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Look, I know that this isn’t the optimal place to ask questions like this, but as one who is in their mid 30’s and having developed the very first signs of gingivitis at 11 years of age( I’m almost 36 years old now), yet I know that somehow there are possibly oral hygienists or periodontists lurking on this forum of city data who could at the very least offer me guidance on what needs to happen. Long story short, my last dental visit happened back in late January of this year but to no avail as no cleanings or even anything apart from dental x rays were done and at least with me a very brief perioprobe analysis was done. What are some telltale signs of having moderate periodontal disease, and furthermore is advanced periodontal disease any worse than mild or moderate periodontal disease? Please help give me feedback and as much guidance(as a hygienist/periodontist) whoever you are. Thanks.
...my last dental visit happened back in late January of this year but to no avail as no cleanings or even anything apart from dental x rays were done and at least with me a very brief perioprobe analysis was done. What are some telltale signs of having moderate periodontal disease, and furthermore is advanced periodontal disease any worse than mild or moderate periodontal disease? Please help give me feedback and as much guidance (as a hygienist/periodontist) whoever you are. Thanks.
Those dental x-rays should've been able to show whether or not you have bone loss.
Bone loss is the endgame of perio disease.
If your dental professional is competent, he/she should've been able to make that determination.
Assuming minimal or no bone loss, the next step would be charting of your gingival pockets.
0-3 mm depth is "normal", 4-5 mm is considered reversible, 6+ mm is consistent with periodontitis.
The physical appearance (color, texture) of the gums can give clues as to their health, but are secondary to the x-rays & charting.
Bleeding isn't the "be all & end all" of diagnosis. While not a good sign, there are other factors that can influence bleeding gums -- medications you might be on (e.g blood thinners, or even high doses of fish oil), & hormonal changes, to name a couple. If you use tobacco (in any form), you're at a further disadvantage.
If/when you get a proper diagnosis of perio disease, fastidious home care is paramount; followed by professional cleanings every 3 months. You'll likely be told you need SRP (scaling and root planing). While not pleasant (nor cheap), you should do it. Even pockets as deep as 7 mm, if they are stable & cleaned regularly, probably don't need surgery. YMMV, depending on pre-existing conditions.
IMO: a Sonicare toothbrush, a water flosser (with a little hydrogen peroxide put in the reservoir each time), and an anti-gingivitis rinse, are must-have's for said home care.
Surgical intervention should always be a last resort. I've found that most dentists/periodontists are quick to push for traditional flap surgery, when there are more modern alternatives like Perio Protect and LANAP that could be tried first. None of these are going to be inexpensive though, nor are they going to be covered by insurance
Those dental x-rays should've been able to show whether or not you have bone loss.
Bone loss is the endgame of perio disease.
If your dental professional is competent, he/she should've been able to make that determination.
Assuming minimal or no bone loss, the next step would be charting of your gingival pockets.
0-3 mm depth is "normal", 4-5 mm is considered reversible, 6+ mm is consistent with periodontitis.
The physical appearance (color, texture) of the gums can give clues as to their health, but are secondary to the x-rays & charting.
Bleeding isn't the "be all & end all" of diagnosis. While not a good sign, there are other factors that can influence bleeding gums -- medications you might be on (e.g blood thinners, or even high doses of fish oil), & hormonal changes, to name a couple. If you use tobacco (in any form), you're at a further disadvantage.
If/when you get a proper diagnosis of perio disease, fastidious home care is paramount; followed by professional cleanings every 3 months. You'll likely be told you need SRP (scaling and root planing). While not pleasant (nor cheap), you should do it. Even pockets as deep as 7 mm, if they are stable & cleaned regularly, probably don't need surgery. YMMV, depending on pre-existing conditions.
IMO: a Sonicare toothbrush, a water flosser (with a little hydrogen peroxide put in the reservoir each time), and an anti-gingivitis rinse, are must-have's for said home care.
Surgical intervention should always be a last resort. I've found that most dentists/periodontists are quick to push for traditional flap surgery, when there are more modern alternatives like Perio Protect and LANAP that could be tried first. None of these are going to be inexpensive though, nor are they going to be covered by insurance
Oh...haha...nevermind. I was curious because I have...er...had...this tooth with some bone loss that has been giving me trouble lately. I've been to the dentist twice in the last couple weeks for an xray and root scaling.
But it broke off at the gum line during dinner tonight, so I guess I have new problems now. Like getting the rest extracted, whether this is going to start hurting like hell tonight and whether there is enough bone and money in the bank for an implant.
Other than getting a consult for it, no.
Insanely expensive, and alot of down-time.
I made the decision to use Perio Protect. 10 months of it (initially, twice daily; tapered down to once per week), and was able to reverse all of the 4's, 5's, 6's.
I now use the other home care stuff I mentioned, plus quarterly cleanings, and have maintained 2's and 3's for 9 years now.
I did lose one molar to an abscess (probably due to a poorly installed crown, on top of multiple insults over the decades).
...But it broke off at the gum line during dinner tonight, so I guess I have new problems now. Like getting the rest extracted, whether this is going to start hurting like hell tonight and whether there is enough bone and money in the bank for an implant.
Sorry to hear that, I'd be in a panic if it were me.
If you're not in any pain, just keep the area clean until you see the dentist.
Rinsing with hydrogen peroxide, avoiding hot/cold, the usual.
If pain develops, analgesics are the most you can do.
After extraction of what's left, ask for stitches. Otherwise you might get dry socket.
My additional 2 cents -- don't rush for implants, regardless of how much bone (and how much cash) you have. You'll be told that the surrounding teeth will wander, but the older you are, the less likely that is to happen to any great degree.
(assuming that the surrounding gums/bone are healthy)
Other than getting a consult for it, no.
Insanely expensive, and alot of down-time.
I made the decision to use Perio Protect. 10 months of it (initially, twice daily; tapered down to once per week), and was able to reverse all of the 4's, 5's, 6's.
I now use the other home care stuff I mentioned, plus quarterly cleanings, and have maintained 2's and 3's for 9 years now.
I did lose one molar to an abscess (probably due to a poorly installed crown, on top of multiple insults over the decades).
Interesting. I'll look into it. I've been able to maintain things, but rarely get any improvement like that.
Quote:
Originally Posted by JG183
Sorry to hear that, I'd be in a panic if it were me.
If you're not in any pain, just keep the area clean until you see the dentist.
Rinsing with hydrogen peroxide, avoiding hot/cold, the usual.
If pain develops, analgesics are the most you can do.
After extraction of what's left, ask for stitches. Otherwise you might get dry socket.
My additional 2 cents -- don't rush for implants, regardless of how much bone (and how much cash) you have. You'll be told that the surrounding teeth will wander, but the older you are, the less likely that is to happen to any great degree.
(assuming that the surrounding gums/bone are healthy)
Yeah being an incisor I am none too happy about it. But I put the broken tooth under my dissecting scope and could see the nerve hanging out of it so I probably won't have any pain unless it abscesses. The tooth was apparently dead. I have a consult for extraction and implant in late October, which is the soonest I could get, and am on a cancellation list. But I don't think implants will be an option. I lost the same incisor on the other side 5 years ago due to bone loss and they didn't think it was a good candidate for an implant because of bone loss. This might be the same story, although the other side was worse. I will probably face the same bad choices as before, ruin the (somewhat) good adjacent teeth for a bridge or get a flipper that's intolerable. I wore a flipper for a couple years on the other side and then got a bridge done in Mexico, which is better than nothing but not top quality either.
...Yeah being an incisor I am none too happy about it. But I put the broken tooth under my dissecting scope and could see the nerve hanging out of it so I probably won't have any pain unless it abscesses. The tooth was apparently dead. I have a consult for extraction and implant in late October, which is the soonest I could get, and am on a cancellation list. But I don't think implants will be an option. I lost the same incisor on the other side 5 years ago due to bone loss and they didn't think it was a good candidate for an implant because of bone loss. This might be the same story, although the other side was worse. I will probably face the same bad choices as before, ruin the (somewhat) good adjacent teeth for a bridge or get a flipper that's intolerable. I wore a flipper for a couple years on the other side and then got a bridge done in Mexico, which is better than nothing but not top quality either.
Sorry to hear that, losing an incisor sucks.
I had a congenital defect wherein the permanent teeth for numbers 24 & 25 never showed up. I have a Maryland Bridge (consisting of just one normal size tooth, as the rest of the bottom ones spread nicely to fill in the gap) in their place. Instead of being anchored to one tooth on each side, the bridge is anchored to the adjacent two on each side. In November it'll be 26 years since the install, no signs of wear (thought it had to be re-cemented a couple of times). An upper incisor will see more stress, but a M.B. is an under-utilized option these days. The adjacent/anchor teeth need nowhere near the amount of modification that a conventional bridge does.
Sorry to hear that, losing an incisor sucks.
I had a congenital defect wherein the permanent teeth for numbers 24 & 25 never showed up. I have a Maryland Bridge (consisting of just one normal size tooth, as the rest of the bottom ones spread nicely to fill in the gap) in their place. Instead of being anchored to one tooth on each side, the bridge is anchored to the adjacent two on each side. In November it'll be 26 years since the install, no signs of wear (thought it had to be re-cemented a couple of times). An upper incisor will see more stress, but a M.B. is an under-utilized option these days. The adjacent/anchor teeth need nowhere near the amount of modification that a conventional bridge does.
I had a lovely bunch of genes that made my teeth come in crooked as all hell and practically sideways in my foremandible. Thanks Mom, I love ya! I had to have about 8 teeth pulled just to make room to straighten the rest. And thanks for paying for all that, lol.
I never heard of a Maryland Bridge until now, I wish I'd been offered or at least told about that option when I lost my other lateral incisor. Maybe it wasn't a viable option, I don't know, but I will sure as hell ask about it now. I would much prefer that to grinding down another couple of teeth, and its surely cheaper too.
Last edited by Deserterer; 09-21-2021 at 08:52 PM..
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