Why Your Dentist Sent You to a Periodontist

What Your Dentist Saw

Most referrals to a periodontist come from one of a few findings at a routine visit:

• pockets around the teeth measuring five millimeters or deeper
• bleeding that hasn’t resolved after a cleaning
• bone loss on the X-rays
• gum recession that has exposed a root or is progressing
• a tooth that has become loose
• a tooth that can’t be crowned without more tooth showing
• a missing tooth your dentist thinks should be replaced with an implant

None of these are emergencies in the usual sense. All of them are things a general dentist can see and a periodontist is trained to treat.

They are also common. In the national survey reported by Eke and colleagues, an estimated 42 percent of US adults aged 30 and older who still had teeth had periodontitis, and 7.8 percent had severe periodontitis, and the authors note that general dentists who find it may refer those patients to a periodontist for specialty care.

What a Periodontist Is

A dentist who completed three more years of surgical residency after dental school, specifically in the gums and bone that support teeth and implants. The American Academy of Periodontology describes that as three additional years of education beyond dental school, with in-depth surgical training that most general dentists do not receive. Periodontists treat gum disease surgically and non-surgically, graft receding gums, place implants and build the bone for them, and do the surgical procedures general dentists refer out. Board certification, which Dr. Verrett holds, means passing the specialty’s written and oral examinations on top of the residency; the American Board of Periodontology publishes a public directory of the periodontists who hold it.

What Will Happen at the Visit

An exam that measures the gums around every tooth, X-rays or a 3D scan, and a conversation. It is the comprehensive periodontal evaluation the American Academy of Periodontology recommends annually, covering the teeth, the plaque, the gums, the bite, the bone structure, and the risk factors. You’ll be told what was found, what it means, what the options are, and what each costs, in writing. Nothing is done at the first visit. You can take the plan back to your dentist before deciding.

Already Have an Appointment?

Three things make the visit go smoothly. Complete the patient forms before you come, or arrive fifteen minutes early to do them in the office. Bring your insurance card and a list of your medications; the practice is out of network with every plan, files the claim for you, and your insurer reimburses you directly, so nothing about your coverage changes what happens at the first visit. Parking is free at the building, with accessible spaces by the entrance. Your first visit has the rest.

If your dentist mentioned a graft, gum grafting explains what is actually done and gum graft recovery describes the week afterward, day by day. Most people find the reality smaller than the reputation.

What Won’t Happen

You won’t lose your dentist. A periodontist treats the specific problem and sends you back. Your dentist gets a written report after every visit, keeps doing your cleanings and restorative work, and shares your periodontal maintenance with this practice afterward. The practice doesn’t do fillings or crowns and doesn’t want to.

Why Not Just Have the Dentist Do It

Some general dentists do treat early gum disease and place straightforward implants, and do it well. The referral usually means your dentist has judged that your case is beyond what they do routinely, or that the outcome will be better with a specialist. That judgment is a good sign about your dentist.

What your first visit involves at Austin Periodontal Associates is performed by Dr. Andrew Verrett, a board-certified periodontist in North Austin.

What a periodontist is, and whether you need one covers the training, the board certification, and how a periodontist differs from an oral surgeon for an implant.

The One Thing to Do Now

Call. Untreated periodontitis does not usually stand still. In a long-term study of Sri Lankan tea plantation workers who had never had preventive or dental treatment, Löe and colleagues found moderate progression in about 81 percent, rapid progression in about 8 percent, and no progression beyond gingivitis in about 11 percent. Nobody can tell in advance which pattern a particular mouth will follow, which is why waiting is a gamble rather than a saving. Request a consult, or call (512) 346-6097.