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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.

Testimonials.

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Testimonials

If you want to know what I think of Dr. Afzali and her staff all you really need to know is that I live in Portland and I fly to San Diego to see Dr. Afzali for all my dental work. That might seem a bit extreme, and perhaps it is, but hear me out before you decide. A couple of years ago when I was living in the Bay Area I had to have one of my front teeth removed and dental implant inserted in its place by a dentist in the Bay Area. The implant looked a little shorter and darker than my other teeth, and even made my gum above it look a bit darker than the adjacent gum. In short, it didn't look natural. So I wasn't completely satisfied with how my smile looked, but I thought that was the best that could be done. It wasn't.

Last summer while I was in San Diego visiting my parents I went to Dr. Afzali for a routine cleaning. She examined my mouth and immediately asked me whether I was happy with the way my implant looked. When I said I wasn't, she explained that she could make it look better and possibly even indistinguishable from my other teeth. She was right. My implant looks just like my other teeth, and my gum is pink again. In fact, my new implant looks so natural that I sometimes forget it's an implant. I couldn't be happier. One final point. Dr. Afazli's entire staff is great. When I walk in they all make me feel like I'm the most important patient they have. And Julie is particularly great. Because I live in Portland my visits to Dr. Afzali's office had to me perfectly timed with receipt of the various parts necessary for my procedures. Julie made sure that everything arrived when necessary, without fail, so that no flights or appointments had to be rescheduled.

Riley P.

Recently, while on a trip from Canada to visit friends in San Diego, I broke a tooth. I phoned RB Dentistry and was given an appointment without delay. Dr. Mary Afzali was reassuring and professional and did an excellent job fixing the broken tooth. Her dental assistant, Marinette, was kind and gentle and made me feel comfortable throughout the procedure. Julie at Reception was welcoming, warm and made me laugh with her wonderful sense of humour and handled the insurance processing with no complications. Thank you so much Dr. Afzali, Mari and Julie for one of the most pleasant dental appointments I've had in a long time! Hope to see you in Vancouver, B.C. sometime!

Pam C.

I know I am in good hands with Dr. Afzali at RB Family Dentistry. The cavity fillings and tooth root fillings I got there were done so well that when I went to the Southwest College Dental Hygenist school to help out a friend, they could barely even detect the fillings! The teachers there were very impressed. At RB Family Dentistry, the staff and hygenists are friendly, organized and very knowledgable, and the Dr. always gives me as much time as I need and answers all of my questions. The office is beautiful and state-of-the-art. They never try to sell me on additional products or services that I don't need.

Scripps Ranch M

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RB Family & Cosmetic Dentistry
16776 Bernardo Center Dr. #105 San Diego, CA 92128
Phone: (858) 485-0044 URL of Map