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.
If you have severe gum disease, periodontitis or ANUG, you may need further treatment, such as periodontal surgery. In some cases, it is necessary to remove the affected tooth. Your dentist will be able to tell you about the procedure needed and how it is carried out.n some cases of gum disease, root planing (debridement) may be required. This is a deep clean under the gums that gets rid of bacteria from the roots of your teeth. Before having the treatment, you may need to have a local anaesthetic (painkilling medication) to numb the area.