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Medical Forum / General / Dentistry / April 2008Pyorrhea, Periodontitis
Hello, I have a question about Pyorrhea: Recently, I experienced this, on the outer portion of the gum, Lower Right Quadrant. I went to a periodontist, they are suggesting to remove the tooth and the wisdom tooth behind it (47-48 respectively) The pocket is nearing 11mm (I think it is less than that) I am told there is lots of bone loss in this area, though on the X-Ray, does not look so bad, there is bone still there i.e. |...| (... = Regular bone level) --- (Present bone level) A bit reluctant about the removal, would prefer to keep the teeth (at least the wisdom one behind the problematic area, which is not loose, but teeth apparently migrate into empty spaces, so that's an issue) 1. Any advice on preserving the teeth? Could a deeper, perio cleaning help? 2. Anything I should know about the removal process? 3. What happens after removal? Does the Periodontitis still persist? Does bone loss still continue, even after removal? 4. Is it possible for the gums to heal, after a Periodontist cleans it, making the tooth stronger? > Hello, > [quoted text clipped - 26 lines] > 4. Is it possible for the gums to heal, after a Periodontist cleans > it, making the tooth stronger? I too had some deep pockets ( 12 mm ) and my Periodontist has been able to reduce them to 2 mm through deep cleaning. Four teeth were considered very periodontically unsound, present age 58yrs. He originally wanted to do extractions and implants where the bone was sufficient. However he went along with my preference for giving deep cleaning a go. For this to have a chance you have to be rigorous in your own daily cleaning and flossing. Two years on and I still have all of my teeth except for 2 that were lost 20 years ago. The doc seems pleased but I have been warned that things could turn for the worse, especially with any let up in oral hygine. Tell your Perio you want to keep your teeth unless he can mount a very solid counter argument! Oh, and he did say that removal of teeth stops the disease in its tracks. Good Luck. Mick. Hi Mick, Thanks a lot for the info. Did you have a root canal as well? And, as for the following: >Probably already 'bought' it. >;-( >D I don't think so, and I do not find any humour in this. > <bruce1v...@gmail.com> wrote in message > [quoted text clipped - 46 lines] > its tracks. > Good Luck. Mick. > Hi Mick, > [quoted text clipped - 58 lines] >> its tracks. >> Good Luck. Mick. No root canals. But 6 fillings, scaling, root planing and gum curatage were performed by a dentist before he sent me off to the Perio for further assessment. Took about 6 hours ( in 4 sessions ) in the chair with the dentist and 40 minutes ( 2 sessions ) with the Perio doing the deep pocket cleaning. I'll let you guess which guy cost the most! Cheers Mick. >>Probably already 'bought' it. >>;-( >>D > > I don't think so, and I do not find any humour in this. OK dude. Just let me know in a couple of years that you still have this tooth and that it only cost ??? Bet it's gone and you lost a bundle (if you can find anyone to take your money to try and keep it). Best wishes, Steve If you notice the emoticon, it is with a frown. Sometimes people need someone to shake them into reality. 11 mm pockets are just not normally treatable with any long term success. A possible exception is if this is a lesion that began with endodontic problems in the tooth and there is no other significant perio disease in the rest of your mouth (and you aren't a smoker). All we have to go on is the words on the screen. A real life exam is needed for any concrete statements. 11 mm pockets just do not create much optimism. D > And, as for the following: > [quoted text clipped - 3 lines] > > I don't think so, and I do not find any humour in this. > 11 mm pockets just do not create much optimism. Unless you were *hoping* for a bridge or implant. <grin> Had a fellow in this morning who had a couple of 5's. The rest were 7-9 <OUCH>. 50% bone loss throughout. Off to the periodontist, but likely headed for plastic in the long run. D >>11 mm pockets just do not create much optimism. > > Unless you were *hoping* for a bridge or implant. > > <grin> > If you notice the emoticon, it is with a frown. Sometimes > people need someone to shake them into reality. 11 mm pockets [quoted text clipped - 10 lines] > > D Thanks for the info. I don't smoke, though Periodontitis is a problem in other regions, and this is for a young person The tooth question, which has the problem, began with a tiny cavity. Had that filled (the dentist I visited used some new age material, did not bother to do a traditional filling because it was so small) 7 months later, this started, with a swollen gum, then the Pyorrhea (which was never a problem before) My dentist and the perio have both suggested that Periodontitis is the problem. Ideally, I would have preferred to keep the tooth, get the area cleaned properly, as in a perio deep cleaning. (My dentist has suggested that I could keep it for a year or two this way) Though there is some pain, and some looseness when pressed hard, it still feels quite strong. On the X-Ray, it *looked* to me like a 4mm loss, but not more than that (Will have to check this again) If not, what are the after effects of a removal? For example, I have heard that bite problems can occur, or that other teeth, can become loose because of a missing tooth, a whole range of issues. P.S. Any tips on what I should look for in a good Periodontist? On the X-Ray, it *looked* to me like a 4mm loss, > but not more than that (Will have to check this again) X-rays are two dimensional representations. Pocket location may prevent a true indication of total bone loss on film. That's why probing and measuring pockets is essential to help diagnose the problems. It is also possible to have a 'walled defect'. IOW's the whole of the bone around the root has not resorbed, but there is space between the root and the bone. There is more hope of gaining new attachment under this condition. > If not, what are the after effects of a removal? For example, I have > heard that bite problems can occur, or that other teeth, can become > loose because of a missing tooth, a whole range of issues. Depends on which tooth, the condition of the remaining teeth, occlusion, parafunctional habits, etc. (IOW's can't say from here <G>) > P.S. Any tips on what I should look for in a good Periodontist? A referal from your present dentist? D Get a second opinion in real life  Signature/ Amatus / > Hello, > [quoted text clipped - 26 lines] > 4. Is it possible for the gums to heal, after a Periodontist cleans > it, making the tooth stronger? > Hello, > [quoted text clipped - 18 lines] > 1. Any advice on preserving the teeth? Could a deeper, perio cleaning > help? Agree with AC. Get a second opinion. > 2. Anything I should know about the removal process? Most of these are pretty routine extractions. > 3. What happens after removal? Does the Periodontitis still persist? > Does bone loss still continue, even after removal? By definition, the periodontal process will no longer be present after healing at THAT site. However, if you've got periodontal disease of this severity, you likely have it in other areas of your mouth. Even after extraction, there is some continued bone loss. This is unrelated to the periodontal disease previously in this area. > 4. Is it possible for the gums to heal, after a Periodontist cleans > it, making the tooth stronger? With anywhere near 11 mm pockets, I wouldn't bet the farm. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Probably already 'bought' it. ;-( D > With anywhere near 11 mm pockets, I wouldn't bet the farm. > > Steve |
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