Just Need Some Reassurance
 

Hi,

I am 40 years old and in relatively good health. However, I have been having gum disease treated for a few years and the dentist had recommended that I visit a periodontist but I had put this off due to cost. Anyway, I have finally had the consultation and am currently feeling a little low.

Essentially, my gum disease is only affecting my molars but where it is affecting them it is pretty bad. The numbers he was taking were between 7 and 10. At the end of the session he suggested that the only course of action would be to remove all the wisdom teeth and another 4 molars. He said one side wasn't too bad as the molars requiring removal were on the opposite sides but the other side may require an implant or bridge as they were not opposite.

My mother has had severe gum problems but I guess I didn't really consider the consequences until it was too late and wish I knew at a young age more about all this. Anyway, I guess hindsight is a wonderful thing and I need to make the best of things now.

I find the thought of losing all these teeth very daunting, especially at my age. I am worried about the pain, cost and whether it will successfully treat the periodontal disease I have or whether I will now experience constant problems for the rest of my life like my mother has which has also sent her into depression. I am trying to find some positives out of this but really cannot think of anything except worry.

I am not entirely sure why I joined here or posted this, as there isn't anything anyone can do. I just guess I would like a little reassurance and feel like I have the company of others who may have similar experiences.

Thanks for any advice!

:(

Hi m4tthall,

I am in the dental field and can offer you some information here.

It is always alarming to find out that you have a severe dental problem. Everyone who has experienced that news feels like the bottom just dropped out and confusion, worry and fear tend to set in pretty quickly. So please know that you are absolutely not alone.

Many people over the age of 30 have some degree of periodontal disease. This is in part due to the standard diet that many people consume.
Yes, there are genetic factors associated with this disease. But the actual cause of periodontal disease is poor oral hygiene and/or poor dental care and a diet that is consistently moderate/high in sugar and simple carbohydrates.

I inform you of those facts to let you know that aside from the severity of the condition in the posterior regions of your mouth, there really is hope to get control of the periodontal disease before it spreads to the rest of your mouth. But it will mean that you have to alter your oral hygiene and your eating habits :)

I first want to address something you had said as it is a very common problem....
"However, I have been having gum disease treated for a few years and the dentist had recommended that I visit a periodontist but I had put this off due to cost. "

It is so common for general dentists to "treat" gum disease way longer then they really should. It's as if they are doing their patient a favor or somehow saving them money. Most general dentists are not trained, knowledgeable enough or technically equipped to treat moderate/progressive periodontal disease and neither are their hygienists. It does not behoove the patient for their dentist to watch the progression of the disease as it only ends up being more costly in the long run... not just financially but systemically. There is eventually a loss of teeth and bone as well. Most people will continue seeing their GD for this condition because they are left to believe that their condition is "status quo" when in reality is like a runaway train. There is so much involved in treating a patient with periodontal disease.... both dentally and nutritionally. So please know that ALL of the blame does not fall just on your shoulders.

Regarding the perio in the molar areas of your mouth..... 7 -10 mms are deep pockets and they indicate that the bacteria has not only been present for many years, it means it has been progressing. So if you were not informed of the continued progression before now, you should have been. The bacteria responsible for this stage of periodontal disease is unfortunately not just limited to that area of your mouth. You can have shallower pockets in other areas of your mouth but the disease it systemic and unless it were found in just one specific area or tooth due to an acute infection, it is literally a concern with your entire dentition. You need to be aware of that fact so that you become better informed as to how to effectively proceed with your periodontist.

When a periodontist recommends extraction of teeth, this indicates that the disease is advanced and the bone loss is moderate to severe. Basically un-restorable. Extracting the "severe" teeth will only address those immediate areas which means the remaining teeth and gums will need some intervention to attempt to eradicate the bacteria overall or the disease will continue to progress further. Some periodontists have a laser that they use for what is called LANAP therapy. This laser treatment can work extremely well, even better than deep hand scalings, in areas where the disease has not progressed too badly. Does your periodontist perform LANAP therapy?

Along with extractions and perio therapy, it is imperative to understand that your oral hygiene and diet will play huge roles in bringing the perio under control. Your periodontist or his hygienist will instruct you on how to brush and floss properly and will keep a close eye on how effective your oral hygiene is at your frequent cleaning appointments. Regarding diet, some people choose to buy books about nutrition others seek the help of a nutritionist. I cannot stress enough how healing and important it is to eat healthy and eliminate or drastically reduce sugars and simple carbs from your diet while adding whole fresh foods to it. A great book that I have been recommending to patients and friends is called "The Blood Sugar Solution Cookbook by Dr Mark Hyman". This book is not meant for just diabetics or over weight people, it is awesome for anyone who wants to eat healthier. The recipes are simple and so healthy!

My whole reason for giving you all of this information is to let you know that is it not too late to reverse the progression of your periodontal disease. There is a positive light at the end of the tunnel if that is truly what you are seeking and you do not have to face the constant worry of loosing more teeth to periodontal disease. Yes, you have some teeth that need to be removed, but there is hope for the rest of your teeth and things you can do to prevent from taking the same unfortunate path that your mom has been on.

If you desire more information about something specific with the information that I have given you, please don't hesitate to ask.

Bryanna

Thanks for the reply

I don't know if my periodontist performs LANAP therapy but will find out.

I always thought my diet was pretty good. Yes, at the weekends sometimes I may have a takeaway or something not entirely healthy but for the most part I would be eating vegetable stir fries (sometimes with prawns or chicken) for dinner during the week. My breakfast would consist of something like a Greek yoghurt. My lunches would be carrots, an apple and a simple wrap. Occasionally I may have something sweet but less than most people. Comparing this to a lot of other people I thought it was OK.

With regard to looking after my teeth I will certainly concede I can take a lot of blame here. Although I regularly brushed, I didn't floss and didn't visit the dentist for a long period during my 20s. I wish I had been educated better around dental hygiene and the consequences. It wasn't until I first noticed bleeding gums in my early/mid 30s that I knew anything about gum disease. Quite embarrassing really.

Over the last 6 years or so I have regularly brushed, used interdental brushes and various mouthwashes. The dentist/hygienist/periodontist all remark on how well I look after my teeth but I guess the damage was done before I got into this routine. Both the dentist and hygienist had remarked on how much better the gums were looking but were still concerned, hence my trip to the periodontist eventually. Again, I should have gone earlier and I am to blame here but they didn't really express the importance of doing so.

I guess I now need to wait for the report to discuss with my dentist what steps I should now take.

Thanks again

Hi,

I have a couple of questions. I assume there is no alternative other than to have those teeth extracted? The periodontist said that this would be part of the treatment and wouldn't continue without extraction. I am sure this is right I just wanted to check.

Also, if I have the teeth extracted they suggested it would be a local anaesthetic. I would have four extracted on one side of the mouth, I would return two weeks later to have the other four removed. I am obviously a little concerned about the extraction procedure while being awake, I was hoping I would be knocked out! Also, I guess I will have difficulty eating for at least a month? Any advice on this side of things would be helpful.

Thanks

Have you ever been tested for the H-pylori bacteria? This bacteria is implicated in both ulcers and periodontal disease. They can either due a blood test or breath test. It may worth exploring.