I watched a relaxing movie about Hawaii and the ocean. Both doctors are soothing and often talk to you a long time previous to treatment. It helps a lot. They're gentle also and will ask you for feedback if there's pain or discomfort. Very empathetic doctors as well as being brilliant clinically is rare. Highly recommended!!!

M D.

I cannot believe I am giving ANY dentist that I have personally seen any stars. But I must say Dr. Howard Igaskai, deserves every single one of them. I am not an easy person to get into a dental office let alone a dental chair! My fear of dentist started as a child & never went away. Dr. Howard aka Papa Howard, knew of my anxiety & went as far as unbuttoning his top collar & removing his coat just to make me feel at ease. I honestly have major trust issues w/dentist. I have horrible teeth due to the lack of dental care. I need a lot of work & it took a lot for me to even make this appointment. With that being said Dr. Howard took his time to explain & examine everything. I have to admit I didn't trust him from the get go & had a stink face but as the appointment went on he made me feel comfortable enough to make me want to return to his office. Yes, you read that right. I will go BACK....WILLINGLY! I'm still afraid & nervous as heck but from the front desk ladies, to the dental assistants & Dr. Howard....thank you! Thank you for NOT giving up on me. Thank you for making me feel comfortable enough to want to return. I'll see you again (still anxious) but I will be there.

Diana A.

I am SO honored to be able to rate and provide information on my dentist's office. In a world where people freak out about seeing the dentist, I LOVE mine! The front staff is great (very welcoming and informative), Elsie is my favorite hygienist (very inviting and great to talk to - even with tools in your mouth!), and Dr. Howard is da bomb! This is the one doctor I see religiously!

My parents were smart in taking me with them to the dentist (they are patients here, as well) when I was very young. I don't recall what age I was when Dr. Howard first started treating me, but I don't ever recall not knowing or feeling comfortable with him. And, now that I'm old, he still asks about my migraines, my family, and is just very pleasant to speak with any time I do.

I wanted to whiten my teeth and he told me no - that mine are naturally bright. He could have done it anyway, but that's just one way he is always looking out for me.

God willing, I will NEVER not have the wonderful folks here as my dental professionals! I always get compliments on my teeth!

Anika C.

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Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.
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