What is a periodontist?
A periodontist is a dentist who has completed an extra two to three years of training at the University level, to specialize in the prevention, diagnosis and treatment of the inflammatory disease – periodontitis. The job of a specialist is to keep current in the latest techniques that relate to potential tooth loss, but also to enhance your smile and chewing ability. Since periodontal disease is not yet curable, only controllable, and dental materials and tissue engineering are constantly changing, there is always new information that can be used to assist you and your general dentist in achieving your goals.
What is periodontal disease?
This is an inflammatory process whereby the supporting structure of the teeth, the periodontal membrane and the bone are destroyed, eventually leading to tooth loss. This can be a long, slow process taking many years, or can occur very quickly. Risk factors include smoking or tobacco use, diabetes, clenching or grinding teeth possibly related to stress and medication use. Pregnancy, puberty, poor nutrition and other diseases can also play a role.
What are the symptoms of periodontal disease?
Sometimes there are no symptoms that lead you to seek a periodontal examination. Also, even after active treatment has been completed, the disease can recur since, like diabetes, it is only a controllable disease process. That’s why your diagnosis may have come as a surprise and you may not have had any symptoms. In other cases, patients note that they have experienced bleeding, swollen gums, or even dental pus since their last dental cleaning. Persistent bad breath that does not respond to better home care, recession of tissue or pulling away of the gums from the teeth may also be significant. Loose teeth or a change in the way the teeth come together when biting may be important factors and should be reported to your dental professional.
When should I have a periodontal exam?
An examination usually occurs every time you visit your dentist or hygienist. If you are not sure if the exam has occurred, please ask. If you have not seen a dental professional for some time, any of the above symptoms should lead you to seek an evaluation. The initial exam is usually completed by a general dentist to determine the severity of the disease. If significant loss of tooth support has occurred, you will be referred to a periodontal specialist. A full series of x-rays will be needed for any professional to help evaluate your status.
What will happen at my first visit to the periodontist?
First, a full medical and dental history will be necessary. Past and present medical and dental treatment, medications, home care routine and habits will be discussed. Please be prepared with a list of current medications and your physicians name and contact information. Also, if you require premedication due to artificial valves or joints, heart murmurs, severe diabetes or hypertension, please inform us of such and take your antibiotics as prescribed. Remember to bring your insurance card if you have one since we will take a copy for your records. A complete set of current x-rays will be needed for the evaluation. If you do not have one, our office will be happy to take the x-rays and provide another copy for your referring dentist. The amount of bone loss, tissue loss and mobility of the teeth will be precisely charted. Your bite will be evaluated. Depending of the condition of your gum tissue, the exam should be relatively painless. If your gums are very inflamed, topical medications can be used to make the exam easier for you. Just ask for medication if you feel you would benefit from its use. A treatment plan will be developed with you and your dentist to restore the health of your gums. If you are a minor (under age 18) you must be accompanied by a parent or guardian at your appointments.
What will periodontal treatment cost?
Your periodontist must complete your examination before establishing your treatment plan and therefore, cost. The fee for treatment will vary considerably depending on the type of treatment and complexity. Usually, the fee can be determined at the consultation visit, however, in more complex cases, treatment is divided into phases and further diagnosis will be needed to determine the cost of the next phase. We will make every effort to inform you if you fit into the more complex case category so that you will know that further fees may apply. We will treat you as conservatively as possible but our mutual goal is to help you save as many teeth as possible for your lifetime.
Will my insurance cover the cost?
Depending on your company and level of coverage, all, some, or none of your treatment may be covered. We make every effort to help you in all phases of your experience with Coast Periodontics to help you know your out of pocket expenses and we pride ourselves on being good liaisons to your insurance carrier.
Does all periodontal treatment mean surgery of my gums?
Not necessarily. There are many levels of the disease process. In the early stages, better home care, possibly a bacterial sample of the tissue fluid around the teeth and antibiotic treatment and more precise dental cleaning may be enough to restore gum health. In more severe cases, deep cleaning or root planing in the four quadrants of the mouth is needed, with or without antibiotic treatment. Bite therapy, either an adjustment of the existing bite or the use a night guard or day guard may be part of initial or phase I treatment. After either of the above treatments, a reevaluation of therapy is completed, usually within six weeks of completion. If periodontal surgery is needed, it is discussed at this phase.
What is periodontal surgery?
There are many different types of surgery. The first is performed to eliminate hiding places for bacteria under the gum line. Sometimes this requires removal of gum tissue and the subsequent “longer tooth” look. At other times, bone regeneration is possible, leaving the relationship of the tooth to the gums intact. The latest product that we use to achieve this goal is GEM 21S from OSTEOHEATH. You can read more about this product from their website www.osteohealth.com . Esthetic surgery is also possible to achieve the SMILE you have hoped for. This can include adding more gum tissue to a tooth that is too long or removing tissue if you have a GUMMY smile. Also, if a tooth has broken off at the gum line, surgery can be performed which will expose more tooth so that a dental crown can be made.
What are the pre and postoperative instructions?
For all surgery, we suggest that you plan on going home afterward. If you have not taken an oral sedative, you will be able to drive yourself. You should come with a full stomach since your next few meals will be softer food. We do not use general anesthesia so, the full stomach is OK. Pre and postoperative medications will be discussed with you prior to your procedure since you may be asked to start one or more of these prior to surgery day. The duration of the surgery will be dependent on your needs and can be discussed with Dr. Sayre-Carstairs when your appointment is made. Postoperative discomfort is different for everyone, but we will make every effort to have you be as comfortable as possible. With the use of the Biolase laser, procedures are less invasive and therefore tend to be less uncomfortable.
What happens after I have completed my treatment at the periodontal office?
Supportive treatment is very important. Since periodontal disease is not curable, it can recur at any time. Good home care, including brushing, flossing and the use of the WaterPik or perioaid is mandatory. Routine dental cleanings and checkups at a three month interval are necessary to monitor your periodontal health. These periodontal cleanings are completed by the dental hygienist. Any new gum changes are reported to the periodontist for determination of the next potential step of treatment.
What happens if I do not choose to have periodontal treatment?
Statistically, tooth loss will occur over time if you allow the bacteria and their toxins to go unchecked. How long that will take is unknown and varies with different patients. If you smoke or are a diabetic, the chances are that you will lose teeth faster than if you do not have either of these situations.
Can I prevent periodontal disease?
There is data to suggest that periodontal disease is one of the most prevalent diseases in humans and may have a genetic component. Good brushing, flossing and routine dental cleanings can reduce the severity of the disease process, but cannot prevent the actual disease.
Dr. Lynn C. Sayre-Carstairs Office Locations
The SLO office is convenient to the 93401 zip code and surrounding areas. The address is:
The San Luis Obispo Periodontist Office can be reached at (805) 545-9400.