Your first consultation

What does a periodontist actually do?

A periodontist is a dentist who, after a five-year undergraduate dental degree, has completed an additional four-year full-time university specialist programme — the MChD in Periodontics and Oral Medicine — and is registered with the HPCSA as a Specialist in Periodontics and Oral Medicine. In South Africa, periodontics and oral medicine are a single combined specialty: the same four-year MChD covers both the diseases and surgery of the gums and supporting bone and the medical conditions of the oral mucosa (ulcers, white patches, autoimmune lesions, dry mouth, oral cancer screening). There is no separate "periodontist" versus "oral-medicine" qualification — which is why both Dr Leande Kotze and Dr Christa Blignaut hold the full scope (University of Pretoria — MChD Periodontics and Oral Medicine, a four-year specialist degree leading to HPCSA specialist registration).

In practice, periodontists and oral medicine specialists work on the parts of the mouth that are not the teeth themselves. Restorative dentistry — fillings, crowns, dentures, root canals — stays with your general dentist. We see you alongside them, not instead of them.

Do I need a referral?

A referral letter from your dentist is helpful but not required. Under South Africa's National Patient Rights Charter, every patient has the right to choose their own health care provider, so you can book a registered specialist directly. You can phone our reception or use the booking form directly. If you arrive without a referral, we will write to your dentist after the consultation as a courtesy, so they remain in the loop on your care.

If your dentist has referred you, ask them to forward any recent x-rays or photographs digitally — this saves us repeating imaging you have already paid for.

What happens at a first periodontist or oral medicine consultation?

A first consultation runs 45 to 60 minutes. It is structured into three parts:

1. The conversation

We start by understanding the reason for the visit. This is usually one of:

• A specific concern: bleeding gums, a loose tooth, a missing tooth, a white patch, a recurring ulcer.
• A referral for a defined procedure: gum graft, implant placement, oral biopsy.
• A request for a second opinion before a planned treatment elsewhere.

We will also ask about your medical history, the medications you take, smoking history, family history, and any prior dental treatment. This is not a formality — many of the conditions we treat have systemic links, and the answer to "what's happening in your mouth?" almost always partly lives outside it.

2. The examination

A full periodontal or oral medicine examination is more thorough than a check-up at a general dentist. It includes:

• A visual assessment of the lips, cheeks, tongue, palate, and floor of the mouth.
• Probing depths recorded on each tooth surface (six measurements per tooth).
• Bleeding indices and a recession map.
• Mobility and furcation involvement where relevant.
• An assessment of the bite (occlusion) and how the teeth meet.
• Photographs of any clinically significant lesion.
• Necessary x-rays — typically a panoramic view, and periapical x-rays of teeth that warrant a closer look. If you brought recent x-rays from your dentist, we may not need to repeat them.

For oral medicine consultations, the examination may also include palpation of the lymph nodes of the head and neck, and tests of salivary flow if dry mouth is a concern.

3. The discussion

At the end of the appointment, we walk you through what we found, on a screen with your photographs and x-rays. Diagrams help. We will tell you:

• What is happening, in plain English.
• Whether anything needs to be done now.
• What the options are, with the trade-offs of each.
• What it is likely to cost.

You leave with a written clinical report (typically sent to you and to your referring dentist within two working days) and, if treatment is needed, a separate itemised estimate.

What you should bring

• Your medical aid card (even if you are paying privately — it speeds up the post-visit reimbursement claim).
• A list of current medications, including supplements and over-the-counter products.
• Any recent x-rays, photographs, or treatment plans from your dentist or specialist. Digital is easiest; printed is fine.
• If you are seeing us for a specific lesion, a quick note of when you first noticed it and whether it has changed.

You do not need to fast, you do not need to take a day off work, and you should keep taking any medication you are on (unless your doctor has already told you otherwise).

What it costs

A first consultation costs R 1,400. This includes the clinical examination, all routine intra-oral photographs, the written report to you and your dentist, and the time to discuss findings.

The fee does NOT include:

• X-rays, which are charged separately per the practice's own fee schedule. South Africa has no statutory dental tariff, and SADA — which publishes standardised procedure codes for medical-aid claims, not prices — is legally barred from recommending fees (SADA Patient FAQs).
• Any treatment performed on the day (we do not normally treat at a first visit; if something urgent comes up, we will discuss it before proceeding).
• The cost of any subsequent procedure, which is itemised in the estimate we send afterwards.

We accept cash, debit card, credit card, and EFT. Payment is settled at reception after the visit.

Medical aids

We are not contracted in with any medical aid scheme. In practice this means:

• You pay the consultation fee at the practice.
• We give you a detailed statement with ICD-10 codes and procedure codes the medical aid recognises.
• You submit the statement to your medical aid for reimbursement.
• How much you get back depends on your specific plan, your remaining annual dental benefits, and whether the procedure code is covered.

Specialist consultations are usually reimbursed in part or in full from the specialist-dentistry portion of a medical aid plan. Major procedures (implants, gum grafts) are often funded from a major-dental sub-limit and may require pre-authorisation — we can help you assemble what you need to apply.

If a planned procedure exceeds your available benefits, ask us about a payment plan. We are reasonable.

How long until you will be seen

For routine consultations, the wait is typically one to three weeks. We aim to see urgent referrals (suspicious lesions, acute swelling, traumatic injuries to teeth or supporting tissues) within two working days where the diary allows — phone the practice and say it is urgent.

What happens after the consultation

Typically within two working days, you and your dentist receive a written clinical report summarising findings, diagnosis, and the recommended treatment plan. If treatment is needed:

• For procedures that take a single visit (a biopsy, a small gum graft, a single implant in a healed site), we usually offer dates within the next two to four weeks.
• For staged treatment (full periodontal therapy, multiple implants, complex regenerative work), we send a sequenced plan with each phase costed separately so you can plan over time.
• For conditions that need ongoing review rather than treatment (lichen planus, monitored oral lesions, post-treatment maintenance), we book you into a review cycle that fits the condition.

Attending a consultation does not commit you to any treatment. The consultation provides a clinical opinion and a written plan; what you do with both is your decision.