Periodontitis - 90% bone loss Posted: 02-04-08 20:00pm
Hi, I am 36 yrs old. I recently
discovered some loose teeth in my mouth,
which had me running to the dentist.
After full mouth x-rays it was discovered
that I have extremely advanced
periodontitis with 90% bone loss. Ugh.
On visiting a periodontist he measured
pocket depths of 7-8 mm all throughout my
mouth. Ugh again. He recommended scaling
& root planing. When I asked him what
the likelihood of this procedure was to
stop the progression of the bone loss, he
said: slim to none. We went onto discuss
flap surgery.
This perio wanted to do the SRP right then
and there, and wanted me to pay up front
for it, "incase insurance doesn't cover
it." Yeah so tomorrow I am seeking a
second opinion. I happen to know already
that my dental insurance will not cover me
for anything, because when I joined the
plan I was what they call a "Late
Entrant", and so my coverage is delayed
for 2 years. The good part of this is
that the company I work for may pay for
part of my treatment because it is their
fault I was signed up late. I am also
looking into financing for the whole deal.
I hear it's ridiculously expensive!!
I am willing to do anything to save my
teeth. There are several very loose ones
in there and I only hope they don't fall
out during surgery. I have started
brushing, flossing, stimudenting and
rinsing with Listerine after every meal (3
times a day). At first the prospect of
surgery scared me too much, but now the
prospect of having no teeth scares me
more.
My main question for the periodontist
tomorrow is going to be whether we can
just skip the scaling & root planing
and go straight for the flap surgery.
With pocket depths of 7-8mm I really don't
think this infection is going to slow down
unless arrested right at the bone.
I am also going to ask him about the
possibility of using minocycline
microspheres in conjunction with the flap
surgery.
I am glad I found this board, no one in my
life wants to hear me drone on about my
teeth. Both dr's I have seen so far say
that this has to be genetic in my case;
though I wouldn't know because I am
adopted. They said I am really young to
have it this bad and if I don't do
something fast, I won't have any teeth
left, or any bone for a denture to hold
onto.
I have been a smoker for the past 23 yrs
also, so I imagine that cannot have helped
any. I am willing to quit smoking after
the surgery. I am willing to go to
absolutely any lengths to save my teeth.
I like chewing and talking. Thanks for
reading this if you made it this far!
I have a great smile, but bone...not so
much.
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prdent1
Supporter
Joined: 26 Dec 2007 Posts: 70
Posted: 02-04-08 21:04pm
before any periodontal surgery you have to
had a very low percent of plaque and no
calculus inside those pockets because
those bacterias could infect the healing
processes and could be worse ,thats why
root planning and curreteage is made for
to clean inside your gums and control the
inflamation . it would be good to use
tetracycline and peridex or perioguard too
. do the surgery its the best option to
save your teeth maybe not all of them but
maybe there are ones with better prognosis
than others.
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greatsmile
New User, Becoming EHEALTHy
Joined: 04 Feb 2008 Posts: 5
Thanks: 1
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Posted: 02-05-08 21:58pm
I saw another dentist today who told me he
does not recommend the flap surgery
because my bone loss is so advanced and
flap surgery would cause more bone loss.
He said that not every area in my mouth
has as severe bone loss as many others.
My 2 rear molars are pretty well rooted in
bone, while everything forward of them is
not.
He recommended the scaling and root
planing, and when 2 or more of my teeth
fall out during that procedure, which he
assured me they will, to replace them with
bonded bridges. To the cool tune of $1200
a bridge.
My question becomes this: if I do get the
scaling & root planing and 2 or more
of my teeth do fall out and say I do get
them replaced by bridges...all the while
the bone in my mouth is melting away under
the periodontal disease.
At what point will I have waited too long
to act and there is now no longer any bone
for a denture to hold onto? The first
periodontist I saw made this point. Only
now is it just sinking in. Dentures hold
onto the bone in your mouth, right? Well
my jaw bone is melting away, most
especially in my lower front. The guy
today said he thinks plaque & tartar
must be the only things holding my front
lower teeth in. You can clearly see on
the x-ray the lack of any BONE around the
bottoms of those teeth.
I think I may call the original
periodontist again and get his perspective
some more. I just don't see sinking $1200
bucks a pop into replacements if I am
going to ruin any future chances of a
denture by taking these temporary
measures.
I also have an appointment with yet
another periodontist on February 25th. I
realize I am not going to find a dr. to
tell me my teeth won't fall out: because
they will. I just want to take the most
effective action I can to ensure my
ability to eat and talk well into my old
age. I don't have a spare $3000 laying
around, and if I spend the money I want it
to be money well spent, not on a losing
battle that obviates more spending.
|
prdent1
Supporter
Joined: 26 Dec 2007 Posts: 70
Posted: 02-06-08 18:38pm
its difficult to know what is best to you
without looking the radiographs but you
have to ask your dentist if the teeth that
would support the bridge are hard(no
mobility ) and have no deep pockets, if
they have good prognosis the bridge is a
good option . look if there is a perio
-prosthesis specialist in your area that
can help you
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greatsmile
New User, Becoming EHEALTHy
Joined: 04 Feb 2008 Posts: 5
Thanks: 1
Thanked:0
Posted: 02-07-08 06:16am
All of my teeth have deep pockets
measuring 7-8 mm. Almost all of them have
some degree of looseness also. All of the
teeth around the ones they are almost
certain will fall out during SRP are also
loose.
I did call the original periodontist I saw
and asked about having them all removed,
but he didn't recommend that either.
It seems these dentists really want me to
hold onto my original teeth, but my teeth
do not share their idea!!
I don't want to sink thousands of dollars
I do not have into a losing venture. I
wish I could just find a dentist who will
pull all my teeth and give me dentures
right now!! Before all my jawbone is gone
and a denture won't stay in.
|
prdent1
Supporter
Joined: 26 Dec 2007 Posts: 70
Posted: 02-07-08 19:44pm
for us ,dentist, in this modern times with
all new technique in bone replacement
theraphy it is very difficult to find a
dentist that extract teeth without reasons
, teeth are very important for our speech
, digestive process and taste and
appeareance having a complete denture is
not a pleasant experience firt of all you
can not have the same perception of taste,
hot and cold because a lot part of your
mouth will be covered by acrilic, second
you can not eat hard things as you do with
your natural teeth (its dificult for
complete denture patients to bite an apple
be) you have to learn how with your tounge
and muscle maintain the dentures in place,
you will have a feeling like is your mouth
is entirely full with something hard and
dont thing you will not loose bone ,you
with loose more bone because if no teeth
are present bone reabsorb faster. dentists
study more than 6 years to cure disease
and replace function of patients mouth if
your dentist is telling you that you can
preserve your teeth with ambulatory
surgery do it , is the best you could do
to preserve it and if periodontal disease
is controlled bone loss stop
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greatsmile
New User, Becoming EHEALTHy
Joined: 04 Feb 2008 Posts: 5
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Posted: 02-07-08 20:57pm
A very good friend of mine has full
dentures since she's 24 yrs old. She is
48. She can bite an apple and eat corn on
the cob and you'd never guess she has
dentures. They fit her so well that she
doesn't even have to use that glue junk.
Anyway, I won't be needing dentures.
And prdent, whoever you are, to suggest
surgery without knowing a thing about my
situation, is reckless and unethical.
I saw my 3rd and final periodontist today.
He says I definitely DO NOT need surgery.
He focused on something that NONE of the
other periodontist focused on. The fact
that I clench my teeth when I sleep. I
have what he called Occlusive
Periodontitis. I told all the other
"doctors" this but none of them addressed
it in their "treatment" (banking) plan.
This Doctor says I need a course of deep
gum treatment, including subgingival
antibiotics, 4 quadrant root scaling &
planing and a bunch of other follow up
care. He said I MAY possibly lose 4 teeth
but even that is unlikely. He said it is
not really as bad as the other idiots made
it out to be. AND the best part is that
this whole phase of the treatment will be
about $2200 bucks. Not the eventual $8000
for flap surgery the other two steered me
towards.
So as I suspected, the other "doctors"
were trying to sell me UNECESSARY SURGERY
just to line their pockets.
The sad fact is, that those other doctors
are probably just not intelligent enough
or motivated enough to keep up in their
field. They tell people they need
surgery, they use fear to sell unecessary
medical treatment, and people jump for it.
I wonder how many completely unecessary
flap surgeries that other perio I saw does
every year.
Enough to buy him that Porsche Carrera
parked in the lot.
So if anyone out there reading this has
gotten an opinion from a dentist or
periodontist, SEEK ANOTHER ONE.
Keep seeking until what that doctor says
strikes a chord in you that RINGS TRUE.
I had researched subgingival antibiotics
and each dr I mentioned them to seemed
alarmed that I knew about them. I flat
out asked one of them if he never used
subgingival antibiotics, or if they were
just too cheap a solution for him to
offer? The one guy answered that they
don't work. And that if I didn't go with
his idea, I'd be back in his office in a
few years begging for implants.
The perio I went to today SPECIALIZES in
implants - but never mentioned implants to
me even once. He gave me hope, and a plan
of action, and a reasonable price tag.
Quite the opposite of what the others did,
which was fill me with MORE fear.
Fear is a great tool of manipulation.
It's a good thing I am past that stage of
my life.
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prdent1
Supporter
Joined: 26 Dec 2007 Posts: 70
Posted: 02-11-08 16:59pm
first of all let me tell you that there
are a lot of different schools approve by
the ADA that have differents theories of
how to address periodontal problems and
all theories are scientifically and
clinically proved.
there are some dentist that address the
periodontal problem by bone augmentation
and remodel surgery,pocket elimination
surgery and other minor surgicals
technique and other dentist uses other
methods
the majority of them uses is the root
planning and curreteage technique for
cleaning deep pockets. so the thing is
there are not bad dentists and good
dentists ,they're just using different
methods to reach the same
result(periodontal stabilization).
I personally prefer surgery phase because
I have seen better results with it . and
sorry if I offend you ,the thing is that I
was trying to convince you that if there
exist posibilities to retain your tooth
dont think in the idea of getting them all
extracted because maybe your friend could
bite an apple but believe me there are
many patients that cant,and its not the
same to have plastic teeth than to have
the teeth that God gave you
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y2val
New User, Becoming EHEALTHy
Joined: 20 Mar 2008 Posts: 1
omg exact same story Posted: 03-20-08 22:08pm
my teeth are perfect but losing them to
peridontal disease.i have been advised to
have all my teeth pulled.i know i have 2
very loose teeth,but the dentist said in
the next year i will lose them all.guys
please keep me informed of your treatments
i really dont want dentures.i also told
them i grind my teeth and always have them
clenched due to stress can,t relax
