The service at Dr. MacDonald's office is minimal. It is his custom to only see patients every other visit. The hygenists seem nice and qualified, but they do not measure or keep a record of pockets around your teeth and could therefore make no determination of changes. I've had some gum recession and would have thought this is something that the doctor would want to track. A filling that he performed left me with jaw pain for a few days which was something I never experienced with prior dentists doing fillings. I can not recommend Dr. MacDonald.