Hi ddd,

A general dentist who is practicing for 30 years has experienced a lot of things but aside from his experience, his dentistry may not be an advantage. If he has modernized his office and equipment (nothing fancy just updated), as well as the sterilizing techniques and also practices current state of the art dentistry then that's all positive signs of current practices. But if he has not done those things (say his office looks like a time capsule from the 70's) and he still uses amalgam/mercury fillings, does not emphasize the significance of preventing periodontal disease (as in does not do regular periodontal probings) etc.... then his dentistry may be a reflection of his old school practices.

On many levels dentistry has come a long way in the last 30 years and much of it is for the better. Updating the environment generally means utilizing current and safer standards, newer technology like digital radiography minimizes radiation exposure, newer dental materials are less toxic for the patient, and preventive dental care is of the utmost importance and should be largely emphasized.

If your dentist or hygienist has not spoken to you in detail about your bone loss and your gum health, and neither of them do a routine periodontal probing, then neither of them is practicing preventive care dentistry. That would not really be in your favor. As I said, periodontal disease is a bacterial infection and it is not just limited to the mouth. So your periodontal health is imperative to not just your oral and dental health but to your overall health.

Oral surgeons and other specialists rely on referrals from their peers as a means of staying in business. So most of the time the specialist will just focus on the one issue that the patient was referred to them for and not venture too far past that. They do this because they don't want to step on the toes of the dentist who made the referral by opening up a can or worms that the patient may not have been informed of by their general dentist. I know that sounds stupid... but this is how it's done. That's why it's better if the general dentist is very preventive oriented with his patients and he's open to the findings of his peers as that opens the door for a specialist to look at the patients oral health from a broader perspective.

Regarding post operative complications after the extraction and dental implant... it is imperative that the surgery of the extraction be very thorough and that the bone be healthy and adequate to receive the implant. Placing an implant in unhealthy bone and/or just bone graft spicules will not hold the implant in place. The implant needs to be drilled into solid healthy bone and than if necessary, bone graft material would be packed around the areas where bone loss has occurred. Bone grafting does not take the place of your own bone. The material is used to stimulate your own cells to grow your own bone. The new growth of bone eventually takes over the graft material. But this can only happen properly if the site is healthy and the implant is placed in solid bone to begin with. If there is periodontal disease, then the amount of new bone growth may be diminished and the success of the integration of the implant may not be ideal or healthy.

Also, certain drugs inhibit or reduce the cells necessary to repair and grow new bone. Are you on any bone drugs like Fosamax, Boniva, etc?

Bryanna










The bone loss that you have is usually indicative of dental neglect. Meaning someone is not practicing preventive dental care.