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.
A full cleaning under the gum-line where periodontal disease lurks. It would be impossible to clean this area on an awake dog or cat, but this is where periodontal disease begins with bacteria âlivingâ below the gum tissue. Professional scaling and polishing of the crown, or visible part of your dog or catâs teeth. A veterinary cleaning does require scaling or scraping the tooth to remove plaque and calculus. Scaling is completed to remove plaque and tartar build-up on the tooth crown.