First Visit to a Periodontist

A periodontist is a dental professional specializing in the prevention, diagnosis, and treatment of gum disease. Periodontists also provide implant placement surgery as well as a number of other treatments, including cosmetic gum procedures. Dentists and periodontists typically work together on their patients’ cases and will discuss diagnosis, treatment, and the results over the duration. Even if you visit a periodontist that you were not referred to, they will still be in communication with your general dentist. Here, we will review what to expect at your first visit to a periodontist.

What do I need to bring to my first visit?

For your initial visit, it is important to bring your dental insurance card or information, some form of personal identification, a list of medications that you are currently taking, and, if you were referred by your dentist, make sure that you bring the referral slip. You do not have to be referred to a periodontist to have an evaluation. If you experience symptoms of gum disease, it is perfectly fine to contact a periodontist on your own.

What should I expect during my first visit?

Your periodontist will need a full medical history, so they will have you complete a health history form prior to your appointment. You may have the option to do this online before you even get to the office! If you do not complete the forms prior to your appointment, it is ideal to arrive 15 minutes prior to your appointment time to complete your registration forms so that the doctor can use all of the time allotted to provide excellent service.

If you have a current, complete set of dental X-rays, your dental office can forward them to us, or you can bring them with you to your appointment. If not, we will take new images when you arrive. Imaging is where an accurate diagnosis begins, because the bone and connective tissue that support your teeth cannot be evaluated by looking in the mouth alone.

Most dental offices rely on flat, two dimensional X-rays. Those images are useful, but they press the mouth’s real anatomy onto a single plane, so bone, tooth roots, nerves, and sinuses all overlap one another. Details that matter a great deal when we are diagnosing gum disease or planning surgery can hide in that overlap. In one quick scan a cone shaped beam rotates around your head and builds a true three dimensional model of your teeth and jaw. Rather than an outline, we can measure the exact height, width, and density of your bone, see precisely where your nerves and sinuses sit, and study an area of bone loss from any angle. For dental implants and bone grafting in particular, that view is what allows us to plan placement to the millimeter, protect important structures during surgery, and give you specific answers before treatment ever begins.

After reviewing your imaging, our periodontists will evaluate your mouth, checking for bone loss, loose teeth, and signs of periodontal disease, along with an oral cancer screening. They will also check your bite and your temporomandibular joint (TMJ) to be sure everything is working as it should.

Once they have completed their evaluation, the doctor will review their diagnosis and proposed treatment plan to get your mouth back to a healthy state. While some treatments can be daunting, it is important to receive treatment. Issues in the mouth never resolve on their own and will only get worse, causing further damage down the road.

Some doctors are more aggressive with their treatment plan than others. It is important to understand the treatment philosophy of the doctor that you are seeing to make sure that it aligns with your own needs and wants. A more conservative doctor may try a non-surgical treatment option before determining that surgery is indeed needed.

One such non-surgical treatment is scaling and cleaning. This is often referred to as a deep cleaning and requires a local anesthetic to be administered to the area being treated. If you need to have scaling and root cleaning done on your whole mouth, you can expect multiple visits because the doctor will not want to numb your whole mouth all at one time. The anesthetic allows the doctor to clean tartar and bacterial buildup from well below the gum line while keeping the patient comfortable. Note that it is normal to experience some minor tenderness and discomfort once the anesthetic wears off, but this should resolve within a couple of days.

If scaling and root planing does not work, they may decide to move on to a surgical procedure like flap surgery. This procedure is a technique in which an incision is made in the gum tissue being treated. The tissue is then flapped back, allowing the doctor to see your tooth roots so that they can clean them and smooth them out before replacing the gum tissue and suturing it into place.

How much will my first visit cost?

The fee for your first visit will vary, depending on X-rays and the expertise of your periodontist. Doctors who have been practicing for a long time may have higher fees than those who have not been practicing as long. Patients in metropolitan areas can also expect to pay more than those in more rural areas. Since no treatment is done at the first visit, your dental insurance may cover the full cost of the evaluation, but make sure that you understand your dental benefits and what coverage you have, if any, for periodontal work. Periodontics and general dentistry are not the same and are not billed to insurance the same.

Some offices offer payment plans or in-house financing, and still others work with third-party financing companies to ensure as many patients as possible can receive great dental care. Some of these third-party financing companies offer promotional purchases, which allow the patient to make payments over a certain amount of time during which interest does accrue, but if the purchase amount is paid off in the allotted time, the patient does not have to pay the interest. These are called deferred interest loans.

Will I continue to see my general dentist?

A periodontist is a specialist and works side-by-side with your general dentist for the duration of your treatment. After treatment with a periodontist is complete, you will resume regular visits to your general dentist as before. Patients who receive treatment of any sort from a periodontist can still have their professional cleanings done with their general dental office, but they will be a more specialized cleaning called periodontal maintenance. Even if you did not have periodontal disease, maybe you just had an implant placed, you would still be considered a periodontal maintenance patient. The only change to your oral care team is that your periodontist may want to see you once or twice a year to ensure your treatment does what it was intended to do!

Can treatment wait?

Periodontal disease is a condition that needs to be addressed and treated as soon as possible. It is identified by tender, swollen gums, chronic bad breath that does not go away with oral hygiene, loose teeth, and ill-fitting dental prosthesis. If you notice any of these symptoms, you can call a periodontal office on your own to get in for an evaluation. Left untreated, periodontal disease quickly leads to gum recession, deterioration of the bone tissue, loose teeth, and eventually tooth loss.

When bone loss occurs, losing a tooth is almost inevitable. When a tooth is lost, bone deterioration is inevitable. These two conditions feed off of each other and create a domino effect of tooth loss, bone loss, additional tooth loss, and further bone loss.

Multiple studies show a link between periodontal disease and systemic health issues. Patients who develop periodontal disease are at a higher risk of developing heart disease, diabetes, and even cognitive function decline conditions like dementia and Alzheimer’s.

Do not wait to seek treatment for periodontal disease. Your dentist can help guide you to a periodontist that they know and trust. The two will work together to make sure that your smile is healthy for years to come.

Related Article: What is a Periodontist?