Your first periodontal visit will consist of an evaluation. You will be asked about your dental/medical history. If you have medical problems, advise your periodontist, since many diseases can affect your mouth and gums.

You also should list any medicines you take, including oral contraceptives, because certain medications can adversely affect your gums or have contraindications for antibiotics. Antihypertensive medication can often cause xerostomia (dry mouth) that can accelerate decay and periodontal breakdown.

If you smoke, you will be advised to quit, particularly if you are undergoing gum surgery. Smoking, which increases the risk of periodontal disease, also worsens the disease if you already have it. It can also impair the healing process.

Your periodontist also will examine:

•Your head, neck and jaw joint(temporomandibular joints, or TMJ)

•Your mouth and throat

•Your teeth and gums

X-rays will be taken. A periapical X-ray - which reveals the entire tooth from crown (top) to the end of the root in your jaw - shows the amount and pattern of bone loss around each tooth. A panoramic radiograph - an X-ray of your entire mouth - shows other important skull structures, including the jaw joints.

Once the examination is complete, your periodontist will develop a treatment plan based on your individual wants and needs. Typically, following treatment you will be placed on a periodontal maintenance program.

In addition to a proper oral hygiene regimen of daily at-home brushing and flossing, this treatment plan will include regular follow-up examinations and cleanings, which are essential for the continued health of your mouth and gums. If you have gingivitis, many periodontists recommend visits every six months for a deep cleaning. For more serious conditions, see your periodontist every three months.

Choosing a Periodontist

An excellent way to find a qualified periodontist is to request a referral from your general dentist. Additionally, there are several points to consider when selecting a periodontist, including:

•How long has the periodontist been in practice?

•What continuing education and/or recertification courses has the periodontist taken? How recently have they been completed?

•What is the periodontist's diagnosis and proposed treatment plan? Ask about all the options for your periodontal condition, as well as the pros and cons of each. Periodontists have different treatment philosophies. While some focus on treating the disease aggressively with surgery, others prefer more conservative non-surgical alternatives. Make sure you fully understand why your periodontist recommends a particular treatment and that you feel comfortable with the proposed plan.

•What is the periodontist's training/clinical experience in performing the specific procedure(s) you need?

•What are the estimated costs of the proposed treatments? Does your periodontist accept your insurance? In cases where dental insurance does not cover treatment costs, does the periodontist offer third party and/or in-house financing?

•What types of dental technology/equipment does the periodontist's practice provide?

•What medication and pain-relief options are offered?

•Does the periodontist have a pleasant chairside manner, and is the staff accommodating and professional?

•Does the periodontist practice alone, or is he/she part of a multi-specialty dental group that can provide you with the one-stop oral health care? It is important to note that while these multi-specialty practices may offer convenience, they may not provide the finest specialists for the specific procedures you need, or give referrals outside of the practice.

•Who is part of your periodontist's referral network? If your periodontist works in collaboration with other dental/medical professionals on your case, you must have the same level of confidence in their professional expertise as you do in those of your periodontist. You also need to determine whether these dental/medical professionals accept your insurance, and whether the specific treatments they will perform are covered under your insurance plan. If laboratory-fabricated restorations are involved, is your periodontist satisfied with the work quality of the laboratory and/or technician?

•Are the office hours and location convenient for you?

•What type of emergency care is available?