What Happens at a Periodontal Consult
A referral to a periodontist is often a surprise. Here is exactly what the first visit involves, minute by minute, so nothing about it is a surprise too.
Most new patients arrive with a referral slip and a vague sense that something in their mouth is worse than they thought. The consult is designed to replace that feeling with facts. Here is what it involves.
Before You Arrive
The office will return your call as soon as possible during business hours and aims to respond within the same business day. You complete your history online or on paper. If your dentist has recent X-rays, the office asks for them rather than repeating them. Bring a list of medications. If you are anxious, say so when you book; it changes how the visit is planned.
The Exam, About 30 Minutes
Dr. Verrett does the exam himself, not an assistant. He looks at every tooth and measures the space between gum and tooth at six points around each one. Healthy is one to three millimeters. Deeper pockets, bleeding on the probe, recession, and tooth movement are all recorded. Bleeding is recorded because it adds something depth alone does not: in a study of treated patients followed for two and a half years, Lang and colleagues found that sites which consistently did not bleed on probing were very unlikely to lose further attachment, a negative predictive value of 98 percent, while bleeding by itself was a much weaker predictor of future loss. This is the comprehensive periodontal evaluation the American Academy of Periodontology recommends annually, which looks at the teeth, the plaque, the gums, the bite, the bone structure, and the patient’s risk factors. It is not painful; it feels like gentle pressure along the gumline. If there is a specific problem your dentist sent you for, a tooth that needs crown lengthening or a site for an implant, that gets the same close look.
The Scan
For implants and larger grafts a cone-beam CT is taken in the office; for gum disease, standard X-rays are usually enough. It takes about twenty seconds and shows bone in three dimensions, which an ordinary X-ray cannot. Dr. Verrett reviews it with you on the screen. Most patients find this the most useful part of the visit, because they can see for themselves what is being described.
The Conversation
This is the point of the appointment. You get a diagnosis in plain words, what happens if nothing is done, what the options are, and which one Dr. Verrett recommends and why. For gum disease, the diagnosis follows the classification adopted at the 2017 World Workshop, in which, as the consensus report by Papapanou and colleagues sets out, periodontitis is given a stage, reflecting its severity and how complex it will be to manage, and a grade, reflecting how quickly it has progressed and the risk of further progression. Periodontitis stages and grades explains both. If a tooth cannot be saved, he says so. If a tooth can be saved and you were expecting to lose it, he says that too. Sedation options are covered if surgery is involved. You should leave able to explain your own situation to someone else.
The Plan and the Estimate
Before you leave, the treatment plan coordinator goes through the written plan with you: the procedures, the sequence, the timing, and an itemized estimate. The practice is an out-of-network provider, but it files your dental insurance claims on your behalf so you can receive reimbursement directly from your insurance company, and the coordinator can show you what a payment plan looks like. Nothing is scheduled at the consult unless you want it to be. Many patients take the plan home and call back in a day or two; that is entirely normal.
What Your Dentist Gets
Your dentist receives a written report with the findings, the plan, and the timing for any work they will do, such as the crown after an implant. You stay their patient throughout. How the practice works with your dentist explains the whole loop.
What It Is Not
It is not a sales visit, and it is not a cleaning. Nobody will pressure you, and nothing is done to your mouth that day beyond the exam and the scan, unless something is urgent and you ask for it to be handled. New patients has the practical details: directions, parking, what to bring.
Request a consult at Austin Periodontal Associates is performed by Dr. Andrew Verrett, a board-certified periodontist in North Austin.
Frequently Asked Questions
Will anything be done at the first visit?
No treatment is performed at a consultation. It is an examination, a diagnosis, and a conversation, and you leave with a written plan and an itemized estimate to take home.
How long does a periodontal consult take?
Around an hour in total, of which the exam itself is roughly thirty minutes. Nobody is waiting on the room, and there is time to ask everything you want to ask.
What actually happens during the exam?
Every tooth is measured at multiple points around it, bleeding points are recorded, tooth mobility is checked, and X-rays are read for bone loss. A 3D scan is taken in the office where the case calls for one, and it is reviewed with you on the screen.
What should be brought to the appointment?
A list of medications, your medical history, and any recent X-rays your dentist has, which saves repeating them. If you are anxious, say so when booking, because it changes how the visit is planned.
Does a referral from a dentist have to come first?
No. Many patients are referred, and many book directly. Either way your own dentist stays involved and gets a written report after the visit.