Final answer:
Patients with severe aggressive periodontitis should be referred to a periodontics specialist due to the advanced nature of the disease, which requires specialized treatment.
Step-by-step explanation:
When considering a decision for referral to a specialist in periodontics, patients with severe aggressive periodontitis should normally be referred. Gingivitis can progress to periodontitis when plaque-induced inflammation of the gums worsens due to colonization by bacteria like Porphyromonas, Streptococcus, and Actinomyces, leading to infection and damage to the structures surrounding the teeth such as gums, ligaments, and bone. Specialized treatment from a periodontist is necessary when periodontitis becomes severe, as it can result in significant erosion of gums, tooth loss, and may require complex procedures such as deep cleaning, antibiotics, or surgery.