Many PM&R physicians choose to pursue additional advanced degrees (MS, PhD) or complete fellowship training in a specific area of the specialty. Fellowships are available for specialized study in such areas as musculoskeletal rehabilitation, pediatrics, traumatic brain injury, spinal cord injury, and sports medicine.
If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, periodontitis treatment may require dental surgery, such as: 1  Flap surgery (pocket reduction surgery).2  In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and root planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. 2  After you heal, it's easier to clean these areas and maintain healthy gum tissue. 3  Soft tissue grafts.
Periodontitis. When gingivitis is not treated, it can advance to âperiodontitisâ (which means âinflammation around the toothâ). In periodontitis, gums pull away from the teeth and form spaces (called âpocketsâ) that become infected.The bodyâs immune system fights the bacteria as the plaque spreads and grows below the gum line. Medications. 2  There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. 3  Without enough saliva, the mouth is vulnerable to infections such as gum disease.