Most gum disease is treated in a general dental practice. A periodontist is a dentist with further training in gum and bone conditions, and there are cases where their involvement is the right call. But dentists and oral health therapists are trained to treat the majority of periodontal disease, and for most people that is where treatment begins and ends.
If you have been told you need gum treatment and you are unsure what to do next, ask us.
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What is a periodontist?
In Australia, "periodontist" is a protected title, used by a dentist who has completed three additional years of full-time postgraduate training in periodontics after a general dental degree.
Periodontists focus on the gums and the bone supporting the teeth. Their work includes advanced and aggressive forms of gum disease, surgical and regenerative procedures, gum grafting, and periodontal problems complicated by significant medical conditions. They also manage complex cases involving dental implants.
For the cases that need that level of care, there is no substitute.
What can a general dental practice treat?
A great deal more than most people assume — and this is where the confusion usually sits.
Gingivitis, early periodontitis and a large share of moderate periodontitis are routinely and effectively managed in general practice. That means periodontal charting to measure the pockets around each tooth, X-rays to assess bone levels, staging and grading the disease, non-surgical periodontal therapy under local anaesthetic, and a structured maintenance programme afterwards.
Berala Dental is a general dental practice. It provides periodontal treatment and does not have a periodontist on site. Treatment is carried out by dentists and oral health therapists, and where a periodontist is the better path, a referral is arranged.
"Only a specialist can treat this"
This is the belief that most often gets in the way, and it is worth addressing plainly.
Specialists are excellent, and there are cases that belong with them. But the idea that periodontal disease as a category can only be handled by a specialist is not accurate. Oral health therapists and dentists complete substantial training in periodontal assessment and non-surgical treatment, and it forms a core part of everyday practice.
Anyone quoted a large figure for gum treatment is entitled to understand what is being proposed and why, and to seek a second opinion. That is not a criticism of whoever gave the first one — two clinicians can look at the same mouth and reasonably propose different approaches. It simply means asking questions is reasonable.
How does the decision actually get made?
Not on a single measurement. It is a judgement based on the full picture: how much bone has been lost and how quickly, how the tissue responds to initial treatment, medical history, and whether there are complicating factors like a tooth that has become loose.
At Berala Dental the approach is straightforward. Treatment begins with a full periodontal assessment and non-surgical therapy, followed by maintenance appointments every three to four months. Progress is measured over roughly the first twelve months.
If stabilisation has not been achieved after about a year, or if the condition is clearly worsening despite treatment, a referral is arranged. Where a tooth is loose, a dentist assesses it and refers as required. And where a case is clearly severe from the outset, referral happens immediately rather than after twelve months of trying.
What is osseous surgery, and would you need it?
Osseous surgery is a periodontist’s procedure for reducing pockets that have not responded to non-surgical treatment. Under local anaesthetic the gum is lifted away from the teeth, the root surfaces and the bone beneath are cleaned directly under sight, uneven bone is reshaped so that the gum can sit closely against the tooth again, and the gum is stitched back at a lower level. The result is a shallower pocket that the person can clean at home and that a clinician can maintain, at the cost of some exposed root and, typically, more sensitivity for a period afterwards. In selected sites a regenerative material is placed to encourage some bone to re-form, though the general rule that lost bone does not come back still applies.
It is a surgical procedure and it is not carried out at Berala Dental. Berala Dental is a general dental practice providing non-surgical periodontal treatment and maintenance; where surgery is the appropriate next step, a referral to a periodontist is arranged. Whether a person would need it depends on how the pockets respond to the first phase of treatment. Most people do not: in most cases the deep clean and a maintenance programme bring the pockets down to a level that can be kept stable.
The situations where osseous surgery is generally considered are pockets that remain deep, usually 6mm or more, after non-surgical therapy and maintenance; bone that has been lost in an uneven, crater-like pattern around particular teeth; a case that has not stabilised after roughly twelve months of treatment; or disease that is severe from the outset. That is the same threshold at which Berala Dental refers, and the referral is made with the periodontal chart, the X-rays and the treatment record so the periodontist can see what has already been done.
What does treatment involve?
Non-surgical periodontal therapy — often called a deep clean — removes hardened deposits from below the gumline and smooths the root surfaces so tissue can reattach. It is done under local anaesthetic, usually across more than one visit depending on severity.
At Berala Dental the initial phase is $400 per quadrant, or $1,600 for the full mouth, all-inclusive, covering the OPG and relevant X-rays, full periodontal charting, staging and grading, the treatment itself, and oral hygiene instruction. Periodontal charting is included within that fee rather than added to it. Maintenance appointments then run every three to four months at $400 each, including relevant X-rays and an updated chart, and are not included in the $1,600.
After twelve months, patients whose condition has stabilised generally move to a six-monthly recall. All figures assume your health fund contributes nothing. Some extras policies contribute toward periodontal treatment and some do not; the amount is set by your fund, so it is worth asking them directly, and we can put a written quote against your policy first.
Want to understand what a quote you have been given actually covers? We are happy to talk it through.
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Why every three to four months?
Because hardened deposits return quickly in the months following treatment, and the three-to-four-month interval is set to interrupt that cycle before it re-establishes. The visit reassesses pocket depths, checks plaque and gum health, and updates the record of progress.
The first maintenance appointment is not an exam and is not something to be nervous about. It is the first look after treatment finishes, in a setting meant to be comfortable rather than testing. Some reduction in pocket depths and less bleeding is what is generally hoped for at that point.
Quick answers
Can a regular dental practice treat gum disease?
Yes. Dentists and oral health therapists are trained to assess and treat most periodontal disease, including gingivitis, early periodontitis and much of moderate periodontitis.
When should someone see a periodontist?
Commonly for advanced or rapidly progressing disease, where surgical or regenerative treatment is indicated, where a case is complicated by significant medical factors, or where a general practice has not achieved stability after roughly twelve months of treatment.
Is a periodontist better than a general dental practice?
Not better — differently trained, for a different group of cases. The question is which is appropriate for the individual mouth, and that is what an assessment establishes.
What if I have been quoted a very large amount for gum treatment?
Ask what the quote covers and why that approach has been recommended. Seeking a second opinion is reasonable and common, and a written quote should always be provided before treatment begins.
Finding out where you stand
A periodontal assessment answers the question with measurements rather than guesswork. Berala Dental has provided periodontal care in Berala since 2002.
If you would like a second opinion on a gum treatment plan, you are welcome to ask.
Call (02) 9649 6468 · Book online · WhatsApp
You can also read about deep cleaning and periodontal treatment, the difference between a regular clean and a deep clean, or how our fees work.
Written and reviewed by Humzah Aly, Oral Health Therapist. This article is general information only and is not a substitute for personalised dental advice. Please see a dental practitioner to discuss what is right for you.
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