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When to See a Periodontist

A periodontist is a dentist specializing in the prevention, diagnosis and treatment of infections and diseases in the soft tissues surrounding the teeth, and the jawbone to which the teeth are anchored.  Periodontists have to train an additional three years beyond the four years of regular dental school, and are 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.

Periodontal disease begins when the toxins found in plaque start to attack the soft or gingival tissue surrounding the teeth.  This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial infection.  As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums.  The response of the body is to destroy the infected tissue, which is why the gums appear to recede.  The resulting pockets between the teeth deepen and if no treatment is sought, the tissue which makes up the jawbone also recedes causing unstable teeth and tooth loss.

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, a consultation with a periodontist may be recommended.  However, a referral is not necessary for a periodontal consultation.

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.
  • Gangrene in the tissues – Gangrene is 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, 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 regime 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 always be performed as the initial nonsurgical treatment.  In addition to tose 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.

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

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I WISH I COULD GIVE YOU 10 STARS!!!!
Omg!!! SOOOOO happy I found you!!!
I've had these 4 veneers on my front teeth for about 5 years, put on, again, and again and again, after pop offs and cracks and breaks, and several thousands of dollars, by another Santee dentist's office (won't mention who).
After about 4 years of miraculously no problems, I felt a familiar crunch while biting into a fish taco... I was so upset, I just froze staring at this tiny piece of porcelain in my hand. The tears starting welling up as I was reminded of the nightmares I often have of this exact thing happening on a date, or during a job interview... I knew I wouldn't be able to enjoy the rest of my mom's birthday lunch w my daughters, and luckily, I decided to drive myself. I held back the tears, apologized and asked that they wrap up the rest of my meal and I'll see you at home, and ran to my car, wanting to just vomit.... I'm not too vain, am I?
Not just for vanities sake, but the thought of coming up with another 2 grand to fix this, again, was taunting me! My head was spinning. I felt like I had been kicked in the jaw - literally.
First thing I did, after having a few glasses of wine to calm down, was do a search on Yelp. Dr. Fossett was the first to come up -- but still wanted to give my old office a chance, seeing as especially how They WERE THE ONES WHO PUT THE ORIGINALS ON. But, they offered no rest for my weary soul -- no discounts, no deals and no financing. And a replacement will cost @2000!!
I called Dr. Fossetts office next and was enchanted by Robyn, who understood my plight and offered all the help she could; gave me a rough estimate on cost (final cost was LESS than what she quoted!), and applied for Care Credit for me over the phone.
I could go on and on about how my appointment went -- didn't even have to sit or wait, was brought back for a consultation immediately. Not expecting to have everything even started the same day, the assistant and Dr. Dave came back in two minutes and said, let's get started!
Not more than 30 minutes later, I looked in the mirror to the most gorgeous "Temporary" veneer I have ever seen!! I mean, I'd be happy w this for years! The last office would spackle on this horrible looking crap that had no esthetically pleasing value at all!! THIS is a premier job!
And I'm a chronic perfectionist! Especially when it comes to my looks (hair, teeth, ect).
SO IF IM HAPPY, YOU BETTER KNOW THE JOB WAS STELLAR!!!
Thank you Dr. Fossett and staff-- THANK YOU!!!

Vanessa M.

Yesterday was my first visit to this wonderful Dental office. I haven't felt more welcome and comfortable in a Dental facility since I was 19... Now 31 years young. I grew up, going to a father/son dental group and Dr. David and Dr. Douglas Fossett had the same family centered vibe and conservative but smart dental care I've been searching for! As a Registered Nurse, quality care and patient centered care is the core of my own practice. Dr. David and Dr. Douglas exemplify this to a tee! I've finally found my go to family Dental office. I feel like a weight has been lifted off my shoulders after getting a second option from these very well informed Dentists!

Haylee R.

Great office!!! From the moment I walked in I felt very welcomed by the staff. I'm always nervous when going to the dentist no matter how many times I go, however after my visit to Dr. Fossett's office I felt much more relaxed and at ease. They did everything they could to make me comfortable. I felt the staff was very knowledgeable and answered any questions I had. The assistants are top notch . The smiles , kind hearts and exceptional service will keep me coming back. Thank you to the office for a positive experience.

Rachel Y.

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