At Mosaic Periodontics, our mission is simple: prevent unnecessary tooth loss whenever possible. In dentistry, the term edentulism refers to the loss of natural teeth. Unfortunately, some teeth are extracted when advanced periodontal treatment may have offered an opportunity to save them.

If your dentist has recommended tooth extraction and you are wondering whether the tooth may still be salvageable, scheduling a consultation with Dr. LaRisse Skene at Mosaic Periodontics in Salt Lake City can provide valuable answers. Every situation is unique, and a comprehensive periodontal evaluation can determine whether treatment options exist that may help preserve your natural teeth.

Comprehensive Periodontal Evaluation and Treatment Planning

Dr. LaRisse Skene performs a thorough review of your medical history, dental history, and clinical findings to ensure that any treatment is both safe and predictable. Following your examination, you will receive a diagnosis, prognosis, and comprehensive treatment plan tailored to your individual needs.

Dr. Skene completed both dental school and advanced specialty training in Periodontics and Dental Implant Surgery at the University of Pennsylvania School of Dental Medicine, one of the nation’s most respected dental institutions. During her specialty training, she also completed a fellowship in geriatrics and was mentored by Dr. Morton Amsterdam, widely recognized as the father of perio-prosthodontics. Upon graduation, she received the prestigious Morton Amsterdam Award.

In periodontal and implant dentistry, treatment success is not determined by surgery alone, but by how well surgical outcomes integrate with long-term restorative function. This is a defining principle at Mosaic Periodontics in Salt Lake City. Dr. Skene’s approach is clinically significant because it reflects a restorative-driven philosophy of periodontal surgery. Rather than treating surgical and restorative phases as separate disciplines, every treatment plan is developed with the final restorative outcome in mind from the beginning.

This integrated approach ensures that decisions made during periodontal surgery—such as osseous recontouring, implant positioning, grafting, and tissue management—are guided by long-term prosthetic stability, esthetics, and maintainability. By aligning surgical precision with restorative goals, treatment outcomes become more predictable, biologically stable, and functionally durable over time.

For referring dentists and patients, this means periodontal therapy is not just focused on eliminating disease, but on creating an optimal foundation for restorative success. This philosophy is especially important in complex cases involving implants, advanced periodontal disease, or full-mouth rehabilitation, where coordination between surgical and restorative planning directly impacts long-term prognosis.

Collaboration for Ideal Dental Implant Health

Today, many dentists throughout Utah rely on Dr. Skene’s expertise when managing complex periodontal cases. She frequently collaborates with restorative dentists, orthodontists, oral surgeons, and other specialists to coordinate treatment plans designed to achieve long-term stability and predictable outcomes.

Expertise in Advanced Periodontal Surgery

As a board-certified periodontal specialist who focuses exclusively on periodontal and implant-related procedures, Dr. Skene performs advanced surgical procedures every day, including:

• Dental extractions
• Dental implant placement
• Bone grafting and ridge augmentation
• Gum grafting and connective tissue grafting
• Sinus lift procedures
• Osseous surgery
• Treatment of peri-implantitis
• Cosmetic periodontal procedures
• Crown lengthening

Because these procedures are performed routinely, treatment is delivered efficiently and predictably. Surgical efficiency is associated with reduced tissue trauma, improved healing, and a more comfortable recovery experience for patients. Dr. Skene’s goal is always to provide the highest quality treatment with the least amount of discomfort possible while maintaining excellent long-term results.

Patients receive detailed post-operative instructions, specific to their unique medical history, and personalized guidance to ensure they are fully prepared for recovery and healing.

Saving Teeth Is Always the First Goal

One of Dr. Skene’s primary professional passions is saving teeth that others may consider hopeless. She has extensive experience diagnosing and treating periodontally compromised teeth and helping patients avoid unnecessary extractions.

Before proceeding with tooth removal, patients are encouraged to seek a periodontal evaluation to determine whether treatment options such as:

• Osseous surgery
• Bone grafting
• Gum grafting
• Regenerative periodontal therapy
• Orthodontic treatment coordination
• Implant disease treatment

may help preserve their natural dentition.

Many teeth that appear questionable on initial examination can often be stabilized and maintained for years when periodontal disease is properly diagnosed and treated.

When periodontal disease is treated surgically in cases with moderate pocketing (approximately 5–7 mm), teeth can often be predictably treated through procedures such as osseous surgery and regenerative techniques, including bone grafting where appropriate. These approaches allow for thorough debridement of infected root surfaces and recontouring or rebuilding of supporting bone, with the goal of restoring periodontal health and stability. When periodontal therapy is successful in reducing probing depths to 2–3 mm, the condition is generally considered to be well controlled and in a maintainable range of health. At this level, patients are typically able to sustain periodontal stability with consistent oral hygiene practices at home—primarily effective brushing and interdental cleaning, combined with ongoing professional maintenance therapy with a dental hygienist.

Achieving and maintaining these reduced pocket depths is a critical treatment endpoint, as it significantly improves the long-term prognosis of the dentition. Shallow, non-inflamed sulcus depths allow for better biofilm control, reduced bacterial reaccumulation, and a lower risk of future attachment loss when supported by regular periodontal maintenance care.

In more advanced cases with deeper pocketing (often 8–10 mm or greater), treatment becomes more complex and prognosis is more variable. While surgical therapy may still be possible in select situations, the ability to fully eliminate infection and regenerate lost support is sometimes limited by the extent of bone loss, root morphology, proximity to anatomic structures such as the maxillary sinus or neurovascular canals, and the risk of further reducing already compromised tooth support. In these cases, careful case-by-case evaluation is essential to determine whether tooth preservation is predictable, or whether alternative treatment options such as dental extractions or dental implants should be considered as part of a comprehensive long-term plan.

A Trusted Resource for Complex Cases

Dr. Skene has performed thousands of dental implants, periodontal surgeries, bone grafting procedures, and gum grafting procedures throughout her career. She has practiced full-time periodontics since 2008 and serves as an expert witness for Utah’s Professional Insurance Exchange (PIE), providing professional opinions on dental standards of care and complex clinical cases.

Her experience allows her to evaluate the entire mouth. Not just individual teeth, but to determine the most predictable path toward long-term oral health.

When teeth truly cannot be saved, Dr. Skene helps patients navigate replacement options using evidence-based treatment planning that prioritizes long-term function, esthetics, and stability.

The Connection Between Periodontics and Orthodontics

Periodontal health and orthodontic treatment are closely connected. Improper treatment planning, including incorrect extraction decisions, unmanaged periodontal disease, malocclusion, or failure to address underlying bone loss, can compromise long-term outcomes.

Dr. Skene has extensive experience treatment planning complex perio-ortho cases and works closely with trusted orthodontists and restorative dentists throughout Utah. By coordinating care among specialists, she helps patients achieve healthier gums, improved function, and more stable long-term results.

Whether you are considering orthodontic treatment, dental implants, gum grafting, or advanced periodontal therapy, a comprehensive periodontal evaluation can help ensure that your treatment is built on a healthy foundation.

Looking for a Second Opinion Before Tooth Extraction?

If you have been told that one or more teeth need to be extracted, schedule a consultation with Dr. LaRisse Skene at Mosaic Periodontics in Salt Lake City, Utah. A comprehensive periodontal evaluation may reveal treatment options that could help preserve your natural teeth and maintain your smile for years to come.  Early periodontal treatment with Dr.  Skene may help you avoid the need for dental extractions, implants and dentures.

At Mosaic Periodontics, our philosophy is simple: save teeth whenever possible, replace them only when necessary, and provide every patient with the information needed to make confident decisions about their oral health.  The transformation from disease to health is possible and predictable.

Successful periodontal treatment begins with an accurate diagnosis and realistic prognosis. Not all teeth have the same likelihood of long-term success. A tooth with a 90–95% projected survival rate may be worth preserving whenever possible, while a tooth with a significantly lower prognosis may be better managed with alternative treatment options.

Dr. LaRisse Skene helps patients understand the expected long-term outcomes of every treatment recommendation, including how the health of one tooth can influence adjacent teeth, supporting bone, future implant options, and overall oral function. By understanding the prognosis before treatment begins, patients can make informed decisions that maximize long-term tooth retention, minimize future complications, and preserve their oral health for decades to come.