Which of the following is NOT a factor mentioned for referring to a periodontist?

Referrals to a periodontist are typically based on clinical factors related to the periodontal health and condition of the patient. Furcation involvement, accessibility for scaling and root planing, and mobility of teeth are all significant clinical factors that indicate the need for specialized care.

Furcation involvement refers to the condition where periodontal disease has affected the area between the roots of multi-rooted teeth, indicating the potentially severe progression of periodontal disease that requires specialized treatment. Accessibility for scaling and root planing is another important factor; if the clinician finds an area that is difficult to treat or requires advanced techniques, a referral to a periodontist may be warranted. Mobility of teeth can also be a direct indicator of advanced periodontal disease, necessitating further assessment and treatment by a specialist.

In contrast, dental insurance status does not affect the clinical need for referral; it pertains more to financial considerations rather than the medical or clinical assessment of the patient's periodontal health. Therefore, it is not a valid factor for determining the necessity of a referral to a periodontist. The urgency and type of periodontal treatment needed should always prioritize the clinical status of the patient rather than their ability to pay or insurance coverage.