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A periodontist is a dentist who completed three additional years of specialty training in the gums and jawbone, and periodontists, oral surgeons, prosthodontists and general dentists with implant training all place dental implants. No single specialty owns the procedure. The surgical side is a matter of training, imaging and case volume; the restorative side (the crown or bridge) is a matter of who designs it and whether the two halves are coordinated. This guide explains what each provider does, when a specialist is the right call, and the questions that tell you more than a title does.
Reviewed by Dr. David Basar, DDS, Advanced Smile Dentistry, Toms River, NJ. Updated October 2026.
This article is part of our complete dental implants guide, which covers the treatment itself; here the focus is on who provides it.
What does a periodontist do?
Periodontics is one of the dental specialties recognized by the American Dental Association. After dental school, a periodontist completes a three-year residency focused on the supporting structures of the teeth: gum tissue, the ligament that holds the tooth and the bone around it. Their day-to-day work includes treating gum disease (deep cleaning, gum surgery), gum grafting for receded gums, bone grafting, crown lengthening and placing dental implants. Because implants live in the same bone and gum a periodontist treats, implant surgery became a natural part of the specialty, and many periodontists place implants every day.
You would typically see a periodontist when gum disease is advanced, when gums have receded enough to expose roots, when a significant bone graft is needed before an implant, or when a previous implant has developed bone loss around it (peri-implantitis). Periodontists do not usually make the crown; they place the implant and refer you back to a restorative dentist for the tooth on top.
What does an oral surgeon do?
An oral and maxillofacial surgeon completes a four- to six-year hospital-based residency after dental school, often including a medical degree. Their scope covers extractions, wisdom teeth, jaw surgery, facial trauma, biopsies and implant placement, usually under IV sedation or general anesthesia. For implant cases involving complex extractions, large sinus lifts, zygomatic implants, jaw reconstruction or patients with serious medical histories, an oral surgeon’s hospital training is a real advantage. Like periodontists, oral surgeons rarely make the final crown or bridge.
What does a prosthodontist do?
A prosthodontist is the specialist in replacing teeth: crowns, bridges, dentures and the design of implant-supported teeth. Their three-year residency focuses on bite, function and esthetics. Some prosthodontists also place implants; more often they plan the case, decide where the implants need to be for the final teeth to work, and restore them after a surgeon places them. In complex full-arch cases the prosthodontist is frequently the one coordinating everyone else.
What does a general dentist with implant training do?
General dentists are not restricted from placing implants. Many have completed hundreds of hours of post-graduate implant education, residencies or fellowship programs and place implants routinely, and in a large number of practices the general dentist both places the implant and restores it. The practical advantage is continuity: one office plans the case, places the implant where the crown needs it, makes the crown and provides the follow-up. The honest caveat is that “general dentist” tells you nothing on its own about implant experience; the questions in the next section do.
One term to be careful with: “implantologist.” It is not a specialty recognized by the American Dental Association, and in most states a dentist cannot advertise as an implant specialist. A dentist who describes themselves as an implantologist may have excellent training, but the word itself is a marketing term, not a credential. Fellowships and diplomate status from organizations such as the American Academy of Implant Dentistry or the International Congress of Oral Implantologists do indicate structured training and case review, and are worth asking about.
Specialist or general dentist: which do you need?
| Your situation | Usually appropriate | Why |
|---|---|---|
| Single missing tooth, healthy gums, adequate bone | General dentist with implant training, periodontist or oral surgeon | Routine case; continuity of care and cost favor a single office |
| Active or advanced gum disease | Periodontist first | Disease must be controlled before any implant; gum and bone grafting expertise |
| Significant bone loss needing large grafts or sinus lift | Periodontist or oral surgeon | Advanced grafting training |
| Full-arch (All-on-4) with multiple extractions | Experienced implant dentist, oral surgeon, or a surgeon plus prosthodontist team | Surgical volume and sedation; restorative design is critical |
| Zygomatic implants, jaw reconstruction, serious medical history | Oral surgeon | Hospital-based training, anesthesia |
| Failed or infected existing implant | Periodontist | Peri-implantitis treatment and bone regeneration |
| Complex bite or esthetic case, many teeth to restore | Prosthodontist-led team | Restorative planning drives implant positions |
The pattern is simple. The more the case is about diseased gums or missing bone, the more a periodontist or oral surgeon earns their fee. The more it is about getting the final teeth right, the more the restorative dentist or prosthodontist matters. For the large middle ground of routine cases, the provider’s experience with cases like yours matters more than the letters after their name.
The two halves of implant treatment
Every implant case has a surgical half and a restorative half, and understanding that split explains most of the differences between providers. The surgical half is placing the implant in the right bone at the right angle and depth, with any grafting needed to make that possible. The restorative half is designing and fitting the crown, bridge or denture that goes on top, and it is the half you live with every day.
The restorative half should drive the surgical half. The implant has to be exactly where the crown needs it to be, which is why modern cases are planned backwards: the final tooth is designed digitally first, then the implant position is chosen to support it, then a surgical guide is printed so the implant goes where the plan says. When one provider does both halves, this is straightforward. When a surgeon places the implant and a separate dentist restores it, it depends on the two offices sharing the plan. Most do this well; the failure mode, an implant placed where there is bone rather than where the tooth needs to be, is what a prosthodontist is trained to prevent and what a patient should ask about when care is split.
What happens when you are referred to a specialist
A referral is a normal part of good implant care, not a sign that something has gone wrong. A typical sequence: your dentist takes the 3D scan and identifies, say, advanced gum disease around the remaining teeth and a thin upper ridge. You are referred to a periodontist, who treats the gum disease over a few visits, performs a sinus lift and places the implants three to six months later. Once the implants have healed, you return to your dentist, who takes the impressions and makes the crowns or bridge. Throughout, the two offices share the scan, the surgical plan and the restorative design. You should know before you start who is responsible for each phase, what each will cost, and who you call on a weekend if something hurts. If those answers are vague, ask again before you book surgery.
Warning signs, whoever the provider is
No 3D scan before surgery. A quote that does not name the implant brand. Pressure to decide the same day, often tied to a discount that expires. Results shown only as stock photos. A full-arch plan with no discussion of the final bridge material. A practice that does not ask about your medical history, smoking or diabetes. Any one of these is reason to get a second opinion, from a periodontist, an oral surgeon or another implant dentist, before proceeding. Specialty does not protect against any of them; process does.
Eight questions to ask any implant provider
How many implants do you place a year, and how many cases like mine? Volume matters. A provider who places a few implants a year is not the same as one who places several a week, regardless of specialty.
Will you take a 3D cone-beam CT scan before planning? Two-dimensional X-rays cannot show bone width or the exact position of the nerve and sinus. Planning on a CBCT scan is the standard of care for implants.
Who places the implant and who makes the crown? If two offices are involved, ask how they communicate and who you call when something is wrong. If one office does both, ask who made the crowns in the results you are shown.
What implant system do you use, and why? A clear answer with a recognized brand means parts will be available for future repairs. Vagueness is a warning sign.
What is your success rate and what happens if an implant fails? Published survival is around 96% at ten years. Ask whether a failed implant within the first year is replaced at no charge or at a reduced fee.
Can I see before-and-after photos of your own patients? Stock photos are not evidence. Ask for cases similar to yours.
What is the total, itemized cost for a finished tooth? Implant, abutment, crown, scan, extraction and grafting on one sheet.
What continuing education have you done in implants? For a general dentist, this is where the real answer about training lives: residencies, fellowships, hours per year and whether cases are reviewed by peers.
How Advanced Smile Dentistry fits
Dr. David Basar is a general dentist with a focus on dental implants, trained at NYU College of Dentistry. At Advanced Smile Dentistry in Toms River, implant cases are planned on a cone-beam CT scan, placed and restored under one roof, so patients have one treatment plan, one point of contact and one fee schedule from the first scan to the final crown. [VERIFY: Dr. Basar’s implant residency/fellowship/CE details; confirm all surgical phases are performed in-office] Cases that call for a periodontist’s or oral surgeon’s skills, such as advanced gum disease, major reconstruction or zygomatic implants, are referred to specialists we work with, and we coordinate the restorative side. [VERIFY referral arrangement] Our article on dental implants in Toms River covers what to look for locally, and periodontal treatment, where needed, always comes before implant surgery.
What a periodontist or specialist costs
Specialists usually charge more per procedure than general dentists, reflecting training and overhead. A periodontal consultation commonly runs $100 to $300 before imaging; gum grafting and bone grafting are priced per site. Implant placement fees by a specialist are often several hundred dollars above a general dentist’s, and the crown is billed separately by the restorative office. For a routine single tooth that difference is real money; for a case that would otherwise fail without specialist grafting, it is the cheaper route. Our New Jersey dental implant cost guide puts all of these numbers in one place.
Next step
If you are not sure whether your case is routine or needs a specialist, a 3D scan answers most of that question in one visit. Advanced Smile Dentistry offers a complimentary scan and consultation at 2224 Route 37 East, Toms River, NJ 08753; call (732) 608-6478 or book online. If your case belongs with a periodontist or oral surgeon, we will tell you, and we will coordinate the rest.
Frequently asked questions
Should a periodontist or an oral surgeon place dental implants?
Either can, as can a trained general dentist. Periodontists are the choice when gum disease or gum and bone grafting is central to the case; oral surgeons when complex extractions, jaw reconstruction, zygomatic implants or medical complexity are involved. For routine cases, experience and imaging matter more than specialty.
What does a periodontist do?
A periodontist treats the gums and jawbone: gum disease, gum recession, bone grafting and dental implant placement. The specialty requires three years of residency after dental school.
Is “implantologist” a recognized specialty?
No. The American Dental Association does not recognize implantology as a specialty. The term describes a focus, not a credential; fellowships from implant organizations are a better indicator of training.
Can a general dentist place dental implants?
Yes. Many general dentists have completed extensive implant training and place and restore implants routinely. Ask about case volume, training and imaging.
When should I see a periodontist instead of my dentist?
For advanced gum disease, significant gum recession, major bone grafting needs, or bone loss around an existing implant.
Does a periodontist cost more than a dentist?
Usually, per procedure. For complex gum or bone cases that cost is often recovered through a more predictable result.
Sources
- American Dental Association. Specialty definitions recognized by the National Commission on Recognition of Dental Specialties and Certifying Boards (periodontics, oral and maxillofacial surgery, prosthodontics).
- American Academy of Periodontology. What is a periodontist? perio.org
- Howe MS, Keys W, Richards D. Long-term (10-year) dental implant survival: a systematic review and sensitivity meta-analysis. Journal of Dentistry. 2019;84:9-21.