What does a specialist periodontist treat?

A specialist periodontist treats all forms of gum disease (gingivitis and periodontitis), including advanced cases with significant bone loss. They also provide crown lengthening, soft tissue grafting for gum recession, pre-implant periodontal assessment, peri-implantitis management, and surgical periodontal procedures. At ISCD Dublin, Dr. Shruta Narayanan holds an M.D.S in Periodontics and Implantology. The Dental Council of Ireland's Register of Dental Specialists currently recognises two specialties only — Orthodontics and Oral Surgery — so there is no specialist register for periodontics in the State.

When should a dentist refer a patient to a periodontist?

Key indications for specialist periodontic referral include: pocket depths consistently ≥6mm after initial therapy; persistent bleeding on probing despite compliance; progressive bone loss on sequential radiographs; Grade C (aggressive) periodontitis; furcation involvement Grade II or III; planned implant placement in a patient with any history of periodontal disease; and gum recession or aesthetic crown lengthening requirements. ISCD Dublin accepts referrals from general dental practitioners via online referral form or by calling (01) 504 2065.

Can gum disease be treated successfully?

With specialist periodontic treatment, periodontal disease can be arrested and tooth loss prevented or significantly delayed, even in advanced cases. The bone lost to periodontitis does not fully recover with standard treatment, but disease progression can be halted and, in selected cases, regenerative procedures can partially recover bone. Early referral — before significant bone loss — gives the best long-term outcomes.

Periodontist Dublin

Q: How common is gum disease?

Periodontal disease is highly prevalent globally. A 2025 analysis of the Global Burden of Disease study published in Frontiers in Oral Health found over 1 billion cases of periodontal disease worldwide in 2021 — approximately 1 in 7 people across all age groups. The analysis projects continued increases in case numbers through to 2040.

Specialist gum disease treatment by Dr. Shruta Narayanan, M.D.S Periodontics & Implantology — for active, advanced, or non-responsive periodontal disease.

The Institute of Specialist and Cosmetic Dentistry (ISCD) provides specialist periodontal treatment in Dublin 1 for patients referred by their general dentist and for those with active or progressive gum disease that has not responded to standard hygiene care.

Specialist periodontic treatment at ISCD is provided by Dr. Shruta Narayanan, who holds an M.D.S in Periodontics and Implantology, is registered as a dentist with the Dental Council of Ireland and practises exclusively in periodontics, working as part of ISCD’s multidisciplinary specialist team at the IFSC.

What Is a Specialist Periodontist?

A specialist periodontist is a dentist who has completed a minimum of three additional years of full-time postgraduate training in the prevention, diagnosis, and treatment of gum disease, and whose practice is limited to that field. The Dental Council of Ireland’s Register of Dental Specialists currently recognises two specialties only — Orthodontics and Oral Surgery — so there is no specialist register for periodontics in the State.

Periodontics is the specialty concerned with the health of the tissues that support and surround the teeth — the gums, bone, and ligaments. When these tissues are affected by bacterial infection (periodontal disease), the damage to bone and gum is largely irreversible without specialist treatment. Arrested early, the prognosis for affected teeth is considerably better than when treatment is delayed until the disease has progressed.

A specialist periodontist has training and clinical experience in surgical and non-surgical periodontal treatment, soft tissue grafting, crown lengthening, and implant-related soft tissue procedures — a scope considerably broader than the scale and root planing available in a general dental setting.

How Prevalent Is Gum Disease?

Periodontal disease is one of the most prevalent chronic conditions globally — a 2025 analysis of the Global Burden of Disease study found over 1 billion cases of periodontal disease worldwide in 2021, representing approximately 1 in 7 people across all age groups.

A comprehensive analysis published in Frontiers in Oral Health using Global Burden of Disease 2021 data found 1,066,953,744 prevalent cases of periodontal disease globally, with incident cases exceeding 89 million per year and rising. The authors describe periodontal disease as a substantial global health challenge with projections indicating case numbers will continue to increase substantially by 2040. (Hu M, Zhang R, Wang R, Wang Y, Guo J. Front Oral Health. 2025. PMC12332980.)

The clinical significance of this prevalence for general dental practitioners is considerable: in a typical general dental practice in Ireland, a meaningful proportion of adult patients have active periodontal disease — the majority of whom have not received specialist assessment or treatment. Early referral, before significant bone loss has occurred, is when specialist periodontic intervention has the most impact on long-term prognosis.

What Conditions Does ISCD’s Periodontist Treat?

Specialist periodontal treatment at ISCD covers the full spectrum of gum disease management, from non-surgical periodontal therapy for active disease to surgical procedures including osseous surgery, soft tissue grafting, and implant-related periodontal treatment.

Conditions and presentations commonly referred to ISCD for specialist periodontic care include:

Stage III and IV periodontitis — advanced gum disease with significant bone loss, complex furcation involvement, or poor initial response to scale and root planing
Aggressive periodontitis — rapid bone loss in younger patients or with atypical patterns of destruction
Periodontal maintenance in complex cases — ongoing specialist monitoring and supportive therapy following active treatment
Crown lengthening — surgical exposure of tooth structure to allow restoration, or for aesthetic improvement of a gummy smile
Soft tissue (gum) grafting — to treat gum recession, improve root coverage, or augment tissue around implants
Pre-implant periodontal assessment — evaluation and treatment of the periodontium before implant placement in patients with a history of gum disease
Peri-implantitis — management of inflammatory disease affecting the tissue around dental implants
Furcation management — treatment of bone loss in the area where tooth roots divide, one of the most technically demanding areas of periodontics

For Referring Dentists: When Should You Refer for Periodontic Assessment?

The most important time to refer for specialist periodontic assessment is earlier than most general practitioners instinctively do — when bone loss is first identified, when response to initial therapy is inadequate, or when implant placement is planned in a patient with any history of periodontal disease.

Specific indications for specialist referral:

Pocket depths consistently ≥6mm following initial periodontal therapy
Persistent BOP (bleeding on probing) despite patient compliance
Progressive bone loss visible on sequential radiographs
Grade C (previously classified as aggressive) periodontitis in younger patients
Furcation involvement Grade II or III on any posterior teeth
Patient requires implants and has any history of periodontal disease — a specialist periodontal assessment before implant placement is best practice and reduces peri-implantitis risk
Gum recession causing patient concern or affecting aesthetics
Gummy smile requiring aesthetic crown lengthening
Peri-implantitis that has not responded to non-surgical management

ISCD accepts referrals from general dental practitioners via our online referral form or by calling (01) 504 2065. A full written report is provided following specialist assessment.

What to Expect at a Specialist Periodontic Consultation

The specialist periodontic consultation at ISCD includes a full periodontal examination including pocket charting, assessment of furcation involvement and mobility, review of radiographs, a diagnosis, a written treatment plan, and a transparent cost estimate before any treatment begins.

The consultation typically lasts 45–60 minutes. Dr. Narayanan will take a comprehensive medical and dental history (systemic conditions including diabetes and smoking history are highly relevant to periodontal prognosis), carry out a full periodontal assessment, and explain findings in full before outlining treatment options.

Many patients are understandably anxious at a first periodontal consultation — concerns about what treatment will involve and what the outcome will be are natural. Our approach at ISCD is to explain findings clearly and honestly, discuss realistic prognosis, and outline the full treatment pathway before asking patients to commit to anything.

Specialist consultation at ISCD is €150. Treatment fees are provided following assessment and depend on the complexity and extent of periodontal involvement.

Frequently Asked Questions — Periodontist Dublin

Can gum disease be cured?

Periodontitis (the more severe form of gum disease involving bone loss) cannot be fully reversed — bone that has been lost does not regenerate with standard treatment. However, with specialist periodontic treatment, the disease can be arrested and tooth loss prevented or significantly delayed. In selected cases, regenerative procedures can partially recover lost bone. The earlier specialist treatment begins, the better the long-term prognosis for the affected teeth.

Do I need a referral from my dentist to see a periodontist?

ISCD is primarily a referral-based practice, and your general dentist can refer you via our online referral form or by calling (01) 504 2065. Patients wishing to self-refer for a specialist opinion are also welcome to contact ISCD directly.

Is specialist gum treatment painful?

Non-surgical periodontal treatment (deep scaling and root planing) is carried out under local anaesthesia and should not be painful during the procedure. Patients typically experience some sensitivity and mild discomfort for a few days following treatment. Surgical periodontal procedures are also performed under local anaesthesia; IV sedation is available at ISCD for patients who are particularly anxious.

How does gum disease affect implant treatment?

Patients with a history of periodontal disease have a significantly higher risk of peri-implantitis — an inflammatory condition affecting the bone and tissue around an implant analogous to periodontitis around natural teeth. For this reason, specialist periodontic assessment and treatment before implant placement is considered best practice for any patient with active or historical periodontal disease. ISCD’s multidisciplinary team means periodontal and implant treatment can be planned together from the outset.

Refer a Patient or Book a Specialist Consultation

ISCD accepts referrals from general dental practitioners for periodontic assessment and treatment. Patients can also self-refer for a specialist consultation.

Practice: ISCD — Institute of Specialist and Cosmetic Dentistry
Address: 4 NCI, Lower Mayor Street, IFSC, Dublin 1, D01 R7W7
Phone: (01) 504 2065
Email: info@iscd.ie
Consultation fee: €150