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Periodontics & Oral Surgery of Manhattan Beach
Dr. Caden Lim, DMD, MPH

When to See a Periodontist

A Periodontist is familiar with the most advanced techniques necessary to treat periodontal disease and place dental implants.  Periodontists also perform a vast range of cosmetic procedures to enhance the smile to its fullest extent.

Referrals from General Dentists and Self Referral

There are several ways treatment from a Periodontist may be sought.   In the course of a regular dental check up, if the general dentist or hygienist finds symptoms of gingivitis or rapidly progressing periodontal disease, the need for improved esthetics involving the gums, finds growths or other irregularities in the mouth which may require a biopsy, a consultation with a Periodontist may be recommended.  However, a referral is not necessary for a periodontal consultation. Often patients ask their dentist or a friend for a referral for a Periodontist.

If you experience any of these signs and symptoms, it is important that you schedule an appointment with a Periodontist without delay:

  • Bleeding while eating or brushing – Unexplained bleeding while consuming food or during the course of daily cleaning is one of the most common signs of periodontal infection.

  • Bad breath – Continued halitosis (bad breath) which persists even when a rigorous oral hygiene program is in place, can be indicative of periodontitis, gingivitis or the beginnings of an infection in the gum tissues.

  • Loose teeth and gum recession – Longer looking teeth can signal recession of the gums and bone loss due to periodontal disease.  As this disease progresses and attacks the jawbone, (the anchor holding the teeth in place) the teeth may become loose or be lost altogether.

  • Infection in the tissues with pus – An active infection is often hard to self diagnose but the general dentist and Periodontist will check for its presence in the soft tissues, alveolar bone and periodontal ligament.

  • Related health conditions – Heart disease, diabetes, HIV or other immune-compromised conditions, rheumatoid arthritis, lupus, and osteopenia and osteoporosis are highly correlated with periodontitis and periodontal infections.  The bacteria infection can spread through the blood stream and affect other parts of the body.

Diagnosis and Treatment

Before initiating any dental treatment, the Periodontist must extensively examine the gums, jawbone and general condition of the teeth.  When gingivitis or periodontal disease is officially diagnosed, the Periodontist has a number of surgical and non surgical options available to treat the underlying infection, halt the recession of the soft tissue, and restructure or replace teeth which may be missing.

  • Gingivitis/mild periodontal disease – When the gum pockets exceed 4mm in depth, the Periodontist or hygienist may perform scaling and root planing to remove debris from the pockets and allow them to heal.  Education and advice will be provided on an effective cleaning regimen thereafter.

  • Moderate periodontal disease – If the gum pockets reach 4-6mm in length a more extensive scaling and root planing cleaning might be required.  This cleaning is usually performed under local anesthetic.

  • Advanced periodontal disease – Gum pockets in excess of 6-7mm are usually accompanied by bone loss and gum recession.  Scaling and root planing will usually be performed as the initial nonsurgical treatment.  In addition to those nonsurgical treatments, the Periodontist may recommend surgical treatment to reduce pocket depth.

  • Tooth loss – Where one or several teeth are missing due to periodontal disease, dental implants are an effective option.  If the bone is strong enough to provide a suitable anchor for the prosthetic tooth, the implant can be placed.  However, if the bone is severely eroded, bone grafts may be performed by the Periodontist to provide a suitable anchor for the new tooth/teeth.
  • Biopsy - This is a common, relatively quick procedure, as used in dermatology, to remove growths or tissue that are unusual in appearance.  The biopsied tissue is sent for pathologic examination and diagnosis, to ensure that a serious problem does not exist or is found at an early stage.

Ask your Periodontist if you have questions about periodontal disease, periodontal treatment or dental implants.