First Visit to a Periodontist

As you plan for your first visit to a periodontist, even if you were referred by your general dentist, you might be curious about what to expect at your first visit and want details about how to prepare. When you book your appointment, and during appointment confirmations, you’ll review whatever specifics you might need to keep in mind or bring with you, but as a general guideline for any introductory visit to a medical professional, including dental professionals, it’s helpful to have ready access to a list of all medications that are being taken, including prescription and over-the-counter drugs. You’ll also be asked about medical conditions you may have or have had, and compiling all this information in advance can help make your first visit to a periodontist more efficient and informative. If you have dental insurance, bring that information with you to your first visit, and if you have a referral that includes x-rays or other medical documentation and information, bring that with you, too.


In addition to reviewing your medical and dental health and medication history, your periodontist will conduct a comprehensive oral examination that includes a screening for oral cancers, and they will look for any problems with the bite, signs of existing periodontal disease, and the presence of damage or defects in the teeth and bones. A periodontal examination shouldn’t be painful; at the very worst, the exam might cause minor discomfort when the periodontist probes your gums to assess the depth of the pockets at the gum line. If x-rays were not provided by the general dentist, the initial examination will also include these images. The periodontist will use these x-rays in tandem with clinical instruments to assess the health of the periodontium and determine the extent of periodontal disease. The key indicator of periodontal disease is the depth of the space between the gums and teeth, immediately below the gun line. This space is called the gingival sulcus, and, in a healthy mouth, the gingival sulcus should be no deeper than three millimeters. When the gingival sulcus deepens in the presence of periodontal disease, periodontal pockets form, and the ligaments that hold the teeth in place gradually deteriorate and loosen.


In general, deeper periodontal pockets are an indication of more advanced periodontal disease. When periodontal disease is present, even in its early stages, the gum tissue often bleeds, and this bleeding upon probing of the gingival sulcus is one of the more common first signs of periodontal disease. When periodontal disease has progressed, noticeable bone loss could occur, and dental x-rays can reveal existing bone loss and other issues that might not normally be visible. After assessing the depth of periodontal pockets by probing, examining the periodontium and overall cavity visually and manually, and evaluating the patient’s x-rays and comprehensive medical history, your periodontist will diagnose the situation and discuss your treatment options with you.


You should discuss possible costs with your periodontist as you plan your consultation and treatment, but in general, treatment costs depend on the diagnosis and the extent and complexity of treatment. Your periodontist can provide a cost estimate for your treatment plan during your consultation, though additional testing or procedures may be required at various points throughout treatment. These additional procedures, and their associated costs, will be explained thoroughly, allowing you to make an informed decision. In many cases, dental insurance policies will cover at least part of a periodontal treatment, and you should review this information with your insurance provider and your periodontist’s office staff to confirm your own coverage as you plan treatment.


When periodontal disease is intercepted early, it can usually be controlled without requiring surgical intervention. When intercepted later, after it’s progressed and begun to destroy the connective ligaments and gingival tissues, periodontal disease can’t be reversed, though non-surgical treatment methods might still be available. In some cases, however, surgical treatments are necessary to halt and repair the effects of periodontal disease, and to create conditions that will discourage periodontal disease from happening again. If saving the natural teeth is possible, treatment will be primarily directed toward this goal. If the natural teeth cannot be saved, the treatment will shift toward clearing disease from the oral cavity to restore it to health and prepare it for dental restoration possibilities. These dental restoration options are vast and varied, and there are restoration options that can suit all sorts of lifestyle preferences, clinical needs, and budgets.


In some cases, especially in its earlier stages, periodontal disease can be mostly painless. This might make you forget you have periodontal disease, or you might believe that if something doesn’t hurt, it’s okay to ignore it. Delaying treatment for periodontal disease is a universally bad idea, however, as it allows periodontal disease to progress and wreak further havoc on the periodontium. Periodontal disease also accelerates additional periodontal disease, so it might not take that long for periodontal disease to get worse and lead to tooth loss. With routine visits to your general dentist, gum disease can be detected and reversed before it begins to destroy the periodontium, and, if your dentist refers you to a periodontist, your periodontist will attempt non-surgical treatment methods for your advanced periodontal disease. The most common non-surgical treatment procedure is scaling and root planing, which is a deep cleaning of the gums that removes and prevents infection. Periodontists also perform a variety of surgical procedures, like bone and tissue regeneration and dental implant treatments, that are intended to help restore the periodontium to a healthy appearance and function. Some periodontal surgeries are broken up into separate procedures that occur intermittently, allowing sufficient healing between procedures, and this can lead to longer treatment times. For most people, stopping the destructive effects of periodontal disease and restoring the health of the oral cavity, often successfully saving the teeth, is worth the investment.


At your first visit to your periodontist, you and the doctor will review your treatment timeline. If your treatment plan includes required surgical procedures, your periodontist will explain these procedures to you and make sure you are properly prepared. If you have diseased or infected teeth, these teeth will be treated or extracted by a dental specialist working in collaboration with your periodontist. If you’re seeing a periodontist to prepare your jawbone dental implants, you and your periodontist will plan your associated surgery, and your periodontist will assess your healing timeline to make sure you’re thoroughly ready for dental implants to be placed. Depending on the reasons for your visit to a periodontist, you may need more or less frequent maintenance visits during treatment. The scheduling of these maintenance visits will be based on the severity of the patient’s condition, the presence of additional risk factors for periodontal disease, and your demonstrated commitment to maintaining an effective oral hygiene routine. Most patients who are in generally good oral health and overall health see their periodontists at recommended six-month intervals, though patients with severe periodontal disease who are earlier in their treatment timeline might be counseled to schedule maintenance appointments every three or four months.


The frequency of maintenance appointments for periodontal disease will lessen as treatment progresses and the disease remains under control. Certain factors affect the timeline of maintenance visits and overall treatment, including some medical conditions, your diet and nutritional choices, whether you smoke or otherwise use tobacco, and the integrity of your home hygiene practices. If you want advice about smoking cessation or diet and lifestyle choices that affect the periodontal and oral health, ask your periodontist and your primary care provider. With holistic attention to the causes and symptoms of periodontal disease, you and your medical providers can reduce the risk of recurrence for periodontal disease and keep it from progressing past the point of no return.

How to Choose a Periodontist