FAQs

Periodontal Surgery Experience for Complex Gum and Implant Conditions

When considering periodontal surgery, gum grafting, or dental implant treatment, experience matters—especially when care involves esthetic concerns, complex anatomy, bone loss, or a failing tooth or implant.

Dr. LaRisse Skene has practiced full-time periodontics since 2008, focusing exclusively on periodontal surgery, gum grafting, dental implants, bone grafting, ridge augmentation, and complex periodontal and implant conditions. Because she performs these procedures every day, she has developed a refined surgical approach designed to achieve predictable results while preserving as much healthy tissue as possible.

Gum Grafting for Gum Recession and Exposed Roots

Gum grafting is a procedure Dr. Skene performs every day.

With many years of clinical experience, Dr. Skene performs thousands of surgical procedures each year, including soft-tissue grafting for gum recession, exposed tooth roots, thin gum tissue, and esthetic concerns.

Her approach to gum grafting goes beyond covering exposed roots. She evaluates the thickness and quality of the existing gum tissue, the position of the tooth, the surrounding bone, and the esthetic demands of your smile. Her goal is to create a natural, stable result while preserving the delicate tissue architecture around neighboring teeth and implants. She offers traditional connective tissue grafts and the conservative pin-hole root coverage procedure when appropriate.

Treating Failing Dental Implants and Peri-Implantitis

Dr. Skene routinely evaluates ailing and failing dental implants, including implants affected by inflammation, infection, bone loss, or changes in the surrounding gum tissue.

The first step is an accurate diagnosis. Dr. Skene evaluates your implant clinically and with appropriate imaging to determine whether inflammation is limited to the soft tissue or whether supporting bone has been lost.

If you have peri-implant mucositis, inflammation is limited to the soft tissue surrounding the implant, and the prognosis can often be favorable with appropriate conservative treatment.

If you have peri-implantitis, bone loss has occurred around the implant and treatment becomes more complex. Depending on the amount and location of bone loss, treatment may include surgical therapy, bone regeneration, implant removal, or replacement.

Dr. Skene believes you should understand your options before treatment begins. She evaluates the condition of the implant, the surrounding bone and soft tissue, and the long-term prognosis so you can make an informed decision about whether the implant can be saved or whether replacement offers a more predictable outcome.

Bone Grafting and Ridge Augmentation for Dental Implants

Dr. Skene performs bone grafting and ridge augmentation procedures every day and has extensive experience rebuilding the bone needed for dental implant placement.

Her philosophy is conservative: preserve existing bone whenever possible and augment only when necessary.

When the jawbone has narrowed or lost height after tooth loss, ridge augmentation can restore the bone volume needed for stable, long-term dental implant results. Dr. Skene uses a minimally invasive approach designed to protect the surrounding soft tissue and esthetic anatomy. Her goal is to preserve papilla during bone grafting whenever possible.

She also performs sinus augmentation procedures, including lateral-wall sinus lifts, when additional bone height is needed in the upper jaw. These procedures can create the foundation necessary for predictable implant placement while helping preserve the surrounding natural teeth.

Atraumatic Tooth Removal and Bone Preservation

Complex tooth removal requires considerably more than simply extracting the tooth. It requires experience to manage all situations including maxillary sinus proximity, mandibular nerve proximity, avoiding damage to neighboring bone, papillae, teeth and restorations.

Dr. Skene frequently treats teeth that have become brittle following failed root canal treatment or teeth located close to important anatomical structures such as the maxillary sinus or mandibular nerve.

Her surgical approach emphasizes atraumatic tooth removal and preservation of the surrounding bone and soft tissue. Using specialized instruments and techniques, she can section difficult teeth into smaller segments when necessary rather than placing excessive force on the surrounding structures.

Preserving the bone and soft tissue during extraction can help protect neighboring teeth, maintain the natural contours of the gums, preserve the papillae, and create a better foundation for future dental implants when replacement is necessary.

Papilla Preservation in Esthetic Periodontal and Implant Surgery

The papilla is the small triangular portion of gum tissue between teeth. Although it may be easy to overlook, it plays an important role in the appearance of a natural smile and the esthetic outcome of implant treatment.

Dr. Skene has devoted years of advanced periodontal training to tooth preservation, bone grafting, soft-tissue grafting, and esthetic periodontal and implant surgery. Her surgical philosophy places particular emphasis on preserving the papilla and maintaining the natural architecture of the gums whenever possible.

For patients seeking gum grafting or dental implant treatment in the esthetic zone, these details can make a significant difference in the final result.

A Conservative Approach to Periodontal and Implant Surgery

Not every missing tooth requires extensive bone grafting, and not every failing dental implant needs to be removed.

Dr. Skene begins with a detailed diagnosis and considers the least invasive treatment capable of achieving a predictable long-term result. When surgery is necessary, her goal is to preserve healthy bone and soft tissue, protect the papillae, minimize trauma, and create the best possible environment for healing.

For complex periodontal and implant problems, experience is not simply about how many procedures a surgeon has performed. It is about knowing when to intervene, when to preserve, and which treatment approach offers the best long-term outcome for your individual anatomy and goals.

Understanding Your Periodontal Prognosis and Chances of Treatment Success

What Are My Chances of Success?

If you are considering periodontal treatment, you deserve more than a recommendation. You deserve to understand why treatment may be recommended, what it is intended to accomplish, what alternatives may exist, and which factors can influence your long-term outcome.

A periodontal evaluation with Dr. LaRisse Skene can provide a clearer picture of your gum health, supporting bone, teeth, and dental implants. During your evaluation, she will assess your periodontal condition, identify areas of infection or bone loss, and explain how your findings may affect your treatment options and prognosis.

Because every patient has different anatomy, bone levels, gum tissue, oral hygiene habits, and medical and dental history, there is no single success rate that applies to everyone. Instead, Dr. Skene develops an individualized prognosis based on the factors specific to your teeth, gums, bone, and implants.

Her goal is to help you make an informed decision—not to promise a particular result.

What Can I Learn From a Periodontal Evaluation?

A periodontal evaluation can help answer important questions about your oral health, including:

• Whether you have periodontal disease or another gum-related condition
• How much bone and supporting tissue may have been affected
• Which teeth or implants may require treatment
• Whether your condition may be managed with nonsurgical care, surgical treatment, or ongoing monitoring
• What may happen if treatment is delayed
• How your home care and periodontal maintenance may affect your long-term outcome
• Whether additional dental or medical factors should be considered

Understanding these factors early may help you address periodontal disease before it causes more extensive damage. An evaluation does not obligate you to proceed with treatment. It gives you information you can use to make decisions that are appropriate for your health, priorities, and circumstances.

What Is My Prognosis Without Treatment?

One of the most important questions to ask is not only “What happens if I have treatment?”, but also “What may happen if I do nothing?”

Untreated periodontal disease can continue to damage the bone and tissues supporting your teeth. As bone loss progresses, periodontal pockets may become deeper and more difficult to clean, increasing the risk of persistent inflammation, infection, tooth mobility, tooth loss and damage to adjacent sinuses and nerves.

The rate and extent of progression vary from person to person, and some patients may have few noticeable symptoms. That is why a professional evaluation is important, particularly if you have bleeding gums, persistent bad breath, gum recession, loose teeth, changes in your bite, or a history of periodontal disease.

Dr. Skene will explain what may be expected if your condition is monitored, treated conservatively, or treated surgically. This information can help you weigh the potential benefits and limitations of each approach.

What Is My Prognosis With Treatment?

Prognosis means what we can reasonably expect for the future based on your current condition and available treatment options.

Dr. Skene evaluates the prognosis of each tooth and implant—not simply the overall condition of your mouth. She considers factors such as bone loss, periodontal pocket depth, gum tissue, tooth anatomy, mobility, existing restorations, infection, smoking, systemic health, and your ability to maintain the area after treatment.

Her goal is to help you understand:

• Which teeth may be maintainable with appropriate care
• Which teeth or implants may require periodontal treatment
• Which areas may have a guarded or poor prognosis
• What treatment may improve the likelihood of maintaining a tooth or implant
• What limitations or risks may remain after treatment
• What may happen if treatment is delayed
• How each tooth or implant fits into your long-term oral health plan

This comprehensive approach helps you make decisions based on long-term tooth and implant preservation, rather than simply treating the most obvious problem.

What Factors Affect the Success of Periodontal Treatment?

The outcome of periodontal treatment depends on more than the procedure itself. One important factor is whether the treated area can be kept clean and maintained over time.

Creating access for effective home care is a major component of periodontal treatment.

Dr. Skene may recommend treatment intended to reduce inflammation, control infection, improve access for cleaning, or address damaged gum and bone tissue. In some cases, reducing periodontal pocket depths may make daily brushing, interdental cleaning, and professional periodontal maintenance more effective. Pocket depth goals vary by patient and by location, and no specific measurement guarantees long-term health.

The anatomy of your teeth and bone, the severity and extent of periodontal disease, smoking or tobacco use, oral hygiene, inflammation, systemic health factors, medications, genetics, and your commitment to ongoing periodontal maintenance can all influence the long-term outcome.

A periodontal evaluation helps identify which of these factors may apply to you and what steps may support a more favorable prognosis.

Why Treating Bone Loss Early Matters

Early evaluation and treatment of periodontal disease may help preserve natural teeth and reduce the risk of more complex treatment later.

As periodontal disease progresses, bone loss can affect multiple teeth and may involve important surrounding anatomical structures. Advanced bone loss can make treatment more complex and may affect the ability to preserve a tooth or place a dental implant predictably.

Dr. Skene’s periodontal training allows her to evaluate the entire periodontal environment, rather than focusing only on an individual tooth or isolated pocket. Her goal is to identify disease, control infection and inflammation, preserve healthy bone and gum tissue when possible, and help prevent periodontal disease from progressing unnoticed.

Even when periodontal disease is advanced, an evaluation can clarify what may still be treatable and what options may be appropriate for your situation.

A Treatment Plan Based on Your Long-Term Prognosis

Dr. Skene believes the best periodontal treatment is not necessarily the most aggressive treatment. It is the treatment that is appropriate for your condition and goals, while preserving as much healthy tooth, bone, and gum tissue as possible.

Whether you are concerned about gum disease, periodontal bone loss, gum recession, a failing dental implant, peri-implant disease, or another periodontal condition, she will explain your diagnosis, prognosis, treatment options, alternatives, and expected maintenance needs before you move forward.

The goal is not simply to treat periodontal disease. The goal is to help preserve your natural teeth, protect supporting bone and gum tissue, and create a foundation for long-term oral health.

Schedule Your Periodontal Evaluation

If you have bleeding gums, gum recession, loose teeth, bone loss, persistent bad breath, a history of periodontal disease, or concerns about a dental implant, consider scheduling a periodontal evaluation with Dr. Skene.

An evaluation can help you understand what is happening, what may be contributing to the problem, and which treatment or monitoring options may be appropriate. Contact the office to schedule an appointment and take the next step toward a clearer understanding of your periodontal health.

When You Need More Than Another Dental Cleaning: Advanced Periodontal Care in Salt Lake City

If you have been told you have 5 mm or deeper periodontal pockets, bleeding gums, bone loss, gum recession, or persistent periodontal disease, you may benefit from a comprehensive evaluation with a periodontist in Salt Lake City. The appropriate treatment depends on the severity, extent, and activity of the disease, your response to previous care, and your overall health.

A periodontist is a dental specialist with advanced training in the gums, periodontal ligament, supporting bone, dental implants, and conditions that can contribute to tooth loss or implant complications.

At Mosaic Periodontics in Salt Lake City, Utah, we help patients understand what is happening to their gums and supporting bone, why periodontal disease may not have resolved, and which evidence-based treatment options may be appropriate.

Is Your “Deep Cleaning” Treating the Underlying Gum Disease?

Many patients are told they need a “deep cleaning” because they have periodontal pockets. The clinical term for this treatment is scaling and root planing (SRP). It is a specific periodontal treatment—not simply a more thorough routine dental cleaning.

SRP is commonly used as initial non-surgical periodontal therapy for patients with periodontitis. It involves removing bacterial deposits and calculus from below the gumline and smoothing contaminated root surfaces, usually with local anesthesia. The goal is to reduce inflammation and pocket depth while creating conditions that support healing and effective daily plaque control.

SRP can be effective, but the response varies by patient and by site. Pocket depth, bleeding, root anatomy, calculus, bone defects, tobacco use, diabetes, oral hygiene, and other risk factors can influence healing. Some sites may improve substantially with non-surgical treatment, while others may retain inflammation or deeper pockets in the bone requiring additional evaluation by a Salt Lake City periodontist.

What If 5 mm, 6 mm, or Deeper Periodontal Pockets Remain?

Persistent periodontal pockets after SRP do not automatically mean that periodontal surgery is required, and they do not mean that previous treatment was inappropriate. A periodontist may reassess the tissues after an appropriate healing interval, review plaque control and risk factors, and determine whether additional non-surgical treatment, localized therapy, periodontal surgery, or ongoing monitoring is indicated.

Deeper residual pockets—particularly those that bleed on probing or are associated with calculus, furcation involvement, vertical bone defects, or difficult root anatomy—may be more difficult to maintain and may carry a greater risk of continued disease progression.

Treatment decisions should be based on a comprehensive periodontal examination, radiographs when indicated, clinical findings, and your goals and overall health. A periodontal evaluation can help determine whether your pockets are stable, improving, or showing signs of active disease.

When Periodontal Surgery May Be Appropriate

An experienced periodontist in Salt Lake City can determine whether periodontal surgery may provide a reasonable benefit after non-surgical therapy and reassessment.

In selected cases, osseous surgery, also called periodontal pocket reduction surgery, may improve access to root surfaces and periodontal defects that cannot be adequately treated with non-surgical instrumentation alone. It may also allow the clinician to modify irregular bone contours and reduce pocket depth in areas where this is clinically appropriate.

Periodontal surgery is not necessary for every patient with deep periodontal pockets, nor is it always the preferred next step. It may be considered when active disease persists, when anatomy limits non-surgical access, or when a specific periodontal defect may benefit from surgical treatment.

In other situations, continued periodontal maintenance, localized non-surgical care, regenerative procedures, extraction, or monitoring may be more appropriate. The objective is to control active disease, preserve the natural tooth whenever possible, establish a periodontal environment that can be maintained, and select the least invasive treatment likely to provide a predictable benefit.

What Role Do Antibiotics Play in Periodontal Treatment?

Antibiotics are not a substitute for mechanical removal of bacterial deposits, effective plaque control, risk-factor management, or appropriate periodontal follow-up.

In selected cases, a periodontist may recommend locally delivered or systemic antibiotics as an adjunct to mechanical periodontal therapy. Potential benefits depend on the diagnosis, disease pattern, severity, medical history, and the risks of adverse effects or antibiotic resistance. Local antibiotics may be considered for specific residual sites, while systemic antibiotics are generally reserved for carefully selected clinical situations rather than routine use.

Placing an antibiotic into a periodontal pocket may help reduce bacterial levels or inflammation in some cases, but it does not by itself correct every underlying periodontal defect. If persistent bleeding or deep pockets remain, a comprehensive periodontal reassessment can help determine whether additional treatment, periodontal surgery, maintenance, or monitoring is appropriate.

What Should Happen After Periodontal Treatment?

After active periodontal therapy, patients typically enter supportive periodontal care, also called periodontal maintenance. The purpose is to monitor periodontal health, remove new deposits, reinforce home care, and identify recurrent or persistent disease early.

A three-month maintenance interval is commonly recommended for many patients with a history of periodontitis, particularly those at higher risk of recurrence or progression. However, the appropriate interval is individualized. Some patients may benefit from visits at approximately three-month intervals, while others may require a different schedule based on disease stability, risk factors, treatment history, and response to care.

Three-month maintenance is intended to support long-term periodontal stability. It does not replace active surgical treatment when inflammation, bleeding, progressive bone loss, or other signs of uncontrolled disease are present. Conversely, being placed on a three-month maintenance schedule does not automatically mean that periodontal surgery is necessary.

If you continue to experience deep periodontal pockets, bleeding gums, bone loss, or recurrent periodontal inflammation, a periodontal evaluation can help clarify whether the condition is stable, requires additional treatment, or can be managed with continued supportive care.

When a Periodontist May Be Helpful

Your general dentist and dental hygienist are essential members of your dental care team. A periodontist in Salt Lake City may be especially helpful when periodontal disease is advanced, localized to complex areas, associated with significant bone loss or recession, affecting dental implants, or not responding as expected to initial therapy.

A periodontist has specialized training in diagnosing and treating:

• Periodontitis
• Periodontal bone loss
• Persistent or deep periodontal pockets
• Gum recession
• Gum and bone defects
• Failing dental implants
• Peri-implantitis
• Bone loss around implants
• Conditions affecting the tissues supporting your teeth and implants

If you have been told that you have 5+ mm periodontal pockets, have completed scaling and root planing, or have not achieved the improvement you expected, a periodontal consultation or second opinion in Salt Lake City may provide a clearer understanding of your diagnosis, prognosis, and treatment options.

A second opinion can be particularly helpful when you are unsure whether you need periodontal surgery, continued non-surgical treatment, maintenance care, or another approach. It can also help you understand the risks, benefits, alternatives, and expected goals of each option.

Advanced Periodontal Care in Salt Lake City, Utah

At Mosaic Periodontics, Dr. LaRisse Skene provides specialized periodontal care for patients who require advanced evaluation or treatment, including:

• Advanced gum disease treatment
• Non-surgical periodontal therapy
• Periodontal maintenance
• Periodontal surgery
• Osseous surgery
• Regenerative periodontal procedures
• Gum grafting
• Bone grafting
• Dental implants
• Peri-implantitis treatment
• Complex periodontal care
• Periodontal second opinions

Our philosophy is simple:

Understand the cause and activity of the disease, provide treatment supported by the clinical findings, and develop a maintenance plan that helps preserve your teeth and implants for as long as possible.

If you are searching for an experienced periodontist near you in Salt Lake City, Utah, need treatment for deep periodontal pockets, are considering periodontal surgery, or want a second opinion for persistent periodontal disease, contact Mosaic Periodontics to schedule a comprehensive periodontal evaluation.

What Would You Recommend If I Were Your Family Member?

When you are choosing a periodontist for periodontal surgery, gum grafting, bone grafting, or dental implant treatment, one of the most important questions you can ask is:

“What would you recommend if I were your family member?”

At Mosaic Periodontics, Dr. LaRisse Skene believes the answer should always begin with what is biologically, functionally, and esthetically best for the patient—not simply what is fastest or easiest.

Her approach to periodontal and implant treatment is centered on careful diagnosis, conservative treatment when appropriate, and long-term preservation of your natural teeth, bone, and gum tissue.

A Periodontal Treatment Plan Based on Your Entire Health

Periodontal disease and dental implant treatment are not isolated from the rest of your body.

Your immune response, bone biology, medications, systemic health, oral hygiene, previous dental treatment, and individual anatomy can all influence healing and long-term treatment outcomes.

Dr. Skene begins with a thorough medical and dental history and evaluates the factors that may affect your periodontal treatment or dental implant outcome. Her goal is to understand why the problem developed, what structures are affected, and what treatment has the best potential for long-term success in your specific situation.

Rather than taking a one-size-fits-all approach, she develops an individualized treatment plan based on your:

• Periodontal health and history of gum disease
• Bone levels and quality
• Gum tissue thickness and recession
• Tooth and root anatomy
• Dental implant condition and position
• Bite and tooth position
• Existing dental restorations
• Overall medical and systemic health
• Ability to maintain the treated area with effective home care

The right treatment is the treatment that makes sense for your biology and your long-term goals.

Choosing the Right Dental Implant for Long-Term Success

Dental implants are not all the same.

The implant system, implant design, implant-abutment connection, three-dimensional implant position, surrounding bone, gum tissue, and final restoration all contribute to the long-term health and esthetic result.

For many patients, Dr. Skene recommends Straumann dental implants, particularly when treating highly esthetic areas such as the front teeth.

Straumann implants have extensive clinical research and are designed with precise implant-abutment connections. Dr. Skene considers the implant system carefully because the connection between the implant and the final crown can influence the ability to establish and maintain healthy tissue around the implant.

This becomes especially important in the esthetic zone, where the position of the implant, thickness of the surrounding gum tissue, amount of bone, shape of the crown, and relationship to neighboring teeth can determine whether the final result looks natural.

For Dr. Skene, dental implant treatment is not simply about replacing a missing tooth.

It is about creating a healthy foundation for an implant that functions well, looks natural, and can be maintained for the long term.

Getting Your Dental Implant Right the First Time

Replacing a failing dental implant can be significantly more complicated than placing the original implant.

Implant removal can affect the surrounding bone and soft tissue and may require additional bone grafting, soft-tissue grafting, or other reconstructive procedures before another implant can be placed.

That is why Dr. Skene believes in careful diagnosis and comprehensive treatment planning before implant surgery begins.

When appropriate, she works with your restorative dentist and orthodontist to coordinate the entire treatment plan before surgery. The position of the teeth, final crown, bite, bone, gum tissue, and implant should all be considered together.

Sometimes the best dental implant treatment plan is not the fastest treatment plan.

Orthodontic treatment, bone grafting, sinus augmentation, or gum grafting may occasionally be recommended before implant placement when these procedures can improve the long-term health, function, or esthetics of the final result.

Dr. Skene’s philosophy is simple:

Do the right treatment at the right time rather than taking a shortcut that could compromise the result later.

Preserving Natural Teeth Whenever Possible

A dental implant is an excellent treatment option when a tooth cannot be predictably saved—but Dr. Skene believes a natural tooth should be preserved whenever it has a reasonable long-term prognosis.

As a periodontist, Dr. Skene evaluates whether periodontal treatment, bone regeneration, gum grafting, or other treatment may allow a natural tooth to remain healthy and functional.

Her approach is consistent with a fundamental principle of periodontal care:

If a natural tooth can be predictably maintained, preserving it should be carefully considered before replacing it with a dental implant.

When a tooth truly cannot be saved, Dr. Skene can plan the extraction, bone graft and subsequent implant treatment with preservation of the surrounding bone and gum tissue in mind.

A Conservative Approach to Periodontal and Implant Surgery

Dr. Skene’s philosophy is not to perform the most treatment possible.

It is to perform the right amount of treatment necessary to achieve a predictable long-term result.

For periodontal disease, this may mean treating infection and inflammation before significant bone loss progresses.

For gum recession, it may mean a carefully planned gum graft to increase tissue thickness and protect the tooth.

For a failing dental implant, it may mean treating peri-implant disease and attempting to preserve the implant—or determining that removal and replacement offers the more predictable outcome.

For a missing tooth, it may mean bone grafting or soft-tissue augmentation before implant placement to create a better foundation.

Every situation is different.

Dr. Skene’s goal is to preserve healthy tissue, minimize unnecessary treatment, and make decisions based on your long-term periodontal and implant prognosis.

Sedation Options for Periodontal Surgery

Your comfort matters.

Sedation is available for patients who experience dental anxiety or who would simply prefer to be more relaxed during periodontal surgery, dental implant surgery, gum grafting, or bone grafting.

Sedation is not necessary for every procedure. Many periodontal surgeries are performed comfortably with local anesthesia alone.

Because Dr. Skene uses a precise and atraumatic surgical approach, patients are often surprised by how quickly their procedure passes and how comfortable they are during recovery.

Before treatment, the Mosaic Periodontics team will discuss your anesthesia and sedation options so you can choose the approach that best fits your needs.

A Better Experience With Your Periodontist, Dentist, and Hygienist

Exceptional periodontal care is about more than performing excellent surgery.

At Mosaic Periodontics, we believe the best patient experience comes from creating a partnership between the patient, periodontist, general dentist, and dental hygienist.

Your dentist and hygienist play an important role in maintaining your periodontal health after treatment. Our goal is to return you to your dental team with healthy periodontal tissues, stable bone, predictable implant results, and a foundation that can be maintained for years to come.

We want you to leave Mosaic feeling informed, cared for, and confident that you made the right decision for your oral health.

The Mosaic Periodontics Philosophy

When patients ask Dr. Skene, “What would you recommend if I were your family member?”, her answer begins with the same principles she uses for every patient:

Diagnose carefully.

Preserve what can be preserved.

Treat disease before it causes unnecessary damage.

Plan comprehensively.

Protect bone and soft tissue.

Consider the long-term outcome.

And never recommend treatment simply because it can be done.

At Mosaic Periodontics, every decision is made with the long-term health of the patient in mind.

Do You Treat Complex Periodontal and Dental Implant Cases?

Yes. Mosaic Periodontics specializes in the diagnosis and treatment of complex periodontal disease, severe bone loss, failing dental implants, peri-implantitis, gum recession, and cases where the long-term prognosis of individual teeth is uncertain.

Dentists and dental specialists throughout Salt Lake City and the surrounding Utah communities seek Dr. LaRisse Skene’s expertise when a periodontal case is particularly complex or when they need help determining whether a tooth can be predictably saved.

At Mosaic Periodontics, Dr. Skene approaches complex cases from a comprehensive medical and surgical perspective. Her goal is not simply to treat periodontal disease or remove a tooth—it is to determine what can be saved, what should be saved, and what treatment will provide the healthiest and most predictable long-term result.

A Periodontist Who Looks at the Whole Case

Complex periodontal treatment rarely exists in isolation. The health of the gums and supporting bone must be considered alongside the teeth, dental implants, bite, orthodontic position, and planned restorative treatment.

When appropriate, Dr. Skene collaborates with:

• General dentists
• Dental hygienists
• Orthodontists
• Endodontists
• Prosthodontists
• Other dental specialists

This interdisciplinary approach allows the treatment sequence to be carefully planned before irreversible treatment is performed.

The goal is comprehensive care—not simply treating one tooth at a time.

For example, when a tooth has significant bone loss or an uncertain prognosis, determining whether it can be saved may affect the timing of periodontal treatment, orthodontics, endodontic treatment, extraction, implant placement, bone grafting, and restorative dentistry.

Dr. Skene believes that preserving a natural tooth when it can be predictably maintained is often preferable to replacing it unnecessarily. When a tooth cannot be predictably saved, the goal becomes creating the healthiest possible foundation for future tooth replacement or dental implant treatment.

When Dentists Need a Second Opinion on a Difficult Case

One of the most important services Dr. Skene provides is helping dentists evaluate difficult periodontal cases before treatment decisions are made.

A dentist may refer a patient to Mosaic Periodontics when:

• The prognosis of one or more teeth is uncertain
• There is severe periodontal bone loss
• Periodontal pockets are unusually deep
• A tooth has significant mobility
• Gum recession has exposed the root
• Previous periodontal treatment has not produced the desired result
• A dental implant is failing
• Peri-implantitis is present
• Bone loss is occurring around a dental implant
• The patient needs periodontal surgery or bone grafting
• The treatment sequence between periodontal, orthodontic, endodontic, implant, and restorative treatment is unclear

In these situations, Dr. Skene evaluates the entire periodontal and dental condition and develops a treatment strategy based on the patient’s individual anatomy, periodontal health, prognosis, and long-term goals.

The question is not simply, “Can we treat this tooth?” The more important question is, “What treatment gives this patient the best chance of maintaining a healthy, functional result for the long term?”

Do You Treat Failed Periodontal or Dental Implant Treatment?

Yes. Mosaic Periodontics treats periodontal and dental implant cases that have not responded as expected to previous treatment.

Dr. Skene routinely evaluates patients who have experienced complications, recurrence of periodontal disease, continued bone loss, gum recession, failing dental implants, or infection around dental implants.

A previous treatment outcome does not necessarily mean there are no remaining treatment options.

Dr. Skene carefully evaluates why the original treatment failed before recommending retreatment. This may include evaluating periodontal infection, bone levels, implant position, soft-tissue health, occlusion, restorability, endodontic status, oral hygiene, and the overall treatment plan.

The goal is to identify the underlying problem and determine whether the tooth or implant can be predictably treated, maintained, or restored.

Complex Cases We Commonly Treat

Mosaic Periodontics provides advanced periodontal and implant-related treatment for patients with:

• Peri-implantitis and infection around dental implants
• Failing or compromised dental implants
• Severe periodontal bone loss
• Advanced periodontal disease
• Deep periodontal pockets
• Gum recession and exposed tooth roots
• Complex recession defects
• Periodontal defects requiring regenerative or surgical treatment
• Bone loss requiring periodontal surgery or bone grafting
• Complications following periodontal surgery
• Complications following dental implant treatment
• Periodontal treatment that has failed or relapsed
• Uncertain tooth prognosis and difficult tooth-saving decisions

Do You Treat Complications After Periodontal Surgery or Dental Implant Treatment?

Yes. Patient care at Mosaic Periodontics does not end when surgery is completed.

If an unexpected concern develops following periodontal surgery, gum grafting, bone grafting, tooth extraction, or dental implant treatment, our team is available to evaluate the situation and determine the appropriate next step.

Before surgery, patients receive detailed information about the expected healing process, including recovery time, activity restrictions, pain management, swelling, and warning signs that may require additional evaluation.

We believe that patients should understand what normal healing looks like and when a concern warrants a call to the office.

Patients are provided with direct contact information so they can reach the Mosaic Periodontics team if questions or concerns arise during healing. When an evaluation is necessary, we make every effort to see patients promptly and determine whether additional treatment is needed.

Our commitment is to provide comprehensive periodontal and implant care from the initial consultation through surgery, healing, follow-up, and long-term maintenance.

Why Patients Are Referred to Mosaic Periodontics for Complex Cases

Complex periodontal cases require more than a procedure. They require accurate diagnosis, careful prognosis, thoughtful sequencing, and a long-term treatment strategy.

At Mosaic Periodontics, Dr. LaRisse Skene combines advanced periodontal training with a strong focus on tooth preservation, periodontal health, dental implant health, bone biology, and interdisciplinary treatment planning.

Her approach is simple:

Every decision should be made with the patient’s long-term health in mind.

When saving a natural tooth is predictable, Dr. Skene believes preservation should be strongly considered. When a tooth cannot be predictably maintained, she works with the patient’s dental team to create the healthiest possible path toward tooth replacement or dental implant treatment.

This comprehensive approach is the foundation of the Mosaic philosophy: every part of the treatment plan must work together to create the best possible outcome for the patient.

Complex Periodontal Care in Salt Lake City, Utah

Mosaic Periodontics provides advanced periodontal care for patients throughout Salt Lake City, Murray, Holladay, Sugar House, and surrounding Utah communities.

If you have been told that you have severe periodontal disease, significant bone loss, a failing dental implant, peri-implantitis, gum recession, or a tooth with an uncertain prognosis, a consultation with a periodontist can help clarify your options.

At Mosaic Periodontics, our goal is not simply to treat disease. Our goal is to determine the most predictable path to preserve your teeth, protect your dental implants, restore periodontal health, and achieve a healthy long-term result.

What Happens If I Do Nothing About Gum Disease?

One of the most important questions to ask when you have been diagnosed with periodontal disease is:

“What happens if I don’t treat it?”

Periodontal disease can be difficult to recognize because it often progresses without significant pain or obvious symptoms. A patient may feel completely healthy while inflammation and bone loss are gradually affecting the tissues that support the teeth.

Dr. LaRisse Skene believes patients deserve to understand where their periodontal disease is headed if it is left untreated—and what may be possible if the disease is treated early.

Periodontal Disease Does Not Always Hurt

One of the most concerning characteristics of gum disease is that significant periodontal damage can occur without significant pain.

Periodontal disease is an inflammatory infection affecting the gums and supporting structures around the teeth. As inflammation persists, the bone and connective tissues that support the teeth can be progressively damaged.

You may not feel this process happening.

By the time a tooth becomes loose, the gums have visibly receded, or other symptoms become obvious, significant bone loss may already have occurred.

That is why periodontal evaluation and early treatment can be so important—even when your gums do not hurt.

What Happens as Periodontal Disease Progresses?

As periodontal disease advances, periodontal pockets can become deeper. A healthy gum pocket is generally 3 mm or less. When a periodontal pocket is greater than 3 mm, routine home care becomes less effective because toothbrush bristles and floss cannot adequately clean the entire pocket.

When tartar remains attached to the root surface, it can initiate an inflammatory response in susceptible patients. This inflammation can increase osteoclastic activity—the process responsible for bone resorption—leading to changes in the bone surrounding the teeth. As bony craters begin to form below the gumline, the attachment between the tooth and its supporting tissues becomes compromised. The resulting deeper pockets are even more difficult to clean, allowing the disease to progress uninhibited.

Once residual periodontal pockets remain after scaling and root surface cleaning, topical products or locally delivered antibiotics may not be sufficient to stop the disease process. In many cases, treatment requires surgical access to the affected bone so the area can be thoroughly debrided and the bony anatomy recontoured when appropriate. This can reduce pocket depth, improve access for ongoing maintenance, and create a healthier environment around the teeth. This procedure is called osseous surgery and has a very high success rate in re-establishing 3 millimeter pockets.

Dr. Skene places particular emphasis on treating periodontal pockets before they become more difficult to manage.

When appropriate, she may recommend periodontal treatment for 5 mm and 6 mm pockets—and selected 7 mm pockets—because reducing pocket depth can improve access for professional treatment and daily home care.

In appropriate cases, periodontal surgery such as osseous surgery or regenerative periodontal therapy can reduce deep periodontal pockets and create a healthier, more maintainable environment.

The goal is not simply to make a pocket smaller.

The goal is to control periodontal inflammation, preserve supporting bone, and create an environment that you and your dental team can maintain for the long term.

Why Delaying Periodontal Treatment Can Make Treatment More Difficult

When periodontal disease continues to progress, the supporting bone around the teeth can be permanently lost.

Advanced bone loss may result in:

• Deeper periodontal pockets
• Tooth mobility
• Gum recession
• Changes in the position of teeth
• Tooth migration or shifting
• Loss of the papilla between teeth
• Black triangles between the front teeth
• Longer-looking teeth
• Difficulty maintaining areas with home care
• Increased risk of tooth loss
• More complicated tooth replacement
• Greater need for bone grafting or tissue regeneration

Once substantial bone and soft tissue have been lost, rebuilding the original anatomy can become much more difficult—and sometimes impossible.

Bone loss on front teeth can lead to cosmetic defects that are irreversible. Bone loss between front teeth can lead to loss of gingival papillae resulting in unsightly black triangles (large embrasure spaces). Treating front teeth with pockets during early stage periodontal disease (5mm pockets) is imperative for a predictable cosmetic outcome. As periodontal pockets deepen around the front teeth, treatment becomes increasingly complex, with a greater risk of permanent aesthetic defects along the gum line and smile.

Treating periodontal disease early may allow you to preserve anatomy that cannot easily be recreated later.

Periodontal Bone Loss Can Affect More Than One Tooth

Periodontal disease is not necessarily isolated to the tooth that initially brought you to the dentist.

Because periodontal disease affects the supporting tissues around teeth, untreated inflammation can involve multiple areas of the mouth over time.

Dr. Skene evaluates the entire periodontal environment to identify areas of active disease, bone loss, deep periodontal pockets, and other factors that may place teeth at risk.

Her goal is to intervene while teeth still have a reasonable opportunity for long-term preservation.

The earlier periodontal disease is identified and appropriately treated, the more options you may have.

Advanced Bone Loss Can Affect Future Dental Implant Treatment

Severe periodontal bone loss can also complicate future tooth replacement.

When teeth are lost after advanced periodontal disease, the jawbone naturally changes and can lose the volume needed for predictable dental implant placement.

Depending on the location and severity of bone loss, future treatment may require:

• Ridge augmentation
• Bone grafting
• Sinus augmentation
• Soft-tissue grafting
• More complex implant surgery
• Extensive restorative rehabilitation

In the upper jaw, advanced bone loss may also affect the relationship between the missing tooth and the maxillary sinus. In the lower jaw, bone loss can become increasingly important when planning around the inferior alveolar nerve.

This is one reason Dr. Skene emphasizes preservation whenever possible.

It is generally easier to preserve healthy bone than to reconstruct bone after it has been extensively lost. Vertical bone loss on the mandible is particularly debilitating.

Can Periodontal Disease Damage the Appearance of Your Smile?

Yes.

Advanced periodontal bone and tissue loss can change the appearance of the smile as well as its health.

As supporting bone and gum tissue are lost, teeth may appear longer. Teeth can shift or flare, and the papilla—the triangular gum tissue between teeth—may recede, creating black triangles between the front teeth.

These changes can be particularly challenging to reconstruct in the esthetic zone.

Even when periodontal disease is successfully controlled, replacing lost bone and recreating the original gum architecture may require complex periodontal and implant procedures.

Preserving the natural architecture of the gums and bone is often preferable to trying to reconstruct it after advanced periodontal disease has destroyed it.

Should I Have All of My Teeth Removed and Get Implant-Supported Dentures?

Not necessarily.

Patients with advanced periodontal disease are sometimes told that removing all of their teeth and replacing them with implant-supported dentures or full-arch dental implants is their only option.

In some cases, full-mouth extraction and implant rehabilitation may be appropriate.

But it is not automatically the best treatment for every patient with periodontal disease.

If there are natural teeth that can be predictably treated and maintained, Dr. Skene believes their long-term prognosis should be carefully evaluated before irreversible treatment is performed.

This is especially important because a history of periodontal disease can also increase the risk of peri-implant disease, including peri-implant mucositis and peri-implantitis.

Before making the irreversible decision to remove multiple or all of your natural teeth, a comprehensive evaluation by a periodontist can help determine:

• Which teeth may be saved
• Which teeth have a poor prognosis
• Which teeth may benefit from periodontal treatment
• Whether extraction is truly necessary
• Whether dental implants are appropriate
• What bone and gum tissue would be available for future implants
• What treatment would provide the best long-term outcome

If you have been told that you need all of your teeth removed, seeking a periodontal second opinion before proceeding can be an important step.

Natural Teeth vs. Dental Implants: Preservation Matters

Dental implants can be an excellent solution for replacing teeth that cannot be saved. However, implants are not immune to inflammation or bone loss.

Patients with a history of periodontal disease need to understand that the same susceptibility to inflammatory disease can affect the tissues surrounding dental implants.

For that reason, Dr. Skene approaches implant treatment with the same philosophy she applies to natural teeth:

Preserve healthy tissue. Control inflammation. Plan carefully. Create an implant that can be maintained.

When teeth do need to be removed, careful extraction, bone preservation, implant positioning, and appropriate periodontal maintenance can help establish a healthier foundation for long-term implant function.

“My Job Is to Help You Understand Where This Condition Is Headed.”

Dr. Skene believes that understanding periodontal disease can change the way patients approach their oral health.

Her goal is not to frighten patients into treatment. It is to give them information, options, and hope.

Many patients who have been diagnosed with periodontal disease have more potential to preserve their teeth than they realize. Even when periodontal disease is advanced, there may be teeth that can be treated and maintained for many years.

A periodontal consultation can help you understand exactly where you stand.

Dr. Skene will evaluate your periodontal health, bone levels, pocket depths, teeth, gum tissue, and dental implants when applicable. She will explain what is healthy, what is diseased, what may be treatable, and what the future may look like with or without treatment.

Take Control of Your Periodontal Health

Periodontal disease does not have to mean that you will inevitably lose your teeth. With an accurate diagnosis, appropriate treatment, and consistent periodontal maintenance, many patients can stabilize their disease and maintain their natural teeth for years.

Dr. Skene loves helping patients understand their periodontal disease and become active participants in their treatment.

The goal is to move you from uncertainty to understanding—and from active disease toward stable, maintainable periodontal health.

If you have been told that you have gum disease, periodontal bone loss, deep gum pockets, loose teeth, or failing dental implants—or if you have been told that your teeth cannot be saved—consider a comprehensive periodontal evaluation before making an irreversible decision.

You may have more options than you realize.

Should I get a second opinion for my gum disease?

Deep Gum Pockets and Periodontal Disease Treatment at Mosaic Periodontics in Salt Lake City

If you have been told that you need all of your teeth pulled, you may feel overwhelmed and unsure whether extraction is truly your only option. Before making an irreversible decision, consider a comprehensive evaluation with an experienced periodontist in Salt Lake City.

At Mosaic Periodontics, LaRisse Skene provides advanced, personalized periodontal care for patients with deep gum pockets, severe periodontal disease, bone loss, loose teeth, and complex treatment recommendations. A thorough periodontal evaluation can help determine which teeth may be treatable, which teeth may have a poor prognosis, and whether a combination of periodontal treatment, tooth replacement, or dental implants is the most appropriate path forward.

The goal is not to preserve every tooth at any cost. The goal is to create the healthiest, most predictable long-term outcome—while preserving natural teeth whenever they can be predictably saved.

Understanding Deep Gum Pockets and Advanced Gum Disease

Deep gum pockets are a common sign of periodontal disease, also called gum disease. These spaces form between the teeth and gums when inflammation causes the gum tissue to pull away from the teeth. As periodontal pockets deepen, bacteria can collect beneath the gumline, contributing to ongoing infection, gum recession, bone loss, loose teeth, and eventual tooth loss.

Advanced periodontal disease may not always cause significant pain. Some patients seek care after noticing bleeding gums, persistent bad breath, tooth mobility, changes in their bite, or difficulty chewing. Others are referred after being told that extensive treatment or complete tooth removal is necessary.

At Mosaic Periodontics, LaRisse Skene evaluates the health of your gums, supporting bone, and remaining teeth to determine whether periodontal disease treatment may help control infection and preserve teeth—or whether extraction and dental implant treatment would provide a more predictable result.

A Second Opinion Before Full-Mouth Tooth Extraction

If you have been told that all of your teeth need to be removed, a second opinion from a periodontist may provide valuable clarity before proceeding with full-mouth extraction, dentures, or full-arch implant treatment.

A comprehensive evaluation may help answer important questions, including:

• Are all of the teeth truly hopeless?
• Which teeth may be treatable with periodontal therapy?
• Is the bone loss localized or widespread?
• Are loose teeth unstable because of active infection, bite forces, or both?
• Could periodontal treatment improve the prognosis of selected teeth?
• Would removing some teeth while preserving others provide a better long-term result?
• Is immediate full-arch implant treatment appropriate for your gums, bone, health, and goals?
• Would additional treatment be needed before dental implants can be placed?

Every patient’s situation is different. Some teeth may be predictably preserved with appropriate periodontal treatment. Other teeth may have advanced bone loss, severe structural damage, infection, or an unfavorable prognosis and may be better replaced. The purpose of a second opinion is to provide an objective diagnosis and explain your options clearly before irreversible treatment begins.

Personalized Periodontal Evaluation in Salt Lake City

Your general dentist and dental hygienist play important roles in identifying gum disease, providing preventive care, monitoring changes, and supporting your oral health. When periodontal disease is advanced, recurring, or does not improve with initial treatment, evaluation by a periodontist may be appropriate.

At Mosaic Periodontics, your evaluation may include:

• Measuring periodontal pocket depths
• Assessing gum inflammation, bleeding, and recession
• Reviewing bone levels with appropriate dental imaging
• Evaluating tooth mobility and bite-related concerns
• Examining the condition of existing dental work
• Assessing the health and stability of individual teeth
• Reviewing your medical history, medications, and risk factors
• Determining whether teeth may respond to periodontal treatment
• Evaluating whether dental implants or full-arch treatment may be appropriate

These findings help determine whether deep gum pockets may respond to nonsurgical periodontal therapy or whether additional procedures should be considered. LaRisse Skene can then develop a personalized treatment plan based on your diagnosis, priorities, health, and long-term goals.

Advanced Periodontal Disease Treatment Options

Treatment recommendations depend on the depth of your gum pockets, the severity of periodontal disease, the amount of supporting bone, the condition of your teeth, your overall health, and how you respond to initial treatment.

Depending on your needs, treatment may include:

• Scaling and root planing
• Nonsurgical periodontal therapy
• Periodontal maintenance
• Localized or comprehensive periodontal surgery
• Osseous surgery
• Gum grafting
• Bone grafting
• Guided tissue regeneration
• Treatment for bite-related trauma
• Extraction of teeth with an unfavorable prognosis
• Dental implant planning and site development

Some patients benefit from a combination of treatments performed over time. Ongoing periodontal maintenance and consistent home care are essential for controlling gum disease and reducing the risk of recurrence.

Saving Natural Teeth When Possible

The goals of periodontal treatment are to reduce inflammation and deep pocket depth, control bacterial infection, slow or stop periodontal disease progression, protect supporting bone, and preserve natural teeth whenever possible.

A tooth may be considered treatable when it has enough healthy supporting bone and remaining structure to remain stable, functional, and maintainable after treatment. However, not every tooth can or should be saved. Attempting to preserve teeth with a hopeless prognosis may delay appropriate treatment and compromise future options.

At Mosaic Periodontics, treatment recommendations are based on predictability. LaRisse Skene will explain which teeth may be candidates for periodontal treatment, which teeth may require extraction, and how each decision may affect your long-term oral health and restorative options.

When Dental Implants or Full-Arch Treatment May Be Appropriate

When a tooth cannot be predictably preserved because of advanced bone loss, severe damage, infection, fracture, or other concerns, dental implants may provide a stable option for tooth replacement. Dental implants replace missing tooth roots and can support a crown, bridge, or implant-supported prosthesis.

For patients who have been told they need all of their teeth removed, treatment may involve individual implants, implant-supported bridges, or full-arch implant solutions. Full-arch treatment may be appropriate for some patients, but it is not automatically the best choice for everyone. The decision should be based on the condition of the remaining teeth, the health of the gums and bone, medical considerations, functional needs, esthetic goals, and long-term maintenance requirements.

Dental implant treatment may involve:

• Tooth extraction
• Infection control
• Bone grafting
• Ridge preservation
• Sinus augmentation when appropriate
• Implant placement
• Temporary teeth
• Final implant-supported restoration

Healthy gums and adequate bone are important for successful implant treatment. Active periodontal disease should be evaluated and controlled before implant placement whenever possible. Patients with a history of gum disease also require ongoing periodontal maintenance after implant treatment because implants can develop peri-implant disease.

LaRisse Skene can assess your gums, bone, remaining teeth, and overall oral health to determine whether you may be a candidate for dental implants or full-arch implant treatment. If bone loss has occurred, bone grafting or other regenerative procedures may be recommended to improve the foundation for implant placement.

High-Quality Periodontal Care for Complex Treatment Decisions

Patients seeking advanced periodontal care often want more than a quick recommendation. They want a careful diagnosis, clear communication, modern treatment options, and a plan designed around long-term health.

Mosaic Periodontics provides individualized care for patients who value a thoughtful, evidence-based approach to complex gum disease and tooth replacement decisions. Whether your priority is preserving natural teeth, improving the health of your gums and bone, preparing for dental implants, or understanding whether full-mouth extraction is necessary, a periodontal evaluation can help you make an informed decision.

Schedule a Periodontal Second Opinion in Salt Lake City

If you have been told that you need all of your teeth pulled, do not assume that extraction is your only option without a comprehensive evaluation. Schedule a second opinion with LaRisse Skene at Mosaic Periodontics in Salt Lake City to understand your diagnosis, prognosis, treatment alternatives, and long-term options.

Timely periodontal care may reduce the risk of further bone loss and tooth loss while helping determine whether your natural teeth can be preserved. If teeth cannot be predictably saved, careful planning can help create a healthy foundation for dental implants or other tooth replacement options.

Mosaic Periodontics can help you understand whether your teeth and gums may be treated and preserved, whether selected teeth should be removed, or whether a comprehensive implant-supported solution should be considered. A thorough evaluation is the first step toward making a confident, informed decision about your periodontal health and future smile.

Can Periodontal Treatment Help Me Keep My Natural Teeth Long Term?

For most patients diagnosed with periodontal disease, the question that matters most is not simply:

“Will this periodontal treatment work?”

It is:

“Will I still have my natural teeth 10, 20, or even 30 years from now?”

That is the perspective Dr. LaRisse Skene brings to periodontal treatment.

The goal of periodontal therapy is not simply to treat an infection or reduce a periodontal pocket today. The goal is to control periodontal disease, preserve supporting bone and gum tissue, and create the best possible conditions for maintaining your natural teeth for the long term.

Tooth Preservation Is the Long-Term Goal

Whenever a natural tooth has a reasonable long-term prognosis, Dr. Skene believes preservation should be carefully considered before extraction and replacement with a dental implant.

Early diagnosis and appropriate treatment can make a significant difference.

When periodontal disease is identified before extensive bone and tissue destruction occurs, there may be more opportunities to control the disease and preserve the tooth.

Dr. Skene evaluates each tooth individually, considering:

• The amount and pattern of periodontal bone loss
• Periodontal pocket depth
• The condition of the gum tissue
• Tooth mobility
• Root and tooth anatomy
• Existing dental restorations
• The presence of infection
• Your ability to maintain the area with home care
• Your overall health and other factors that may affect healing
• The long-term prognosis of the tooth

This allows her to determine whether a tooth can be predictably treated and maintained—or whether extraction may ultimately provide a better long-term outcome.

Can Periodontal Surgery Help Save My Teeth?

In many cases, periodontal treatment can help stabilize teeth affected by gum disease and bone loss.

When periodontal pockets become deep, they can be difficult to clean effectively. Depending on the location and severity of the disease, periodontal procedures such as osseous surgery, periodontal pocket reduction, or regenerative periodontal therapy may be recommended.

The purpose of treatment is not simply to make the gums look healthier.

The objective is to control inflammation, eliminate or reduce areas that cannot be adequately maintained, preserve supporting bone when possible, and create a periodontal environment that can be maintained over time.

Dr. Skene often focuses on treating periodontal disease while there is still a reasonable opportunity to preserve the natural tooth rather than waiting until bone loss becomes advanced and treatment options become limited.

Why Early Periodontal Treatment Matters

Periodontal bone that has been lost cannot always be predictably recreated.

As untreated periodontal disease progresses, a tooth may lose more of its supporting bone and become increasingly difficult to maintain. Advanced bone loss can also affect neighboring teeth and make future tooth replacement more complex.

Early periodontal treatment may help preserve:

• Natural teeth
• Supporting jawbone
• Healthy gum tissue
• The papilla between teeth
• The natural contours of the smile
• The bone needed for future dental implant treatment if an extraction eventually becomes necessary

Preservation is often easier than reconstruction.

This is one of the reasons Dr. Skene emphasizes early evaluation and treatment when periodontal disease is detected.

Looking Beyond Today’s Surgery

Dr. Skene believes periodontal treatment should be planned with the future in mind.

A successful periodontal procedure is important—but the ultimate question is whether the tooth remains healthy, stable, functional, and maintainable over time.

That means considering what the tooth will look like and how it will function years after treatment, not simply whether the surgical site heals.

For some patients, the best treatment may be periodontal surgery.

In advanced cases, a tooth may ultimately have a poor prognosis and extraction may be the more predictable option.

The important thing is to make that decision based on an accurate diagnosis and long-term prognosis—not simply because a tooth has periodontal disease.

What Is the Lifetime Outlook for My Teeth?

No periodontist can guarantee that a particular tooth will last a lifetime. However, Dr. Skene can evaluate the factors that influence a tooth’s long-term prognosis and help you understand what can be done to improve its chances of remaining healthy.

Her goal is to give you a realistic answer to questions such as:

Can this tooth be saved?

How long might it reasonably be maintained?

What treatment could improve its prognosis?

What happens if we wait?

What will I need to do to maintain the result?

Would extraction and a dental implant actually provide a better long-term solution?

These are the questions that lead to better treatment decisions.

Solving the Problem—Not Just Treating the Symptom

Dr. Skene strives to provide more than a temporary solution.

Her approach is centered on problem-solving, long-term stability, and preservation.

Rather than simply treating the area that is currently causing concern, she looks at the underlying periodontal disease, the systemic risk factors, the surrounding bone and gum tissue, the neighboring teeth, your ability to maintain the area, and the long-term consequences of each treatment option.

Sometimes the best treatment is the simplest treatment.

Sometimes a more involved periodontal procedure is necessary to preserve a tooth.

And sometimes the most predictable long-term solution is to remove a tooth that cannot be predictably maintained and carefully plan its replacement.

The goal is not to save every tooth at any cost. The goal is to save every tooth that can be predictably maintained—and to make the best long-term decision when it cannot.

A Periodontist Focused on Long-Term Tooth Preservation

Dr. Skene has practiced full-time periodontics since 2008, with her practice focused on periodontal surgery, gum disease treatment, gum grafting, bone grafting, dental implants, and complex periodontal and implant conditions.

Her philosophy is straightforward:

Diagnose early.

Treat appropriately.

Preserve healthy tissue.

Control periodontal disease.

Create a maintainable result.

Plan for the long term.

If you have been diagnosed with periodontal disease, bone loss, deep periodontal pockets, loose teeth, gum recession, or a failing dental implant, understanding your long-term prognosis is an important first step.

You may have more potential to preserve your natural teeth than you realize.

How Is Periodontal Disease Diagnosed? Understanding Deep Pockets, Bone Loss, and Tooth Prognosis

When you are diagnosed with periodontal disease, deep periodontal pockets, bone loss, or a tooth that may need to be removed, you deserve to understand how that diagnosis was reached.

At Mosaic Periodontics, Dr. LaRisse Skene provides comprehensive periodontal evaluations based on clinical findings, periodontal measurements, dental X-rays, and your individual risk factors—not assumptions. She evaluates your teeth, gums, supporting bone, bite, restorations, dental implants, medical history, and periodontal pocket depths to determine what is causing the problem, whether it can be treated, and whether affected teeth may be preserved.

What Does a Periodontal Examination Include?

A comprehensive periodontal diagnosis combines several pieces of information. No single measurement, X-ray, or symptom tells the entire story.

Dr. Skene typically evaluates:

• Periodontal pocket depths
• Bleeding and gum inflammation
• Gum recession and attachment levels
• Bone levels and patterns of bone loss
• Tooth mobility
• Tooth anatomy and root shape
• Bite and occlusion
• Crowns, bridges, fillings, and dental implants
• Possible decay, fractures, or endodontic concerns
• Your medical and dental history
• Smoking, diabetes, medications, oral hygiene, and other risk factors
• Your response to previous periodontal treatment

Looking at these findings together helps distinguish active periodontal disease from other causes of gum inflammation, tooth mobility, or bone loss. It also helps determine whether nonsurgical treatment, periodontal surgery, regenerative treatment, extraction, or another approach may be appropriate.

This evaluation can answer important questions, including:

• Do I have periodontal disease?
• How deep are my periodontal pockets?
• How much bone loss has occurred?
• Is the bone loss localized or generalized?
• What is causing inflammation around a particular tooth?
• Can periodontal treatment reduce the disease?
• Can a tooth with bone loss or a deep pocket be saved?
• What is the long-term prognosis for each tooth?
• Is tooth extraction truly necessary?
• Should I seek a periodontal second opinion?

We Show You What We See

Dr. Skene believes you should be able to see and understand the condition she is diagnosing.

Each treatment room at Mosaic Periodontics is equipped with a large screen, allowing her to review your dental X-rays, CT scans, and clinical findings with you in real time.

Rather than simply telling you that you have bone loss or periodontal disease, she can show you:

• Where bone has been lost
• How deep your periodontal pockets are
• Which teeth are affected
• Whether the pattern of bone loss is localized or generalized
• How your bite may be contributing to periodontal problems
• How existing restorations may affect the gums and bone
• Whether open contacts or food trapping may be contributing to inflammation
• Whether a tooth appears to have a reasonable long-term prognosis
• What treatment options may be available

You should never leave a periodontal consultation feeling like you still do not understand what is happening inside your mouth.

How Do Periodontal Pocket Measurements Help Diagnose Gum Disease?

A periodontal probe is used to measure the space between the gum tissue and the tooth. These measurements help identify areas where the gum tissue has detached from the tooth and where inflammation or bone loss may be present.

Dr. Skene reviews the measurements throughout your mouth rather than focusing on one isolated number. The depth, location, bleeding, recession, attachment levels, bone levels, and overall pattern all contribute to the diagnosis and prognosis.

Deeper periodontal pockets can be more difficult to clean effectively because plaque and bacteria may remain beneath the gumline. Pocket depth is therefore an important consideration when determining whether nonsurgical periodontal treatment is likely to be sufficient or whether periodontal surgery should be considered.

What Do 4, 5, 6, 7, 8, or 9 mm Periodontal Pockets Mean?

Pocket depth is one part of the diagnosis, but it does not determine the entire prognosis by itself.

Shallower pockets may be easier to maintain, while deeper pockets can make it more difficult to remove plaque and bacteria beneath the gumline. Bleeding, bone loss, tooth anatomy, mobility, recession, and your response to initial treatment also matter.

A 5 or 6 mm periodontal pocket does not automatically mean that a tooth needs to be extracted. Depending on the location, bone defect, inflammation, mobility, and overall prognosis, periodontal treatment may be able to reduce the pocket and create a more maintainable environment.

Pockets measuring 7, 8, or 9 mm can be more challenging and may be associated with a more guarded prognosis. However, pocket depth alone does not determine whether a tooth is hopeless. Dr. Skene evaluates the entire clinical picture to determine whether periodontal surgery, regenerative treatment, bone grafting, or another approach may provide a reasonable opportunity to preserve the tooth.

What Do Dental X-Rays Show About Periodontal Bone Loss?

Dental radiographs allow Dr. Skene to evaluate the bone supporting your teeth and identify patterns of bone loss that cannot be seen simply by looking at the gums.

Periapical radiographs can provide detailed information about individual teeth, including the surrounding bone and root anatomy. These images may help evaluate:

• The level of bone supporting each tooth
• Horizontal or vertical patterns of bone loss
• Bone defects around individual roots
• Furcation involvement on multirooted teeth
• Root shape and anatomy
• Possible endodontic or tooth-related concerns
• Changes around dental implants

Dr. Skene can review your full mouth series of X-rays with you and explain where the bone level is, where bone has been lost, and how those findings affect the prognosis of each tooth.

Why Does the Pattern of Bone Loss Matter?

Not all bone loss is the same.

Some patients have bone loss isolated to one tooth or a small number of teeth. In others, bone loss is present throughout the mouth. The pattern can provide important diagnostic information.

Localized bone loss may be associated with:

• A tooth-specific problem
• A defective restoration
• An endodontic problem
• Root anatomy
• Food impaction
• An open contact
• Trauma from the bite
• A localized periodontal defect

Generalized bone loss may indicate a broader periodontal condition and may warrant consideration of risk factors such as smoking, diabetes, genetics, medications, oral hygiene, immune response, and other systemic or behavioral factors.

The pattern of periodontal disease helps Dr. Skene determine what needs to be treated—and why.

If another dental problem is contributing to inflammation around a particular tooth, she can coordinate with your general dentist, endodontist, orthodontist, or another specialist when appropriate.

How Can My Bite and Dental Restorations Affect My Periodontal Health?

Your bite can influence the forces placed on your teeth and supporting structures. In certain situations, excessive or unfavorable forces may contribute to tooth mobility, recession, or periodontal problems, particularly when combined with inflammation or reduced bone support.

Dr. Skene also evaluates crowns, bridges, fillings, implants, and other restorations. Margins, contours, contacts, or the position of a restoration may contribute to plaque accumulation, food trapping, inflammation, or difficulty maintaining the area.

Open contacts between teeth can allow food to become trapped and may contribute to localized inflammation. When a restorative or bite-related problem is contributing to periodontal inflammation, treating the gums alone may not resolve the underlying cause. Periodontal, orthodontic, and restorative treatment may need to be coordinated.

Why Is Periodontal Surgery Sometimes Necessary for Deep Pockets?

Many patients wonder why they need periodontal surgery when they have already been seeing their general dentist and dental hygienist regularly.

Patients referred to a periodontist have often already made a significant effort to improve their oral health through professional cleanings, scaling and root planing, and improved home care. However, certain areas may continue to have deep periodontal pockets or active disease.

When inflammation and deep pockets persist despite appropriate nonsurgical treatment, periodontal surgery may provide access to areas that cannot be adequately treated or maintained through nonsurgical methods alone.

Surgery allows the periodontist to directly visualize and treat affected areas beneath the gumline and, when appropriate, reshape or regenerate damaged bone and reduce periodontal pocket depth.

The need for surgery depends on your response to initial treatment, the anatomy of the affected area, the amount and pattern of bone loss, and whether the area can be maintained over time.

Can a Tooth With Bone Loss or a Deep Pocket Be Saved?

A tooth’s prognosis is based on more than one measurement.

Dr. Skene considers:

• Periodontal pocket depth
• The amount and pattern of bone loss
• Bleeding and inflammation
• Tooth mobility
• Root shape and anatomy
• Furcation involvement
• The condition of the tooth itself
• Decay or fractures
• The quality of existing restorations
• Your ability to maintain the area
• Your overall periodontal risk factors
• The expected response to treatment

A tooth with bone loss or a deep periodontal pocket may still be treatable in some situations. Other teeth may have a questionable or poor prognosis and require more complex treatment. Some teeth may not be predictably maintainable and may be better treated with extraction and replacement.

Dr. Skene will explain the factors affecting each tooth’s prognosis rather than relying on a single pocket measurement or X-ray finding. If a tooth cannot be predictably maintained, she will explain why and discuss replacement options.

Have You Been Told That You Need All of Your Teeth Removed?

If you have been told that your teeth cannot be saved—or that you need to have all of your teeth removed and replaced with dentures or implant-supported teeth—it is reasonable to seek a periodontal second opinion before making an irreversible decision.

In some situations, full-mouth extraction and implant rehabilitation may be appropriate. However, not every patient with advanced periodontal disease needs to have every tooth removed.

Dr. Skene can evaluate the prognosis of each tooth and explain:

• Which teeth may be treatable
• Which teeth have a questionable prognosis
• Which teeth may have a poor prognosis
• What periodontal treatment may accomplish
• Whether bone regeneration is possible
• Whether extraction is truly necessary
• What options exist if a tooth cannot be saved
• How future dental implants could be planned if needed

If a tooth can be predictably maintained, preservation should be considered before extraction.

If a tooth cannot be saved, Dr. Skene can help develop a thoughtful replacement plan while preserving as much bone and gum tissue as possible.

When Should You Get a Periodontal Second Opinion?

A periodontal second opinion may be especially valuable if you have been diagnosed with:

• Advanced periodontal disease
• Significant bone loss
• Deep periodontal pockets
• Loose or mobile teeth
• A failing dental implant
• A poor or hopeless tooth prognosis
• The need for multiple extractions
• The need for full-mouth extraction and replacement teeth

A second opinion does not guarantee that a tooth can be saved. Its purpose is to provide an independent evaluation of your diagnosis, treatment options, and long-term prognosis before you make an irreversible decision.

Dr. Skene will not promise that every tooth can be saved. Instead, she will provide an honest assessment of which teeth may be treated, which may require extraction, and what options are available for the future. The rational for extraction and surgical treatment will be reviewed.

Preserving natural teeth, healthy bone, and gum tissue whenever possible is an important part of Dr. Skene’s approach to periodontal and implant treatment.

A Periodontal Diagnosis You Can Understand

At Mosaic Periodontics, Dr. Skene wants you to leave your consultation understanding:

What is happening.

Why it is happening.

What can be treated.

What cannot be treated.

What your options are.

And what she recommends for the long term.

She will review your periodontal measurements and X-rays with you, explain the biology behind your diagnosis, and answer your questions before you make a decision.

If another dental or medical issue is contributing to your periodontal condition, she will coordinate with the appropriate dental or medical specialist when necessary.

The goal is not simply to give you a periodontal diagnosis. The goal is to give you clarity—and a treatment plan based on evidence, biology, and the long-term health of your teeth and implants.

Schedule a Comprehensive Periodontal Evaluation or Second Opinion

If you have been diagnosed with periodontal disease, gum disease, bone loss, deep periodontal pockets, gum recession, loose teeth, or a failing dental implant, a comprehensive evaluation with a periodontist can help you understand your diagnosis and treatment options.

If you have been told that your teeth cannot be saved, that you need extensive tooth extraction, or that you need full-mouth rehabilitation, consider getting a periodontal second opinion before making an irreversible decision.

At Mosaic Periodontics, Dr. Skene will show you what she sees, explain what it means, and help you understand whether periodontal treatment and tooth preservation may be possible.

What Are the Risks and Alternatives to Periodontal Treatment?

When considering periodontal treatment, you deserve to understand the benefits, risks, alternatives, and expected long-term outcome before deciding how to proceed.

At Mosaic Periodontics, Dr. LaRisse Skene explains what she recommends, why she recommends it, what alternatives are available, and what may happen if treatment is delayed or declined.

The right approach depends on your health, periodontal condition, anatomy, and long-term goals.

What Are the Risks of Periodontal Treatment?

Risks vary by procedure and individual health. Before treatment, Dr. Skene reviews your medical history, medications, dental history, and other factors that may affect healing or surgical outcomes, including:

• Diabetes: Poorly controlled blood sugar can affect healing and periodontal health.
• Smoking: Smoking can impair healing and reduce the predictability of procedures such as gum grafting.
• Systemic or immune-related conditions: These may influence inflammation and healing.
• Medications affecting bone metabolism: Certain osteoporosis medications and other drugs may affect how bone responds to surgery.
• Blood thinners and antiplatelet medications: These may increase bleeding. Dr. Skene coordinates with your physician when necessary rather than asking you to change prescribed medications on your own.
• Individual anatomy: Bone loss, gum thickness, tooth anatomy, and the location of structures such as the sinus or nerves can influence surgical risk.

Identifying these factors in advance helps Dr. Skene plan treatment as safely and predictably as possible.

What Are the Benefits of Treating Periodontal Disease?

The primary goals of periodontal treatment are to control infection and inflammation, preserve the tissues supporting your teeth, and improve their long-term prognosis.

Depending on your diagnosis, treatment may help:

• Reduce inflammation and deep periodontal pockets
• Preserve supporting bone and prevent further bone loss
• Improve access for home care
• Reduce the risk of tooth loss
• Preserve natural teeth
• Improve gum health and esthetics
• Create healthier conditions around dental implants
• Make future dental treatment more predictable

For many patients, the greatest benefit is keeping their natural teeth healthy, functional, and maintainable for as long as possible.

What Are the Alternatives to Periodontal Surgery?

Surgery is not automatically the first treatment for every patient. Depending on your diagnosis, alternatives may include:

Nonsurgical Periodontal Treatment

Scaling and root planing and other nonsurgical therapies can be effective, particularly when disease is diagnosed early or periodontal pockets respond appropriately.

Dr. Skene evaluates your response before recommending additional treatment. If deep pockets or active disease remain, surgery may provide access to areas that cannot be adequately treated or maintained nonsurgically. When surgery is appropriate, she uses a minimally invasive approach whenever possible.

Periodontal Maintenance and Monitoring

Close maintenance and monitoring may be appropriate for some patients. However, ongoing inflammation, progressive bone loss, or deep pockets that cannot be maintained may worsen if treatment is delayed.

If immediate surgery is not appropriate because of your health, circumstances, or preferences, Dr. Skene can create a staged plan to stabilize your periodontal health and complete treatment when the timing is right.

You should never feel pressured into surgery. Dr. Skene will explain what nonsurgical treatment can realistically accomplish, the potential consequences of waiting, and the trade-offs of each option.

What If My Tooth Cannot Be Saved?

If a tooth has a poor or hopeless prognosis, extraction may provide a more predictable outcome than attempting to maintain a tooth that cannot be predictably treated.

When extraction is necessary, Dr. Skene can help plan tooth replacement, which may involve:

• Dental implant placement
• Bone preservation or grafting
• Ridge augmentation
• Gum grafting or soft-tissue augmentation
• Sinus augmentation
• An implant-supported restoration
• Coordination with your restorative dentist

Because Dr. Skene provides both tooth preservation and dental implant surgery, she can consider the complete treatment sequence and preserve as much healthy bone and gum tissue as possible.

Dental implants are not the only replacement option. Depending on your anatomy, bite, esthetic goals, and long-term oral health, alternatives may include a fixed bridge or removable partial denture. Dr. Skene can coordinate with your general or restorative dentist to determine which option best fits your needs.

What Should I Expect During and After Periodontal Surgery?

If surgery is recommended, Dr. Skene will explain:

• What will be treated and why
• How the procedure will be performed
• The expected duration
• Appropriate anesthesia or sedation
• Recovery and activity restrictions
• Oral hygiene and dietary instructions
• Follow-up and periodontal maintenance

Sedation is your choice. Depending on your procedure and medical history, options may include:

• Local anesthesia
• Nitrous oxide
• Oral sedation
• IV sedation

Not every option is appropriate for every patient. Dr. Skene will review your health history and recommend the safest, most suitable approach.

Postoperative instructions are individualized and may include guidance on pain control, oral hygiene, diet, activity, follow-up care, and antibiotics when clinically indicated. Medications are not prescribed automatically; if antibiotics are appropriate, Dr. Skene will select them based on your specific needs.

Mosaic Periodontics also provides postoperative support, including after-hours instructions and access to Dr. Skene when clinically necessary. You will have a clear plan for recovery and for addressing questions or concerns.

What If I Am Not Ready for Treatment?

That is okay. If you need time to decide, Dr. Skene can help you maintain your periodontal health while you consider your options.

Treatment may be completed in stages. The first step may be controlling inflammation, completing nonsurgical therapy, or monitoring your response. In other cases, surgery may be the most predictable way to preserve a tooth.

Your treatment plan should fit your clinical needs—not the other way around.

An Honest Discussion of Your Options

Before moving forward, you should understand:

• What happens if you proceed
• What happens if you wait
• The risks and benefits of treatment
• Whether nonsurgical alternatives are appropriate
• Whether your natural tooth can be saved
• What replacement options are available if it cannot
• Which approach offers the best long-term outcome

At Mosaic Periodontics, Dr. Skene will explain your options in straightforward language and help you make an informed decision.

The goal is not simply to complete a procedure. It is to control disease, preserve teeth and supporting tissues, create a maintainable environment, and protect your long-term oral health.

How to Compare Periodontists and Periodontal Treatment Results

Patients may not always ask this question directly, but it is one of the most important questions they are considering:

“How do I know I am choosing the right periodontist for my situation?”

When you trust a specialist with your teeth, gums, bone, or dental implants, you want more than a treatment recommendation. You want evidence of experience, sound clinical judgment, technical skill, and a commitment to long-term results.

At Mosaic Periodontics, Dr. LaRisse Skene has built her practice around complex periodontal treatment, tooth preservation, gum grafting, bone regeneration, dental implant surgery, and treatment of failing dental implants.

Her approach combines advanced specialty training, years of clinical experience, continuing education, collaboration with referring dentists, and a conservative philosophy focused on long-term periodontal health.

What to Look for When Choosing a Periodontist

When comparing periodontal specialists, consider more than how many procedures a practice performs.

Look for a periodontist who can:

1. Accurately diagnose the underlying problem
2. Explain your diagnosis in a way you can understand
3. Give you an honest prognosis for each tooth
4. Treat complex periodontal and implant conditions
5. Preserve natural teeth whenever they can be predictably maintained
6. Use a conservative, tissue-preserving surgical approach
7. Plan dental implants around the final functional and esthetic result
8. Recognize when a tooth cannot be predictably saved
9. Coordinate treatment with your general dentist and other specialists such as orthodontists and endodontists
10. Plan for long-term maintenance—not simply short-term healing

These are important factors to consider when choosing a periodontist, and they guide treatment at Mosaic Periodontics.

Experience With Complex Periodontal and Implant Cases

Dr. Skene has practiced full-time periodontics since 2008.

Her practice is focused exclusively on periodontal and implant-related treatment, including:

• Advanced periodontal disease
• Deep periodontal pockets
• Periodontal bone loss
• Gum recession and gum grafting
• Periodontal surgery
• Osseous surgery
• Regenerative periodontal procedures
• Ridge augmentation and bone grafting
• Sinus augmentation
• Dental implant placement
• Failing dental implants
• Peri-implantitis
• Complex tooth extraction
• Tooth preservation
• Implant-site development

Because these procedures represent the core of her practice, Dr. Skene treats periodontal and implant problems every day.

Experience matters most when it translates into better diagnosis, better treatment planning, and better decision-making for the individual patient.

How to Evaluate a Periodontist’s Treatment Results

One of the best ways to understand a periodontal specialist’s work is to review appropriate clinical cases and treatment documentation.

Mosaic Periodontics can show before-and-after cases demonstrating procedures such as:

• Free gingival grafts
• Connective tissue grafting
• Dental implant placement
• Bone grafting
• Ridge augmentation
• Sinus augmentation
• Periodontal surgery
• Treatment of advanced periodontal bone loss

Clinical photographs and dental X-rays can demonstrate not only how the gums look after treatment, but also how the underlying bone and supporting tissues have changed.

For patients considering complex periodontal or implant treatment, reviewing clinical results can provide valuable context for what is realistically achievable.

Treatment outcomes vary by patient. Factors such as smoking, oral hygiene, medical conditions, bone quality, periodontal maintenance, and the complexity of the case can all affect healing and long-term stability.

Periodontist Training, Board Certification, and Continuing Education

Dr. Skene’s commitment to periodontal care did not end with residency.

She has maintained board certification since 2008 and continues her professional education through advanced courses, clinical training, and continuing education focused on areas including:

• Dental implant surgery
• Periodontal surgery
• Gum grafting
• Bone regeneration
• Implant complications
• Esthetic periodontal treatment

She has also had the opportunity to learn from internationally recognized leaders in periodontology, including Dr. Pierpaolo Cortellini, whose work in periodontal regeneration and minimally invasive periodontal surgery has influenced modern periodontal treatment.

For Dr. Skene, continuing education is not simply about collecting courses.

It is about continually refining surgical technique and incorporating evidence-based advances that can improve patient care.

A Periodontist Who Teaches Other Dental Professionals

Dr. Skene’s role extends beyond treating patients.

She has taught dental hygiene and dental professionals throughout Utah, including educational programs associated with the University of Utah, Utah Valley University (UVU), Salt Lake Community College (SLCC), and the Utah Dental Association.

Teaching requires more than knowing how to perform a procedure. It requires understanding the underlying biology and being able to explain why a particular diagnosis or treatment approach makes sense.

That same philosophy carries into patient care.

Dr. Skene wants you to understand your diagnosis—not simply accept a recommendation.

Why Dentists Refer Complex Cases to a Periodontist

Mosaic Periodontics works closely with general dentists, dental hygienists, restorative dentists, orthodontists, and other specialists.

Many patients come to Dr. Skene through a professional referral because their dentist or hygienist recognizes that a periodontal or implant problem requires specialized evaluation or treatment.

However, you do not need a referral to seek a periodontal evaluation at Mosaic Periodontics.

If you are concerned about your gums, have been diagnosed with bone loss, have deep periodontal pockets, are experiencing gum recession, have a failing dental implant, or have been told that a tooth needs to be removed, you can request an evaluation directly.

Dr. Skene can then communicate her findings and recommendations with your existing dental team.

Coordinated Care With Your Dentist

Mosaic Periodontics is a specialty practice.

Our role is to diagnose and treat the periodontal and surgical portion of your care and then return you to your general dentist for ongoing restorative and preventive treatment whenever appropriate.

Your general dentist remains an important part of your long-term oral health.

We often describe the completion of periodontal treatment as “graduation day.”

When applicable, the goal is to stabilize your periodontal health, complete the necessary surgical treatment, and send you back to your dentist and hygienist with a healthier foundation for continued care.

A Conservative Approach to Periodontal and Implant Treatment

More treatment is not necessarily better treatment.

Dr. Skene believes the best treatment is the least invasive approach that can provide a predictable, maintainable long-term result.

That philosophy is particularly important when treating:

• Natural teeth with periodontal bone loss
• Gum recession
• The esthetic zone
• Dental implant sites
• Failing dental implants
• Areas requiring bone or soft-tissue regeneration

Whenever possible, Dr. Skene focuses on preserving existing bone, gum tissue, papillae, and natural teeth rather than creating additional problems that may need to be reconstructed later.

Comparing Periodontists for Dental Implant Treatment

Dental implant success is not simply about whether an implant integrates with the bone.

Long-term implant health depends on careful diagnosis, three-dimensional implant positioning, adequate bone and soft tissue, the implant-abutment connection, the quality and fit of the final restoration, oral hygiene, and ongoing periodontal maintenance.

Dr. Skene frequently uses Straumann dental implants, particularly when treating esthetically demanding areas.

Her implant planning emphasizes:

• Preservation and management of bone
• Soft-tissue management
• Appropriate implant selection
• Careful surgical technique
• Coordination with the restorative dentist
• Long-term periodontal maintenance
• Follow-up evaluation of implant health

Mosaic Periodontics also treats peri-implantitis and failing dental implants, giving Dr. Skene experience not only in placing implants but also in diagnosing and managing complications when they occur.

When comparing periodontists for dental implants, ask how each specialist evaluates bone and gum tissue, coordinates with the restorative dentist, manages complications, and plans for long-term maintenance.

Why Long-Term Periodontal and Implant Follow-Up Matters

An implant or periodontal procedure is not truly successful simply because the surgery went well.

Long-term health requires maintenance.

Mosaic Periodontics uses postoperative and periodontal follow-up to evaluate healing, tissue stability, and—when appropriate—bone levels around dental implants.

This allows potential problems to be identified earlier rather than waiting until an implant becomes painful, mobile, or severely compromised.

The goal is not simply to place an implant. The goal is to create an implant that can remain healthy and maintainable for the long term.

Diagnosis and Prognosis: Understanding Your Treatment Options

These two words are particularly important when evaluating periodontal disease:

Diagnosis: What Is Happening Now?

A diagnosis identifies the problems affecting your teeth, gums, bone, or dental implants.

It answers questions such as:

Do I have periodontal disease?

Where is the bone loss?

How deep are my periodontal pockets?

Why is this tooth losing bone?

Is the problem localized or generalized?

Prognosis: What Can We Expect in the Future?

A prognosis looks forward.

It considers:

Can this tooth be saved?

How predictable is treatment?

What happens if we do nothing?

What treatment could improve the prognosis?

How maintainable will this tooth or implant be?

What is the likely long-term outcome?

This distinction is central to Dr. Skene’s approach.

She believes patients deserve more than a list of problems. They deserve to understand where their periodontal condition is headed and what can realistically be done about it.

When to Seek a Periodontal Second Opinion

General dentists and dental hygienists play an essential role in preventing and managing periodontal disease.

However, some cases require the additional training and surgical expertise of a periodontist.

If you have been told:

• “Your pockets are too deep.”
• “There is too much bone loss.”
• “This tooth may not be savable.”
• “You need to have several teeth extracted.”
• “Your implant is failing.”
• “There is nothing else we can do.”

—you may benefit from a comprehensive periodontal evaluation or periodontal second opinion.

Dr. Skene can provide an independent assessment of your diagnosis, prognosis, treatment options, and long-term outlook.

She will not promise that every tooth can be saved.

Instead, she will tell you realistically which teeth may be treatable, which teeth have a questionable prognosis, which teeth may not be predictably maintainable, and what options exist if replacement becomes necessary.

The Mosaic Periodontics Standard for Specialist Care

At Mosaic Periodontics, expertise is not defined simply by the number of procedures performed.

It is defined by the ability to make the right decision for the right patient at the right time.

Dr. Skene’s approach is built around:

Accurate diagnosis.

Evidence based prognosis.

Advanced surgical expertise.

Conservative treatment whenever possible.

Preservation of natural teeth, bone, and gum tissue.

Careful dental implant planning.

Treatment of complex periodontal and implant problems.

Collaboration with your dental team.

Long-term periodontal maintenance.

Most importantly, Dr. Skene wants you to understand why she recommends a particular treatment—not simply what treatment she recommends.

Your Periodontal Health Deserves an Expert Opinion

If you have periodontal disease, significant bone loss, deep periodontal pockets, gum recession, loose teeth, a failing dental implant, peri-implantitis, or have been told that your teeth cannot be saved, a comprehensive evaluation by a periodontist can help you understand your options.

At Mosaic Periodontics, Dr. Skene combines advanced periodontal expertise with a conservative, long-term approach to help you preserve your natural teeth and achieve the healthiest possible outcome for your gums, bone, and dental implants.

Sometimes the most important treatment decision is determining what not to do.