Nowadays, a dentist can take advantage of many technologies and advances that help them to predictably and safely treat their patients. Digital software, guided implant surgery, orthodontic devices, phone applications are all tools that can help clinicians to approach different cases of different levels of difficulty.
The real question is where is the threshold that requires the intervention of a specialist. Periodontist, orthodontist, prosthodontist and radiologists are specifically trained to face complex cases that need an extra level of expertise.
During their training and in their everyday activities they study, analyze and treat cases that require detailed knowledge to be solved. General dentist have the great responsibility of being proficient in defining a diagnosis, prognosis and deliver a multi-specialty treatment. Sometimes, the complexity of a case requires a clinician specifically trained to handle it in the most predictable way and manage its possible complications.
In the specific case of periodontists, they are trained to treat patient that often have a multifactorial and systemic involvement. Besides their expertise in refined surgical procedures, periodontal patients often require a full time dedication to control all the risk factors that keep the disease active. Furthermore, their practice set-up involves the presence of dental hygienist team that highly contribute in the monitoring and maintenance of such complex cases.
One of the most difficult tasks for a Periodontist is to define the prognosis of a tooth. Most of the time that a periodontist is consulted, he/she is asked to make a precise prevision of a tooth survival projection in time. A deep knowledge that starts from the pathogenesis of the disease and ends with a detailed surgical treatment, provides vital information to the restorative dentist that often has to decide whether to retain or not a tooth. With the advances in grafting materials, biologics and techniques the periodontist can deliver a minimally invasive treatment that helps the patient to have a smooth post-operative recovery.
Besides the surgical and mechanical approach, the fairly recent discoveries in the link between chronic and periodontal disease makes the periodontist a strategic ally to Medical Doctors. The periodontist is often the first line of discovery patients with diabetes, cardiovascular disease and obesity. These subjects can be then referred to a MD to visit them, diagnose and treat their systemic conditions. A periodontal patient is not only analyzed by the amount of bone loss but also from a systemic point of view.
A multi-specialty approach is often the best way to start to treat a patient from a single tooth to a systemic point of view. The indications and suggestions from a specialist can lead to a more comprehensive and tailored treatment for every single patient.
– By Lorenzo Mordini DDS, MS