Dee Nishimine, D.D.S., Inc.
Sophia Y. Tseng, D.M.D.
Periodontics & Dental Implants
Call: (559)229-6557

When to See a Periodontist

Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng are  periodontists who specialize in the prevention, diagnosis and treatment of infections and diseases in the soft tissues surrounding the teeth, and the jawbone to which the teeth are anchored.  They have trained an additional three years beyond the four years of regular dental school, and are familiar with the most advanced techniques necessary to treat periodontal disease and place dental implants.  We also perform a vast range of cosmetic procedures to enhance the smile to its fullest extent.

Periodontal disease begins when the toxins (posions)  found in bacterial plaque which attack the soft or gingival tissue surrounding the teeth.  The bacterial plaque  embeds itself in the gum and rapidly breeds, causing a bacterial infection. The toxins become embeded into the root surfaces.  As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the roots of  the teeth and gums.  The response of the body is to destroy the infected tissue, which is why the gums appear to recede.  The resulting pockets between the roots of the teeth deepen and if no treatment is sought, the jawbone is lost and also recedes causing unstable teeth and tooth loss.

Referrals from your General Dentists and Self Referral

There are several ways treatment from Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng may be sought.   In the course of a regular dental check up, your general dentist or hygienist finds symptoms of gingivitis or rapidly progressing periodontal disease, an examination and  consultation with our Doctors may be recommended.  However, a referral is not necessary for a periodontal consultation.  If you feel that you have any of the following signs and symptoms, a complete periodontal implant examination should be provided.

If you experience any of these signs and symptoms, it is important that you schedule an appointment with our office without delay: Phone: (559) 229-6557 or (209) 383-2196. Contact us

  • Bleeding while eating or brushing – Unexplained bleeding while consuming food or during the course of daily brushing and flossing  is one of the most common signs of periodontal infection.  Normal healthy tissues should never bleed. If you were bathing a child and their skin was bleeding you would immediately seek medical attention.  Many people think that gums bleeding is natural.  This is absolutely wrong!

  • Bad breath – Continued halitosis (bad breath) which persists even when a rigorous oral hygiene program is in place, can be indicative of gingivitis, periodontitis, which is an infection that may cause unecessary tooth loss.

  • Loose teeth and gum recession – Longer looking teeth can signal recession of the gums and bone loss due to periodontal disease.  As this disease progresses and attacks the jawbone, (the anchor holding the teeth in place) the teeth may become loose or be lost alltogher. 
  • Red swollen painful gums - is a sure sign of gingivitis or periodontitis and may lead to acuter periodontal abscesses that can contribute to rapid and severe bone loss.

  • Related health conditions – Heart disease, diabetes, respiratory disease, stroke, osteopenia, osteoporosis are highly correlated with periodontitis.  Low birth weight and premature term babies will also affect pregnant females with advanced periodontitis.  The bacterial infection can spread through the blood stream and affect other parts of the body.

Diagnosis and Treatment

Before initiating any periodontal treatment, Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng must provide a thorough and complete examination of your gums, jawbone, x-rays, and general condition of the teeth.  When gingivitis or periodontal disease is diagnosed, we have a number of surgical and non surgical options available to treat the underlying infection, halt the recession of the soft tissue, and may rebuild or replace the missing bone and teeth.  Your comfort and smile are our greatest concerns.

  • Gingivitis/mild periodontal disease – When the pocket depths exceed 4mm in depth, we  or the RDH or hygienist may perform scaling and root planing (SRP'S)  to remove debris from the pockets and allow them to heal. Topical or local anesthetics may be used, Oral Hygine Instructions (OHI) brushing and flossing will be reviewed at each and every visit.  Please bring all of your brushes and oral hygiene aides at each visit.  We will be able to show you how to use them effectivley and remove the Bacterial Plaque daily.  We want you to brush your teeth 4-5 times per day and floss your teeth two times per day to remove the Bacterial Plaque daily.

  • Moderate periodontal disease – If the pocket depths reach 4-6mm in length a more extensive scaling and root planning  (SRP's) cleaning might be required. Moderate bone loss has occured.  This cleaning is usually performed under local anesthetic and or sedation.  If the case does not resolve non-surgicallly we will recommend minor corrective procedures to control the periodontal disease.  We do not want it to advance and cause further bone and tooth loss.  We want to be proactive in you care.

  • Advanced periodontal disease – pocket depth in excess of 6-7mm are usually accompanied by moderate to severe bone loss and gum recession.  Scaling and root planning (SRP's)  will always be performed as the initial nonsurgical treatment.  In addition to those nonsurgical treatments, we may recommend surgical treatment to reduce pocket depths and rebuild the bone.  This is the best form of therapy to rebuild the bone and foundation for you.

  • Tooth loss – Where one or several teeth are missing due to periodontal disease, trauma or congenitally missing teeth, dental implants are your best option.  An adequate amount of bone is needed to place dental implants.  If you are lacking the bone we can rebuild it with bone grafting.  Drs. Dennis Nishimine, Dee Nishimine & Sophia Tseng have been placing dental implants since 1990.  We have provided all forms of bone grafting for implant placement and to enhance your smile.
    If you have questions about periodontal disease, periodontal treatment or dental implants please feel free to ask.  Contact us today!