Periodontists in Vancouver: When Your Dentist Might Send You to One

Your general dentist helps you keep your teeth and gums healthy. Sometimes, they might notice signs that suggest you need care beyond what they typically provide. This is when your dentist might suggest you see a periodontist. A periodist is a dental specialist who focuses on the health of your gums and the bone that supports your teeth.

What is a Periodontist?

A periodontist is a dentist who has completed extra, specialized training after dental school [1]. This additional education focuses specifically on the prevention, diagnosis, and treatment of diseases that affect your gums and the bone around your teeth. They also specialize in placing dental implants.

Think of it this way: just as a cardiologist specializes in heart health, a periodontist specializes in the health of the structures that hold your teeth in place. Periodontics is a recognized dental specialty in Canada [1].

Signs Your Dentist Watches For

Your general dentist regularly checks your oral health during your routine appointments. They look for several signs that could mean you need a periodontist's help. Gum disease, also known as periodontal disease, often develops slowly and can be painless until it reaches an advanced stage [2]. This is why regular dental check-ups are so important.

Here are some common signs your dentist might notice:

• Bleeding Gums: If your gums bleed easily when you brush or floss, it can be a sign of gum inflammation. While occasional bleeding might happen, consistent bleeding is a red flag.
• Deep Pockets: Your dentist measures the space between your teeth and gums. Healthy gums fit snugly around your teeth, creating shallow spaces. If these spaces, called "pockets," become deeper, it can mean bacteria are accumulating and causing damage below the gum line.
• Bone Loss on X-rays: X-rays allow your dentist to see the bone supporting your teeth. If they notice that the bone level has decreased, it indicates that gum disease has started to affect the underlying bone structure.
• Receding Gums: When gums pull away from the teeth, they expose more of the tooth root. This can make teeth look longer and can also lead to sensitivity.
• Persistent Bad Breath: While many things can cause bad breath, persistent bad breath or a bad taste in your mouth can be a sign of bacteria related to gum disease.
• Loose or Shifting Teeth: As gum disease progresses and bone is lost, teeth can become loose or even start to shift position.

If your dentist observes one or more of these signs, they might recommend a consultation with a periodontist to get a more specialized assessment.

What Periodontists Commonly Do

Periodontists offer a range of treatments designed to restore gum health and support the structures around your teeth. Here are some common procedures they perform:

• Deep Cleaning (Scaling and Root Planing): This is often one of the first treatments for gum disease. It involves thoroughly cleaning the surfaces of the teeth and roots below the gum line to remove plaque and tartar (hardened plaque). This smooths the root surfaces, making it harder for bacteria to attach.
• Gum Graft Surgery: If your gums have receded, a periodontist might perform a gum graft. This procedure involves taking a small piece of gum tissue from another part of your mouth or using donor tissue and attaching it to the area where the gum has receded.
• Pocket Reduction Procedures: When deep pockets around teeth cannot be effectively cleaned with scaling and root planing, a periodontist might recommend surgery to reduce the pocket depth. This involves folding back the gum tissue, removing bacteria, and smoothing irregular bone surfaces before securing the gum tissue back in place.
• Regenerative Procedures: In some cases, a periodontist might use techniques to help regenerate bone and tissue that have been lost due to gum disease. This can involve using special membranes, bone grafts, or tissue-stimulating proteins.
• Dental Implant Placement: Periodontists are highly trained in placing dental implants, which are artificial tooth roots placed into the jawbone to support replacement teeth. They have expertise in ensuring the implant is placed correctly within healthy bone and gum tissue.
• Crown Lengthening: This procedure adjusts the gum and bone level to expose more of the tooth structure. It might be done for cosmetic reasons (to make a "gummy" smile look less gummy) or to prepare a tooth for a crown or other restoration.

A periodontist can assess whether any of these procedures fit your specific needs.

The Referral Dance: Your Dentist and the Specialist

Most often, your general dentist will refer you to a periodontist if they identify signs of gum disease or other issues requiring specialized care. They will typically send a referral letter and any relevant X-rays to the periodontist. This helps ensure the periodontist has all the necessary background information before your first visit.

However, you can also self-refer to a periodontist. If you are concerned about your gum health, you can directly contact a periodontist's office to schedule a consultation. It's often helpful to let your general dentist know if you plan to see a specialist, as they can share your dental history.

Good communication between your general dentist and your periodontist is key. They will often work together to ensure your overall oral health is managed effectively. For example, after a periodontist treats your gum disease, you might return to your general dentist for regular cleanings and check-ups, with periodic follow-ups with the periodontist.

If you are looking for a general dental clinic in Vancouver, you can explore options at our Vancouver dental hub. For more general information about dentistry in the city, you can read our article on the state of dentistry in Vancouver, BC.

Verifying Credentials in BC

In British Columbia, all dental professionals, including periodontists, must be registered with the British Columbia College of Oral Health Professionals (BCCOHP) [3]. This college is the regulatory body that ensures dental professionals meet specific standards for education, competence, and ethical conduct.

Before you choose a periodontist, you can verify their registration and ensure they are licensed to practice in BC. You can typically do this by visiting the BCCOHP website and using their online registrant directory [3]. This step helps ensure you are receiving care from a qualified and regulated professional.

Costs of Specialty Care

It's important to understand that specialty dental care, like treatment from a periodontist, typically costs more than general dental care. This is due to several factors:

• Specialized Training: Periodontists have invested in extensive post-doctoral education and training.
• Advanced Procedures: The treatments they provide often require specialized equipment, materials, and longer appointment times.
• Complexity of Cases: Periodontists often treat more complex or advanced cases of gum disease.

When considering treatment with a periodontist, always ask for a written treatment plan that outlines the recommended procedures and their estimated costs. This allows you to understand what to expect financially.

If you have dental insurance, it is a good idea to submit the proposed treatment plan to your insurance provider for a "predetermination" or "pre-authorization." This process allows your insurance company to review the plan and tell you in advance how much of the cost they are likely to cover. This way, you can better plan for any out-of-pocket expenses.

The Bottom Line

Taking care of your gums is just as important as taking care of your teeth for your overall oral health. If your general dentist suggests you see a periodontist, or if you have concerns about your gum health, a consultation with a specialist can provide a clear path forward. They can offer specialized knowledge and treatments to help you maintain a healthy smile for years to come.

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