Most people first hear about gum disease from their regular dentist. Many cases can be handled there. But when gum disease starts to affect the bone, or keeps coming back after treatment, a periodontist is usually the better next step.
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The short answer
See a periodontist if your gums keep bleeding or swelling, your gums are receding, a tooth feels loose or your bite has changed, or your dentist has found deep pockets or bone loss. The American Academy of Periodontology lists these as common reasons a general dentist refers a patient to a specialist.
| What you notice | Usually your dentist | Time to see a periodontist |
|---|---|---|
| Gums bleed when you brush | Early, mild bleeding that improves with cleanings and better home care | Bleeding that keeps coming back, or returns after a deep cleaning |
| Pocket depth at your checkup | 1 to 3 millimeters, the usual healthy range | Deeper pockets your dentist is watching or measuring again |
| Your gum line | Stable | Teeth look longer, or roots are exposed or sensitive |
| Your teeth and bite | Firm, no change | A loose tooth, teeth shifting, or a change in your bite |
| X-rays | No bone loss | Bone loss around the teeth |
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What a periodontist does differently
A periodontist is a dentist who specializes in gum disease, the bone that supports the teeth, and dental implants. According to the AAP, periodontists complete three additional years of education beyond dental school.
Many general dentists treat milder gum disease well. As the AAP notes, they often refer the more challenging cases to a periodontist. A periodontist can offer treatments a general office may not, such as laser therapy, gum recession repair, regenerative procedures, and implants.
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Early signs your dentist can usually handle
Gum disease usually starts as gingivitis: gums that are red, swollen, or bleed easily. The NIDCR notes that early gum disease caused by plaque buildup can often be reversed by daily brushing and flossing, along with professional cleanings.
If your gums improve after a cleaning and better home care, your regular dentist is usually the right place to keep treating it.
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5 signs you've crossed into specialist territory
1. Pockets deeper than normal
Your dentist measures the space between each tooth and the gum with a small probe. The NIDCR notes that healthy pockets are usually 1 to 3 millimeters, and deeper pockets can be a sign of periodontal disease.
2. Bone loss on X-rays
X-rays can show whether gum disease has started to affect the bone that holds your teeth. Bone loss is a sign the disease has moved past the gums.
3. Receding gums
Gums that pull back make teeth look longer and can leave roots exposed and sensitive. See our guide to treating receding gums.
4. Loose teeth or a change in your bite
When the supporting bone is damaged, teeth can loosen or shift. The AAP lists loose teeth and a change in your bite among the reasons for a periodontal referral.
5. Treatment isn't working
If bleeding, swelling, or deep pockets come back after a deep cleaning, it is worth a specialist's opinion on what else may help.
Higher-risk patients
The AAP also suggests a periodontist when you smoke, or have a personal or family history of conditions such as heart disease, diabetes, or osteoporosis.
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What happens at a first periodontist visit
A first visit reviews your medical and dental history, then a full gum exam: pocket measurements, recession, loose teeth, your bite, and X-rays of the bone. The AAP calls this a comprehensive periodontal evaluation.
At Sterling Periodontics, your consultation with Dr. Mohamed Khaled is free. You leave with a written treatment plan and a quote, so you can review it at home before deciding. Read more about what to expect at your first periodontist appointment.
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LANAP® laser therapy: when it's an option
For some patients with moderate to advanced gum disease, LANAP® is an option instead of traditional gum surgery. It is an FDA-cleared laser protocol that treats gum disease without traditional incisions. Whether it suits you depends on your exam.
Learn more about LANAP laser treatment, or read our guide to non-surgical and surgical gum disease treatment. The AAP also explains the non-surgical options that often come first.
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Gum recession: Pinhole vs. traditional grafting
Traditional gum grafting usually takes tissue from the roof of the mouth and stitches it over the receded area. The Pinhole Surgical Technique instead repositions your own gum tissue through a small opening, without a graft from the palate, for suitable cases.
See Pinhole gum recession treatment to watch Dr. Khaled explain the difference.
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How to choose a periodontist in Beverly Hills
A few questions make it easier to compare specialists:
- Are you board certified? A Diplomate of the American Board of Periodontology has completed the board's certification process.
- Which treatments do you offer? Ask whether laser therapy, recession repair, and implants are all available.
- Will I get a written plan? A clear plan and quote helps you decide without pressure.
- Do you take my insurance? Ask before your visit, and whether your plan needs a referral.
“Your first visit is a conversation, not a procedure. We send your plan in writing after, so you can think it over at home.”
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Next step
Dr. Mohamed Khaled is a board-certified periodontist on Wilshire Boulevard in Beverly Hills who treats only gum disease and dental implants. Your consultation is free, and same-day visits may be available. Call (310) 278-3666 or request a consultation.
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Frequently Asked Questions
Can my regular dentist treat gum disease, or do I always need a periodontist?
Many general dentists treat early or mild gum disease. A periodontist is usually recommended for moderate or severe gum disease, deep pockets, bone loss, receding gums, loose teeth, or when treatment is not working.
Will I need surgery, or is laser treatment an option for advanced gum disease?
It depends on your exam. Many patients start with deep cleaning (scaling and root planing). For some patients with moderate to advanced gum disease, LANAP laser therapy is an option instead of traditional gum surgery.
Does insurance cover a periodontist visit, or will I have to pay out of pocket?
Coverage depends on your plan. Sterling Periodontics is in-network with Aetna, Delta Dental, Guardian, and Humana, and your benefits are reviewed before treatment begins. Some plans require a referral. Your first consultation with Dr. Khaled is free.
Do I need a referral to see a periodontist?
Not always. Many patients are referred by their dentist, but you can also request a consultation directly. Check whether your insurance plan requires a referral.
What is a normal gum pocket depth?
In a healthy mouth, the pockets around the teeth are usually between 1 and 3 millimeters. Deeper pockets can be a sign of periodontal disease.
Sources
- American Academy of Periodontology: What is a periodontist? www.perio.org/for-patients/what-is-a-periodontist/
- National Institute of Dental and Craniofacial Research: Periodontal (gum) disease www.nidcr.nih.gov/health-info/gum-disease
- American Academy of Periodontology: Comprehensive periodontal evaluation www.perio.org/for-patients/gum-disease-information/comprehensive-periodontal-evaluation/
- American Academy of Periodontology: Non-surgical treatments www.perio.org/for-patients/periodontal-treatments-and-procedures/non-surgical-treatments/
This article is general education and does not replace a diagnosis or individualized treatment advice.
