Frequently Asked Questions

Below are answers to questions many of our patients have asked us. Simply click on the question you have to be taken to the answer. If you have a question that does not appear below, please do not hesitate to contact us.

What is periodontal disease?

Periodontal disease (commonly known as gum disease or pyorrhea) is an ongoing infection or inflammation in the gums around your teeth. The cause of this disease is bacteria which gets into your gums. This infection starts destroying the bone which supports your teeth. If left untreated, it can lead to tooth loss.

What are the consequences of periodontal disease?

When your gums and bone are damaged by periodontal inflammation or infection, there is less support for your teeth. As this support disappears and pockets form around the teeth, plaque and debris will accumulate causing bad breath, red, swollen and bleeding gums. Eventually the teeth will become loose and then can be lost due to unrestorable damage.

The lost teeth will have to be replaced with dental implants, bridges, partial or full dentures. When treatment is recommended, it is important to get started as soon as possible.

Are there medical consequences if I delay treatment?

When periodontal causes breakdown of the gums, bacteria can then be released into the bloodstream. From there it travels to other parts of the body and can contribute to medical problems. Research has shown that patients with periodontal disease are more likely to have these medical problems:
- Heart disease & Heart attack: 2.7 times higher risk.
- Stroke: 3 times higher risk.
- Pre-Term Childbirth: 7-8 times more likely to have premature baby.
- Diabetes: causes a raise in blood sugar & when treated reduces need for insulin.
- Respiratory Disease: can lead to pneumonia, bronchitis and emphysema.
- Your Bacteria can be Transmitted: from parent to child or spouse to spouse.

Risk Factors include:
- Chronic Stress
- Smoker
- Sedentary and Overweight
- Frequent Colds, Flu, etc

Periodontal disease is a progressive, painless infection. Delay can cause you further bone loss and more expense. If your teeth are lost, dentures are never as effective as your own teeth.

What are the symptoms of periodontal disease?

Many times, there are no symptoms, especially in the early stages of the disease. As the disease progresses, you can have some of the following symptoms:
- Red, swollen or tender gums
- Tooth sensitivity to hot or cold
- Bad breath
- Deep pockets around the teeth
- Spaces between the teeth
- Loose or shifting teeth
- Receding gums around the teeth (longer looking teeth)

Why, all of a sudden is my dentist sending me to a periodontist?

Patients with periodontal infection have lowered resistance to periodontal bacteria. This causes a continuing gum infection which can grow in "bursts". Some factors which can cause a dramatic exacerbation of your periodontal disease are:
- Poor Oral Hygiene
- Smoking
- Genetic factors
- Stress
- Diet
- Age
- Illness
- Lack of regular dental cleanings

When you have a "burst" of growth or when there are signs that this may occur, periodontal treatment may be recommended. Periodontists have advanced training in the treatment of periodontal disease and dental implants, therefore your general dentist will refer you when he/she feels that the disease has progressed beyond their capabilities of therapy.

Our office and your Dentist will work closely together. If crowns and fillings are needed your Dentist will provide them. Regular visits to your Dentist are an important part of periodontal maintenance.

Why must I start treatment right away?

Since periodontal disease grows in "bursts of activity", it is important to eliminate the bacteria causing the disease as soon as possible to prevent irreversible damage of the supporting structures of your teeth.

Do I need x-rays?

We will need current periodontal x-rays in order to see disease not otherwise visible. If your referring dentist has taken x-rays, you may request that they be forwarded to us.

How is periodontal infection treated?

There are several different treatments for periodontal disease depending on the severity and location of the disease. The treatment goals are to remove the infectious bacteria, restore lost bone, gingiva or teeth, create a cleansable environment and prevent its recurrence.

Does periodontal treatment hurt?

One of our primary concerns is that you have a comfortable experience during treatment. Motrin and Tylenol are usually all the post operative pain relief required. If this is not sufficient to minimize discomfort, stronger medications are also available.

We will be as gentle as possible. The periodontal exam can be completed with little or no discomfort.

What is going to happen on my first visit?

During your first visit, you will receive a comprehensive periodontal evaluation. Afterwards the findings and options for treatment will be thoroughly explained. In addition, Dr. Raez will answer any questions you may have.

Please assist us at the time of your initial visit to the office by providing the following information:

Your referral slip and x-rays from your referring dentist.
A list of medications you are currently taking (please note that you can fill out your patient registration and medical history form on this web page.)
If you have dental insurance, please bring any forms or insurance cards with you to the appointment.

Please Note: All patients under 18 must be accompanied by a parent or guardian at the consultation appointment.

Please notify the office if you have a medical condition or concern prior to surgery (e.g. artificial heart valves or joints, heart murmurs requiring pre-medication, severe diabetes, or hypertension.)

We will complete an in depth medical and dental health history and a thorough examination to measure for bone loss, loose teeth, bite, oral cancer screening, TMJ and other signs of periodontal disease.

What are implants?

Dental implants are artificial replacements of natural tooth roots. They attach firmly into the gum and jawbone, becoming quite solid after 4-6 months of healing. Implants act as an anchor for crowns to replace missing teeth. They also serve to retain partial or full dentures and prevent further bone loss from the pressure of the dentures. The advantages of dental implants are:
- Most advanced tooth replacement system ever devised
- Help preserve the jawbone to prevent the appearance of premature aging
- Allow you to eat the foods you love and talk, smile and laugh with confidence
- Never develop decay nor require root canals, but can develop periodontal disease
- More attractive appearance
- Speech improvement
- Greater comfort

The success rate of implants are 90-98% for nonsmokers and should last a lifetime. Smokers have 2x greater risk of failure of the implants. The procedure is done under local anesthesia and usually has very little post operative discomfort.

Will I need surgery?

Not everyone needs periodontal surgery. If treated early, gum disease can be controlled without surgery. We will make recommendations based on your individual situation. Our philosophy of practice is to treat as conservatively as possible to attain treatment goals.

Do you use the latest equipment and techniques?

We keep ourselves up to date regarding equipment and surgical techniques. You are guaranteed to receive the state-of-the-art care. Regarding sterilization, we believe that all procedures should be safe as well as comfortable. We use only the latest sterilization techniques.

How much will my treatment cost and will insurance cover it?

Everyone deserves to keep their natural teeth for a lifetime. While periodontal treatment is not as costly as replacing natural teeth due to tooth loss, its cost can vary greatly depending upon your needs. If you have dental insurance, this may provide full or partial coverage. We will assist you in filing for insurance reimbursement. Please understand, however, that you are ultimately responsible for payment of all services. Should your insurance not cover what is predicted, then you will be responsible to pay any uncovered portion. We feel that finances should never be an obstacle to treatment. For your convenience, we offer several payment options. We have payment plans to suit your individual needs. Our business manager will be happy to answer any of your financial or insurance questions.

Do you work with my general dentist regarding my periodontal care?

Your general dentist knows your entire dental history, the condition of your teeth, and your future dental needs. He/She is in charge of your overall dental care. We work closely with him or her to ensure you receive the best possible dental care. In many cases, your general dentist may do your preliminary periodontal treatment and a portion of your periodontal maintenance afterwards.

What will it cost?

Since all patients are different, your Periodontist must complete your examination before establishing your treatment plan and the fee for care. The fee for periodontal treatment can vary considerably depending on the type of problems and the complexity and length of treatment. An approximate fee can usually be determined at the initial visit; but on occasion, some initial treatment or further diagnostics must be completed before the final treatment plan can be established. Our philosophy of practice is to treat as conservatively as possible to attain treatment goals.

What are your Payment Options?

Oakwell Periodontics, P.A. is a fee-for-service practice. Most insurance plans are accepted as partial payment. In addition, we accept all major credit cards and financing can be arranged through Care Credit. You can apply for Care Credit at or by calling toll free (800) 365-8295. We will be glad to discuss these options with interested patients.

Our insurance coordinators deal with many different insurance companies. Some companies offer many different dental plans. These companies can change benefits, co-pays and deductibles many times throughout the year. We do our best to provide you with accurate coverage estimates based on information available to us. At times, it is almost impossible to accurately estimate our patients' insurance co-payment. Many insurance companies will not give out fees until after the treatment is completed. Dealing with these companies can be difficult and time consuming. As a courtesy, we ask that you keep us informed of any change to your insurance. It is important that all information about you and your insurance is current. Further, most dental insurance policies are limited and often only pay for a portion of the procedure(s) that may need to be done.

As a courtesy to our patients with dental benefit plans, we will submit necessary claim forms, receipts, and other information to your insurance company prior to your treatment to obtain a pre-determination of what your insurance will cover. Therefore you will only pay your portion at the time of treatment.

Will my Insurance cover the cost?

Dental insurance policies often cover periodontal treatment. Please bring all dental benefit information and cards to your examination appointment. Upon request, we will submit a claim to predetermine your insurance benefits; however, this is not required by most plans.