Dr. Alexandra Rutwind on Periodontics, Leadership & Gum Health

quip: Looking back, what sparked your transition from general dentistry to periodontics, and what did that path actually look like?

Dr. Rutwind: My time as a general dentist was invaluable because it gave me a comprehensive view of the restorative and prosthetic side of dentistry. However, I found myself constantly gravitating toward the surgical side of the chair. At the time, I was a multi-practice co-owner in North Vancouver, and I realized that I wanted to go back to school to be a periodontist. So, I sold my practices and moved to LA to complete the Advanced Periodontology residency at USC. It was a massive personal and professional leap, but I knew almost immediately it was the path I was meant to take.

quip: What truly sets periodontics apart clinically from other areas of dentistry?

Dr. Rutwind: Periodontics is unique because we are responsible for the biological foundation of the mouth and managing chronic inflammatory disease. Clinically, this requires a significant amount of delicate surgical work, whether we are regenerating bone, reshaping soft tissue, or treating peri-implantitis. It is incredibly rewarding to see that once we have the periodontal health under control, we aren't just achieving a functional result, we are helping to improve the patient’s overall health. 

 

quip: Is there a connection between periodontal health and overall health, and if so, how do you see it show up in practice?

Dr. Rutwind: Inflammation is a systemic burden. There are clear correlations between gum disease and a range of systemic diseases, including but not limited to diabetes and cardiovascular disease. This is evident with diabetic patients: when we reduce the periodontal inflammation, we see improvements in their glycemic control. I make my patients know that the gums are highly vascular and that gum health is not just a dental, but also a medical priority.

 

quip: When talking with patients about gum health, what misunderstanding do you encounter most often, and what approach helps the message truly resonate?

Dr. Rutwind: The biggest issue is that periodontal disease is often painless until it's very advanced. Because of that, a lot of patients postpone their dental or hygiene appointments because they don’t feel like anything is wrong. I really try to make sure my patients are aware of this, and I routinely stress the importance of those regular cleanings. The sooner we can identify and diagnose an issue, the less expensive the treatment is, both biologically and financially.

quip: From your perspective, what makes the biggest difference in protecting peri implant tissue health over time?

Dr. Rutwind: Prevention and early detection are everything. Implants lack a periodontal ligament and have different vascularity than natural teeth, meaning inflammation can progress rapidly and unpredictably. Therefore, catching a deep pocket or bleeding early can prevent a much more complex (and expensive) treatment later. This is why regular maintenance appointments are extremely important! 

quip: What is one unexpected part of your day as a periodontist that most providers would not guess?

Dr. Rutwind: How much of my day is communicating, coordinating and treatment planning with general dentists and other dental specialists. While surgery is the focus of the appointment, there is a lot of interdisciplinary care and communication involved to make sure that our treatment plans are perfectly aligned for the best interests of the patient. 

quip: As one of approximately 1,050 female periodontists in the U.S., what has your experience been in navigating leadership and visibility in a historically male dominated specialty?

Dr. Rutwind: It has been an amazing and empowering experience. We’ve seen the dental space evolve significantly, with more women entering the field and taking on leadership roles every year. I’ve been fortunate to be inspired and mentored by many incredible female periodontists throughout my journey.

I’ve realized that true leadership comes from being confident in your clinical decisions and standards, but also from staying open to learning new things and constantly evolving. I want to be visible through education and mentorship to help pay that forward because I think for younger women entering dentistry, representation really does matter.