Definition and Overview
Periodontics is a specialty in dentistry that focuses on the structures surrounding the teeth, especially the gums. Dentists who specialize in this field are called periodontists. They focus on the prevention, diagnosis, and treatment of gum problems, oral inflammation, and in the placement of dental implants, which are artificial tooth root made of titanium used to replace missing teeth.
Periodontists are trained to perform reconstructive and supportive treatments. Reconstructive means restoring the form and function of the diseased part of the oral cavity through interventions like bone and gum tissue grafting and augmentation of the sinus. Supportive approaches, on the other hand, are meant to effectively control the progression of periodontal disease and do not necessarily mean surgical procedures.
Because of the specificity of the job description, periodontists receive more extensive training than general dentists. After completing four years of dental school, they proceed to complete extra two to three years’ education that is focused on diagnosing and treating gum diseases.
Who Should Undergo and Expected Results
Not all types of dental care are considered an emergency. In fact, gum disease progresses very slowly. It can take many years before the first symptoms appear, and often, these signs are subtle and gradual that they are not immediately noticed and taken care of by the patient. However, there are cases in which emergency care has to be sought out. This happens if:
The person has an underlying condition – People who already have certain preexisting medical condition prior to the development of gum disease or dental problems have to be checked out by a periodontist as soon as possible. These include men and women who are diagnosed with diabetes, a metabolic condition characterized by abnormally high blood sugar level. Other high-risk patients are those with compromised immune system such as patients who are treated for cancer and those who were diagnosed with AIDS or HIV.
There is excessive bleeding – It’s perfectly normal for a patient to experience bleeding and even bruising after a procedure (such as tooth extraction) is completed. However, the bleeding is expected to cease due to clotting. If the patient continues to bleed continuously after a few hours following a dental procedure, it warrants a quick attention from the periodontist as it could mean the operation has affected some of the nerves.
There are also cases wherein the gum bleeds on its own because the disease has already progressed. This is another case of dental emergency as it is assumed that there are already lesions or open cuts in the gums that can that lead to infection and swelling.
The patient has swollen gums – This may indicate that there is already an infection forming somewhere in the surrounding tissues and structures, especially the roots. The infection has to be removed as soon as possible to avoid the spread of bacteria elsewhere in the mouth and even to other parts of the body.
The cause is trauma – Whether it’s accidental or deliberate, any type of dental trauma is considered a dental emergency, especially since such injuries can be very painful and affect the functions of the mouth such as eating and speaking.
The primary goal of a periodontist in the case of emergency is to stop the bleeding and swelling as soon as possible to stabilize the condition. Other procedures such as surgery can also be performed immediately. Specialists such as oral maxillofacial surgeons may be brought in particularly in trauma cases where fractures are diagnosed.
How Does the Procedure Work?
There are different ways on how to describe emergency care. It may be considered an emergency if the periodontal disease is sudden or has progressed at a much faster rate than expected. It may also be an emergency in the case of trauma in which the patient needs help as soon as he walks into the hospital or clinic. Either way, all emergency cases are given first priority.
Patients who need emergency care simply need to inform the clinic or hospital about the condition. Unlike a regular appointment with a periodontist, there’s no need to set up a schedule, and the patient is attended to before the others. They also have priority over exams and diagnostics like X-ray or scans.
Because of the nature of the condition or issue, periodontists need to make fast and sensible decisions and treatment plan. This is one of the reasons why these dental specialists are well trained and experienced in the field.
Nevertheless, the patient still has to go through basic consultative steps, which include getting their medical history. If the patient is conscious and rational, the periodontist will ask about the cause of the problem, how the condition developed, and possible treatments and medications provided. Otherwise, the periodontist has to rely on his knowledge and expertise, as well as the answers from carers and immediate family members who know about the patient’s condition.
Often, a periodontist emergency is carried in a hospital setting, which typically has complete equipment and access to a number of health providers like a general surgeon. However, some dental clinics today operate for longer hours and are equipped with much-needed tools to provide such service.
Possible Risks and Complications
Periodontist emergency doesn’t offer any guarantees, which means the patient may not receive complete restoration or solution to the problem, and he may have to undergo more procedures later on. Being on emergency care also means that the patient has an increased risk of dental-related complications including bleeding and infection.
Emergency care can also be difficult in cases where the patient is not capable of answering questions properly or there’s no one can do that on his behalf. In this case, the periodontist has the burden of providing the right diagnosis and treatment as soon as possible using his knowledge, expertise, and experience in other similar cases.
Amsterdam JT. Oral medicine. In Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 70.
Kawar N, Gajendrareddy PK, Hart T. Periodontal disease for the primary care physician. Dis Mon. 2011;57(4):174-183.
Chow AW. Infections of the oral cavity, neck, and head. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 60.