When to Refer to a Periodontist vs When to See a General Dentist

Knowing whether to see your general dentist or a periodontist can save you time, protect your smile, and often simplify treatment. Both professionals are essential members of your dental care team—but they focus on different problems. This guide explains how to tell the difference, which signs call for a periodontal specialist, and how general dentists and periodontists work together to keep your teeth, gums, and implants healthy for life.

General dentist vs periodontist: what each one does

General dentists are your primary care providers for oral health. They handle routine exams and cleanings, fillings, crowns, simple extractions, nightguards for grinding, and the overall coordination of your dental care. Think of your dentist as the hub: they manage prevention, diagnose common problems, and determine when a specialist will add value.

Periodontists complete several additional years of specialty training focused on the tissues that support your teeth and implants—the gums, periodontal ligament, and jawbone. They diagnose and treat all stages of periodontal (gum) disease, manage gum recession and esthetic soft-tissue concerns, perform regenerative procedures to rebuild lost support, and plan/execute implant therapy. They also treat complications around implants (peri-implantitis) and design long-term maintenance strategies for people with a history of gum disease.

When a general dentist is the right first stop

Start with your general dentist for the following:

• Routine prevention and maintenance. Semiannual checkups and cleanings for healthy patients, fluoride when needed, and coaching on brushing/flossing technique.
• Common tooth problems. Cavities, fractured fillings, worn teeth, and many crown/bridge restorations.
• Early gingivitis. Mild, reversible gum inflammation often improves with professional cleaning and better home care.
• Bite guards and minor sensitivity. Your dentist can often solve these without a specialist.

If your dentist sees risk factors or signs of deeper gum involvement—pockets, bone loss, recession, or mobility—they’ll often refer you to a periodontist for targeted care while continuing to oversee your overall treatment plan.

Clear signs you should see a periodontist

Consider a referral to a periodontist if you have one or more of the following:

1. Persistent bleeding or swollen gums. Bleeding that continues despite diligent home care can signal periodontal pockets and infection below the gumline.
2. Pocket depths ≥4 mm or bone loss on X-rays. These indicate attachment loss—damage to the support system that holds teeth in place.
3. Gum recession or a “longer” look to a tooth. Recession increases sensitivity and can progress; soft-tissue reinforcement may be needed. Learn how specialized grafting addresses this: Gum Grafting.
4. Tooth mobility, drifting, or spacing that wasn’t there before. These changes often reflect advanced periodontal breakdown.
5. Recurring infections or abscesses near the gumline. Pus, swelling, or a bad taste/odor can indicate active periodontal disease.
6. Complications around implants. Bleeding, deep pockets, or radiographic bone changes around implant fixtures require a specialist’s protocols.
7. Need for regenerative or surgical therapy. When pockets remain deep after initial therapy—or when the goal is to rebuild support—procedures such as pocket reduction or regeneration come into play. Read more: Pocket Reduction Surgery.
8. Complex esthetic concerns. Uneven gumlines, “gummy smile” cases needing crown lengthening, or delicate work in the front teeth benefit from a periodontist’s microsurgical training.

Typical referral scenarios—and why specialty care matters

• 1) Moderate–severe periodontitis
  If your dentist charts multiple sites with ≥5–6 mm pockets, bleeding on probing, or observes bone loss on X-rays, a periodontist designs a plan to arrest disease and stabilize support. This often begins with meticulous, quadrant-based cleaning below the gumline—formally called Periodontal Scaling & Root Planing—and a personalized maintenance schedule (often every 3–4 months). When deep areas persist, surgical access or regenerative procedures may follow to make the mouth easier to keep clean long term.
• 2) Gum recession and thin tissue (“fragile biotype”)
  Recession can expose root surfaces, cause sensitivity, and create esthetic challenges in the smile zone. A periodontist can thicken fragile tissue and reposition the gum margin through techniques like connective tissue grafting or tunnel approaches, protecting teeth and enhancing symmetry. See: Gum Grafting.
• 3) Peri-implant mucositis or peri-implantitis
  Implants can develop inflammation similar to gum disease. Early intervention—professional decontamination, prosthetic adjustments for cleanability, and in some cases laser or regenerative therapy—preserves the fixture and surrounding bone. For minimally invasive options that may be recommended in select cases, learn about Laser Periodontal Therapy.
• 4) Planning for implants or full-arch solutions
  When missing teeth compromise chewing or confidence, a periodontist evaluates bone quality, gum thickness, and smile esthetics, and coordinates with your dentist for the final crown/bridge or full-arch prosthesis. Explore an overview of implant therapy here: Dental Implants.

How your dentist and periodontist co-manage care

Great results are team results. Here’s how the partnership typically works:

• Diagnosis and plan. Your dentist identifies periodontal risks or changes and requests a specialty evaluation. The periodontist performs a comprehensive exam, including charting, imaging, and risk assessment (smoking, diabetes, family history, bite forces).
• Phase I therapy. Initial non-surgical treatment may be completed in either office depending on case complexity and logistics.
• Surgical/regenerative phase (if needed). The periodontist performs site-specific treatment to reduce pockets, correct defects, or enhance soft tissue.
• Restorative coordination. For crowns, bridges, or implants, the periodontist and dentist collaborate on emergence profile, contacts, and esthetics to ensure the final result is beautiful and easy to clean.
• Supportive periodontal care. After active therapy, you’ll follow a customized maintenance interval. Some visits occur with your dentist, some with the periodontist; the cadence is tailored to your risk level and keeps everyone in the loop.

“Do I need a referral, or can I schedule directly?”

Most patients can schedule directly with a periodontist—no formal referral is required. If you’re experiencing bleeding gums, recession, mobility, or discomfort around implants, you can book an evaluation and bring recent X-rays from your dentist (if available). The periodontist will share findings and coordinate your care back with your general dentist so nothing falls through the cracks.

What to expect at a periodontal evaluation

• Medical and dental history review. Systemic conditions like diabetes or medications that affect healing are considered, as are bite forces and clenching/grinding habits.
• Charting and measurements. Pocket depths, gum recession levels, mobility, and bleeding points are recorded to establish a baseline.
• Imaging. X-rays (and, when needed, 3D imaging) help visualize bone support around teeth and implants.
• Personalized plan. You’ll receive a step-by-step sequence—often beginning with non-surgical therapy—plus at-home instructions and a maintenance schedule.

Red flags that should not wait

Call for a periodontal evaluation promptly if you notice:

• Bleeding that won’t resolve with improved home care within two weeks
• Localized swelling or a pimple-like bump near the gumline (possible abscess)
• Teeth that feel looser or have started to move or create new gaps
• Tissue recession that’s progressing or causing sensitivity
• Bleeding, swelling, or tenderness around an implant—especially if it’s new or recently restored

Early treatment is simpler, more comfortable, and more predictable. Waiting allows infection and bone loss to progress—problems become harder (and costlier) to correct.

Cost, comfort, and long-term value

Specialty treatment is an investment in keeping your natural teeth and implants for the long haul. By controlling infection, reshaping deep pockets into healthy, maintainable contours, and reinforcing fragile tissue, periodontists reduce emergency visits and help you avoid tooth loss. Modern techniques emphasize minimally invasive care, precise instrumentation, and clear recovery instructions—most patients return to routine within days.

A simple decision framework

Use this quick checklist to decide where to start:

• No bleeding, healthy checkups, minor tooth issues? See your general dentist.
• Bleeding that persists, deep pockets, bone loss, or recession? See a periodontist for diagnosis and targeted therapy.
• Implant planning or implant problems? Start with a periodontist, then coordinate with your dentist for the final restoration.
• Unsure? Begin with your dentist; if findings suggest periodontal involvement, request a collaborative plan that includes specialty care.

The bottom line

Your general dentist and periodontist serve different—but complementary—roles. Routine prevention, fillings, and many restorations belong with your dentist. Persistent bleeding, deep pockets, bone loss, recession, and implant-related issues warrant a periodontal evaluation. When these professionals collaborate, you get care that’s precise, efficient, and designed to last.

If you’re noticing changes in your gums—or you simply want a specialist’s opinion—Dr. Rana Baroudi is here to help.