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Old 02-18-2009, 05:30 PM
NAM1 NAM1 is offline
Junior Member
 
Join Date: Feb 2009
Location: Las Vegas
Posts: 31
15 yr Member
NAM1 NAM1 is offline
Junior Member
 
Join Date: Feb 2009
Location: Las Vegas
Posts: 31
15 yr Member
Default Crown reduction; New DDS search tactics

Hi Bryanna,

Thans so much for your reply. You are so right abt risk factors. I too have realized over the past 3 yrs how much repeat surgeries have been compromising my health.

Yes, all these Drs were very much aware of my medical and dental histories. I made it clear up front, esp since I have found an understandable gen reluctance to wk w/diabetics and compromised health issues.

There was some disc bt Dr H and her tech re whether the material found was actually cords. They disagreed; Dr H said cords while the tech thot stitches. The areas where the material was left were 8+10. #8 was by far the worst for inflammation.

There was no infectn per Dr H. She felt "provisional" (low fitting pre temp crowns) nec to reduce the severe inflammn in bt her 2 gingivectomies. She would not really elaborate on why she felt the 1st ging was nec other than "baby steps" to "just heal" the "train wreck" due to prev repeat trauma.

She had refused to rewk the crown for #9 herself, insisting another ging was instead nec when this crown was too pointed and the others were not. The gum height was not too high then. It now is. I elected not to cont w/her inc reasons previously discussed.

I am definitely not :-( wanting to have more surgery or bone reductn. What I had initially described in my 1st post was finding a qualified DDS to reduce crown #9 @ gum line to achieve a more balanced look for the 2 teeth in front.

That's my immediate goal while the crowns are still relatively new. Do you feel this is poss?

While the initial goal was for 6 front teeth tb balanced, I have given up on that. Any bridgewk I am considering is to replace old bridges while I still have insurance.

One would be to replace a bridge that inc #11 in lieu of a gum graft which Dr G has offered to redo in order to fix his error during his ging. Because of the error, #11 now shows the tooth underneath the tooth beginning that bridge. Quite honestly, not only do I not want more surgery, I'm not sure he can really do it and am apprehensive abt further error.

I do understand we r in cyberspace + your help is therefore limited w/a complex issue. I have prev been to the IAOMT site + found little real help there other than 3 names. Any receptionist feels their DDS is great.

Perhaps I don't know the correct Qs to ask. Can U help there? Since all the DDSs I have been to ALL have diff opinions I don't know whom to trust or turn to.

Any further suggestions you can offer re the above crown reduction Q + finding a DDS qualified to handle such a complex issue are greatly appreciated.

I hate to give up just (or esp) because I'm diabetic.

Thanks!
NAM
Quote:
Originally Posted by Bryanna View Post
Hi NAM1,

I understand that you are scared and worried. From what you have described, your dental issues are indeed complex and I think there is more to the situation than maybe you even realize.

To begin with, having diabetes especially uncontrolled, puts you in a high risk category for periodontal disease because diabetes impairs the white blood cells which are the main defense against bacterial infections. Periodontal disease is a bacterial infection. Chronic or uncontrolled periodontal disease causes bone loss. Also, healing from gum surgery may be compromised due to limited blood flow to the surgical areas.

Were all of these dentists aware of your diabetes prior to the dental work? It is risky for someone with uncontrolled diabetes to have elective gum surgery, never mind repeated ginigivectomies. I find it beyond comprehension that your dentists performed this surgery on you repeated times.

It is possible that the gum tissue just never healed properly since the first ginigvectomy was done and subsequently there after. The reason for this could be due to your diabetes and not the actual procedure itself. As far as the dentist leaving cord underneath the gum tissue for approx 11 months.... if that were the case, you most likely would have developed a severe, painful bacterial infection in those areas. The inflammation would have been severe and infection would have set in very quickly. So I'm not sure what the dentist thought he pulled out of there, but I highly doubt it was the cord used in the preparation of your crowns or bonding.

You wrote that #9 has been root canaled. Root canaled teeth harbor alot of bacteria in them which can spread from that tooth through the bone to the adjacent teeth. This is commonly seen in the upper front teeth due to vascularity and the thin bone in that area of the mouth. This could be another reason why the gum tissue over 8 and 9 never seems to heal properly.

My suggestion to you would be to avoid any further gum surgeries. The healing of the gum tissue is compromised because of your uncontrolled diabetes and you may never get the results you are hoping for. Perhaps even worse, it is a health risk for you every time you go through the healing process from the surgery. Unless your teeth are broken down, avoid any additional crowns or bridges because they tend to irritate the gum tissue and can be more difficult to keep clean. It is imperative that your plaque level be at a minimum to avoid the progression of the periodontal disease.

There is much literature linking uncontrolled diabetes to poor oral health and vise versa. Studies show that if one of these conditions can be brought under control, the other one is more likely to do the same with proper care and nutrition.

I know you are trying to achieve a certain esthetic look with your teeth, but perhaps you should consider a more conservative approach and seek a dentist who can achieve good esthetic results without surgerizing your gums or reducing your bone any further.

I often refer people to the website IAOMT.org because the dentists and doctors who partake in this worldly organization are more inclined to think outside of the traditional box and because of that, they see the cases that no one else sees.

I really don't think I can be of any other help to you due to the fact that we are in cyberspace and your situation is very complex both dentally and physically.

We are always hear to listen and offer whatever guidance we can.......... please keep us informed on how things are going.

All the best to you...
Bryanna
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