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Periodontal referral form

Periodontal referral form 2025

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The document is a Periodontal Referral Form used by dentists to refer patients for various periodontal treatments. It includes sections for patient and referring doctor information, reasons for referral, previous therapy history, potential tooth extractions, premedication requirements, radiograph instructions, restorative plans, and additional comments. The form also allows the referring dentist to specify communication preferences regarding the patient's care.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can you self refer to a periodontist?

You can refer yourself If you are concerned about your gum condition or have any questions please call and our reception staff will be pleased to help you. Alternatively please fill in the form on the Self referral page.

What happens in a periodontal appointment?

At the appointment well take your medical and social history and discuss your gum problem. Well examine your mouth. This includes checking your gums and teeth to assess inflammation and if you have any gum pockets (openings between your gums and teeth). You may also need to have X-rays.

How painful is a periodontal cleaning?

Heres a breakdown of some common treatments and their pain levels: Scaling and Root Planing (Deep Cleaning): This non-surgical treatment removes plaque and tartar buildup from above and below the gum line. Its generally considered painless, with some patients experiencing mild discomfort or sensitivity afterward.

When to refer to a periodontal specialist?

Here are some possible reasons your general dentist might refer you to a periodontist for more advanced periodontal treatment: You have a moderate or severe level of periodontal disease, with such symptoms as: Bleeding, swollen or receding gums. Loose teeth.

What does a periodontal exam consist of?

During the comprehensive periodontal exam, the dentist will evaluate the color, texture, and contour of the gums. Healthy gums are typically pink, firm, and tightly attached to the teeth. Signs of gingival disease may include redness, swelling, bleeding, and tenderness.

periodontist referral form

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What is a dentist referral form?

Your dental office likely uses referral forms to refer patients to other medical specialists. These forms contain basic information about the patient, their dental issue, and a potential treatment option that requires specialized care. Similarly, other medical professionals can refer their patients to your office.

What is a periodontal appointment?

Although every patient will have a slightly different experience, your first periodontal appointment will typically begin with a review of your dental and medical history. Next, they will examine your jaw joints, neck, and head, the structures in your throat and mouth and your gums and teeth.

What is a periodontal visit?

The periodontist will conduct a thorough examination, discuss treatment options, and create a personalized plan to address the patients periodontal needs. Periodontists are experts in treating gum and bone issues and helping patients achieve and maintain optimal oral health.