ADA Compliant Website Transcript

What is a Periodontist?

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.

Periodontists often treat more problematic periodontal cases, such as those with severe gum disease or a complex medical history. Periodontists offer a wide range of treatments, such as scaling and root planing (in which the infected surface of the root is cleaned) or root surface debridement (in which damaged tissue is removed). They can also treat patients with severe gum problems using a range of surgical procedures. In addition, periodontists are specially trained in the placement, maintenance, and repair of dental implants.

During the first visit, Dr. Scheines reviews the patient’s complete medical and dental histories. It is extremely important to know if any medications are being taken or if the patient is being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.

Dr. Scheines examines the gums, checks to see if there is any gum line recession, assesses how the teeth fit together when biting, and checks the teeth to see if any are loose. Dr. Scheines will also take a small measuring instrument called a probe and place it between the teeth and gums to determine the depth of those spaces, known as periodontal pockets; this helps her to assess the health of the gums. X-rays may also be taken to observe the health of the bone below the gum line.

Who Should See a Periodontist?
Some patients’ periodontal needs can be managed by the general dentist. However, as more and more patients are exhibiting signs of periodontal disease, coupled with research that suggests a relationship between periodontal disease and other chronic diseases of aging, periodontal treatment may necessitate a greater understanding and increased level of expertise by a trained specialist. Patients who present with moderate or severe levels of periodontal disease, or patients with more complex cases, will be best managed by a partnership between the dentist and periodontist.


Cynthia Scheines

D.D.S., M.S., PhD.
Diplomate of the American Board of Periodontology
Assistant Professor, Periodontics
Loma Linda University School of Dentistry
2022 Woman of Distinction by Nationwide Registries

Dr. Scheines is committed to providing each of her patients with the highest care and best dental treatment. Her dental practice offers advanced specialized knowledge about the science and clinical applications of implant dentistry.

Hardev M. Singh

D.M.D., M.S.
Diplomate of the American Board of Periodontology
Adjunct Professor Western University

Dr. Singh is a periodontist who works with various private practice and corporate offices to provide periodontal therapy and implant treatment. We are proud to welcome him to the CS Periodontics team.

Mylene Crammer

Registered Dental Hygienist

Mylene graduated from University of Southern California with a Bachelor’s of Science degree in Dental Hygiene. She has been practicing as a hygienist for over 32 years. As our dental Hygienist she provides quality preventative oral care and education to maintain your healthy smile. She strives for the best periodontal health care for her patients.

Jazmina Haros

Jazmina has over 17 years of dental experience; she is Dr. Scheines Surgical Dental Assistant. She manages all the Implant lab cases and ensures all the day to day surgical needs are met. Her favorite part of the job is meeting new patients and making them feel welcomed and confident. Every day is a learning opportunity and she really enjoys seeing smiles transformed.

Cecilia Gatti

Financial Administrator / Insurance Billing

Cecilia joined our team in 2019. She has worked in accounting and bookkeeping for over 25 years. She specializes in Dental Insurance processing and billing. She works closely with dental Insurance companies to process our patient’s insurance claims. She oversees patient billing, financials, and Insurance verification.

Liz Montes

Liz has been in the dental industry since 2020 working previously as patient care coordinator at Huntington Dental Excellence. She joined our team early in 2023 and has always been motivated and willing to help our patients get their best experience at CS Periodontics & Dental Implants.

Johnnie Le

Dental Hygienist

Johnnie is a US Marine Veteran that graduated from West Coast University with a Bachelor’s of Science Degree in Dental hygiene. He joined our team early in 2023 and has always been motivated and dedicated to his patients oral care and overall well being. As a Registered Dental Hygienist, he strives to educate and provide continuous preventative treatment to all his patients.


Advanced Platelet Rich Fibrin (PRF)

Platelet-rich fibrin (PRF) is a treatment used in various medical and dental procedures to promote tissue healing and regeneration. PRF is derived from the patient's own blood and contains a high concentration of platelets, growth factors, and other bioactive proteins that play a crucial role in tissue repair.

The PRF preparation process involves taking a small amount of the patient's blood and centrifuging it to separate the different components. The resulting PRF clot is rich in platelets and fibrin, which form a gel-like substance that can be applied directly to the treatment site.

In dentistry, PRF is commonly used in procedures such as dental implant placement, bone grafting, and periodontal surgery to enhance healing and improve treatment outcomes. PRF can help accelerate the healing process, reduce inflammation, and promote the formation of new blood vessels and bone tissue.

PRF is considered safe because it is derived from the patient's own blood, reducing the risk of allergic reactions or transmission of infections. However, like any medical procedure, there are risks and potential complications associated with PRF treatment, which should be discussed with your healthcare provider before undergoing the procedure.

All on 4 Dental Implants

All-on-4 dental implants are a dental restoration option for patients who are missing all of their teeth in one or both jaws. This treatment involves the placement of four dental implants in the jawbone to support a full arch of replacement teeth.

The "All-on-4" concept was developed to provide a solution for patients who have lost all their teeth or are facing the loss of all their teeth and want a more stable and permanent alternative to traditional dentures. With All-on-4 dental implants, a fixed bridge of teeth can be attached to the implants, providing a natural-looking and functional replacement for missing teeth.

The key benefits of All-on-4 dental implants include:

  • Improved Stability: The dental implants provide a stable foundation for the replacement teeth, allowing patients to eat and speak with confidence.
  • Preservation of Jawbone: Dental implants help preserve the jawbone and prevent bone loss, which can occur when teeth are missing.
  • Natural Appearance: The replacement teeth are custom-made to match the natural shape and color of the patient's remaining teeth, providing a natural appearance.
  • Convenience: All-on-4 dental implants are a fixed solution, so there is no need to remove them for cleaning or maintenance.
  • Immediate Results: In many cases, the All-on-4 procedure can be completed in a single day, providing patients with immediate results.


CBCT stands for Cone Beam Computed Tomography. It is a special type of X-ray machine used in situations where regular dental or facial X-rays are not sufficient. CBCT uses a cone-shaped X-ray beam to create a 3D image of the dental structures, soft tissues, nerve paths, and bone in the craniofacial region in a single scan.

CBCT is commonly used for:

  1. Implant Planning: CBCT scans provide detailed images that help in planning the placement of dental implants, ensuring they are placed in the optimal position for stability and function.
  2. Surgical Planning: CBCT scans are used in planning and evaluating surgical procedures such as impacted tooth removal, jaw surgery, and bone grafting.

Comprehensive Periodontal Evaluation

A Comprehensive Periodontal Evaluation is a way to assess your periodontal health by examining:

  • Your teeth
  • Your plaque
  • Your gums
  • Your bite
  • Your bone structure
  • Your risk factors

When Dr. Scheines performs this evaluation, she will look at these six areas to determine the state of your periodontal health.

Why do I need a Comprehensive Periodontal Evaluation?

Recent research has indicated that the prevalence of periodontal disease in the U.S. may be significantly higher than originally estimated. This means that all adults should thoroughly assess the state of their periodontal health to receive accurate information about the health of their mouths.

By assessing your oral health on an annual basis, you and your dental professional will know how healthy your mouth is, and will be better able to notice any conditions, such as periodontal disease, that may need additional treatment.

Research has also shown, and experts agree, that there is an association between periodontal disease and other chronic inflammatory conditions, such as diabetes, cardiovascular disease, and respiratory diseases. Therefore, it is very important to treat the inflammation that causes periodontal disease as soon as possible to ensure that your entire body stays healthy.

Crown Lengthening

Crown lengthening is a dental procedure performed to expose more of the tooth's surface, usually to restore a tooth that is decayed, broken below the gumline, or has insufficient tooth structure for a restoration like a crown or bridge.

During the procedure, the gum tissue and sometimes the underlying bone are reshaped to expose more of the tooth. This allows the dentist to place a restoration that adequately covers and protects the tooth. Crown lengthening can also be done to correct a "gummy smile," where the teeth appear short because of excess gum tissue.

Deep Cleanings

Periodontal deep cleaning, also known as scaling and root planing, is a non-surgical procedure used to treat gum disease, specifically periodontitis. During this procedure, the dentist or dental hygienist removes plaque and tartar from the teeth and roots, and then smooths the rough spots on the roots to remove bacteria and help the gums reattach to the teeth. Periodontal deep cleaning is often done in multiple visits, with each visit focusing on a specific section of the mouth. It is an important treatment for gum disease and can help prevent further damage to the gums and bone supporting the teeth.


A frenectomy is simply the removal of a frenum in the mouth. A frenum is a muscular attachment between two tissues. The limited movement of the lip caused by the frenum can lead to mouth breathing or extended tissue can come between the two front teeth and create a gap (diastema).


Gingivectomy is best described as a procedure where excess gum tissue is re-contoured during or after orthodontic treatment.

Guided Bone Regeneration

Guided bone regeneration (GBR) is a dental procedure used to rebuild bone that has been lost due to periodontal disease, tooth extraction, or other reasons. It is often performed in preparation for dental implant placement or to improve the support and stability of natural teeth.

During guided bone regeneration, a dental surgeon will place a special membrane over the area where bone regeneration is needed. This membrane acts as a barrier, preventing soft tissue from invading the healing area and allowing bone cells to regenerate. In some cases, bone graft materials may also be used to stimulate new bone growth.

The membrane used in guided bone regeneration is typically made of biocompatible materials that are absorbed by the body over time. As the bone regenerates, the membrane dissolves or is removed by the dentist.

Guided bone regeneration is a complex procedure that requires careful planning and skill. It is usually performed under local anesthesia, and the recovery time can vary depending on the extent of the procedure. Following the procedure, patients may be prescribed antibiotics and pain medication to aid in healing. Regular follow-up visits with the dentist are necessary to monitor the healing process and ensure successful bone regeneration.

Guided Dental Implant Surgery

Guided dental implant surgery, also known as computer-guided implant surgery or guided implant placement, is a technique used to precisely place dental implants using computer technology and 3D imaging. This technology allows for more accurate implant placement, leading to better outcomes and reduced risk of complications.

The process of guided dental implant surgery typically involves the following steps:

  • CT Scan: A cone beam CT scan is taken of the patient's jaw to create a 3D image of the bone structure and surrounding anatomy.
  • Virtual Planning: Using specialized software, the dentist or oral surgeon can plan the implant placement virtually, taking into account the ideal position, angle, and depth for each implant.
  • Fabrication of Surgical Guide: A surgical guide, also known as a stent, is fabricated based on the virtual plan. The surgical guide is a custom-made device that fits over the patient's teeth or gums and has holes or channels that guide the implant placement.
  • Surgical Procedure: During the actual surgery, the surgical guide is placed in the patient's mouth, and the implants are placed through the guide according to the pre-determined plan.
  • Follow-Up: After the implants are placed, the patient is monitored during the healing process to ensure proper integration of the implants with the bone.

Gum Graft Surgery

A gum graft, also known as a gingival graft or periodontal plastic surgery, is a procedure used to treat receding gums. Receding gums can be caused by a variety of factors, including periodontal disease, aggressive tooth brushing, genetics, or other health issues.

During a gum graft procedure, a periodontist or oral surgeon will take gum tissue from another part of your mouth, usually the roof of the mouth, and graft it onto the areas where the gums have receded. This helps to cover exposed tooth roots, protect them from decay, and improve the appearance of your smile.

IV Sedation Therapy

IV sedation therapy, also known as intravenous sedation, is a type of sedation used in dentistry to help patients relax and feel more comfortable during dental procedures. It involves the administration of sedative drugs through a vein, which allows the medication to work quickly and effectively.

IV sedation is commonly used for patients who experience dental anxiety or fear, have a strong gag reflex, need extensive dental work, or have difficulty sitting still for long periods. It can also be used for patients undergoing oral surgery or other complex dental procedures.

Intraoral Scanner

An intraoral scanner is a digital scanning device used in dentistry to create detailed 3D images of the teeth and oral structures. It is used as an alternative to traditional dental impressions, which involve using a putty-like material to create molds of the teeth.

Intraoral scanners offer several advantages over traditional dental impressions, including increased accuracy, faster turnaround times, and improved patient comfort. They also allow for easier communication between the dental team and the dental laboratory, leading to better treatment outcomes.

Low Exposure Dental Radiology

Low-exposure dental radiology refers to the use of dental X-ray techniques that minimize the amount of radiation exposure to the patient. Dental X-rays are important for diagnosing and monitoring oral health conditions, but it is essential to minimize radiation exposure, especially for routine procedures.

Oral Biopsy

An oral biopsy is a procedure in which a small sample of tissue is removed from the mouth and examined under a microscope to diagnose a variety of conditions, including oral cancer, infections, and other diseases.

An oral biopsy is typically performed under local anesthesia to numb the area. The procedure itself is usually quick and relatively painless. After the biopsy, the tissue sample is sent to a laboratory for analysis. The results of the biopsy can help determine the cause of the abnormal tissue and guide further treatment, if necessary.

It's important to follow post-operative instructions after an oral biopsy to promote healing and reduce the risk of complications.

Oral Cancer Examination

An oral cancer examination is a visual and physical examination of the oral cavity and surrounding tissues to look for signs of cancer or precancerous conditions. It is typically performed by a dentist or oral health professional during a routine dental checkup.

It's important to note that these signs and symptoms can also be caused by other, less serious conditions. However, it is important to have any persistent or concerning symptoms evaluated by a dentist or healthcare professional to rule out oral cancer or other serious conditions. Early detection and treatment of oral cancer can greatly improve outcomes.

Osseous Surgery / Pocket Reduction

Osseous surgery, also known as flap surgery or pocket reduction surgery, is a surgical procedure used to treat advanced gum disease (periodontitis). Periodontitis causes the gums to pull away from the teeth, forming pockets that become infected. Over time, these pockets can deepen, leading to bone loss and tooth loss.

During osseous surgery, the dentist or periodontist will access the roots of the teeth by lifting the gums away from the teeth. They will then remove the tartar (hardened plaque) and bacteria from the root surfaces and reshape the bone to eliminate the pockets. In some cases, bone grafts or membranes may be used to help regrow lost bone and tissue.

Osseous surgery can help to reduce pocket depth, eliminate bacteria, and promote healing of the gums. It can also help to prevent further bone loss and stabilize the teeth. However, it is important to maintain good oral hygiene habits and follow the dentist's instructions for home care to prevent gum disease from recurring.


Peri-implantitis is a condition that affects dental implants. It is characterized by inflammation and infection of the tissues surrounding a dental implant, similar to periodontal disease around natural teeth.

Peri-implantitis can occur when bacteria build up on and around the implant, leading to inflammation of the surrounding gums (peri-implant mucositis) and, if left untreated, progressing to peri-implantitis, which involves bone loss around the implant.

Common signs and symptoms of peri-implantitis include:

  • Red, swollen, or bleeding gums around the implant
  • Gum recession around the implant
  • Pus around the implant
  • Loose or wobbly implant
  • Pain or discomfort around the implant
  • Changes in the appearance of the gums around the implant

Peri-implantitis can be caused by various factors, including poor oral hygiene, smoking, a history of periodontal disease, and poorly placed implants. Treatment for peri-implantitis typically involves nonsurgical or surgical interventions to remove the bacteria and infe

Periodontal Maintenance

A periodontal maintenance appointment is a follow-up visit with a dental hygienist or periodontist after the completion of active periodontal treatment, such as scaling and root planing (deep cleaning) or periodontal surgery. These appointments are important for maintaining the health of your gums and preventing the progression of periodontal disease.

Periodontal Regeneration

Periodontal regeneration is a process aimed at rebuilding the supporting structures of the teeth, including the gums, periodontal ligament, and bone, that have been damaged by periodontal disease. The goal of periodontal regeneration is to restore the health and function of the periodontium (the tissues surrounding and supporting the teeth) and to prevent tooth loss.

There are several techniques used in periodontal regeneration:

  • Guided Tissue Regeneration (GTR): GTR is a surgical procedure in which a barrier membrane is placed between the gum tissue and the tooth root to prevent unwanted soft tissue from growing into the area and allow the bone and connective tissue to regenerate.
  • Bone Grafting: Bone grafting involves placing bone graft material into the areas of bone loss around the teeth to stimulate the body's natural ability to regenerate bone.
  • Growth Factors: Growth factors, such as platelet-rich plasma (PRP) or platelet-rich fibrin (PRF), can be used to stimulate tissue regeneration and promote healing.
  • Enamel Matrix Derivative (EMD): EMD is a protein-based gel that can stimulate the growth of new bone and attachment tissue.
  • Dental Implants: In cases where tooth loss has occurred due to severe periodontal disease, dental implants can be used to replace missing teeth and restore function.

Periodontal regeneration techniques can be highly effective in restoring the health and function of the periodontium and preventing further tooth loss. However, the success of these techniques depends on various factors, including the extent of the damage, the patient's overall health, and their commitment to maintaining good oral hygiene. It is important to consult with a periodontist or dental specialist to determine the most appropriate treatment for your individual needs.

Routine Dental Cleanings

Routine dental cleanings, also known as prophylaxis, is a preventive dental procedure that involves removing plaque, tartar, and stains from the teeth. It is typically performed by a dental hygienist and is an essential part of maintaining good oral health.

During a routine dental cleaning appointment, the dental hygienist will use specialized tools to remove plaque and tartar from the surfaces of your teeth, especially along the gumline and between the teeth. They will also polish your teeth to remove any remaining plaque and stains, leaving your teeth clean and smooth.

Sinus Augmentation

Sinus augmentation, also known as sinus lift surgery, is a surgical procedure used to increase the amount of bone in the upper jaw in the area of the molars and premolars. This procedure is often necessary when there is not enough bone height in the upper jaw to support dental implants.

During a sinus augmentation procedure, the sinus membrane is lifted upward, and bone graft material is placed into the space created between the jaw and the sinus membrane. This bone graft material helps stimulate new bone growth, increasing the height of the bone in the area. Once the bone has healed and has become strong enough, dental implants can be placed securely into the newly augmented bone.

Sinus augmentation is a safe and effective procedure that can help restore the bone in the upper jaw and provide the necessary support for dental implants.

TMJ Disorder

TMJ (temporomandibular joint) disorder can cause pain and discomfort in the jaw joint and the muscles that control jaw movement. Treatment for TMJ disorder by a dentist can vary depending on the severity of the condition and the specific symptoms experienced by the patient. Night guards are usually recommended.


Periodontal Disease and Diabetes

Periodontal disease and diabetes are closely linked, with each condition having an impact on the other. People with diabetes are at an increased risk of developing periodontal disease, and periodontal disease can make diabetes harder to control. Here's how they are connected:

  1. Impact of Diabetes on Periodontal Disease: Diabetes can affect the body's ability to fight infection, including gum infections caused by bacteria. This makes people with diabetes more susceptible to developing periodontal disease. High blood sugar levels can also contribute to gum inflammation and damage.
  2. Impact of Periodontal Disease on Diabetes: Periodontal disease can make it harder to control blood sugar levels in people with diabetes. The inflammation and infection associated with periodontal disease can cause blood sugar levels to rise, making diabetes more difficult to manage.
  3. Bi-Directional Relationship: The relationship between periodontal disease and diabetes is bi-directional, meaning that each condition can have an impact on the other. Poorly controlled diabetes can increase the risk of developing periodontal disease, and periodontal disease can make it harder to control diabetes.
  4. Management and Prevention: Managing both diabetes and periodontal disease is important for overall health. People with diabetes should pay extra attention to their oral health and seek regular dental care to prevent and manage periodontal disease. Good blood sugar control is also crucial for preventing complications.
  5. Collaborative Care: Dentists and healthcare providers can work together to provide collaborative care for patients with diabetes and periodontal disease. This may involve coordinating treatment plans and sharing information to ensure comprehensive care.

Overall, maintaining good oral hygiene, controlling blood sugar levels, and seeking regular dental care are key to managing the relationship between periodontal disease and diabetes and reducing the risk of complications.

Periodontal Disease and Heart Disease

Periodontal disease and heart disease are linked in several ways, although the exact nature of the relationship is still being studied. Research suggests that the bacteria and inflammation associated with periodontal disease may play a role in the development of heart disease. Here are some key points about the relationship between periodontal disease and heart disease:

  1. Inflammation: Periodontal disease is characterized by inflammation of the gums and tissues surrounding the teeth. Chronic inflammation in the body, including inflammation caused by periodontal disease, is believed to contribute to the development of heart disease.
  2. Bacteria: The bacteria that cause periodontal disease can enter the bloodstream through the gums and travel to other parts of the body, including the heart. Once there, they may contribute to the formation of plaques in the arteries, which can lead to atherosclerosis (hardening of the arteries) and increase the risk of heart attack and stroke.
  3. Shared Risk Factors: Periodontal disease and heart disease share some common risk factors, such as smoking, diabetes, and poor oral hygiene. People with these risk factors may be at an increased risk of developing both conditions.
  4. Studies: While more research is needed to fully understand the relationship between periodontal disease and heart disease, some studies have suggested a link. For example, a 2012 study published in the journal Circulation found that people with severe periodontal disease had a significantly increased risk of developing heart disease compared to those with mild or no periodontal disease.
  5. Prevention and Treatment: Maintaining good oral hygiene, including regular brushing, flossing, and dental check-ups, is important for preventing periodontal disease. For people with both periodontal disease and heart disease, coordinated care between a dentist and cardiologist may be beneficial to manage both conditions effectively.

While the relationship between periodontal disease and heart disease is complex, it is clear that maintaining good oral health is important for overall health and may help reduce the risk of heart disease. If you have periodontal disease or are at risk for heart disease, talk to your dentist and healthcare provider about steps you can take to protect your health.

Periodontal Disease Linked to Multiple Health Conditions

Periodontal disease has been linked to several other health conditions beyond heart disease and diabetes. Here are some of the diseases and conditions that have been associated with periodontal disease:

  1. Respiratory Diseases: Periodontal disease may be linked to respiratory diseases such as pneumonia and chronic obstructive pulmonary disease (COPD). The bacteria from the mouth can be aspirated into the lungs, potentially leading to respiratory infections.
  2. Rheumatoid Arthritis (RA): Some studies suggest a link between periodontal disease and rheumatoid arthritis, with inflammation as a common factor. Treating periodontal disease may improve RA symptoms.
  3. Alzheimer's Disease: There is ongoing research into the link between periodontal disease and Alzheimer's disease. Some studies suggest that the bacteria associated with periodontal disease may be found in the brains of Alzheimer's patients.
  4. Cancer: While the evidence is not conclusive, some studies have suggested a link between periodontal disease and certain types of cancer, including pancreatic cancer and oral cancer.
  5. Pregnancy Complications: Periodontal disease has been associated with an increased risk of preterm birth and low birth weight. Pregnant women should take special care of their oral health.
  6. Cardiovascular Diseases: In addition to heart disease, periodontal disease has been linked to other cardiovascular conditions such as stroke, atherosclerosis, and endocarditis.
  7. Osteoporosis: Both osteoporosis and periodontal disease involve bone loss, and there may be a link between the two conditions. Osteoporosis may increase the risk of periodontal disease, and vice versa.

It's important to note that while there is evidence linking periodontal disease to these conditions, the exact nature of the relationship is still being studied. Maintaining good oral hygiene, regular dental check-ups, and managing risk factors such as smoking and diabetes can help reduce the risk of developing periodontal disease and its potential complications.