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Patients with more complex periodontal conditions may require specialist treatment.  Any referred patient should have received appropriate periodontal care (detailed in the referral along with a recent BPE /other detailed periodontal record), in keeping with Greater Manchester LDN Healthy Gums DO Matter Practitioner’s Toolkit and the British Society of Periodontology Parameters of Care:


As there is limited access to specialist periodontal services referrals will only be accepted if the patient has engaged with a process of improving their periodontal health and there is a specific problem with the periodontal tissues, which is beyond the scope of general dental practice.  For example:

  • A concurrent medical factor that is affecting the periodontal tissues
  • Patients requiring complex restorative treatment planning
  • Patients with combined periodontal and endodontic lesions
  • Patients requiring combined periodontal and orthodontic treatment
  • Patients either at risk of or having been identified with aggressive periodontitis
  • A strong family history of early tooth loss due to periodontitis in a patient with periodontal disease
  • Advanced periodontitis in a young patient
  • Patients with desquamative gingivitis
  • Where residual chronic periodontitis persists after periodontal treatment
  • Patients requiring periodontal surgery, such as crown-lengthening procedures, and for the surgical management of mucogingival problems (e.g. treatment of gingival recession or gingival overgrowth)
  • Recent high quality radiographs must be sent with the referral letter. Digital print-outs must be of diagnostic quality.