Hello sci.med.dentistry folks,

I haven't been to a dentist for many years...for a couple of
unfortunate reasons**.  But I'd previously never had problems with my
teeth of any sort--no cavities, and everything was always fine.  So I
was quite surprised after getting a new toothbrush this week to
suddenly become aware of rather large (several millimeter!) gaps/
pockets between my gum and tooth on my lower teeth.  I don't think
they could have spontaneously appeared, so they must have been forming
over a period of time.  Perhaps the new brush whisked out weak gum
tissue and other tooth gunk that had been filling in the holes?
Anyway, I rather suddenly can feel and see these gaps, and it isn't
good!

A little internet research has led me to conclude that this is a
complex problem to manage, and may have several steps involved if any
of this is infected.  And as for closing the gaps, it seems there are
poor solutions which are just expensive and mostly cosmetic in nature
(such as the "gum graft").  I don't have insurance, so I have to be
very careful and specific about how to address this problem.  I really
want to avoid landing in the office of a cosmetic dentist who isn't
focused on the most practical and cost-effective way to address the
primary health threat.  I understand the cosmetics are big to some
people, but not to me.

I am in the Hollywood/LosAngeles area, does anyone have opinion on a
good place someone in my situation can turn to?  Can an ordinary
dentist clean the teeth and gaps as they are, or does it require
visiting a specialist from the get-go?  Has anyone mapped out typical
expenses for procedures to address this kind of problem...what tests
they should do, and about how much is a fair fee for the labwork?

Any advice or referrals appreciated.  Thank you very much...

 --R

**Ok, so what's my excuse?  Well...the biggest reason is that I
haven't had any kind of health insurance for six years now.  Also, the
last time I went to a dentist I had a very unpleasant and generally
quackish experience, where he was trying to sell me on cosmetic tooth
treatments the moment I walked in the door.  When I expressed no
interest and asked to just have a simple cleaning with no X-ray, he
refused and kicked me out of the office.  The whole thing was high
pressure and very odd...and scared me off.  Is that standard practice,
to refuse to clean teeth if a patient does not want an X-Ray because
they'd had one 6 months prior (and even brings that X-ray from the
previous dentist?)