Frequently Asked Questions About Periodontics

Periodontal (gum) disease is an ongoing bacterial infection affecting the gums and bone supporting the teeth. Periodontitis is a chronic inflammatory disease which means inflammation around your teeth slowly erodes their supporting bone. When supporting tissue and bone is destroyed, periodontal pocketing occurs around the teeth. Periodontal measurements aid in determining the extent of bone loss and your access to properly clean your teeth on a daily basis. Healthy pocket depth measurements range from 1 to 3mm.

Periodontal disease can affect one or several teeth. If left untreated, this can lead to tooth loss or potential health risks associated with diabetes, heart disease, prosthetic joint replacement, and pregnancy.

Why am I being referred to you?

A referral is made to a periodontist for highly specialized treatment of the gums and bone or dental implants. Your referring dentist feels you will benefit from the expertise of a periodontal practice. Our periodontists work closely with your referring doctor to ensure you receive optimal periodontal care and dental care.

What can I expect at my first appointment?

The first appointment is with our periodontist, Dr. Paulson or Dr. Ramirez. At this initial visit, we will obtain a complete health history, evaluate records from your referring dentist, and perform a thorough periodontal exam to obtain current clinical findings in our office. Additional x-rays may be necessary to make an accurate diagnosis. Treatment recommendations will be discussed with you, taking into consideration how it will affect the rest of your dentition and overall health.

What causes periodontal disease?

The cause of periodontal disease is bacterial plaque that is consistently forming on your teeth and your body’s response to this bacteria. Lack of dental care and improper homecare is a contributing factor for the disease to develop. There are other factors which can increase your susceptibility to periodontal disease such as smoking, genetic predisposition, diabetes, and pregnancy. Certain medications, hormonal fluctuations, clenching/grinding, and stress can also negatively influence periodontal disease.

Why do I need periodontal scaling and root planing?

Bacterial plaque and hardened deposit accumulations below the gumline cause destruction to the tissue and bone which leads to periodontal disease and pocketing. These pockets cannot be cleansed with normal homecare or even routine professional methods. The goal of this initial therapy is to coach you with your homecare, reduce inflammation, and remove deposits. Scaling and root planing requires multiple, 1-2 hour appointments with the hygienist to thoroughly debride below the gumline. Most times, local anesthetic is used for this procedure.

What is the difference between a regular cleaning/prophylaxis and a periodontal maintenance?

When a routine dental cleaning is performed, the clinician is removing plaque and debris on the tooth structure above the gumline. Patients with periodontal involvement, pocket depths of 4mm and greater, need periodontal maintenance following periodontal therapy to thoroughly clean those deeper pockets as well as the tooth structure above the gumline. Site specific scaling and root planing, where indicated, and polishing are part of the periodontal maintenance.

Why do i need to have my teeth cleaned every 3 months?

The bacteria in the mouth recolonizes in approximately 90 days starting the destruction process. In an effort to maintain healthy pockets and interrupt the formation of bacteria, a three month periodontal cleaning is the usual recommendation. This also gives us the opportunity to monitor your periodontal health.

Why is periodontal surgery necessary?

Following periodontal scaling and root planing, your pocket depths will be reevaluated to determine whether surgery is necessary. If surgery is not indicated, a regimen for your periodontal maintenance will be determined. Deep pockets that persist are best treated with pocket reduction surgery. The surgical procedure will be explained to you based on your individual needs. Reducing pocket depths and recontouring of the soft and hard tissues will enable better homecare and control the disease process for better long-term results. After surgery, regular periodontal maintenance with the dental hygienist will still be necessary to maintain the health of your mouth.

What forms of anesthetic or sedation are used?

Local anesthetic, commonly referred to as Novocaine, is the most commonly used numbing agent. If desired, nitrous oxide or oral sedation can be provided. If you wish to have oral sedation, a responsible adult must accompany you to your appointment, remain in the office during your procedure, and drive you home after surgery.

Does your office accept my insurance?

We are happy to directly file claims and necessary forms to the appropriate insurance company. Keep in mind that each employer designs their own insurance plan and coverage can vary dependent on the plan. Please contact your insurance company or review your policy to find out the specifics of your plan. Upon request, we will send a predetermination to your insurance company to determine benefits.