Periodontists are dentists who specialize in the diagnosis and treatment of diseases affecting the gums and bone that support the teeth. They perform thorough clinical examinations, measuring the depth of gum pockets and checking for gingival bleeding, and may do tests to find out which types of bacteria are involved. Periodontal surgery may be needed in more severe cases of periodontitis. Some periodontists also insert dental implants to replace lost teeth. There are more than 5,000 periodontists employed in the United States.
Periodontist Career History
Although the field of periodontology was formalized in the early 20th century, periodontal disease and treatment have been recognized throughout history. For thousands of years, it was thought that build-ups of calculus, or tartar, were responsible for periodontal disease. Many old civilizations documented periodontal diseases or treatment methods.
In the late 1800s, periodontal surgery techniques were developed and diagnosis was improved by the use of X rays. In recent years, digital radiography and superimposed X-ray images have enhanced the effectiveness of X rays. Surgical methods have also been refined, and lasers are now used in place of scalpels in certain procedures. About 20 to 25 years ago, a multitude of diagnostic procedures were established. Periodontal researchers have developed methods to regenerate lost bone in recent years.
In recent years it has been confirmed that bacterial infection, not calculus build-up, causes periodontal disease. Periodontists now use antibiotics, either in pill form or placed inside the periodontal pocket.
When treatment fails and a tooth must be extracted, dental implants offer a new way of replacing the tooth; artificial teeth or dentures may be attached to implants. An intensive area of periodontal research today is the relationship between gum disease and medical conditions, including heart disease and premature births. Chronic exposure to periodontal bacteria and inflammation may make people more susceptible to other diseases. Future research may provide a vaccine to prevent periodontal infections.
Periodontist Job Description
Periodontists perform thorough clinical examinations, using calibrated periodontal probes to measure periodontal pocket depths and the “attachment level” of periodontal tissues. They check for gingival bleeding, evaluate the amount of plaque and calculus, and assess tooth stability. They also take X rays to see if the patient has bone loss from past periodontal disease. Periodontists may do tests to find out which types of bacteria are involved.
Meticulous removal of calculus below the gum line, or scaling, remains an important part of treatment. Root planing is a more intensive form of scaling that involves removing infected cementum from root surfaces. When their periodontal disease has been stabilized, patients enter the maintenance phase of treatment and return every few months for scaling and root planing.
Periodontists also prescribe antibiotics to eliminate bacteria in the periodontal pockets. Increasingly, antibiotics are placed directly in the pocket in the form of fibers, gels, or chips.
Periodontal surgery may be needed in more severe cases of periodontitis. Periodontics has been one of the most surgically oriented dental specialties, but this may change as more effective antibiotic treatments become available.
Periodontists also can surgically insert bone-regenerating materials into areas with bone loss to grow new bone. This process is known as guided tissue regeneration.
When periodontal disease is left untreated or treatment fails, tooth loss may occur. Periodontists and other dentists can replace lost teeth with dental implants, which are metal or ceramic-metal devices surgically inserted into the jawbone. Artificial teeth or dentures are attached to the implants to restore normal function.
Periodontists may also perform cosmetic procedures, such as reshaping the gum line to make the teeth appear longer in patients with “gummy” smiles.
Those who manage their own practices must hire, train, and supervise employees, including office staff and dental hygienists.
Periodontist Career Requirements
If you are interested in becoming a periodontist, you should begin preparing for this career with a course load emphasizing, but not restricted to, math and science subjects. Courses such as algebra, calculus, chemistry, physics, trigonometry, biology, and health are all solid baseline courses for college preparation.
To enter dental school, applicants generally need significant college course work in the sciences, a bachelor’s degree, and a good score on the Dental Admissions Test, or DAT. After completing four years of dental school, dentists who want to specialize in periodontics attend a three-year graduate training program. According to the American Academy of Periodontology (AAP), 53 institutions (ranging from university settings to military and hospital facilities) offer advanced training programs in periodontics.
Certification or Licensing
Before entering practice, dentists must pass a state licensing examination. Qualified candidates may also seek board certification by the American Board of Periodontology.
Periodontists, like other dentists, must have excellent hand-eye coordination and the ability to do finely detailed work. As procedures and technology change, practicing periodontists must continue life-long learning. They stay up to date on advances in their specialty by taking continuing education courses each year. Also, because many dentists own their own practices, knowledge of business practices is beneficial.
Exploring Periodontist Career
To learn more about the career of periodontist, ask your science teacher or guidance counselor to set up an information interview with a periodontist. Your dentist may also be able to recommend a periodontist who might be willing to talk with you about his or her career. You should also visit the American Academy of Periodontology Web site, http://www.perio.org/, for more information on periodontics.
Like general dentists, more than 93 percent of periodontists are in private practice. They may have a solo practice or work in a group practice with other dentists. Dentists serving in the military treat members of the military and their families. The U.S. Public Health Service also employs dentists to provide care or conduct research. Periodontists may also teach full time or part time in dental schools. Hospitals employ dentists to treat hospitalized patients. Periodontists may work in scientific research or administration at universities, private or government research institutes, and dental product manufacturers. There are more than 5,000 periodontists employed in the United States.
After completing dental school and an advanced training program in periodontology, most periodontists either start their own practices or join an established practice. While many dentists choose to have their own practices, start-up costs can be steep: New dentists often need to borrow money to buy or lease office space and buy expensive equipment.
Periodontists in private practice advance their careers by building their reputation among the general dentists who refer patients to specialists. To establish a good reputation, it is important to communicate effectively and coordinate treatment with general dentists.
Periodontists who teach at dental schools may advance in academic rank and eventually chair the department of periodontology.
Experienced periodontists and periodontal researchers can become more prominent through professional activities such as writing scientific books and articles and being active in professional organizations such as the American Academy of Periodontology.
According to the American Dental Association Survey Center, periodontists under age 40 have an average net salary of about $119,000. This represents the lower end of the salary range. Periodontists who have been in practice for some time generally have higher earnings; the average net salary for periodontists over age 40 is $145,000. The U.S. Department of Labor reports that the median annual earnings for specialty dentists, including periodontists were $94,600 in 2005. The lowest paid 10 percent earned $39,910 annually, and the highest paid 10 percent earned $145,600 or more.
Salaries also vary by geographic region and are influenced by the number of other periodontists practicing in a community. Benefits vary by place of employment. Self-employed periodontists often arrange their own benefits through their dental practices.
Most periodontists work in private dental practices. The hours worked vary; some practitioners work only part-time, perhaps because they also teach part time or are nearing retirement. Others work full time and may treat some patients in the evenings or on weekends.
While many dentists wear comfortable business attire underneath a laboratory coat, some opt to wear surgical scrubs when treating patients.
Periodontists may travel from time to time to attend continuing education courses or meetings held by professional organizations.
Periodontist Career Outlook
The demand for periodontists is expected to remain relatively steady, but the procedures that they perform may change over time. As Americans retain more teeth and live longer, they have more teeth at risk for periodontal disease. Furthermore, as the possible links between chronic periodontal infection and medical diseases become more widely known, people may be more motivated to receive regular periodontal care.
Periodontal surgery is expected to be less common as more patients are managed with antibiotics and preventive care. This is good news for patients because periodontal surgery is expensive, but this may mean reduced income for periodontists.
Lasers allow periodontists to perform some surgical procedures with less bleeding, pain, and scarring. Periodontists who use lasers in their practices may attract patients who prefer laser surgery to conventional procedures.
Some periodontists treat tooth loss with dental implants. Many patients are willing to pay out-of-pocket for implants because they want an alternative to wearing a conventional denture or bridge.