diff --git "a/periodontics_data.json" "b/periodontics_data.json" new file mode 100644--- /dev/null +++ "b/periodontics_data.json" @@ -0,0 +1,1502 @@ +[ + { + "id": 1, + "title": "Gum disease??", + "dialogue": "klindzi: Iv had a really bad start with my teeth from younger when iv had fillings on 30% of teeth. I also grind/clench sub conciously for best part of 20 years which has had an impact on my roots. Iv been quite good with brushing teeth and flossing etc. Now my dentist has said that my roots are showing signs on trauma from grinding. I have worn a mouth guard at night. 2 molars either side of lower mouth have gums receded and started oozing about 4 weeks ago, iv had a round of antibiotics that haven't helped and a deep scale clean. Iv also just had a full mouth xray to check teeth fully to check whether infection has hit the root etc. Now dentist has not got back to me regarding next steps and iv been chasing her can dentist provide any advice as I'm really worried il lose my two teeth if it's not treated quickly. perryferguson: It sounds like you're going through a tough time with your dental health. It's frustrating when you're not getting the answers or treatment you need.\n\nGiven the seriousness of your symptoms – receding gums, oozing, and a history of grinding – it's crucial to get a clear diagnosis and treatment plan from your dentist. I would definitely continue to follow up with her about your next steps.\n\nIf you're still not getting the answers you need, consider seeking a second opinion from another dentist. They might be able to offer different insights or treatment options.\n\nIn the meantime, continue practicing good oral hygiene, including brushing, flossing, and using a mouthguard. It's also important to avoid irritating the affected area by using harsh mouthwashes or dental picks.\n\nI hope you find the answers and relief you're looking for!" + }, + { + "id": 2, + "title": "Dental crown on patient with periodontitis?", + "dialogue": "a.d: I have advanced periodontitis. I need to remove my 3 front teeth. Is a dental crown on 14 teeth on the upper palate with a dental bridge recommended to replace the extraction of my 3 front teeth? Thanks! Dr M: Has the periodontitis been addressed? Usually if the periodontal disease has been deemed stable by a specialist, crowns and bridges are not contra-indicated. a.d: Dr M said:\n\n\n\n\t\t\tHas the periodontitis been addressed? Usually if the periodontal disease has been deemed stable by a specialist, crowns and bridges are not contra-indicated.\n\t\t\nClick to expand...\n\nThank you very much for your response. I do dental cleaning 4×/year in a periodontitis clinic. During those cleanings, the periodontist gives me local anesthesia to avoid pain. I think my periodontitis is not stable, but I dont have that information. One dentist told me I can have crowns and another one told that I can't. Here's a complete scan of my teeth if it can give you more information on my periodontitis. I need to extract 3 teeth on the front, because there is no more bone supporting them and that is why a dentist gave me the plan to make crowns and bridges. Thank you! Dr M: If the periodontal disease is not stable, I would not recommend any crown and bridge work. Rather consider a temporary partial denture, until the periodontal disease has been stabilized. You can ask your periodontist how far you are from that point." + }, + { + "id": 3, + "title": "Periodontitis and the Bonner method", + "dialogue": "bledisloe: Hello everybody. I was diagnosed with severe periodontitis earlier this year and the periodontist I've been referred to uses the Bonner method. This method is not commonly used (in the UK, it's not practiced at all) and so I'm a little concerned. Researching it, it's seems an effective method so I guess I just wondered why it is so uncommon.\n\nEdit: a link to a research study if anyone wants more detail\n\n\n\n\n\n\n\n\n\n\t\t\t\t\t\tGingival Parasitic Infections as a Contributor to Periodontitis: Identification and Treatment | Auctores\n\t\t\t\t\t\n\nObjectives: Parasites play a role in the pathology of periodontal disease with the protozoan Entamoeba gingivalis&n\n\n\n\n\n\t\t\t\t\tauctoresonline.org honestdoc: There are not a lot of peer reviewed literature, but since this method is minimally invasive, it has a lot of promise. Since it requires a lot of behind the scene work, I believe the treatment may be pricey. If you can wait, I'll inquire a couple of periodontists on their opinions. honestdoc: One of my trusted periodontist does not believe this guy is genuine. She does not recommend this treatment. bledisloe: That's interesting. I've started the treatment now, with only the final cleaning stage (ultrasound) to go. Not a lot I can do now. Sadly, I was totally unaware this was not the usual course of treatment when I was referred by my dentist. Guess I'll just have to hope for the best! honestdoc: Since you started, I would continue. In the past I've encountered a lot of experiences totally contrary to others' opinions. I would just be aware of unknown costs or procedures. bledisloe: Thanks for your advice. Costs and procedures are known, outlined in advance, so there ought be no surprises. To be honest, I've had nothing but good experiences so far. The team are professional and courteous, and there are plenty of other patients! I've no reason to doubt the practice.\n\nMy concern was more of the methodology and why, despite it being around for years, it not being overly popular. I know there a number of periodontists using the Bonner method in the US, Australia and parts of Europe - not the UK though, where it's not authorised by the British Dental Association. As a patient, it's just a little intriguing. honestdoc: According to my Periodontist, the guy Bonner from Canada could never provide solid evidence to the American Academy of Periodontology. As long as all the costs and procedures are transparent (no hidden fine prints), you should just follow through their treatment. honestdoc: Sorry, my other Periodontist source says the same thing. Since you can't back out now, and you're fine with the costs, just finish it and if the results are good then you benefit greatly. bledisloe: Hooley said:\n\n\n\n\t\t\tI was diagnosed in Nov 2021 and told I would lose all my teeth within 10 years and there was nothing I could do about it. I went to see Dr Bonner in Quebec Canada in Dec 2021. I started on his program in Jan 2022, working in conjunction with my \"home\" dentist. In Jan 2023 I returned to Dr Bonner and I am cured. My \"home\" dentist is amazed. I feel it is a miracle. And far less expensive than having teeth pulled.\n\t\t\nClick to expand...\n\n\nThank you for your comments Hooley. It's good to hear of your success, and knowing that your own actions will have been a good part of the reason for that success, I think I can say 'well done you'!!!\n\nFor the record, I too have now completed my course of treatment (the cleaning and flossing obviously never stops) and am also free of the infection. Pockets have closed up and teeth are more stable. I still have concerns over a couple of teeth (much better than it was, 19 were at risk originally) but my oral health is loads better. Whether those results would have been achieved (or bettered) with a periodontist practicing 'standard' methods, I obviously can't say BUT I certainly have no complaints about the Bonner method. MattKW: The \"Bonner method\" is still undergoing analysis. It should be noted that the role of parasites in periodontal disease has been debated since as early as 1849.\nIn the most recent and widespread evaluation of the role of parasites within periodontal disease, Parasites in Periodontal Health and Disease: A Systematic Review and Meta-analysis (2022), the authors noted, \"It is noteworthy that the definition of periodontitis greatly varies between the studies... For instance, in the Bonner study [2014] patients could be at any stage of the disease...It is too early to determine the role of the parasites in the pathophysiology of periodontitis, but their presence is undoubted and unequivocal...Future studies will determine which part they take in the pathophysiology of the disease and if they are bona fide prognosis markers and possible targets to control the disease.\"\nThat was reached after looking at 1200 studies related to parasites only, not including other known micro-organisms such as bacteria, viruses, and fungi. So, the jury is still out and there is nothing firm to suggest that his particular approach is any better than standard perio treatment. Samsing: bledisloe said:\n\n\n\n\t\t\tThank you for your comments Hooley. It's good to hear of your success, and knowing that your own actions will have been a good part of the reason for that success, I think I can say 'well done you'!!!\n\nFor the record, I too have now completed my course of treatment (the cleaning and flossing obviously never stops) and am also free of the infection. Pockets have closed up and teeth are more stable. I still have concerns over a couple of teeth (much better than it was, 19 were at risk originally) but my oral health is loads better. Whether those results would have been achieved (or bettered) with a periodontist practicing 'standard' methods, I obviously can't say BUT I certainly have no complaints about the Bonner method.\n\t\t\nClick to expand...\n\nHi, I live in the UK. How do I find a dentist who does the Bonner method? \n\nDo I need to go to Canada or is there a closer dentist? \n\nThanks bledisloe: Samsing said:\n\n\n\n\t\t\tHi, I live in the UK. How do I find a dentist who does the Bonner method?\n\nDo I need to go to Canada or is there a closer dentist?\n\nThanks\n\t\t\nClick to expand...\n\nIt's my understanding that you won't find one in the UK as the British Dental Association has not approved the Bonner method. So unless dentists are allowed to practice in the UK without BDA approval, you'll have to hop over to Europe or further afield to the US or, as you say, Canada.\n\nEven then, they're not commonplace. I've not seen a list of them anywhere but you could web search or contact the 'Institut International de Parodontie' (Bonner's training centre in Nice, France). to see if there is someone across the channel. \n\nI knew nothing about Bonner and just happened by chance to be referred to a dentist who practiced the method. Even my own dentist, who referred me, wasn't aware that he was referring me to someone who used the Bonner method! As I say, they're rare. \n\nBoth Bonner and the more practiced/accepted method aim to get to the same place, they just go different routes. I'd guess a lot of people might prefer the more 'natural' and non-invasive claims of Bonner. John Morgens: The Bonner Method is a non-traditional approach to treating periodontal disease that is completed over the course of approximately twelve months.The method mainly targets the elimination of pathogens, including amoebae from the infected pockets, and the lowering of motile bacterial activity below 1%.\nThe Bonner Method was developed by Dr. Mark Bonner from Canada, assisted by Solange Dunoyé from France, and is based on the original works of Dr. Weston Price.The method includes microscopic visualization of the biofilm in all examinations and all appointments for the periodontal therapy protocol.\nWhile the Bonner Method is not commonly used, it has been shown to be effective in treating periodontal disease.The Bonner Method analyzes the plaque at a microscopic level to understand the patient's specific disease and correlate it with their overall health.\nIt is important to note that while the Bonner Method may not be commonly used, it has been shown to be effective in treating periodontal disease. If you have concerns about the method, it is recommended to discuss them with your periodontist. MattKW: But not better than traditional approaches, just sounds more \"pioneering\" and therefore appealing to the layperson. Lalasana: Hooley said:\n\n\n\n\t\t\tI was diagnosed in Nov 2021 and told I would lose all my teeth within 10 years and there was nothing I could do about it. I went to see Dr Bonner in Quebec Canada in Dec 2021. I started on his program in Jan 2022, working in conjunction with my \"home\" dentist. In Jan 2023 I returned to Dr Bonner and I am cured. My \"home\" dentist is amazed. I feel it is a miracle. And far less expensive than having teeth pulled.\n\t\t\nClick to expand... Lalasana: Hooley said:\n\n\n\n\t\t\tI was diagnosed in Nov 2021 and told I would lose all my teeth within 10 years and there was nothing I could do about it. I went to see Dr Bonner in Quebec Canada in Dec 2021. I started on his program in Jan 2022, working in conjunction with my \"home\" dentist. In Jan 2023 I returned to Dr Bonner and I am cured. My \"home\" dentist is amazed. I feel it is a miracle. And far less expensive than having teeth pulled.\n\t\t\nClick to expand...\n\nHi Hooley,\nYou gave me hope! My daughter is only 20 years old and was diagnosed with periodontitis, I would go ahead and get her appointment right away with a periodontist here in Los Angeles that treats patients with the Bonner Method. Please reply and share more of your miracle! Gray area: Hi Lalasani, who is the Dr in Los Angeles? If it’s the same one I heard about, they are really expensive at 10k. Thanks Tudor: Hi @bledisloe, would you be able to recommend the same doctor from the UK? Like you and others I'm having a hard time finding someone who practices the Bonner method. I contacted the 'Institut International de Parodontie' and they gave me a list of around 5 doctors in France but I'd prefer to go somewhere in London or the UK if possible. Can you please reach out when you get a chance and we can discuss more about it? Many thanks. bledisloe: I'm sorry @Tudor but I doubt you'll find one in the UK because the British Dental Association has not approved the Bonner method for use there, and I don't think dentists can practice in the UK without BDA approval. bledisloe: My apologies @Tudor, just now rereading your post I think I might have misunderstood your question. \n\nI'm in France and so the dentist I saw is probably on the list of names you have. I would recommend them but I don't know if that's what you are asking me." + }, + { + "id": 4, + "title": "LANAP surgery vs. Bone graft surgery for 7-8 mm pocket behind #18", + "dialogue": "Danni M.: Hello,\nI have a 7-8 mm pocket behind molar #18. By way of background, I had an impacted wisdom tooth removed from the area many years ago. A small part of my jaw was apparantly removed as well. Two years ago, I was told I had a small cavity in this area, and an amalgam filling was placed. I recently had the filling replaced due to recurrent decay. I was also told of the existence of the pocket. I had a deep cleaning of the tooth done, and visited a periodontist.\n\nThe periodontist presented me with two options. The first was surgery where they would remove a small portion of the gum, place bone in the site and suture the area. The cost was $2800. The second was described as laser surgery, similar to LANAP, where the laser would, hopefully, stimulate bone and tissue growth. The cost of this is $1500. The periodontist said if, for some reason, the laser surgery didn't work, he would apply the cost towards the bone grafting surgery. He also said he thought both procedures were likely to be successful, although they have only been doing the laser surgery there for six months. \n\nGiven all that he said, my strong preference would be for the laser. I did want to see if there was anyone who was familiar with both procedures, though, who could give me some further insight. \n\nI'm attaching my most recent x-ray of the tooth, in case this helps.\n\nThanks very much Dr M: Laser surgery is my preference, since the procedure in itself is painless. The only downside in my opinion, is that bone growth is not always guaranteed. It is nice that the periodontist is willing to count the cost of the laser. towards the cost of the alternative surgery. Danni M.: Thank you very much for your reply, Dr. M. Initially, I was very much on board with the laser procedure. However, upon doing some research, it seemed as though a lot of people were disappointed with the results and also felt their bites were distorted with subsequent necessary adjustments. I was concerned to hear that the periodontist also intended to file my adjacent tooth, so that the laser would not hit it. The bone and tissue graft, on the other hand, seemed like a very serious procedure with a long recovery time, and I wasn't prepared to undertake it, at this point.\n\nI was surprised that surgery was recommended for me at all. At my last dentist visit on 1-31, I was told that the pocket was 6-7 mm, and that a deep cleaning, proper home care, and possibly the application of Arestin was all that was needed. Since that time, I've been diligent with tending to the area, and the persistent bad taste which bothered me for months, has all but disappeared. I went to the periodontist because I wanted to have another doctor check the area and see if there was anything else, like the Arestin, that could be done to get me to 100%.\n\nAt this time, I'm keeping up with my home care, and my plan is to see another dentist in the near future for a second opinion. My hope is that the pocket will shrink, and that other options will be available. \n\nIn your opinion, Dr. M., is this a prudent course, and are there any less aggressive, non-surgical options you would recommend trying before either the laser or bone graft?\n\nThanks very much for your time and expertise. Dr M: You can delay treatment for now, and have your dentist measure the pocket depth with your usual check up visits. It will be important that you go every 6 months, without fail Danni M.: Thank you again for your reply, Dr. M. You've put my mind somewhat at ease. I will do as you suggested, and stay on top of my check ups and keep up with my home care as well. Danni M.: Several weeks ago, I went to a periodontist for a second opinion regarding my gum pocket. This doctor has excellent reviews and forty years of experience. So, when he recommended osseous surgery plus a bone graft, I decided to go forward.\n\nI had the procedure done on April 9, and initially all went well. Nine days later, I went in for my follow up appointment, and the doctor said I was healing well. He told me to start brushing my tooth and gumline, and that in doing so, I would dislodge the two dissolvable stitches I had. He said there might be some bleeding, but not to worry.\n\nTwo days later, one stitch came out without me even knowing. With the other stitch, though, I felt a definite pinch as it was dislodged. While it didn't bleed, later on, I had a strong taste of blood and also felt like I had a cut in my mouth.\n\nI called the office when they reopened on Monday, and the doctor had me come in that day. He said the area was fine, to continue brushing it twice a day, and that I needed to give my body more time to heal.\n\nIt's been eight days since I saw him, and ten days since my stitches came out. I no longer taste blood nor do I feel like I have a cut in my mouth. What's bothering me, though, is that for the last few days, I have the same bad taste in my mouth as I had before the surgery, except it's worse. It's particularly noticeable when I rinse my mouth out with plain water.\n\nI'm wondering if this is caused by inflammation or something else? I appreciate that the doctor said the area is healing well, but this is very annoying. My next, and final, appointment is scheduled for May 9. Is there anything else I should be doing to aid in the healing? How long might this last? \n\nIf anyone has any advice, I would greatly appreciate it. Thanks very much." + }, + { + "id": 5, + "title": "Periodontal bone loss surrounding 35+ yr old rct tooth", + "dialogue": "Rebeccah: I have a 35+-year-old root canal treated tooth #30 (right lower first molar) with a new draining infection, circumferential bone loss around the back root including loss of the cortical bone on the cheek side of it, and a periapical lesion at the conjoined tip of the front roots. Endodontist went in through the gold crown and has done a cleanout and disinfection of the tooth interior, roots, and the pocket on the side of the tooth (and I think he sealed the roots), and now we're waiting a few weeks to see how the gum responds before deciding whether or not to proceed with the full re-do root canal treatment. No cracks in the tooth or roots were seen.\n\nSo far, the gum is doing great. Swelling and tenderness continue to decrease a week out, there hasn't been any more drainage since day 2 following the procedure, and the gum is re-epithelializing where it had been draining before. So I think the odds are good that we will be going ahead with the full root canal treatment, although we'll know more when the effects of the disinfection solution have had time to wear off.\n\nMy question is regarding that bone loss. Is that something I should consider getting bone grafted? Should I see the periodontist ASAP (probably a few months to get in to the see the one I have a referral to, as he is a well-respected and popular implant specialist and the referral is for implant evaluation), or wait until this tooth declares itself, or until after the endodontist is finished? At this point, extraction is my fall-back, with then the decision whether to proceed with an implant ($$$) or with something more affordable, like a removable denture.\n\nThanks for any suggestions. honestdoc: I suspect root fracture around the root with the bone loss. You can monitor healing around the tooth but I wouldn't spend too much on it. Save your money for an implant with possible bone grafting for the implant. Bone grafting will never regain horizontal bone loss. It may help with vertical bony defects. Rebeccah: Thanks, honestdoc. Of course, you know that's not what I want to hear. \n\nHere's an arch section through the body of #30:\n\n\n\n\n\n\n\n\nAnd 3-d reconstruction (which, of course, you really get the best benefit of when you can twist it around in real time in the software):\n\n\n\n\n\nLots of artifact from the 3 gold crowns... Rebeccah: And here is a selfie of the gum 13 days after removal of old root canal fillings, post and most of the core, and looking through the microscope with illumination, for a crack; passing a probe down next to the tooth and taking an ultrasonic scaler to the pocket; disinfecting the tooth with bleach and pocket with chlorhexidine; treating with calcium hydroxide -- I believe, inside and out; and then I lost track, I don't know what else he did in the way of sealing, but I do have a temporary filling and there is cotton on the floor of the tooth.\n\n\n\n\nThere is essentially no swelling of the gum any more, even the bump at the gingival margin where the infection had pointed is gone. No more bone or gum tenderness to palpation. I never had any actual pain, just mild tenderness -- and that sensation that the tooth was a fraction of a mm high and contacted first when I would bite down, which has been gone for some time now. I don't feel any looseness of the tooth. There is a little more recession since that appointment but it's resolving some, we'll see if that continues to fill in. I can still feel the bony defect when I palpate with my finger.\n\nRebeccah Rebeccah: Just in case anyone was curious about how this turned out, the endodontist totally saved my tooth. A couple of months after the cleanout, he finished the revision root canal treatment. A year later (March 2023), most of the bone had grown back, including the cortical bone that appeared blown out on the buccal side of the root in December of 2021. Last month I had a new crown placed." + }, + { + "id": 6, + "title": "Crooked molar teeth", + "dialogue": "philippa: My son X ray is as attached\nDentist said: need to remove the crooked molar teeth then cut open the gum for wisdom teeth.\nIs there any less invasive method? MattKW: Ouchy! You would be better removing the wisdom teeth (8s) and see if the 2nd molars (7s) can be uprighted. An orthodontist opinion is required. To take out the 1st molars will mean the loss of very important teeth.Wisdom teeth don't have the size or solid root structure of 7s or 6s. I worry about the distal surface of 46 but can't be sure from an OPG. philippa: MattKW said:\n\n\n\n\t\t\tOuchy! You would be better removing the wisdom teeth (8s) and see if the 2nd molars (7s) can be uprighted. An orthodontist opinion is required. To take out the 1st molars will mean the loss of very important teeth.Wisdom teeth don't have the size or solid root structure of 7s or 6s. I worry about the distal surface of 46 but can't be sure from an OPG.\n\t\t\nClick to expand... philippa: Thank you ... (oh dear...this will be painful)" + }, + { + "id": 7, + "title": "Possible damage after drug abuse. Help!", + "dialogue": "Nhzinni11: My roommate for the past two weeks has been locking himself in his room abusing crack cocaine. He generally smokes it all day. I don't know how much he uses as he does not tell me but I can only imagine it's a lot. He doesn't eat a lot, but he drinks a fair amount of water to combat his dry mouth. I know he brushes and flosses at least once a day. \n He showed me his mouth the other day, and it scared the living hell out of me. There were these weird geek colored sores on the roof of his mouth. The ball shaped thingy that hangs from the back of his throat was very red with white spots. His tounge has this weird green looking fungus layer to it on 2/3 of the surface. Above his back lower molars on the right side there is a red and white spot. And finally, next to the ball shaped thingy and all around is throats are big red spots that look like burns.\n He doesn't complain of any symptoms. Should I be worried for him? Should I get him to see a doctor? Thanks. CringingFidgeter: Is he just a room mate or a friend? Personally I'd move out if my room mate was abusing illegal drugs...especially crack since it makes people terribly unstable and irrational sometimes (or all of the time...). \n\nHis dental health isn't your concern, to be perfectly honest with you. But I like to be very cut and dry with my legalities. I've been screwed over by poor room mates before.\n\nI'd honestly suggest moving, or finding a new room mate but that's just me. Worry about your own mouth; not other people's. Reserve your empathy, sympathy and energy for people that deserve it like friends and family. =)\n\nThat's one opinion, anyway! Good luck! smithwilfer: Yes, you should be worried about your roommate's health. The symptoms like sores, redness, white spots, and unusual growths in his mouth, could indicate serious health issues. It's necessary to encourage him to see a doctor as soon as possible to get a proper diagnosis and necessary treatment." + }, + { + "id": 8, + "title": "Mystery external resorption in multiple teeth", + "dialogue": "confusedandscared: Sorry for the repeat posting. I'm posting to all the subgroups because my issue seems to be partially related to all of them.\n\n2 days ago, I went to a dentist for extreme tooth pain/sensitivity in several molars. I get mild, brief pain when any food or drink touches the area between those teeth, and if the food or drink is hot, cold, or extremely sweet, forget it--the pain will almost bring me to tears (though it lasts only a few seconds). This pain/sensitivity started about 6 months ago and only got worse. I'm 24 years old and female. I don't smoke or drink. I floss daily and brush 2x/day for a while now.\n\nThe doctor performed the cold test, and I had sharp pain, lasting about 3 seconds. He looked at my X-rays and found that I had signs of external resorption in 3 molars. (Although almost all of my teeth have developed similar sensitivity to lesser degrees. He only took X-rays of the ones I said were hurting the most.) He referred me to an endodontist that I will be seeing in 2 days.\n\nAfter googling what external resorption means, I'm freaking out. Most sources are saying that in the majority of cases, the teeth will need to be extracted, which is alarming since all of my teeth have developed the same sensitivity/pain to varying degrees. My dentist couldn't answer why the resorption occurred and said it could be idiopathic. Does anyone have any theories? How do I prevent further resorption?\n\nI've never had trauma. I did braces from about 2013-2015 and Smile Direct Club invisible aligners from about 2017-2019. I've been wearing my retainers nightly since completing my last alignment treatment. Throughout the day, my teeth will shift slightly and putting on the retainers at night will be a bit tight/painful. I always thought this wasn't normal but my dentist/ortho said it was and some people just have faster relapse speeds than others.\n\nAs of about a month, I also developed some other symptoms I believe may be related like occasional, mild ear and jaw pain (ears will feel mildly painful pressure, jaw is more of an ache and stiffness. I'll have the urge to open wide and stretch it out) and random, brief numbness or pain in my hands and feet 10-20 times a day. Both the facial pain and bodily numbness occur on both sides of my body, but more on the left, which is also where I experience more dental pain.\n\nPlease help, I'm really at a loss." + }, + { + "id": 9, + "title": "Help with xray", + "dialogue": "klindzi: Hy can a dentist please help with xray to identify whether root canal/tooth removal is required Lower jaw molars either side Dr M: Based on your x-ray, it does not look like any molars need root canal treatments or extractions. If you are planning on doing some orthodontic treatment, you might need to remove your wisdom teeth. klindzi: Thankyou for having a look that has eased my anxiety. The for advice re wisdom teeth" + }, + { + "id": 10, + "title": "What is it", + "dialogue": "Craig804: A few days ago I was driving and I felt a swelling in my mouth with a bump. A small white bump. It did not hurt. A couple of days later I guess as I was bothering it, it started to hurt. I also noticed that the white spot had grown more flat and larger. Prior to this I did have some pain under the white jaw. I do have periodontal disease but wanted to know if it is related to an abscess or if it is a canker sore." + }, + { + "id": 11, + "title": "How painful is bone graft?", + "dialogue": "Aspen: I heard some people say recovery is very painful but dentist websites say very minimal pain. Which is it? How was your experience for those who had it? Thank you Dr M: It all depends on your own pain tolerance level. Usually the pain is easily managed with pain killers and lasts for about 1 week. dental_care: Bone grafting itself shouldn't be painful. It is typically performed under anesthesia, either local or general. \nFollowing the anesthesia, the surgical site might feel sore and tender. This is normal and can be managed with pain medication prescribed by your dentist or doctor. Swelling around the grafted area is also common and should subside within a few days." + }, + { + "id": 12, + "title": "How quickly do bone loss occur?", + "dialogue": "Aspen: I do my cleanings every 4 months and the dental check up twice a year. My dentist never said anything about posible bone loss that I need to watch out for. Then out of nowhere in my last check up upon complaining of tenderness, he referred me to a periodontist who said I need a bone graft and extraction due to severe bone loss. How can this happen so quickly? Should my dentist or hygieniest have known this prior to my last check up? Dr M: Did he take regular x-rays when you go for your check-ups? This seems like something that should have been picked up earlier. Periodontal disease with bone loss, does not happen overnight. Aspen: Thank you for the reply. My last xray was a year ago, my check up was 8 months ago and my cleaning 4 months ago. Is it possible to only see this through xray and for my pocket to go from 3 to 10 in a year? Dr M: Seems highly unlikely. Most likely there was already some bone loss present 1 year ago." + }, + { + "id": 13, + "title": "Gum surgery", + "dialogue": "Mo24078: Hello forum,\n\nI posted about the root aspects of my current problem in the endodontics forum last week. My molar 14 developed a periodontal abscess a few weeks ago. I have attached an X-ray, with gutta percha inserted up the abscess. As can be seen in the X-ray, the gutta percha travels very deep. I was referred to the endodontist to rule out any root involvement. I visited the endondontist a few days ago who examined the tooth and said that the root is vital and therefore a root canal is not needed. He referred me back to the periodontist to have gum surgery.\nMy question is how does gum surgery correct this deep tract that grows almost to the apex of the root? Is the area just cleaned and then the tract filled with a temporary material? Will the periodontist cut open my gum all the way up to where the tract ends?\n\nThanks in advance. honestdoc: I will get another endodontist opinion. All clues lead to pulpal disease. I believe the tooth to be partially necrotic due to the tooth having 4 canals and may have have some canals responding vital. That particular tooth is notoriously difficult to root canal and even more so with the canals calcified and the bridge abutment distorting natural anatomic landmarks. I would find an endodontist that uses chairside microscope. davidrix: Is it possible that our modern dental practices are failing to address the root causes of oral health issues, leading to conflicting advice and confusion among patients? As advancements in technology and research continue to shape the field of dentistry, are we truly addressing the underlying issues or merely treating symptoms?" + }, + { + "id": 14, + "title": "Inflamed ligament", + "dialogue": "Sandybob23: I have been going through hell for almost 2 years. I had a horrible toothache that resulted in a root canal, which did not stop the biting pain that I was having since before the root canal. About a year later, he redid the root canal. This was about a month ago and I still have the biting pain. I’ve been researching this for years because I had pretty much the same thing happened about 10 years ago. I’m almost convinced that this is not a tooth problem anymore but it is something to do with the ligaments or the nerves under my tooth. I cannot get anyone to help me at least not in the dental profession, I found this online read below, should I discuss this with my general practitioner I have a feeling my Dentist will just shrug his shoulders like he usually does but there is something going on in my tooth. The symptoms are either a crack that can’t be seen or there is a problem with the ligament what do I do? I’ve never been so frustrated in my life with doctors .\n\n“‘Depending upon what created your sprain or if the factors that are repeatedly affecting your PDL aren't removed or reduced, inflammation can hang around for a long time and cause your lingering toothache to get even worse. In this case, the pain can spread to your surrounding gum tissue and neighboring teeth.\n\nIn some cases, inflammation goes away, but your ligament(s) remain sensitized to the degree that you can't chew on a tooth or even touch it with your tongue without pain. In this scenario, it's common for x-rays to look normal and for the tooth to be structurally sound. The cause of the pain is the result of the nerve endings in the ligament remaining in an irritated or what we call a sensitized state. As a result, even normal function produces pain.\n\nWhen this happens, your persistent ligament pain may require the use “…. Brause: I am having a similar problem and the doctor wants the ligament to heal with a custom made night guard.\n\nIf the problem was advanced pulpitis, the X-ray would show a secondary infection around the root apex. And there must be a reason for the pulpits, which is usually caries, that would also show up in an X-ray.\n\nIf the conduit for bacteria into the pulp was a fracture, this is difficult to image and may not show. But if the culprit for the pain is a root fracture, the tooth is lost. In this case, there should also be a \"rarefying osteitis\" showing on the X-ray (a black halo around the root).\n\nIf the ligament was the culprit, there should be a thin black seam around the whole root on the X-ray, which depicts a widened ligament space (the ligament itself is not imaged as it is a soft part...see middle tooth on image). Brause: This tooth turned out to have a root fracture and had to be extracted. The CBCT scan reveals a black halo around the mesial root.\n\nSince the fracture was not imaged, the Endodontist preformed RCT, which did not solve the problem.\n\nIf the ligament was the issue, these halos would not exist. harrisonorepe: Thrilled to observe this! Amazing insight and the excellence of details provided is excellent! \nThank you everybody!" + }, + { + "id": 15, + "title": "Are paediatric partials for toddlers safe?", + "dialogue": "Dentalquestions6484: 5 year old knock out front top incisor a year ago, we put a pedi partial in which he’s happy with, but when it came out temporarily, I could see the gum had recessed, further than the neighbouring teeth - I understand this would happen with an extraction anyway , but am not wondering it the pedi partial may be contributing and more importantly whether any recession in the alveolar gum/bone will correct itself when the permanent tooth comes in alakuni: Considering the safety of paediatric partials for toddlers is a valid concern, and it's entirely natural to be emotional about it.\n\nPaediatric partials are typically custom-made dental appliances designed to address specific dental issues in children. Safety is a top priority when it comes to any dental treatment for young kids. These partials are created under the guidance of pediatric dentists who specialize in caring for children's oral health.\n\nIt's crucial to consult with a trusted pediatric dentist to determine if a partial is the right solution for your toddler's dental needs. They will consider your child's age, specific condition, and overall health to ensure that any treatment is both effective and safe.\n\nWhile it's natural to be concerned about your child's well-being, you're in good hands with a caring dental professional who will prioritize their safety and comfort. Their expertise will guide you in making the best decisions for your toddler's oral health, allowing you to feel more at ease about the process. Dentalquestions6484: venerabrostol said:\n\n\n\n\t\t\tPediatric partials, or partial dentures designed for toddlers, can be safe and effective when prescribed and monitored by qualified dental professionals. These dental appliances are typically used to replace missing teeth in children, promoting proper oral development and function. However, their safety relies on several factors.\n\nVeda Dentistry and Cosmetology\n\nClick to expand...\n\nThanks what factors pls? dental_care: Receding gums are common, while bone loss may occur but can be mitigated by the growing permanent tooth. Consult your child's dentist, they can assess the situation and advise on adjustments or alternatives. Proper oral hygiene remains crucial." + }, + { + "id": 16, + "title": "Gum recession getting worse, need advice", + "dialogue": "Kass: Hello everyone,\n\n\nI suffer from gum recession since september and I've been told by my dentist to use the sonicare electric toothbrush. I find it traumatizes the gums even on the lowest setting and when I use a soft manual toothbrush (advised by another dentist), I find it's not good enough to remove plaque. When brushing I use the down motion on the upper teeth and the up motion on the lower teeth. I also use these motions with the electric brush) What would you personally recommend, electric or manual brush? And how many strokes per area? I also started flossing, if there's any flossing tutorial vid you think is good don't hesitate to send it.\n\nQuick history:\n\n- Diagnosed with recession on left molar on september 20th and told to use Electric brush. Found it too rough after a week and a half of use, so i switched to soft manual\n\n- used soft manual for about 2 months (and sometimes the electric brush) but I think plaque accumulated and made the recession on my molar worse\n\n-got a scaling done end of november at dentist’s in korea, they told me the reason the recession got worse was the electric brush \n\n-once I got back to my dentist at home he said to keep using the electric brush. My upper front teeth gums’ are a bit inflamed now and he said it was because I don’t brush well enough on that side? It’s been about a week since I saw him and continually use the electric brush and my gums are more sensitive, I even now have the start of a recession on the right molar and on the back of one of my canines \n\nAnd as described in my first paragraph I use the recommended brushing technique, but is it really good, I’m starting to question everything.\n\nPlease tell me what you think I’m at a loss\n\nThank you Dr M: Not all electric brushes are beneficial, especially when a patient is suffering from recession. In your case I would rather stick to a manual brush. Consider using an ultra soft brush. Well known brands include Curaprox or Oral- B. Even though these brushes are ultra soft, they still clean your teeth. Try using the circular motion instead.\n\nIf the recession increases, there might be additional contributing factors. You might need to consider seeking the advice of a specialist periodontist. They will have a broader look at your case, looking at factors such as systemic diseases, gingival biotypes etc. In severe cases, the recession won't ''heal'' on its own, and you might need to consider surgical augmentation of these sites. Kass: Dr M said:\n\n\n\n\t\t\tNot all electric brushes are beneficial, especially when a patient is suffering from recession. In your case I would rather stick to a manual brush. Consider using an ultra soft brush. Well known brands include Curaprox or Oral- B. Even though these brushes are ultra soft, they still clean your teeth. Try using the circular motion instead.\n\nIf the recession increases, there might be additional contributing factors. You might need to consider seeking the advice of a specialist periodontist. They will have a broader look at your case, looking at factors such as systemic diseases, gingival biotypes etc. In severe cases, the recession won't ''heal'' on its own, and you might need to consider surgical augmentation of these sites.\n\t\t\nClick to expand...\n\nThank you for the reply. Are you suggestion using the modified bass method? I do have the curaprox and it doesn’t clean off the plaque well enough with the sweeping motions\n\nAnd for patients with recession do you recommend classical string flossing or other flossing alternatives? Dr M: Yes, you can try the modified bass method. How do you know that the curaprox doesn't clean off the plaque efficiently enough? Kass: Dr M said:\n\n\n\n\t\t\tNot all electric brushes are beneficial, especially when a patient is suffering from recession. In your case I would rather stick to a manual brush. Consider using an ultra soft brush. Well known brands include Curaprox or Oral- B. Even though these brushes are ultra soft, they still clean your teeth. Try using the circular motion instead.\n\nIf the recession increases, there might be additional contributing factors. You might need to consider seeking the advice of a specialist periodontist. They will have a broader look at your case, looking at factors such as systemic diseases, gingival biotypes etc. In severe cases, the recession won't ''heal'' on its own, and you might need to consider surgical augmentation of these sites.\n\t\t\nClick to expand...\n\nThank you for the reply. Are you suggestion using the modified bass method? I do have the curaprox and it doesn’t clean off the plaque well enough with the sweep\n\nAnd for patients with recession do you recommend classical string flossing or other flossing alternatives?\n\n\nDr M said:\n\n\n\n\t\t\tYes, you can try the modified bass method. How do you know that the curaprox doesn't clean off the plaque efficiently enough?\n\t\t\nClick to expand...\n\n\n\n\nDr M said:\n\n\n\n\t\t\tYes, you can try the modified bass method. How do you know that the curaprox doesn't clean off the plaque efficiently enough?\n\t\t\nClick to expand...\n\nBecause there is still visible plaque along my gumlines after using soft manual brushes and my mouth doesn’t feel clean. dental_care: Both electric and manual brushes can work, but choosing the right one is key. For sensitive gums like yours, try a softer electric head and gentle, short strokes with minimal pressure. Manual brushing works too, just focus on technique. Flossing is crucial and regular dental visits and personalized advice from your dentist are essential." + }, + { + "id": 17, + "title": "All on 4 faliure", + "dialogue": "lalu: Can you still get dentures if all on 4 completley fails( given the alveolactomy has been done)?" + }, + { + "id": 18, + "title": "Bone loss?", + "dialogue": "Sophiajoy: Hello everyone,\n\nRecently I have gone to the dentist because I noticed the gums in between my teeth don’t reach all the way down. She did probing all around my mouth and told me my gums were fine and all pocket were 1mm. I was wondering if there is another explanation for these gaps, since it is not periodontal disease? Does this necessarily mean there has been bone loss, or could it because of another reason? Many thanks in advance!" + }, + { + "id": 19, + "title": "Peridex experience at a dentist for a checkup questions", + "dialogue": "Morgan815: Went to the dentist for a cleaning today, I got prescribed local del of chemo into dis of 4 back molars for 60 dollars each after my insurance (Dhmo) I have very bad gums they were 6 and the other 4 back molars teeth in March so that wasn't a total surprise (those teeth are now at a 4 and were at 6/7 level before.\n\nBut I also got prescribed a one time mouth rinse at the dentist called peridex which I never heard of before today for 150 dollars, is this a normal rinse to perscibe to someone like me? I looked up the drug online and it costs 12 dollars and your supposed to do it after the dentist at home so something isn't adding up but may be totally off\n\nPatient history\nBad gums\nBad over bite jaw grew on the top after my braces later in my teen life and doesn't affect my daily life that bad and don't want to do surgery as it looks awful and painful and expensive\nNo cavities\nDhmo insurance will be upgrading to ppo in January" + }, + { + "id": 20, + "title": "Gum and teeth issues after installing a crown and deep gum pocket cleaning", + "dialogue": "Gaius: Hello,\n\nIn August, my tooth, which had a root canal treatment a year ago (the second from the left at the bottom), was crowned. It hurt for a week. The dentist said it was due to grinding. After a few days, the pain subsided, and I could chew with it.\n\nAfter another week, I developed gum pain between that tooth and the one behind it. The pain wasn't severe, and there was no bleeding. I also noticed that food particles kept getting stuck there.\n\nI went to the dentist, and he believed the issue was related to the gum and the contact was still there. He performed a deep gum pocket cleaning with local anesthesia, saying I would have gum problems for about four more days, and then it would improve. He advised daily cleaning with an interdental brush dipped in chlorhexidine.\n\nOn the same day it hurt and I didn’t feel like trying to eat on that side. The next day, I couldn't chew on that side anymore, mainly because the tooth behind the crowned one hurt when biting. My gum hurt more than before, started bleeding, and never got better.\n\nThree weeks later, I took my tooth band to the dentist and showed him that there was no resistance when cleaning there and told him about the gum issue. He said the gum looked fine and couldn't identify the source of the pain. He suggested the back tooth might be hurting due to grinding, even though it hadn't caused problems before the gum pocket cleaning. He also said my teeth had shifted due to grinding and that’s why there is no contact there anymore, and a new crown was needed.\n\nTwo weeks later, I got a new crown, but all the gum pain persisted, and the farthest tooth still hurt when biting.\n\nIn between it stopped bleeding. \n\nThe new crown was very wide, and the dentist couldn't floss between it, left or right. He gave up, saying my teeth would shift again, creating more space between them.\n\nThe first two days had pressure pain from both sides. On the third day, the weak contact returned, and food kept getting stuck. Gum pain remains.\n\nI have two X-ray images: one of the entire jaw before the first crown, and one with only the crowned tooth and the farthest tooth after the last crown. What's your estimate? Could the dentist have done something wrong? Can you see from the full jaw X-ray (before the crown and before the gum pocket cleaning) if there were already serious gum problems? If so, I wonder why he didn't mention it. Or did these problems arise after the crown placement or even after the cleaning?\n\nMeanwhile the gum started hurting on the other side of the crowned tooth as well, but not constantly and not that severaly and also the crowned tooth started hurting and it kind of radiates into my head. I also got the mouth guard and has bean wearing it for 5 nights so far, but no improvement whatsoever.\n\nA night guard has been ordered, but I'm unsure how it’s going to be with the crown, given the weak contact and food particles getting stuck. I haven't chewed on that side for two months due the various issues.\n\nI gotta say, there is need a contact between the crown and the tooth behind, bit it’s weak and also only like one point of contact, not like with other teeth where the contacts are rather like surfaces.\n\nI previously refused the night guard because I couldn't sleep with it in the past.\n\nAlmost forgot, in addition to everything, on the gum in front under the crowned tooth and to the side, strange sores or a red line keep appearing since the cleaning, and it hurts, especially when brushing. I have two photos of this. The dentist said everything was fine and would go away.\n\nThank you alakuni: Experiencing gum and teeth issues after getting a crown and deep gum pocket cleaning can be emotionally challenging, and it's essential to address them for your overall well-being.\n\nAfter these procedures, some discomfort or sensitivity is normal. It may take time for your gums and teeth to adjust. However, if you're facing persistent pain, gum irritation, or any other concerns, it's crucial to share your worries with your dentist or periodontist. They can reassess your condition and provide appropriate guidance or treatment.\n\nRemember that your dental health is a journey, and sometimes there might be bumps along the way. Your dental team is there to support you and ensure your comfort and satisfaction. Don't hesitate to reach out for the care and attention you deserve, because your oral health is an important part of your overall happiness." + }, + { + "id": 21, + "title": "20 years of itchy gums", + "dialogue": "Dadgirl: Hello, \n\nI have great oral hygiene and I have had the same dental hygienist for 20 years! She has been with two dental offices and I have managed to puzzle all of the doctors. \n\nI had all 4 of my wisdom teeth pulled at the same time 20 years ago. After I healed, I have experienced severe gum itching around 1 bottom tooth (between 29/30). I am constantly sticking toothpicks, floss, or my tongue in-between my teeth to scratch my gums.\n\nThe only answer I have been given is that maybe a nerve was damaged during wisdom extraction. Please, can anyone explain why this is happening but more importantly how to make it stop! I had a gun graft done this year and I hate that I’m already damaging the work done by constantly scratching my gums all day! MattKW: I would suggest you ask your dentist or medical practitioner for a referral to a pain clinic. Your symptoms do not correlate to the extractions. Kate1224: Hello, I have the same problem and xerostomia symptoms, do you have normal salivation? Kate1224: I visited facial pain clinic and made trigeminal nerve blockade, but nothing changes" + }, + { + "id": 22, + "title": "Can a wisdom tooth erupting cause a hole in your gum?", + "dialogue": "j.e.200: So a couple months ago I noticed that the gum behind one of my back bottom molars was swollen and painful. That lasted for a few days, and after that I started getting pains around my jawline (both sides) and occasionally that small area of my gum still hurt while I ate. Automatically I assumed it was because my wisdom teeth are erupting, since I’m around the age that it usually happens.\nThe pain went away completely and I hardly noticed it anymore so I didn’t care and decided not to call my dentist about it. Recently, I started getting pain again—in my jawline and in that area behind my molar. Now its been a while since the first time I started having those pains, so this time when I check I have a hole right behind my molar! It scared me, but the pain over time went away again. It didn’t bother me so I wouldn’t check it. Now that hole has kept growing. And its weird, because at first I could’ve sworn I saw a tooth coming out of it… and just yesterday, as I was brushing my teeth, I noticed there was nothing in the hole. Now its just an empty hole, or at least thats what it seems. I’m really confused, and I was wondering if this was normal for wisdom teeth eruption or if it could be something else?\n\nIn the end I’m definitely going to tell my dentist about it soon. I have an appointment in a few weeks for my scheduled clean-up, but I would really like to know if this is something more urgent and I should go in for a visit now? At first I didn’t think much of it but now that the hole is growing (and the tooth somehow disappeared (?????)) I’m starting to get more worried. I’ve heard of gum diseases that cause holes in the gums, but I don’t know if thats worth worrying about ? I really haven’t felt any discomfort anywhere else in my gums. It really is only that one spot behind my molar, where my wisdom tooth is supposed to come out from. Dr M: I think it is still your wisdom tooth erupting. I am sure that you will be fine waiting until your normal check-up and then your dentist can take an x-ray to confirm this. John Morgens: It's possible that the hole behind your molar is related to an erupting wisdom tooth. This is a common occurrence and can cause pain and discomfort in the surrounding area. It's important to consult with a qualified dentist to determine the best course of action. Depending on the severity of the issue, your dentist may recommend a variety of treatments, including antibiotics, extraction of the wisdom tooth, or other procedures to address the hole in the gum. It's important to address the issue promptly to prevent further complications. If you are experiencing pain or discomfort, it may be worth scheduling an appointment with your dentist sooner rather than waiting for your scheduled cleaning. DariaMerritt00: Yes, the eruption of a wisdom tooth can sometimes cause a hole or opening in the gum tissue. This can happen when the tooth pushes through the gum and creates a small flap or opening. These openings are known as \"wisdom tooth flaps\" and can trap food particles, leading to discomfort or inflammation. It's important to keep the area clean and consult a dentist if you experience any issues with a wisdom tooth eruption. In some cases, the dentist may recommend removal of the wisdom tooth to prevent further problems." + }, + { + "id": 23, + "title": "Is it possible to do a bone graft around an existing implant?", + "dialogue": "two_dollars: I have bone loss around my 20+ year old implant located at 24/25 which has also affected my tooth at 26. \n\nI've seen some medical papers and research about bone grafting/regeneration around existing teeth and in some cases implants, possibly coupled with some laser cleaning for any existing bacteria, etc... I'm not sure if my situation is too severe for that treatment. I've only seen this treatment discussed in research but nothing pointing to a particular practice (in the US) where something like that could be evaluated.\n\nIf the treatment is potentially viable and even a chance it could work in my situation, could anyone provide a recommendation for where I could look further into this.\n\nEven if it were possible, I understand it might not be the best solution but what was offered as the best solution came in at 30k for removal of implant and all neighboring incisors, bone graft/tissue Regen, two new implants at #23 and #26 and an implant bridge. I had a bone scan done and then periodontist thought 23/26 had adequate bone for this treatment, although I'd still probably have to go with a canine anchored bridge and maybe revisit the implant later if possible. MattKW: There is no way of treating the contaminated surface of that implant, it simply has to go. I'd keep it simple for a while, maybe a Valplast single tooth denture. Unfortunately, there has been severe bone loss about adjacent teeth, esp #24 (FDI 31), and I'd like to see how things heal up over next 6 months. \nGiven that you have otherwise excellent teeth, I would consider it very unwise and unethical to make a standard bridge on virgin teeth. I also think looking at re-implantation down the road is wishful thinking. There is a possibility of a minimally invasive cantilevered Marylands bridge, or even a simple cantilevered composite tooth. two_dollars: A friend of a friend is a dentist. He said it would be best to do the removal and graft and a temp bridge. After things heal, you could see if an implant would be viable.\n\nHe suggested the canine tooth anchored bridge because he thought putting implants in #26 and #23 has too high a possibility of later failure. He said the canine bridge could last 10-15 years and then I would need to have implants done at #22 and #27 with a 6 tooth bridge. \n\nSince the implant that needs to go has a crown that resembles two teeth and the old root canal tooth next to it also needs to go, how would a Maryland bridge work? I presume the canine at #27 would have to support one side and the tooth at #23 would have to support the other. #23 seems barely anchored on its own. Could a Maryland bridge be designed to act/look like two or three teeth? MattKW: adityasharma23 said:\n\n\n\n\t\t\tYes, it is possible to do a bone graft around an existing dental implant. This procedure is called a \"bone augmentation\" or \"ridge augmentation.\" It involves adding bone material to the area around the implant to enhance its stability and support. Bone grafts can help address issues like bone loss or gum recession around the implant, improving the overall health and aesthetics of the dental implant site. Your dentist or oral surgeon can assess your specific situation and determine if a bone graft is necessary and suitable for your implant.\n\t\t\nClick to expand...\n\nNo, the original implant surface was specially prepared for sterile insertion into the bone. Once there has been peri-implantitis, bone loss, and exposure of the threads as in this case, then the surface is contaminated with bacteria and the implant prognosis is hopeless." + }, + { + "id": 24, + "title": "Hi, can anybody help me to analyze my x-ray tooth photo?", + "dialogue": "test1199: my periodontal disease have been almost 20 years. I only made 3 or 4 times teeth cleaning.\nrecently, it's worse than before, I found that one tooth can move a little, it's not strong enough, and ache sometimes.\nso I go to a hospital and take a x-ray photo\nmy doctor said that she will make teeth cleaning, and 5 days later she will make scaling , and then she will decide if it's necessary to make a periodontal surgery, it deponds on recovery\nbut she said cleaning and scaling have no help with the ache teeth , it will be movable and ache forever\nso can anybody help me to look at my x-ray photo, and give some suggestions about my alveolar bone?\nhow can I recover my tooth to the strong statement?" + }, + { + "id": 25, + "title": "Periodontal Treatment In Australia.", + "dialogue": "cactus: So I thought I would start this thread and ask for some advice. From those who have been in the same position.\n\n\n I saw a periodontist and was diagnosed with generalised chronic periodontitis (Stage II and Grade B)\n\n\nThe itemised treatment quote is $1800 - though it states at the bottom this is an estimate.\n\n\n$370 per quadrant x4\n\n$80 for periodic oral exam\n\n$75 Clinical periodontal analysis & recording\n\nSupportive periodontal therapy -per appointment $165 ( not sure what this means)\n\n\nNow being on welfare, I would struggle to pay this but, I have a relative who has offered to loan me the money. Is it best to proceed as I am concerned that that there is no way back here?\n\n\n\nI should also note that I have an appointment for a periodontal assessment in the public system although I am not sure what happens there and if any treatment is actually undertaken.\n\n\nI am just concerned if i do the initial cleans and thats not enough i need more work down the line. MattKW: It's a fair quote. The success of periodontal treatment depends upon:\n\nYour initial stage of the disease\nThe contributing lifestyle factors - smoking, poor oral hygiene\nYour motivation to keep your teeth after undergoing therapy\nIf you can get through all that, then you might need only occasional \"touch-ups\" to keep them in good condition. A bit like a beaten up car - still serviceable if treated with care! You should never have to undergo a full course of treatment again. The patients that fail have usually been unable to give up smoking and don't spend enough time keeping gums maintained.\nIn the Austn public system (where I now work as a supervisor for students) it would be a long time to get periodontal treatment (1-2 years?) as you would be judged to be low priority. But if you don't ring the call centre of your Local Health District and get your name on the waiting list then it will never happen. cactus: Thanks for that. I went ahead and booked to have this taken care off.\n\nI was actually on a public waiting list as this periodontist wrote me a referral but i was told by the hospital the initial appointment was to come up with a treatment plan. My own Local Health District said there is no public periodontal service and i would need to pay someone privately.\n\nI was told my issue is mild to moderate. Is that what generalised chronic periodontitis (Stage II and Grade B) is?\n\nI have xrays if it helps. MattKW: Attached is the Staging and Grading classification. \nSo, Stage II is sort of an mild-to-moderate condition, and Stage B means your gum disease is progressing at an average rate. The Staging is based on the worst area in your mouth, but typically means there are many areas of same or less damage. \nIn the Grading you can also see that risk factors such as smoking or poorly controlled diabetes will accelerate the speed of damage.\nIf you live in one of the major cities, check if there is a student program available through one of the universities. For example, Sydney Uni has students at three major hospitals - Sydney Dental Hospital, Westmead Hospital, and Campbelltown Hospital. They also send students out to rural placements like Broken Hill and Ballina. Students will treat periodontitis under the supervision of periodontists." + }, + { + "id": 26, + "title": "Roof of mouth inflammation", + "dialogue": "Longinthetooth: Tooth 10 extracted two months ago following two attempts to save original tooth (external resorbtion). Roof of mouth lumpy since first bone graft/surgery. Salty discharge. Periodontist said that extraction would resolve this issue. Unfortunately, 2+ months following extraction the roof of mouth still inflamed with salty discharge. Periodontist says healing looks good, but swelling and discharge make me feel uneasy. It feels like something is still wrong.\n\nIs it normal to take so long to heal? What could be causing this? MattKW: Photo? Longinthetooth: Periodontist says it looks OK, but salty taste and swelling make me uncomfortable MattKW: Looks OK to me. Longinthetooth: Received the implant 10 days ago. Hard palate was feeling better for a few days after the implant (perhaps due to Novocain?). Now experiencing inflammation again. Color is light pink (similar to photo above), not angry-red.\n\nWhen walking (even slowly), I feel a pulsing sensation in the implant area. \n\nAre these signs of a failed implant, or something else?" + }, + { + "id": 27, + "title": "How long to wait until FGG surgery?", + "dialogue": "MarieP1: I went to see a Periodontist and I have severe gum recession on two of my lower front teeth. I'm a 27 year old female, non-smoker, otherwise healthy. The periodontist told me it's an \"easy\" surgery with a 5 day recovery time frame - the problem is, I'm going abroad for graduate school soon, and I don't have the time to make the surgery before I leave. I won't have dental insurance while I'm abroad, which means I'd need to put off the FGG for a year. Is that too long? What are the risks of waiting another year to do this surgery?" + }, + { + "id": 28, + "title": "Should Root Canal Treatment be conducted during Pericoronitis?", + "dialogue": "RandomIndianGuy: I went to see a dentist in my town following tooth ache and funny taste in my gums (which I learnt later was the taste of pus). I mentioned these symptoms and also said that I had undergone restoration (filling) 2.5 years earlier on my last two molars (I don't have the third molar). The dentist after xray said that the filling was erroneous and that cavities have formed in the gaps left during filling. He immediately performed RCT on the first molar, following which my symptoms worsened the next day, and he had to extract pus the day after; when he told me I have Pericoronitis. I was prescribed Amoxicillin, Metronidazole, chlorhexidine mouth wash, and painkillers. It's been 6 days and I have not seen significant improvements. Although the initial sharp pain is mostly gone, now I have pain spreading to my jaw and temporal skull. I am worried if my infection has become severe. \n\n\n\nAs the thread title reads, I wanted to know if I've been misdiagnosed and if RCT is actually advisable during Pericoronitis? MattKW: Pericoronitis is related to partially erupted teeth (like many wisdom teeth). It is not related to Root Canal Therapy (RCT). Without xrays to show us, it's difficult to say more." + }, + { + "id": 29, + "title": "Any issues here?", + "dialogue": "Nickello5541: I had these taken about two weeks ago when I noticed a small bump on the seam of the gum meeting the inner lip. The location of the bump is around the root of the canine, but I don't think anything appeared on this x-ray. My dentist said there's nothing showing any problems in these images. He also said that the bump/sore is not fixated on a certain tooth and moves around. I should note that the bump does not cause pain even when I push it in. Can anyone here she's insight? MattKW: If you think you are seeing an abscess at the apex on far left tooth, it is easily tested by using a cold test by the dentist. I don't see anything. Nickello5541: MattKW said:\n\n\n\n\t\t\tIf you think you are seeing an abscess at the apex on far left tooth, it is easily tested by using a cold test by the dentist. I don't see anything.\n\t\t\nClick to expand...\n\nApex? What is a cold test? Sorry I should clarify....the bump I found is at the bottom of the tooth with the super long root, I'm just worried about that dark spot at the very root of that tooth on the far left as well Nickello5541: For your reference the bump has been circled. My dentist said not to worry about it but I've never had a bump in my mouth so I'm freaking out. Nickello5541: audaparizeau said:\n\n\n\n\t\t\tBased on the information provided, the bump you noticed may not be visible on the x-ray and your dentist didn't find any issues. Since it doesn't cause pain and moves around, it could be a minor irritation or a benign condition.\n\t\t\nClick to expand...\n\nIs there any way to know for sure? I'm a hypocondriac and I'm freaking out still over a week later......I called my dentist again this past week and he reiterated that I do not need another xray because it is not infection. He said he has strong reason for believing it could be something viral or just irritation. Should I get another opinion or trust my dentist I've had for my whole life?" + }, + { + "id": 30, + "title": "Feeling run down with swollen glands", + "dialogue": "Oscar_Victor: For two months i have been feeling run down and have swollen glands in my neck which I suspect may be caused by gingivitis or peridontitis. The affected area appears to be around /between a crowned lower tooth and an existing natural tooth closer to the front of my mouth.\n\nI do not experience any toothache at all, but I regularly get bloodstained interdental brush after brushing or flossing between these teeth. i get some relief of the symptoms once i have done such cleaning with with either baking soda toothpaste or Corsodyl mouthwash. Symptoms soon return (within 24 hours) until i do this close cleaning work again.\n\n The dentist has x-rayed the tooth and said there is no issue and the crown seal is intact. I have not had any scaling or hygiene work done at the dentist since at least early 2020. \n\ni need to visit my dentist again, but it would be good to get some advice here as I appear to be having difficulty communicating this issue to my dentist. Dr M: I would start with a proper cleaning and then take if from there. Mechanical debridement is necessary to remove calculus, which you can't always remove with normal brushing and flossing. Gingivitis or periodonitis, can cause swollen glands, although this is usually a general sign and might also be an indication of infection elsewhere in the body." + }, + { + "id": 31, + "title": "Idiopathic Acute Necrotizing Gingivitis", + "dialogue": "IchiTaco: This happened to me a few years ago, and it remained an open mystery as to what caused this to happen. I have an appointment with a new dentist in the AM, and that lead me to decide to post this puzzle here to see if anyone has experienced this, or if any of the experts have seen something like this before.\n\nDental history in brief: until I was 25, I was insured through my parents insurance. Being born with crooked teeth herself, my mother made it a point to do whatever she could to ensure I had the best oral hygiene a kid can realistically had, and definitely the best care that (at the time) was available... started on fluoride treatments at 5 years old, regular dental checkups, made to brush my teeth after every meal in addition to when I woke up and before I went to bed...and as soon as she found out about Sonicare brushes, it was with one of those.... Orthodontic work started when I was 9 to pull some impacted baby teeth, and after years of torturous contraptions, a few years with braces, and several years of follow up retainer use every night, I absolutely had perfect effing teeth. Like, movie star smile perfect. \n\nAfter 25 I never had great insurance, but managed to get a checkup and a cleaning once a year or so. Every time - in despite of my smoking and coffee consumption - the dental staff would remark how great my teeth were. I have never had a cavity in my entire life.\n\nSuddenly, when I was 28, I had a strange toothache at work. Now, sometimes if I get a nasty cold that turns into a sinus infection, that will cause jaw pain. So I thought perhaps that's what it was at first. By the time I took my lunch break, I noticed some things that ruled that out. Firstly, I didn't have any other symptoms of a cold. Second, the pain was definitely not coming from the lymph glands around my lower jaw. Rather, it was emanating from my upper gums around my canine on the left side. When I realized it hurt so bad that I couldn't even take a bite of food, I finally decided to look in the mirror (I know...obvious...but I have a tendency to get hyperfocused on my work). That's when I realized that my gum line was in fact red and swollen above that tooth. \n\nI chalked it up to flossing too rigorously...even though I didn't actually recall doing so. I thought perhaps it was the fact that I was using a new brand of disposable flosser....I don't know....denial logic. Throughout that night I started to feel ill. By the time I went to sleep, the swelling had spread to both sides (symmetrical) and to the bottom gums as well in the same vicinity. I took some tylenol and slept. When I woke up, it HURT.\n\nI brushed my teeth lightly... and noticed these little white spots where the painful spots were between my teeth. I went to work. The pain increased. I started to develop a fever. I developed a nasty taste in my mouth, so I rinsed with hydrogen peroxide and lightly brushed. Oh boy....those spots that were white were now mostly black. Some of them were a little bloody...and one little tiny chunk of my gums actually came right off onto my toothbrush with no blood at all. At that point, I went to the University ER (late night, and i knew they had a dentist on call). \n\nThe dentist had called out sick. Three different doctors came in to look and none of them knew what to make of it. They took swabs. My fever had spiked at about 104. They sent me home with percocet, antibiotics AND antifungals, and wished me the best. Someone from the dental school was supposed to call me when the results came back....but they never did...and the only phone number I had for the dental school turned out to be useless (turns out this is an issue at UW).\n\nThe next day, as soon as it had presented, it started to clear up and I felt better. Two days later I was able to eat and function normally again. Still have a little piece of my gum missing. \n\nThis never happened to me again...however, that spot by my canine where that chunk of my gums just fell apart has in recent months (this is years later) developed a tiny little black dot right at the gumline. \n\nSo. Any ideas? Judea: Did u ever find out what caused the issue?" + }, + { + "id": 32, + "title": "Dentist left me confused about gum status", + "dialogue": "Denii933: Hi went to dentist for an exam but she left me so confused, so Friday I go to get my gums and teeth examined she also did a perio probe also x-rays she tells me that my gums look unwell and they were bleeding she told me schedule my regular cleaning which I did which I know about the bleeding because of gingivitis I asked about my teeth she said they were ok no cavities etc. Now about my gums she didn't say if I still had gingivitis or if it progressed just they bleeding a lot and to get the cleaning that's when I decided to ask if the gingivitis progressed or if I passed gingavitis stage that's when she said that I now have periodontal disease I don't understand why she didn't just that right away...she said my my gum pockets where my back teeth are 4mm I think it I think 4-5 kinda loose and the rest was 3 I think so I then I said so I'm at the stage where this isn't reversible but she said it's still reversible I asked about a more deep cleaning she said just get the regular cleaning insurance might not cover I asked about bone loss I think she said I didn't have any at least I think that's what she said, she also told me after I spit out the mouthwash we'll talk more after I did she hands me card to schedule the cleaning and didn't seem as concerned she was talking about this as if I still have gingivitis and not gum disease that has progressed and I always thought the stage after gingivitis is when bone loss occurs the more I asked questions the more she rushed me out of there unless I possibly misheard and she said I do have gingivitis or still do but here I am confused. mojo88: Hi. I got a similar experience with my newly diagnosed Long-term periapical periodontitis on only the one tooth lower d31 thankfully not the others.. yet.. But yeah these dentists dont really seem to care and just rush us out asap without the full story.. thats bad business. Sabs85: Hello, I was informed years back I had periodontal gum disease and paid so much money to have it treated via laser. I was given reassurance this would not come back and the gum pockets would reduce. However I went for checkups the issue still persisted. I stopped going dentists and developed a phobia. I went back this month to nhs dentist who yesterday told me if I don’t take care of my teeth will loose them. I feel this is just causing me more worries and concerns. Seems like this worry will never end and my phobia only gets worse. Stackflow: mojo88 said:\n\n\n\n\t\t\tHi. I got a similar experience with my newly diagnosed Long-term periapical periodontitis on only the one tooth lower d31 thankfully not the others.. yet.. But yeah these dentists dont really seem to care and just rush us out asap without the full story.. thats bad business.\n\t\t\nClick to expand...\n\nHi @mojo88 \nIs your tooth fit better? I have same issues on tooth#31. Is your pain got better now?" + }, + { + "id": 33, + "title": "LANAP Post-Op Question", + "dialogue": "Daytripper64: LANAP Post-Op Question\n\nHi!\n\nI realize I may have just undone thousands of dollars worth of periodontal work and am freaking out. \n\nAbout two weeks ago, I had my whole mouth LANAPed in one go. After which, I could have bet money that my periodontist aide, who gave me the post-op instructions, said to use the mouthwash only for two days after the procedure. So that was what I did, and I assumed that then meant, after those two days, I could begin brushing my teeth again. She gave me one sheet of paper with instructions on what a “soft diet” meant, and that was all the post-op advice I got. I had some antibiotics, no painkillers, and was sent on my way. Also, no direction as to how long said soft diet was to last. I did do this for at least ten days.\n\nThis is where I’m at fault. I didn’t look into any other rules until today, and now, two weeks later, I have realized I may have messed everything up and ruined the healing of my gums, and wasted the procedure entirely. \n\nI’m in a complete state of panic, and I’m not seeing them for my follow-up till Monday.\n\nI need some reassurance or advice on how to proceed. Please don’t be too harsh. Thank you!" + }, + { + "id": 34, + "title": "Perio ligament?", + "dialogue": "Sandybob23: Had an intense toothache last July, after the tooth ache was gone, I was left with biting pain in the tooth (#30). ( Backstory: I clench. Had root canal with similar symptoms 15 years ago on # 31 & had it extracted. )Had first part of root canal in November and second session in January. After the first part I still had biting pain & after the second part I still had biting pain it is now more than nine months since the initial tooth ache and the subsequent biting pain. I have seen two dentists besides the endodontist who I have gone back to several times about the issue.. He told me to wait until this July, which will\nmake it a year to see if the biting pain has gone away if not, he will redo the root canal. All drs say my X-rays & cone beam are perfect & do not see a crack. Of course, not all cracks can be seen. My question is, when I told the endodontist after the first & then the second part of the root canal that I still had biting pain ,shouldn't that have been a red flag? I am most likely not going to go though the probably futile redo of root canal 8\nhave it extracted. Which is lousy be it leaves me missing 2 molars on bottom right. Would a periodontist be able to help me at all with this who helps you with periodontal ligament? I’m having such a hard time between Endo‘s and regular dentist trying to figure out what to do with this tooth." + }, + { + "id": 35, + "title": "Long term periapical periodontitis HELP", + "dialogue": "mojo88: Hi. New member here.\n\nI was recently diagnosed with\nlong term periapical periodontitis on the lower inscisor tooth #31. The dentist has performed two procedures. 1st was grinding the tooth lower to be inline with my biteline & then opening the tooth and removing yellow pulp & then injecting medicine into the tooth. On the 2nd appointment a few weeks later he did the same thing. When I was about to leave I asked about weather I could save the tooth through nutritional changes or LANAP. He then said the tooth is only on the gum and biting hard on a pizza crust could totally rip out the tooth - and the bone is also gone & there is no hope, but he still insists on follow up appointments to redo the same process i.e cleaning out the tooth & injecting medicine. \n\nProcedure(23.01.2023):SAA01;Oral examination, narrow Tooth: d 31;\nProcedure (23.01.2023): EB1AA; Dental X-ray Tooth: d 31;\nProcedure(23.01.2023):WX110;Infiltration anesthesia Tooth: d 31;\nProcedure (23.01.2023): SGA01; Emergency tooth opening Tooth: d 31;\nd31 HF picture, the tooth is intact, it wobbles and the bone around the root has melted, the old fistula is buccally open, dg. occlusion traumatica, trees. the tooth is shortened and the pulp is opened, NaOCl 3%, Biocalc, Kavit, extension. The prognosis is poor. Patient informed.\n2nd appointment\nd 31: Medicine in the root canal; Occlusal surface of the tooth; Filling in the tooth, Material intended for temporary use;\nSGC00;Medical treatment of root canals Tooth: d 31;\nd31 drug exchange, NaOCl 3% Biocalc, Kavit\n\nThe two pics are new & old.\nThe black spot on tooth #31 on the left photo is where he says the bone is gone.\n- its the skew looking tooth.\nYou can see the old photo on the right - from 2012 how the teeth have changed since then.\n\nIs there any hope for saving my tooth & what would be the best solution? or is this too late for help? or must they just pull the tooth?\n\nAny advice would be greatly appreciated.\n\nThanks. Stackflow: mojo88 said:\n\n\n\n\t\t\tHi. New member here.\n\nI was recently diagnosed with\nlong term periapical periodontitis on the lower inscisor tooth #31. The dentist has performed two procedures. 1st was grinding the tooth lower to be inline with my biteline & then opening the tooth and removing yellow pulp & then injecting medicine into the tooth. On the 2nd appointment a few weeks later he did the same thing. When I was about to leave I asked about weather I could save the tooth through nutritional changes or LANAP. He then said the tooth is only on the gum and biting hard on a pizza crust could totally rip out the tooth - and the bone is also gone & there is no hope, but he still insists on follow up appointments to redo the same process i.e cleaning out the tooth & injecting medicine.\n\nProcedure(23.01.2023):SAA01;Oral examination, narrow Tooth: d 31;\nProcedure (23.01.2023): EB1AA; Dental X-ray Tooth: d 31;\nProcedure(23.01.2023):WX110;Infiltration anesthesia Tooth: d 31;\nProcedure (23.01.2023): SGA01; Emergency tooth opening Tooth: d 31;\nd31 HF picture, the tooth is intact, it wobbles and the bone around the root has melted, the old fistula is buccally open, dg. occlusion traumatica, trees. the tooth is shortened and the pulp is opened, NaOCl 3%, Biocalc, Kavit, extension. The prognosis is poor. Patient informed.\n2nd appointment\nd 31: Medicine in the root canal; Occlusal surface of the tooth; Filling in the tooth, Material intended for temporary use;\nSGC00;Medical treatment of root canals Tooth: d 31;\nd31 drug exchange, NaOCl 3% Biocalc, Kavit\n\nThe two pics are new & old.\nThe black spot on tooth #31 on the left photo is where he says the bone is gone.\n- its the skew looking tooth.\nYou can see the old photo on the right - from 2012 how the teeth have changed since then.\n\nIs there any hope for saving my tooth & what would be the best solution? or is this too late for help? or must they just pull the tooth?\n\nAny advice would be greatly appreciated.\n\nThanks.\n\t\t\nClick to expand...\n\nHi\nI have similar situation on my tooth#31 and apical periodontists. Is your pain get settled down? What did you end up doing?" + }, + { + "id": 36, + "title": "Deep cleaning needed? X-rays and intra oral pictures attached", + "dialogue": "Stackflow: I went to dentist for an exam for my tongue spot with general evaluation and they said they can't do normal cleaning and I need to do deep clean.\n\nI have plaque buildup at tooth 31. But they said I need to get entire mouth deep cleaning. \n\nDo I need to get second opinion from another dentist for deep cleaning?\n\nAnd for the tongue spot, they said I need to referred to oral surgeon which I am waiting for the referral. \n\nDoes my x-rays indicate I need deep cleaning? Stackflow: Xrays Stackflow: Intra oral pictures\n\n\n\n\n\n\n\t\t\t\t\t\tMay x-rays 2023 - Google Drive\n\t\t\t\t\t\n\n\n\n\n\n\n\t\t\t\t\tdrive.google.com" + }, + { + "id": 37, + "title": "Question about potential pocket", + "dialogue": "Jerrychuwanda: Hi all, \n\nDoes this look like a periodontal pocket caused by disease or is it just part of my unattached cheek flesh? \n\nI have no pain/ bleeding/ swelling, I just noticed it while prodding with my tongue and started to worry\n\nI have a check up in a few weeks, and there is still a wisdom tooth to come through back there. \n\nThanks in advance for any advice! MattKW: More of a pseudo-pocket due to the lack of attached gingiva (AG) and the unerupted wisdom tooth. It doesn't require periodontal treatment, but they can be a pain to clean because of the lack of AG. It will probably help to extract the wisdom tooth. Jerrychuwanda: MattKW said:\n\n\n\n\t\t\tMore of a pseudo-pocket due to the lack of attached gingiva (AG) and the unerupted wisdom tooth. It doesn't require periodontal treatment, but they can be a pain to clean because of the lack of AG. It will probably help to extract the wisdom tooth.\n\t\t\nClick to expand...\n\nThat sounds very likely, as I can feel the wisdom tooth crown quite clearly below the surface. Will just take extra care to keep the area clean until I can have it looked at, thank you!" + }, + { + "id": 38, + "title": "What is the correct treatment sequence when involving the dental deep cleaning and implant surgery?", + "dialogue": "compiler: After my tooth #3 was extracted, a surgeon has performed bone grafting and scheduled a dental implant surgery in 6 months. But I need to get the dental deep cleaning too. Should I get the deep cleaning before or after the dental implant surgery? What treatment sequence is better and why? Thank you for your answer." + }, + { + "id": 39, + "title": "Gum condition", + "dialogue": "david562100: hello .\nI am 67 years old and am asking which x-ray (number 1 or number 2) has more receding gums, and if vitamin C on a daily basis can stop deterioration or even improve it, and if so, what dosage do I need.\nBest regards ." + }, + { + "id": 40, + "title": "Periodontal ligament.", + "dialogue": "Sandybob23: My regular dentist told me that a periodontal specialist would not actually deal with issues with the periodontal ligament. This makes no sense to me, and I have not tried to contact one yet, but if not, then who specializes in bruised or mystery symptoms with possibly the periodontal ligament.? I had to have a root canal on a tooth, two sessions,even since before the root canal I still have biting pressure and just touching pain. I haven’t eaten on that side since August. I went yesterday for the first part of a crown because the dentist said that possibly a new crown could stop this issue. Both dentist and the endodontist said the root canal looks beautiful and no one sees a crack anywhere my dentist yesterday put some dye on the tooth and said he does not see a deep crack there was a hairline crack that went away when he put pressure on it. something like that I really couldn’t understand but this is driving me crazy because 10 years ago I also had a root canal that wound up with biting pressure that wouldn’t go away and I had to have it pulled. What is wrong with my mouth? I am so nervous about this and I don’t know where to turn." + }, + { + "id": 41, + "title": "Post Deep Cleaning Problems", + "dialogue": "maranatha23: 3+weeks ago had deep cleaning and root planing procedure. Also they did fillings on 2 upper right teeth and bottom front. Went back for bite adjustment as lower teeth were hitting upper bridge. Dentist filed down upper fillings and shortened down front tooth. Still have same problem and other dentist in office checked and said the problem with my bite is my bridge and front tooth should not have been filed down. He won't fix it and referred me to original dentist who I see tomorrow. Help. MattKW: Not enough detail to understand you. \nWhich upper right teeth and bottom front teeth? \nIn particular, what part of the lower front teeth were filled - the biting edges? \nYou have a ceramic bridge up the top? - which teeth form part of the bridge?\nBut yes, should go back to original dentist. Nobody wants to take over someone else's problems." + }, + { + "id": 42, + "title": "Gum infection between teeth?", + "dialogue": "timmytom: Excuse my lack of Dental knowledge but I have a question regarding a stubborn gum infection between my two back molars.\nI had root canal on the second from the back tooth years ago but I think there has been some ongoing low level infection occurring between that molar and the rear molar (top). I've recently began root canal on the back molar but it seems that this infection between my teeth (deep in the gum) hasn't quiet healed. I have a good dentist who has agreed that getting that gum infection to heal first, before continuing with the root canal, would be a good idea. I have suffered some bone loss on the bone separating the teeth. All holes have been filled in that area, but the gum infection persists.\n\nThere's no pain when I run my fingers along the outside of the gum, nor is there any visible issue. I know it's ongoing though because when I stick a periodontal pick between those two back teeth I always get blood on the tip of it, and below the surface it's sensitive to the pick. I also get a slight feeling of very mild sensitivity when I tap the back tooth only. If I'm not on top of cleaning out the area with a periodontal pick regularly I get more blood than usual and the infection seems to persist. It seems to be a very stubborn infection in there and I don't want to lose my back teeth because of it. There is no ongoing pain until I prod it with the periodontal pick. No bite pain, no lateral pain on the tooth. Just the infection when I stick the pick in there.\n\nI've been using mouthwash, warm salt bathing, various essential oils like oregano, calendula, clove (all diluted of course) to try to kill the infection but I'm only seeing mild improvement. I don't have any other issues with my gums or teeth besides this.\n\nI have a good dentist, and he has pointed out that this could just take a long time to heal, but I'm wondering if it will heal given that it's probably been there for so long. There doesn't seem to be anything outside what I've talked about on the x-ray. Antibiotics have only had a mild affect on healing it.\n\nCan anyone suggest what could be going on and if there's anything else I could try to heal it. Maybe there's something I could suggest to my dentist that we're missing. Months of cleaning have only seen mild improvements.\n\nThanks so much! nolenjames30: A gum infection between teeth, also known as interproximal gingivitis, is an inflammation of the gum tissue that occurs between the teeth. This type of infection is typically caused by plaque buildup in these areas, which can lead to the formation of bacterial colonies. Symptoms of interproximal gingivitis include red, swollen, and tender gums, bleeding while brushing or flossing, and bad breath.\n\nTreatment for interproximal gingivitis typically involves a thorough cleaning of the teeth and gums by a dentist or dental hygienist, as well as improved oral hygiene habits, such as daily brushing and flossing. In some cases, the dentist may recommend using an interproximal brush or other specialized tools to clean between the teeth. In more severe cases, a periodontist may be consulted for additional treatment options." + }, + { + "id": 43, + "title": "Thinking about getting an all-on-4 implant", + "dialogue": "Attire5515: So I still have pretty bad teeth. I'm 25. I brush 2x a day, floss 1x a day, rinse 2x a day. I have started to refrain from junk food, only eat bananas, pasta, rice, wurst, non-carbonated mineral water, the occasional coffee every day. It's boring, yes, but afaik, I'm gonna have to stay away from sugar and acids if I'm gonna stop getting dental problems.\n\nBut my teeth are still hurting. I'm sick of this. Also, a big problem is that my teeth are pretty crowded so it's rather difficult to clean some of them to the fullest extent. I should have got braces when I was a small child, my father noted I would sleep with an open mouth, I already had OSA back then, but he wouldn't do anything and now here I am. My parents' ignorance and neglect have really messed up my bone health, development and my entire dental health as well. \n\nI need double-jaw surgery as well since my jaws are very recessed. But before I can get them, I'll have to correct my bite, or so I was informed.\n\nWould it be possible to get an all-on-4 or all-on-6 dental implant both upper teeth and lower teeth, and get double-jaw surgery after that? I have 28 teeth left, apparently all the cavities have been filled, x-rays have been done but they still hurt and this is pissing me off and ruining my quality of life so much. I just want it to end.\n\nAlso, another question I have is that if I do manage to get the upper and lower all-on-4 or all-on-6 dental implants, since I have a severe form of crossbite (due to my parents' gross neglect of me when I was a child), would this somehow be corrected by the implant? Since you need braces so your natural teeth can be fixed, so your bite can be fixed, but then again, implants don't move, so how does that work in the case of implants?\n\nThank you MattKW: This is really hypothetical, but I doubt you would really benefit from all-on-4 given that you still have all your teeth. Address one issue at a time and get different opinions. If you are having discomfort (hot/cold/sweet sensitivity? pain on biting?...) try to fix this first. Maybe some teeth aren't worth saving, but then any extraction you might do will affect any orthodontic planning. Jaw surgery (orthognathic surgery) is often done in conjunction with orthodontics too. It is serious surgery with significant risks. Don't even think about implants yet. Attire5515: MattKW said:\n\n\n\n\t\t\tThis is really hypothetical, but I doubt you would really benefit from all-on-4 given that you still have all your teeth. Address one issue at a time and get different opinions. If you are having discomfort (hot/cold/sweet sensitivity? pain on biting?...) try to fix this first. Maybe some teeth aren't worth saving, but then any extraction you might do will affect any orthodontic planning. Jaw surgery (orthognathic surgery) is often done in conjunction with orthodontics too. It is serious surgery with significant risks. Don't even think about implants yet.\n\t\t\nClick to expand...\n\nCan I get jaw surgery first before braces?\n\nCan I get jaw surgery with bad teeth? MattKW: No and no. Any dentist or specialist would be unethical and possibly negligent by acting on such a suggestion. Who would risk their career for something foolhardy? Attire5515: MattKW said:\n\n\n\n\t\t\tNo and no. Any dentist or specialist would be unethical and possibly negligent by acting on such a suggestion. Who would risk their career for something foolhardy?\n\t\t\nClick to expand...\n\nBut please understand I absolutely require jaw surgery, my jaws are small and underdeveloped and very recessed.\n\nWhat can I do in such a horrible situation?\n\nCould someone get an all-on-4/6 implant and then get surgery? Would this even be feasible? I am already 25, I should have gotten surgery when I was 18." + }, + { + "id": 44, + "title": "Analyse my OPG please", + "dialogue": "nikroute: Can you please look at my OPG and find all the present issues . Any deformity etc" + }, + { + "id": 45, + "title": "Bridge, implants or bone grafting?", + "dialogue": "didntknowaboutboneloss: Already aware of the state of lower anteriors. Been told by several dentists both on and offline.\n\nPosting cuz I want to know about the options my dentists laid out.\n\nI just want a clear understanding of what:\n\nbridges, [I think they said the center six on the bottom row would be bridged with crowns placed on the two in the middle]\n\nbone grafts, [this is apparently possible if I want to keep my teeth. A dentist I spoke to online told me the bone loss was too far gone for that]\n\nand implants entail. [No clue about these or how they work]\n\nI'm wary about making any changes that alters the natural structure that's already there since I don't know what consequences might follow.\n\nEverything I've learned about dentures leads me to relegate that as a non-option or potential last resort. Dr M: Good day\n\nDid you see a periodontist specialist regarding your case? I would also be wary of bridging the lower anterior teeth, with the amount of bone left. If you decide to go this course, I would consider getting the bone augmentation first, and then see if the procedure is successful. A lot of times the bone augmentation also gives issues and I would not consider crowning any teeth in that area until I know the situation is stable.\nBest option would be to go see a periodontist. He will do a tooth by tooth evaluation in order to determine the long term prognosis of your teeth as well as address the underlying cause of periodontal disease, which lead up to the scenario you are currently in. didntknowaboutboneloss: Hello.\n\nI've been advised to see a periodontist and there are plenty in my area but the only one available on my insurance has mediocre ratings. That hasn't stopped me from trying to book an appointment mind.\n\nSeveral failed attempts both direct and indirect, of reaching them(no one picking up, inbox full, etc.) signaled to me a potential red flag of unprofessionalism suggesting that I was better off finding someone else.\n\nSo, I went to see a highly rated dentist that was available on my insurance instead. The current first step per their appraisal, is a deep cleaning which is pending my insurance's approval. I just wonder how loose my lower anteriors will be afterward given what I've been told about the calculus being the only thing currently holding them in place.\n\nYour post is making me consider just paying out of pocket to see a high rated periodontist if only to get them to examine the teeth. Dr M: There is a chance that the lower anterior teeth might become more mobile after the deep clean. It is best to go and see a periodontist. I agree. didntknowaboutboneloss: Oh. One other thing I've wondered about. Is the bone loss on the back teeth reversible at all? I've heard lots of people say bone can't grow back but not sure if they meant lesions or just any type of bone loss. Dr M: Usually once bone is gone, it is gone. You get procedures like bone augmentation where they try and \" build up\" an area with artificial bone, although the success is dependent on a host of factors. didntknowaboutboneloss: Bone augmentation-is that bone grafting? If so, isn't the bone taken from some other tooth's bone, or the bone from some other body part? Dr M: It is basically the same concept. The bone can come from the donor, or it can be a mixture of artificial or animal bone didntknowaboutboneloss: I see. Something else I've wondered about:\n\nDoes teeth decay on its own over time regardless of diet? Like, do some people keep their natural teeth well into death from old age or is that impossible regardless of whatever measures are taken?\n\nEssentially , I wonder if teeth age like the rest of the body or get worn down over the decades due to wear and tear from use. Dr M: Teeth do undergo some wear and tear over time. The enamel wears away. This does not mean that you end up losing the teeth. You can still retain your own teeth until death. didntknowaboutboneloss: Interesting. So the enamel undergoes natural wear and tear.\n\nTwo last questions:\n\n\nWhat about bone; does it also naturally erode over time or is that only ever due to gum cleaning neglect? I've been told that bone destruction is an effect of bacteria finding a path of invasion through a pocket in the gums.\n\n\nHave you ever witnessed diet to have a strong distinguishing effect in patients? Say strict carnivores for instance; those that avoid all fermentable carbohydrates. I'm inclined to believe they would have very little gum or gum related issues. Dr M: There is constant bone formation and degradation that takes place throughout your life time. Certain conditions such as osteoporosis or osteo-arthritis, does lead to bone loss however. The main reasons gum inflammation leads to bone loss, is due to the inflammatory cells that recruit other cells, such as osteoclasts, which lead to bone loss.\n\nCarbohydrates, as well as other sugars, especially in modern diets, does have a direct effect on caries formation as well as other gum and periodontal issues. There are studies done on this. didntknowaboutboneloss: Thank you for your time." + }, + { + "id": 46, + "title": "Undiagnosed pain - could it be gingivitis?", + "dialogue": "Eros: Last February I had a molar extracted by my dentist then 6 weeks later remaining roots removed by a specialist. In June, I thought the mild pain had stopped only after a few pain free days for it to start building again as a periodic dull ache. It's difficult to pinpoint the site of the pain though it still seems to be the extraction site. Sometimes my lower jaw has been tender to the touch at the bend of the jaw.\nMy dentist checked closely then referred me to an endodontist who did a range of tests, xrays and CT Scan of Lower Right 5, extraction gap and LR 7 and could not find a definite problem. He did say LR5 was non vital but said electric tests are not always accurate. Suggestion of widened ligament on LR5 possibly being the problem but nothing definitive.\n\nLast week the endo and the specialist who removed the roots reviewed the xrays and CT scan and said they could find nothing and to return in six months time for xrays.\n\nI was at the hygienist last week for the first time in 5 years. She said I needed a further 3 visits over the next year to really clean them out. She also said I had gingivitis and inflammation round the molars. I wondered if this might relate to my lower right problem?\n\nUp to now my sleep has not been really effected. The dull ache seems to be getting more regular during the day as well. Painkillers have limited effect.\n\nI'm getting to the stage of being a bit desperate as to know who to turn on. I did wonder if should be going to my doctor to see if its nerve related or some other non tooth reason. Dr M: Good day\n\nDo you perhaps have any x-rays or scans that you can share so that we can evaluate the area in question? Eros: Thanks for your reply Dr M.,\nAttached is an xray taken by my own dentist on 30 June 2022 of lower right 5, gap and lower right 7. \nThe endo saw me a month after the xray. The CT Scan was done in mid August but I dont have the Scan." + }, + { + "id": 47, + "title": "Are all custom made 3D printed subperioasteal dental implants made of grade 5 titanium?", + "dialogue": "nellame: Due to lack of vertical bone height, i need a custom made 3D printed subperioasteal dental implant for mandible rehabilitation. I noticed that unlike concentional dental implants, these are made of grade 5 titanium. I am concerned about having aluminum and vanadium into my body. Is there any chance to find a manufacturier that makes subperioasteal dental implants from cp titanium only?" + }, + { + "id": 48, + "title": "Need help and suggestions", + "dialogue": "nikroute: Dear dentist \n\nI need one advice . Recently my Oral medicine and Radiologist friend visited my home as my anniversary party . I asked him about my oral condition. He sent me for a new CBCT scan as IOPA done by dentist shows nothing abnormal\n\nHe looked my old CBCT and NEW . Than he asked how my redness of left upper molar palatal region stayed \n\nMy first issue wa a gum boil . Than as advised of dentist I have followed antibiotics and antioxidant etc course gum boil resolved but a pimple like feeling remained there .\n\nThe old CBCT shows a perapical abseces with a small palatal cortical plate discontinuity. \n\nDentist extracted my molar but my gums palatal side swellon there after . As my friend says it's periodontitis at mild to moderate level in the area now \n\nHe advised proper treatment is now one more extraction of teeth 27 with existing 28,27,26 flap surgery cause according to him bacteria is still trapped inside my gum that's why I am having stomatitis there along with swelling below gum line \n\nBut dentist here kept prescribing me vitamin for last 4 months . Meanwhile I do have nasty taste coming out of the region .\n\nDo you agree" + }, + { + "id": 49, + "title": "Puss from behind molar - but no pain, swelling, etc.", + "dialogue": "lemonade-jackal: So I have a bit of an odd issue. I will say, I am due a checkup around nov/december, which is why I haven't contaced my dentist yet.\nA few weeks back, I was really over worked and had the flu at the same time. In all this, I also somehow got this weird puss pocket/sunken area behind my molar. Not \"around\" my molar in that sense, but on the surface behind it. There was what looked like a sunken area / almost like how it looks when you get a puncture wound on your skin.\n\nWhen squeezing with a Q-tip, I would get puss oozing out. I couldn't properly get this gone while I was sick and over worked. (Was doing some really hard shifts, double shifts, etc all while running a high fever and general weakness.). Once my flu cleared and I got some rest, I managed to combat this. It was almost like an underground zit in my mouth, where I would squeeze out ooze, soak and dab with Corsydol. After a few days, the puss got more solid, and two days with less puss, with solidness, it was gone.\n\nI got a new toothbrush, just to make sure I didn't bring any bacteria along after that.\n\nI'm a bit overworked again, and lo and behold, it's back. This is day 1 with a bit of puss, so I cleansed with some Corsydol on the problematic area.\n\nI've got some pictures from last time. If anyone would be so kind as to tell me what this might be ? When googling, I am getting the results of \"dental abcess\", \"periapical tooth abcess\" etc, where the symptoms are great pains, swelling, etc heaps of issues.\n\nBut i have none of that. The molar seems unaffected, there is no noticeable swelling (that I notice at least), no pain at all. I wouldn't have noticed if it's not for the fact that I have a habit of smelling my toothbrush while brushing, because I am paranoid, lol.\n\nI brush twice a day, use flouride mouthwash (my teeth very easily get cavities), dont drink or smoke, and I floss near every day, a good amount too. I floss when I chill infront of my PC, I floss at work, when brushing, etc. I have not yet had my wisdom teeth (I am over 30) and last year there was no sign of them moving from their comfy spots.\n\nThe first time I got this, I figured I may have accidentally flossed behind my last molar and maybe cut something, butI have not done that this time, so I am not sure why this re-appeared. If it's just that my body is tired and can't so easily fight off bacteria.\n\nthe images: the darker one is from when the puss \"peaked\" during the first time I had this.The second one was like 1 or 2 days after the height of it. lemonade-jackal: For what it's worth:\nA day 2 update. a bit of \"fresh\" bacteria in the morning when rinsing/squeezing. After waiting a bit, I did another round, and this time I managed to squeeze out some bits of more capsulated bacteria, kinda like the hardened bacteria in a big zit. After squeesing out these bits, there didn't seem to be anything else in there at the time.\n\nI did another rinse, soaking the area and swabbing in corsydol, + rinsing my mouth with it.\n\nAfter some thinking, I realize it's almost exactly the same pattern as last time - a full week of extreme worry (my cat got very sick and had a relapse this week, and both weeks I also had to deal with covering extra shifts at work in addition to my full time work, + some work blues and stress at work that mentally nags me 24/7.\n\nCould it really be related to that? I've never had any problems like this before with my gum. But I've rarely been so burned out, worried overworked as these last weeks - coming on top of a 5 months long hard work period." + }, + { + "id": 50, + "title": "Wisdom tooth dropped out - existing issue - no bleed / discomfort - dentist visit?", + "dialogue": "DabblinG: I had pain and inflammation on my wisdom tooth which led me to visit my dentist a good few years ago.\n\nI had gum disease and bone loss, especially around that tooth and had regular hygiene visits until covid hit.\n\nThere has always been some movement on that tooth, but around 6 weeks ago, I noticed it became much looser. The first week it came to light was when chewing, sometimes I would inadvertently bite onto that tooth on what seemed like at a 45 degree angle, could be quite painful. \n\nIn the past couple of weeks, with careful chewing, I've noticed that it seemed to slot back into placed more easily and movement was not only from side to side, but wiggles back and forth. I also noticed the tepe brushes (grey) would slide straight through if I pulled it through (as it tips the tooth back - I then use my finger to push back in).\n\nTo my surprise, maybe not helped by my tougue playing with the tooth, that tooth has now popped out.\n\nI don't feel any discomfort, there's not blood, not even a tinge of pink in the saliva, no throbbing etc. The question is, do I actually need to visit a dentist?\n\nI was going to say it'll just heal, but that process may have taken place in the weeks leading to this point?\n\nI'd imagine the only point of a visit would be for them to keep a record of the tooth loss and gum condition?\n\nAny advice will be greatly appreciated. honestdoc: I suspect your other teeth may be on the verge of the same fate. You need to get regular checkups and periodontal treatment (deep cleanings, possible surgery) and maintenance. DabblinG: honestdoc said:\n\n\n\n\t\t\tI suspect your other teeth may be on the verge of the same fate. You need to get regular checkups and periodontal treatment (deep cleanings, possible surgery) and maintenance.\n\t\t\nClick to expand...\n\nThanks for our reply.\n\nI have been getting very regular checkups and cleaning until just before covid. Up to that point, things were stable provided I continued with my routine which included the use of tepe brushes.\n\nThe wisdom tooth which fell out was the problematic one, which prompted my initial visit and was advised it will become loose and may need extraction. \n\nMy concern at the moment is whether if I actually need medical attention or will it heal naturally? I feel no pain, discomfort, see no blood - I suppose I will know by now if there's an infection building or are there other signs to indicate infection / further bone loss in that area?\n\nThanks honestdoc: For the most part, your mouth heals fast. I don't believe you need any medical/dental attention for this tooth unless you have swelling. I seen patients' teeth and gums deteriorate dramatically from before Covid to now. I would get a check up as stated before. DabblinG: Thanks again for taking the time to reply honestdoc.\n\nThankfully, no swelling or any indication of infection etc.\n\nI have a feeling that once I felt the tooth was much looser than it normally is (and when it felt like being dislodged when I chewed / bit down on it around 6 - 8 weeks ago), that was probably the point where gums / bones detached and began self-healing? I haven't really noticed any bleeding. I'd only notice pain if I'd inadvertently bit down on it whilst eating, or if it was 'back in its slot', some pain is felt if I pushed down with my finger.\n\nI assume if there was bacteria eating into the bones which held the tooth (the roots of which looks in much worse condition that the tooth itself), I would know about it? honestdoc: Unfortunately you cannot feel your gums deteriorate. By the time your teeth feels loose, it is too late. I cannot force you to get a check up. We cannot reverse teeth loss, but we can prevent, manage and maintain." + }, + { + "id": 51, + "title": "Cyst or gingivitis?", + "dialogue": "zyla18: I'm currently waiting to get my dental insurance active and while I'm waiting I'm anxious because I don't know if I'm suffering gingivitis or a cyst by one tooth (bottom left) sometimes it looks like a swollen gum but in other lights it looks like a bubble. I literally have no money for treatment atm hence why I'm waiting for my insurance and even then it won't cover extensive work :/ can anyone tell me what it could be? Yes I know I need braces. No need to point it out. I have an appointment scheduled in 2 weeks but I'm just full of fear. zyla18: honestdoc: That bump on your gums should go away soon. You may have some hormone fluctuations that can make gingivitis more pronounced. You should plan on having teeth cleaned twice a year. With your teeth crowding, it can be very difficult to keep them clean. I would recommend electric toothbrush like Sonicare or Oral B. Braces can be very expensive and can benefit your condition. If you get braces in the future, you cannot have any gum disease and or cavities or it will be a disaster. zyla18: honestdoc said:\n\n\n\n\t\t\tThat bump on your gums should go away soon. You may have some hormone fluctuations that can make gingivitis more pronounced. You should plan on having teeth cleaned twice a year. With your teeth crowding, it can be very difficult to keep them clean. I would recommend electric toothbrush like Sonicare or Oral B. Braces can be very expensive and can benefit your condition. If you get braces in the future, you cannot have any gum disease and or cavities or it will be a disaster.\n\t\t\nClick to expand...\n\nThank you for replying to me. I'm relieved it should clear up. I have a off brand electric toothbrush. I've never been able ro get braces even though every dentist says I need them. I hope I can one day, I know it will benefit my gums greatly. My last cleaning I was told if I had braces my gingivitis would be less severe and easier to keep on top of." + }, + { + "id": 52, + "title": "Alternatives to Bone Grafting?", + "dialogue": "mnrlwtr: I am 23 female and today my dentist told me I have severe bone loss and the only way to save my teeth is to have bone grafting on the area marked on my x-ray. My dentist says I'm going to have root canal treatment on my left central and lateral incisors before the bone grafting, which is going to make them 50% more fragile. Further, she told me there is a high possibility that I will lose those teeth due to the bone grafting. I am worried that the procedure may worsen my current teeth condition and I may lose my teeth. This devastates me as I am only 23 years old. \nIs there any alternative procedure to bone grafting? For instance, is is possible to apply tooth splinting to reduce tooth mobility and let the bones naturally recover?\nIs there anything I can do to reduce the bone loss while I'm considering my options? I brush my teeth 3 times a day and floss every day.\nAny advice is appreciated. honestdoc: You're too young to have that bone damage. It appears that you may have had trauma to #9 with severe external root resorption and severe bone damage #10. What was your orthodontist's opinion? Moving teeth can stress the teeth and bone leading to further bone destruction and root damage. Bone graft will not replenish the bone level there. The most predictable will be to complete orthodontic treatment and consider implants #9, 10." + }, + { + "id": 53, + "title": "Pain around upper posterior area", + "dialogue": "nikroute: I had a pain , warm feeling for last 3 months . Now I see this\n\nMy left posterior teeth ( wisdom ) removed 4 months ago due to its position. But after that I am having weird feeling there . At first dentist said Nerve , sensitivity,but today I saw my teeth and it looks my gum gone excessively after the molar extraction.\n\nToday done that region IOPAR , no issues found except bone loss and I showed them my gum level \n\n\nI am having sudden throbbing pain and ear ache now a days" + }, + { + "id": 54, + "title": "Radiolucency?", + "dialogue": "Mo24078: I developed a periodontal abscess right above the tooth 14 gumline about two weeks ago. This happened within a few days of using a waterpik for the first time ever. I have a bridge on tooth 14. I visited a general dentist who took a panoramic X-ray (attached) and told me that the root was not involved and referred me to a periodontist. I also took a course of antibiotics for two weeks.\n\nYesterday I visited the periodontist who took a periapical X-ray of the tooth (attached). He told me that he should perform gum surgery to remove the infection but also referred me to an endodontist to make sure root was not involved before proceeding with gum surgery.\nIn the panoramic X-ray took two weeks ago there were no artifacts seen on the root but in this new periapical X-ray, it's not clear to me if there is a radiolucency at the tip or the root is affected in any way. I would really appreciate the forum's opinion on any root involvement observable here. \n\nThanks much in advance. Dr M: Good day\nThere does not seem to be a radiolucent area around the root tip. The endodontist might take a CBCT, which is a 3D scan, in order to confirm this, since not everything is visible on a 2D x-ray." + }, + { + "id": 55, + "title": "Malocclusion and chronic gingivitis", + "dialogue": "yakou: I've been diagnosed with chronic gingivitis and maloccusion since 2012. My upper teeth goes over my lower teeth and doctors have recommended me to have a jaw surgery after slightly reducing the gap between my upper and lower teeth with braces.\n\nI succesfully reduced the gap with braces in 2014 and was arranging to have my jaw surgery. Unfortunately, because of my gingivitis, fears of infection and future risks after doing the surgery, my parents decided against it. Since then I was just asked to wear retainers to keep my upper teeth from not moving back to it's original position. I would just have scheduled appointments with my doctor to retighten the retainer and my orthodontist for my oral hygeine.\n\nBut unfortunately I had to go overseas in 2016 and cannot do my appointments and I didn't wear my retainer since then until now.\n\nNow my current problem is my gingivitis, because no matter how I try to clean my teeth, floss, rinse with mouthwash and go to frequent trips to have my teeth cleaned by my orthodontist, my gum just wouldn't stop bleeding occasionally to the point I'm tired of it and it makes me lose my confidence. Every single night, my gum would bleed and me myself would unconsciously not swallow my saliva when I sleep so everytime I wake up, my mouth would be full of saliva mixed with blood. I don't know what else to do...\n\nThe only time I remember when it did not bleed was when I took antibiotics for my tonsillitis back then...\n\nAny enlightenment will be highly appreciated. Thank you honestdoc: Are you taking medications and or herbal supplements that can thin your blood? Are you taking hormone therapy or have hormone fluctuations that can increase gum inflammation? It is unusual to have excessive bleeding gums. How are your bone levels under your gums? Do you get a lot of tartar (calculus) build up? Would a referral to a gum specialist (periodontist) be appropriate? How were your visits with your primary doctor and do you have medical conditions such as diabetes? yakou: honestdoc said:\n\n\n\n\t\t\tAre you taking medications and or herbal supplements that can thin your blood? Are you taking hormone therapy or have hormone fluctuations that can increase gum inflammation? It is unusual to have excessive bleeding gums. How are your bone levels under your gums? Do you get a lot of tartar (calculus) build up? Would a referral to a gum specialist (periodontist) be appropriate? How were your visits with your primary doctor and do you have medical conditions such as diabetes?\n\t\t\nClick to expand...\n\nHi!\nNo I'm not taking any medications or in any therapy whatsoever. I do notice I have calculus build up on my teeth, especially on my upper front teeth where it portrudes.\n\nI have not really considered going to a gum specialist. I haven't really been to the dentist in a really long while (5 years), my doctor would just refer me to an orthodontist for scaling. Even then they had to inject anesthetic to my gum because I would feel lots of pain and it would bleed lots.\n\nAnd no, I have no other medical conditions" + }, + { + "id": 56, + "title": "Do my gums look off at all? The white scarring and the reddish gum line concern me. Please help!", + "dialogue": "CalebDDulin: honestdoc: From the image it looks fine. You need to have x-rays so the dentist can see the bone health and internal anatomy. CalebDDulin: honestdoc said:\n\n\n\n\t\t\tFrom the image it looks fine. You need to have x-rays so the dentist can see the bone health and internal anatomy.\n\t\t\nClick to expand...\n\nI’m going in a few weeks, but it doesn’t look malignant or pre malignant? honestdoc: Not from the images. A full exam will be more complete. It is very rare to have malignant lesions. The most common pre-malignant lesions are callouses (hyperkeratotic tissue) in the mouth. CalebDDulin: honestdoc said:\n\n\n\n\t\t\tNot from the images. A full exam will be more complete. It is very rare to have malignant lesions. The most common pre-malignant lesions are callouses (hyperkeratotic tissue) in the mouth.\n\t\t\nClick to expand...\n\nIs that super thick white lesions? honestdoc: Like this image. CalebDDulin: honestdoc said:\n\n\n\n\t\t\tLike this image.\n\t\t\nClick to expand...\n\nGot it!" + }, + { + "id": 57, + "title": "Why am I in so much pain.. pain around left lower wisdom tooth", + "dialogue": "dreamymoon: I’ve been to the dentist and they said it is something to do with tissue and they will remove a tooth. Not my wisdom tooth I think because of risks. I’ve tried pain killers, salt water and bonjela… still aching. I have noticed white tiny bumps in the area which seem to be emitting pain… which is excruciating. I also see one around my wisdom tooth. They said nothing about it. Can anyone see anything? Why is it so sore? Dr M: Good day\nWithout any x-rays, it is my opinion that your pain is due to your wisdom tooth. It seems partially erupted and might be partially impacted as well, meaning there is not enough space for it to erupt fully into your mouth. The piece of gum that is covering the tooth, becomes inflammed and leads to a condition called pericoronitis. If x-rays reveal the tooth is impacted, it is best to have the wisdom tooth removed. Not sure why your dentist would remove another tooth, especially if the other tooth is healthy. If he is not confident he can remove the wisdom tooth, then he should refer you to an oral surgeon. dreamymoon: Dr M said:\n\n\n\n\t\t\tGood day\nWithout any x-rays, it is my opinion that your pain is due to your wisdom tooth. It seems partially erupted and might be partially impacted as well, meaning there is not enough space for it to erupt fully into your mouth. The piece of gum that is covering the tooth, becomes inflammed and leads to a condition called pericoronitis. If x-rays reveal the tooth is impacted, it is best to have the wisdom tooth removed. Not sure why your dentist would remove another tooth, especially if the other tooth is healthy. If he is not confident he can remove the wisdom tooth, then he should refer you to an oral surgeon.\n\t\t\nClick to expand...\n\nI did have an X-ray and she mentioned the tissue of my gum and a nerve being irritated. She said nothing about any impaction. I’m going on Friday see what happens Dr M: Sounds like pericoronitis. Do you have a copy of your x-ray? dreamymoon: Dr M said:\n\n\n\n\t\t\tSounds like pericoronitis. Do you have a copy of your x-ray?\n\t\t\nClick to expand...\n\nI just got it now. I had top left wisdom tooth removed since this X-ray photo.\nStill very sore in that back lower left wisdom. Any clues? Dr M: Definitely pericoronitis due to a partially erupted wisdom tooth that is actually impacted. Left lower wisdom tooth needs removal by an oral surgeon or competent dentist trained in surgical extractions. dreamymoon: Dr M said:\n\n\n\n\t\t\tDefinitely pericoronitis due to a partially erupted wisdom tooth that is actually impacted. Left lower wisdom tooth needs removal by an oral surgeon or competent dentist trained in surgical extractions.\n\t\t\nClick to expand...\n\nOh thank you so much for providing that information!" + }, + { + "id": 58, + "title": "My dentist says I have an early periodontal disease but no need for a deep clean. Online info is contradictory.", + "dialogue": "Jo!: I went to the dentist on the 21st June. A few of my gums were swollen but nothing major. My dentist cleaned my teeth & said I have an early periodontal disease. My gums were pink, looking good after the clean. Suddenly after 11 day of having my teeth cleaned my gums got inflamed, red & shiny. I went to the hygienist on the 21st July to have another clean & while it helped with reducing the swelling, my gums were still red & inflamed. On the 1st August I went back to my dentist & he said that i don't need a deep clean as there was no plaque/tartar below the gumline (he said he could see that on the x-rays). It has been a whole month now & my gums are red, inflamed & shiny. All the info online says anyone with any stage of periodontal disease should get a deep teeth clean while my dentist says it's not necessary for me as he can see no plaque/tartar on teeth roots on my x-ray. Advice by a dentist please?\n\nI am a non drinker, non smoker, no medication.\n\nWhat confused me is that my dentist showed me his little dental booklet & said i have the next stage up from gingivitis which is an early periodontal disease with some bone loss (where I've had a couple of onlays done), after 1 month he said the bone has started to fill in.\n\nHe also said calculus/tartar if present can be seen on dental x-rays on tooth roots but he said there isn't any present on my x-rays and therefore he doesn't recommend a deep dental clean.\n\nHow is it possible that i have the next stage up from gingivitis but no calculus/tartar below gums?\n\n(red inflamed gums still present after a month). Dr M: Good day\n\nHow did your dentist determine that you have \" early stage periodontitis\" ? Did he do probing depths around all your teeth and do charting? Did he take x-rays to evaluate bone loss? \nInflammation around your gums, could be because of a lot of reasons. It could be due to systemic diseases, such as diabetes , or certain medications.\nDid your dentist prescribe you anything to combat this inflammation? \nIf you are unsure, you can always get a second opinion from another dentist. Jo!: Hi, thanks for your message!\nHe didn't do any probing depths around my teeth or any charting that i am aware of. He did prode my gums on the first appointment but i don't recall him calling out any numbers. I would have remembered if he did. Maybe it's best i ask him anyway.He took x-rays & said i have some bone loss at the top left jaw in the middle (where I have had a couple of onlays done) , he also said the bone had started to fill in within a month due to my diligent cleaning & some bone loss at the left bottom jaw on one tooth, (again where I've had some dental work done). I can ask him to email these to me if you don't mind having a look at them?\nI have no diabetes & i'm on no medications at the moment.\nI mentioned big stress could have contributed to this, but again no inflammation on the gums should last 5 weeks and ongoing.\nI asked him about antibiotics, he didn't recommend I take any (my impression was he didn't think they would do anything).\n\nWhat is puzzling to me is that if some bone loss means one has irreversible early periodontitis, wouldn't that mean someone would need a deep cleaning (scaling & root planning) to get rid of the infection? He said with the 2 regular cleanings I have had recently there is no need for a deep clean as he can see no tartar on my teeth roots on the x-rays. If this is the case why did the inflammation appear 11 days after i had my 1st teeth cleaning I had done with him as per my attached photos? \nThe swollen gums on my 3rd picture got better with the 2nd teeth cleaning with the hygienist, (result 4th picture) but the inflammation & redness persists after more than a month now.\n\nI the asked him in my situation would he recommend more frequent in office dental cleaning, he replied that every 6 months should be ok.\n\nI am just afraid that if I just wait for the gums to get better on their own, they may not & could start pulling away from my teeth. I have another appointment with him in about a month time.\n\nPlease let me know if you don't mind having a look at my x-rays, i could get them.\n\nI will also look to get a 3rd opinion." + }, + { + "id": 59, + "title": "Conflicting information about the need for a deep dental teeth cleaning. My dentist says I don't need it & all info on the net says I need it?", + "dialogue": "Jo!: I went to the dentist on the 21st June. A few of my gums were swolen but nothing major. My dentist cleaned my teeth & said I have an early periodontal disease. My gums were pink, looking good after the clean. Suddenly after 11 day of having my teeth cleaned my gums got inflamed, red & shiny. I went to the hygienist on the 21st July to have another clean & while it helped with reducing the swelling, my gums were still red & inflamed. On the 1st August I went back to my dentist & he said that i don't need a deep clean as there was no plaque/tartar below the gumline (he said he could see that on the x-rays). It has been a whole month now & my gums are red, inflamed & shiny. All info online says one with any stage of periodontal disease should get a deep dental cleaning, while my dentist says no deep clean is necessary as he can see no tartar build up on tooth roots on the x-ray. What do i do with this conflicting information?" + }, + { + "id": 60, + "title": "Pain 3 weeks after gum flap surgery", + "dialogue": "Littleoldme: I had gum flap and a little bone filed down 3 weeks ago on my lower left moler. I went back last week to have the stitches removed and the surgeon said it healed well. \n3 weeks later, I have pain at the site of the procedure. Its not inflamed and a nice pink colour.\nI do have a painful hole in my top tooth on the same side which is so painful. Do you think it could just be referred pain from that?\nIts seems strange that it's now starting to hurt.\nMany thanks in advance. Dr M: Good day\n\nDifficult to say without any clinical photos or x-rays? Do you perhaps have any that you can share? Littleoldme: Thank you for your reply. Unfortunately I don't have any clinical pictures but I have attached one that I have tried to take myself. Its not the best picture. Dr M: Difficult to see on the photo. The partial denture is not impinging on the soft tissue or teeth in any way? Littleoldme: Sorry, what do you mean by partial denture? Dr M: Apologies. Did not look at the photo properly. \nUnfortunately to determine if the hole on the tooth is causing the pain, a x-ray would be required in order to determine the extent of the decay. Your lower right canine seems like it still has some recession defect present. Are you experiencing sensitivity or a dull pain? Littleoldme: I had an xray on the top tooth with the hole and its quite deep and the crown needs replacing, possible root canal. But the pain at the bottom, in the picture is where I had gum flap surgery 3 weeks ago and it sore where the surgery took place Littleoldme: Littleoldme said:\n\n\n\n\t\t\tI had an xray on the top tooth with the hole and its quite deep and the crown needs replacing, possible root canal. But the pain at the bottom, in the picture is where I had gum flap surgery 3 weeks ago and it sore where the surgery took place\n\t\t\nClick to expand...\n\nIts like a constant ache and sometimes radiates the whole bottom jaw on that side. Dr M: It sounds like it might just be residual surgical pain, which might be normal. Surgical pain can sometimes last a month. You should still mention this to your dentist, when you see him again." + }, + { + "id": 61, + "title": "Should I wait to have my wisdom teeth removed? I believe they are preventing my gum disease from healing.", + "dialogue": "jonathaneid98: My wisdom teeth grew in about 2 years ago. I stuck out the initial pain of them growing in so I never felt the need to have them removed.\nFast forward 2 years, I go to the dentist and I have moderate-severe periodontitis with the deepest pockets being around my wisdom teeth. They also noted my wisdom teeth have a lot of cavities and should be removed. In May, I go to the oral surgeon and he gives me the estimate on the removal for all 4 teeth ~$1200, but my parents said to stick it out and wait until we go back to the motherland for vacation in August because we could get them out cheaper in Lebanon. It is July now and while the inflammation of my gums has gone down noticeably since the initial diagnosis and cleaning, there are still out breaks of infection and bleeding in different parts of my mouth, the 4 bottom middle teeth feel loose, I feel weird pain under them and around my chin, some molars are causing pain when I press in on them. Is the fact I still have the wisdom inside my mouth preventing my gum disease from healing properly, can I wait another month before getting them out or should I just get them out ASAP? Money isn't really an issue, but my parents were just trying to be helpful but they can't feel what's going inside my mouth and I can't tell if I'm freaking out or not." + }, + { + "id": 62, + "title": "What does this look like? The portion I circled. Worried if I need to make an appointment.", + "dialogue": "CalebDDulin: Dr M: Looks like normal anatomy and nothing to be concerned about Karl60: Can you please specify what exactly you consider wrong regarding the portion you circled? Karl60: CalebDDulin said:\n\n\n\nView attachment 5068\n\nClick to expand...\n\nDo you experience any pain in the area? Karl60: Dr M said:\n\n\n\n\t\t\tLooks like normal anatomy and nothing to be concerned about\n\t\t\nClick to expand...\n\nI find that true as well." + }, + { + "id": 63, + "title": "Changing my oral hygiene didn't improve my gingivitis, help!", + "dialogue": "AngelBurikat: I have gingivitis and using orahex for 2 weeks+brushing 3x a day+flossing everyday didn't make improvements and I have pockets nikroute: I had this issue before 2008 , In my case my dentist adviced me to visit him for every 3 months and he carried out some procedures .\n\nGum inflamation root cause might be different so ask your dentist \n\nIt took almost 2 years for me to resolve my gingivitis issue , now i use to get checked out personally every month as well as by the dentist in 6 months .\n\nIt can took many months to treat gingivitis\n\nAs my dentist showed me to check mouth , throat , palate , tongue , glands , cheek , teeth , gums etc\n\nClean hands , look into mouth for white areas which seems skin is erosive , red lesion with erosion and easily bleeds , some red lesion blanch on press so they need not immediate attention most of the time\n\nPalpate the floor of mouth , cheek , palate , glands on extra oral palpation used to be discharge watery thing more when they are normal etc . MattKW: If the gingivitis has been present for a long time, it may have morphed into periodontitis. This requires firstly a thorough scaling - sometimes a dentist will do this, other times you may need to see a periodontist for more assertive treatment. Once the gingivitis or periodontitis has resolved through treatment, then regular brushing and flossing will prevent recurrence." + }, + { + "id": 64, + "title": "Recurring Gum Inflammation", + "dialogue": "Twominustwo: Hello - I have been having recurring gum inflammation between my back two molars for the past few months. Main symptoms are pain from contacting the area when eating and bleeding when flossing. I had a deep cleaning performed about 1 month ago and the symptoms drastically improved, but about a week ago my gums began bleeding again and it feels like I am slowly regressing after only 1 month since having the deep cleaning. I practice good oral hygiene (floss one and brush twice daily and I am very gentle) and have been using salt water and CPC to help relieve some pain. I am a little lost because I do not want to continue going back to the dentist for this same issue if a deep cleaning didn't resolve it. Any advice on home remedies or should I have it looked at again? honestdoc: Sorry, home remedies do not yield predictable and sustainable results. Unfortunately, your concerns are best discussed with your dentist and or periodontist. We don't have your x-rays to view your bone levels and no probing depth values and levels of inflammation. timmytom: Twominustwo said:\n\n\n\n\t\t\tHello - I have been having recurring gum inflammation between my back two molars for the past few months. Main symptoms are pain from contacting the area when eating and bleeding when flossing. I had a deep cleaning performed about 1 month ago and the symptoms drastically improved, but about a week ago my gums began bleeding again and it feels like I am slowly regressing after only 1 month since having the deep cleaning. I practice good oral hygiene (floss one and brush twice daily and I am very gentle) and have been using salt water and CPC to help relieve some pain. I am a little lost because I do not want to continue going back to the dentist for this same issue if a deep cleaning didn't resolve it. Any advice on home remedies or should I have it looked at again?\n\t\t\nClick to expand...\n\nI have the same issue and it's difficult to resolve. Deep cleaning is not sustainable I agree. \nAs long as there are no holes feeding that infection, my dentist tells me that it could take a few months to heal. Mine has been there for a long time.\n\nI have been using Periodontal Pics and dipping them in Alcohol based mouthwash, salt, and diluted essential oils like oregano, calendula, and clove to try to kill the infection, but after months I still get blood on the top of the pic and it's always sensitive.\n\nI see this is what you have. There's probably bone recession there too.\n\nTry the periodontal pics if you haven't already, and pull warm salty water through there after every clean. I've seen some improvement from that.\n\nThe response you received above isn't helpful. This is a forum, and asking questions like this is it's purpose.\n\nLet me know what you discover." + }, + { + "id": 65, + "title": "Dosent cause any pain but it seems to have a sharper edge and feels hardened. Any help?", + "dialogue": "CalebDDulin: Dr M: Good day\nThis is just a normal bony exotosis. Variation of normal anatomy. Nothing to worry about. CalebDDulin: Dr M said:\n\n\n\n\t\t\tGood day\nThis is just a normal bony exotosis. Variation of normal anatomy. Nothing to worry about.\n\t\t\nClick to expand...\n\nOk, awesome! Is it normal for it to have a reddish tent? Just curious" + }, + { + "id": 66, + "title": "My gums have been swollen since childhood", + "dialogue": "TimYanmaz: Hi my name is Tim,\nI am 15 years old, my mother is a dentist.\n\nI have been living with my mouth open since I was a child and I breathe through my mouth when I sleep. Now, this distress has decreased a lot, my mouth is mostly closed, but I think it is open while I sleep. My gums are swollen, not a flat gum. Is the problem with this gingival swelling related to my mouth being open all the time? I brush my teeth regularly morning and evening. I really want to have good mouth look. My gums are kind of on my teeth so i want my gums to recede.\n\nThank you.\n: ) Nancy_Mart: TimYanmaz said:\n\n\n\n\t\t\tHi my name is Tim,\nI am 15 years old, my mother is a dentist.\n\nI have been living with my mouth open since I was a child and I breathe through my mouth when I sleep. Now, this distress has decreased a lot, my mouth is mostly closed, but I think it is open while I sleep. My gums are swollen, not a flat gum. Is the problem with this gingival swelling related to my mouth being open all the time? I brush my teeth regularly morning and evening. I really want to have good mouth look. My gums are kind of on my teeth so i want my gums to recede.\n\nThank you.\n: )\n\t\t\nClick to expand...\n\nHi, Hope it will be okay soon. The better idea is to discuss it with your mother... Though she is a dentist she must know the fact. And also get valuable points from the members here." + }, + { + "id": 67, + "title": "Question about brushing around gum graft site", + "dialogue": "Jeff88: Hey so I'm a little worried I may have been confused about post op care after gum graft surgery around 1 tooth. They told me not to brush that 1 tooth so I didn't. Two weeks after the surgery was my first check up at the periodontist to see how its healing and removing stitches, the periodontist assistant did the appointment and I forgot to ask if I could go back to brushing the tooth, so I called the office when I got home to ask and the assistant said no still not to brush that tooth. So the next check of the site was 3 weeks, making 5 weeks in total that I did not brush the tooth that just got the gum graft, I have advanced periodontal disease and that seems like a really long time to neglect a tooth when my oral heal is already so poor. The assistant said there was alot of plaque build up at the gum line of that tooth which im sure there was, its just the way she said it was like she was surprised to see it when it was her that told me not to brush it in the first place. So I'm wondering if I misunderstood her instructions or did she instruct me wrong not to brush for over a month? Any one here went so long without brushing around graft site as per instructions from periodontist? Is this not too uncommon? Thanks in advance for any help and sorry for wall of text honestdoc: I would call the office. It is very important to keep it clean but extra important not to traumatize the surgical site. Make sure they go over all the details." + }, + { + "id": 68, + "title": "Little white bumps on my top gums", + "dialogue": "Steven York: Hey dental experts. I was wondering if any of you would have any possibly idea with what’s going on with my gums. To start out I am a 37 year old male. A few days ago I noticed a bunch of tiny little white bumps on my top gums in the front. It is not really easy to see them unless light is shining on them. Pls help and advise." + }, + { + "id": 69, + "title": "Is this normal or disease", + "dialogue": "nikassam: My upper gums near front teeths always looks like this , i notice this since last 3 years \n\nIs it a gum disease or normal" + }, + { + "id": 70, + "title": "Help reading xray", + "dialogue": "Marieandtroy12: Help! Can someone please help me read this X-ray? It was taken yesterday since I’ve been having gum swelling around my wisdom tooth which I know has to be taken out. My question is do you see an infection or abscess? Dr M: Good day\nYour wisdom tooth seems impacted. Although it doesn't need infection or an abscess to cause pain, it doesn't mean it can't cause you issues. Partially impacted wisdom teeth, such as in your case, often lead to pericoronitis, which is inflammation of the gum surrounding the part of the tooth that is erupted or visible in the mouth. Pericoronitis can lead to severe pain, even difficulty with mouth opening. I would recommend taking it out. Marieandtroy12: Dr M said:\n\n\n\n\t\t\tGood day\nYour wisdom tooth seems impacted. Although it doesn't need infection or an abscess to cause pain, it doesn't mean it can't cause you issues. Partially impacted wisdom teeth, such as in your case, often lead to pericoronitis, which is inflammation of the gum surrounding the part of the tooth that is erupted or visible in the mouth. Pericoronitis can lead to severe pain, even difficulty with mouth opening. I would recommend taking it out.\n\t\t\nClick to expand...\n\nThank you so much for responding. From the looks of what you can see do you see a severe infection? As I should take antibiotics for? Dr M: Pericoronitis is more a clinical diagnoses than something you can see on an x-ray. I would recommend starting with anti-inflammatory meds and a disinfectant mouthrinse. If you have severe swelling and difficulty opening your mouth, antibiotics might be indicated." + }, + { + "id": 71, + "title": "Can someone tell me if my gums look altered or do they look ok? The front tooth is a fake.", + "dialogue": "Cdulin: Dr M: Good day\nThe front gingiva does appear a bit darker. This could be due to the metal margin if this if a PFM crown. Cdulin: Dr M said:\n\n\n\n\t\t\tGood day\nThe front gingiva does appear a bit darker. This could be due to the metal margin if this if a PFM crown.\n\t\t\nClick to expand...\n\nIt was a completely new tooth. They took out the bone and everything. So it’s fake bone, post and new tooth." + }, + { + "id": 72, + "title": "Soft tissue management", + "dialogue": "Ijberns: My dentist in Manhattan, NY is suggesting I have a soft tissue management procedure. He is charging $1,800. Is this the typical cost? Ijberns: Think this is also known as deep cleaning!" + }, + { + "id": 73, + "title": "No doctor can figure this gum issue out", + "dialogue": "shoo524: Hi long story. Got 6 top veneers Oct 2020. Bit a chip Jan 2021. Felt like something stuck between 2 front teeth could not get it out. Went to doctor that did veneers. He used something he called sandpaper and very violently jammed it between my 2 front teeth. I bled and a space was created between my 2 front teeth that has never filled in. That being said I have tons of issues now. I feel what seems like small pieces of gum that I flick with my tongue. I feel thread like things with my tongue on my incisive papilla. I feel a splinter like thing that I can flick with my tongue where gum meets front left tooth from behind. I feel that deep into my palate when I flick it. I also am constantly sucking saliva to the left of center from what feels like a space. I am miserable. My whole life has been ruined by this. It consumes me all my waking hours. I only have relief when I sleep. I feel these things all day long. Not at same time different things different times . Have been to periodontists, general dentists, prosthodontist. All top notch in my area they are stumped no idea. They say crown your teeth. Oral surgeon sees a cyst behind my front teeth to the left he said. But he's doubtful that's what I feel. Needs to be removed though. Please can anyone help? I must be the only person with this insanity. I can't live like this. Please help me. honestdoc: If you been to numerous specialists visits, this platform will not offer you better advice. You may need to consider new restorations. As a positve note, your gums heal well after trauma unless you have major health problems. shoo524: Thank you for your response doctor. It's the gums behind the one front big tooth. It feels like it's around the tooth and straight up along the side of the incisive papilla. It must be where I bit the chip and it just like shot straight up if that makes sense. Do u think I would need crowns instead of veneers? Or maybe take the veneers off see what is wrong and put new ones on? I don't even know who to turn to now? I am hoping but not confident that when the cyst is removed it might help, but oral surgeon doubts that too. I guess the cyst removal is not in that area even though he said it is to the left of center which is where my torture is. Thank you. honestdoc: What's the opinion of the periodontist? After your area of concern is cleared by the periodontist, you may go back to the restorative dentist for treatment options like new crowns. Since I did not do any clinical exam on you, I cannot give you professional opinions. shoo524: Well I have been to a few periodontist. Some were just baffled and didn't offer any help. One said get crowns. The one the oral surgeon sent me to said get the cyst removed and then if I need to come back to her and maybe try laser treatment. honestdoc: Try the laser treatment. I'm sorry I have no idea what is going on. Like I said, get the area cleared by the periodontist and consider new restorations if appropriate. shoo524: Thank you. I guess I am a mystery." + }, + { + "id": 74, + "title": "Gum disease", + "dialogue": "DaniT12: Hi,\nSo long story short I've smoked heavily for 10 years and had all sorts of issues with wisdom teeth which left me not even wanting to touch my mouth for nearly a year while I waited for oral surgery to have a very painful tooth removed. \nMy gums have receded around every tooth and its become a massive concern to me as one tooth has moved and is a bit wobbly. I spoke to one of the leading periodontists in the country and have followed his advice religiously since.\nI've given up smoking completely stopped drinking fizzy drinks,I use listerine advanced defence gum treatment after brushing, I've purchased an electric toothbrush and also use tepe brushes in between my teeth.\nNothing seems to help? My gums still look pale with sections hurting and I'm sure the receding is getting worse.\nHelp! I don't want to lose my teeth honestdoc: What did your periodontist say about your concerns? We can't really give you much advice without a clinical exam and x-rays." + }, + { + "id": 75, + "title": "Need Advice. Is my Periodontist taking advantage of me?", + "dialogue": "Trader8642: I've been seeing the same Periodontist for years. Early on, I had complained about him extracting a tooth without consulting with me. I wrote a bad review on his Yelp site prompting him to offer me a discount to remove the review. I thought this could be a red flag but continued to get cleanings from his office. Fast forward to today, I was told that I needed gum surgery and it was covered by my insurance. During the procedure, he performs a bone graft and uses a laser to sterilize, both not covered by my insurance and ending up costing me over $1000 out of pocket. Is he doing what's best for me regardless of cost? \nI just don't know and need advice. Rebeccah: I have no idea whether or not he is doing what is best for you regardless of cost, but I personally could not tolerate or stay with a health care practitioner with a history of performing procedures on me without my consent." + }, + { + "id": 76, + "title": "Flossing", + "dialogue": "Minionfan: Would just like to know what's considered to be better? Normal flossing, interdental brushes or using water flossers?\n\nAt the moment I use a mix of flossing and using inter dental brushes but I'm seeing more and more ads for water flossers and just wondered what, if any benefits of it there are? Or if it's simply about selling more gadgets? Dr M: Good day\n\nWater flossers can sometimes reach difficult areas. I however feel that any type of flossing is a good adjunct to normal brushing Minionfan: Thank you Dr M.\n\nAt my last dental appointment my dentist said my gums looked healthier and probings were good.\n\nSo it should be ok to just carry on with what I have been doing? Dr M: Yes. If these were indeed the results, then carry on like you have been doing gerogiad: Water flossers work the best in terms of reaching the difficult places and are honestly the easiest to use as well. But of course they can be quite expensive so regularly flossing well enough can be just as good" + }, + { + "id": 77, + "title": "Very advanced Periodontal disease", + "dialogue": "Mac4: Hi I am not sure about posting here as I am very scared of being judged and my mental health is not good as I said I have very advanced periodontal disease I have issues since 2015 but had a very bad experience with the dentist which did not help my fear of them one bit so 2 years later in 2015 I had gum issues I had just started working and long story short with me and my mum being in tons of debt I could not pay for treatment and I could not get help with payments \n\nso I saved up got the cash which is hard when you earn £300 a month and the majority goes on debt food rent at the end of 2017 and made the appointment for early 2018 problem is my mum figured it would be a good idea to steel the cash to pay off a debt she had knowing she could never pay it back I started saving again then I was just getting there when the pandemic hit so for 2020 I was stuck and the most of the money was used on trying to live and a funeral for a relative who passed during covid anyway I sit here now having had Periodontal disease untreated since 2015 teeth in very bad condition and during the pandemic I noted my face has become misshaped on one side I will be able to get to a dentist I have in February so I started reading and found that I very much might not be able to have dentures because there might not be much left of my jawbone or what is left is to weak\n\nno teeth have feel out so that has given me some hope but I have most other symptoms including thinned out lips especially on top \n\nis there any hope what has me worried is if I cannot have dentures I feel my life is over no one is going to hire a 45 year old man with no teeth and frankly I would become housebound or with my mental health issues I am worried about getting to a place where I just want to end things\n\nI can attach a picture of my gums but not sure as I said if I will get judged or attacked rather than get advice and help honestdoc: If costs are a big concern and major burden, consider going to a dental school or periodontal graduate program where they train gum specialists. Mac4: I will have the cash in February for sure but I hit a snag on it tonight I use sensodyne toothpaste and corsodyl mouthwash which the toothpaste is running out \n\nMy main thing is because it’s in such bad condition with my face looking the way it does feeling that I would no be able to have dentures I know there are 2 kinds and 3 types of implants I just don’t feel I can live with having no teeth and not having dentures it’s not like I have the cash where I could just stay at home and never leave" + }, + { + "id": 78, + "title": "Don't know what to believe!", + "dialogue": "spower: I live in my RV and travel so don't have a regular dentist but I do get my teeth cleaned when I should. So yesterday I got my teeth cleaned in a town I am just passing through. Hygienist tells me my teeth look good (I floss and brush min 2x a day, use a pick after every meal) but then she tells me my rear teeth all have pockets of 5mm and that the gums are red and swollen. Then for the next 1.5 hrs while cleaning my teeth she goes on and on and on about getting a deep cleaning on those teeth. She did clean around them, there was no pain or sensitivity or bleeding. When I got \"home\" I looked with a mirror with flashlight and I don't see any redness back there! None of my teeth bother me.\n\nIs she just trying to upsell me? They want $500 to do the cleaning back there. Since she wouldn't stop trying to sell me on it I just felt like a used car salesman was badgering me.\n\nThoughts???? Thanks!!! honestdoc: Did a dentist examine you? Were there any x-rays? Upselling deep cleanings happen more often than we like. If the x-rays show bone recession, 5 mm or deep pocketing and tarter buildup, you will need deep cleanings. I understand your living situation but it is best to have continuity of care with the same dental team than to have strangers work on you." + }, + { + "id": 79, + "title": "Molar bone addition", + "dialogue": "AVM: Hello,\n\nRegarding the RCT, I see this black lines around the roots, is it bone loss?\n\nThanks! pablomustangue: not necessarily, it appears to be inflammation from periodontics." + }, + { + "id": 80, + "title": "How advanced does my gingivitis appear at a glance? Are those brighter spots up top gum recession?", + "dialogue": "Gjb1999: The Missing front teeth is a hereditary thing. I have some pretty intense pain in the upper corner teeth. Have noticed some asymmetrical gaps using my tongue. do I appear to be nearing permanent gum disease? Gjb1999: Note: I don’t drink. Smoked and vaped a lot in college. Don’t use any substances unless you count the sugar that has clearly caused a lot of damage. Here’s a link to my Reddit post if you’re curious \n\n\n\n\t\thttps://www.reddit.com/r/askdentists/comments/q7tpth Dr M: Good day\n\nThe pictures are a bit unclear. The best would be to go see your regular dentist for an evaluation, to see if there are any signs of gingivitis or tooth wear such as erosion etc.\nThey would also take an x-ray to evaluate the underlying tooth structure." + }, + { + "id": 81, + "title": "Advanced periodontal from insulin use. Is it hopeless?", + "dialogue": "adviceneeded00: Hi, I have a question on behalf of my mom. She is a type 2 diabetic and has been using insulin for the past 30 something years. Around two years ago she started feeling like there was food stuck between her teeth, she later found out it was periodontal disease from longterm insulin use/resistance. Her gaps are pretty large, visible to the eye even.\n\nFor those of you who are familiar with periodontal stemming from insulin resistance, is there any hope to slow or stop this from progressing? If yes, which treatments/solutions did you implement? She's gotten two opinions so far:\n\nDentistry #1 had state of the art tech and recommended fillers (I think) but they also gave me false info about a procedure (that I didn't need) to extract money.\n\nDentistry #2 had older tech but seem to be reliable (from my experience), and they said there was not much they can do.\n\nOther than this she's always kept up with her dental hygiene and still does. She always brushes after every meal and constantly flossing with one of those pick things because her gums are such a nuisance. She's also been using a night card recently, it seems like it sort of relieves her as well. (Idk if all that was necessary but I wanted to include it just in case.)\n\nThank you for any and all advice honestdoc: My best advice is for your mother to control her diabetes as best as possible. She will need more frequent periodontal maintenance visits to prolong her gum attachments. I can't give you any treatment plan advice without proper exam and x-rays to view the amount of bony attachments she has." + }, + { + "id": 82, + "title": "No gum bleeding symptom", + "dialogue": "Laura101: Is it possible to have gum disease without bleeding? I’m worried I have it but my gums don’t bleed after brushing or flossing. \n\nMy lower front teeth are shifting and may have receding gums. I used to have a brace and I think the teeth are going back to where they were. Could this be gum disease? Laura101: Photo of my bottom teeth - gums slightly redder than usual as I’ve just brushed and have been poking around to see if everything is stable Dr M: Good day\n\nFor an evaluation of gum disease, you should see your dentist to probe around the teeth and check the level of attached gingiva. Crowding of lower teeth could lead to certain areas having recession. Did you have a lower retainer wire placed or were you given retainers to wear?" + }, + { + "id": 83, + "title": "Gum redness?", + "dialogue": "db1988: The gums in between two teeth is red. It 'semi-heals', but when i brush, it becomes red like this again. What is this? MattKW: It's hard to see on that tiny JPG (21kB!) but it looks like you have a generalised gingivitis with the other teeth, and this one in particular. If you aren't using floss every day, then this is when you should start. \nAnatomically, the 1st premolar that you show has a groove down the mesial edge that would account for more plaque build-up here than with other teeth. But floss, floss, floss and it should improve. Dr M: Also check your brushing habit. Circular motions with a soft tooth brush is a lot better for your gum health. And make sure that you go for regular professional cleanings with your dentist or oral hygienist, at least once every 6 months." + }, + { + "id": 84, + "title": "SRP by periodontist?", + "dialogue": "Mo24078: I recently posted about a periodontal abscess,\n\n\n\n\n\n\n\n\n\n\t\t\t\t\t\tIs this a radiolucency?\n\t\t\t\t\t\n\nHello there Dentistry Forum community, I have had a periodontal abscess between teeth 18 and 19 for the past couple of months and today my dentist took a few bitewings and periapical X-rays to see what is going on. The good doctor wasn't able make a final determination and suggested a consult...\n\n\n\n\n\t\t\t\t\twww.dentistry-forums.com\n\t\t\t\t\n\n\n\n\nTurns out endodontic involvement is not suspected right now. The periodontist measured a 9mm pocket. He said he strongly suggests doing LANAP versus just an SRP. Now I have a couple of questions that I would appreciate the forum's opinion on,\n\n- Is it possible that part of the large 9mm measurement is due to the swollen and inflamed gums and the actual pocket is less deep were it not inflamed?\n- Is there a chance that an SRP in conjunction with local antibiotic application like Arestin followed up by regular proximal Chlorhexidine brushing at night in the following months lead to a degree of healing that obviates LANAP or even lead to some bone regeneration?\n- I have been calling a few periodontist offices and it seems like everywhere it's the hygienists that do the SRP. For such a sensitive procedure where the roots of the tooth are being reshaped, is there a benefit in trying to find a location where the periodontist does the SRP him/herself?\n\nThanks again in advance." + }, + { + "id": 85, + "title": "Deep Cleaning", + "dialogue": "Clair: Can you use electric tooth brush after deep cleaning? honestdoc: You want to be as gentle as possible and not get too aggressive to allow the deep pocketing to reattach." + }, + { + "id": 86, + "title": "Deep Cleaning Charges", + "dialogue": "rgevans871: I'm in the process of having a deep cleaning which includes root planing and scaling. I was quoted $440 for the left side and $570 for the right side. I've had the left side done. The procedure was done entirely by the hygienist and took about 45 minutes which is about how long they have taken in the past for a standard teeth cleaning which is $105. Why am I charged slightly more than 4 times what a standard teeth cleaning would be when they call it a deep cleaning? I don't have dental insurance. This seems like what they used to call price gouging. I've been a patient of this dentist for a long time, so I don't feel like I deserve to be taken advantage of. honestdoc: Sorry, in the US, scaling and root planing can be difficult to understand and justify. We look at bone loss and probings of 5 mm and greater. At many places, they may scam you for those procedures. If you go in regularly and have healthy gums, and the new dentist/hyg team tells you that you need SRPs, then it may be a scam. If you haven't gone in for years, then it is on you. rgevans871: My question was aimed at trying to understand why I was being charged so much more for a deep cleaning over a standard cleaning when the deep cleaning took about the same amount of time with the hygienist as did my standard cleanings in the past? Approximately 4 times the cost. Prior to the pandemic I was having my teeth cleaned every 6 to 9 months. The probing of my gum pockets identified several 6 mm on the right side and 4 mm ones on the left, so by your 5 mm gage, the deep cleaning was justified at least on the right side. I don't know why the left side was recommended for deep cleaning also. I'm scheduled to go back for deep cleaning of the right side on Aug. 31 with a charge of $570 for the side. I'll be trying to get some explanation for these charges at that time, but was trying to get some other opinions before this second visit. I'm wondering if this pricing may have more to do with getting what the market and insurance will bear rather than any connection to a reasonable profit margin for the dentist? I'm also wondering how one can go about getting some competitive pricing without having to change dentists if I should be advised to have another deep cleaning in the future? MattKW: Unfortunately, if you wanted a 2nd opinion I would suggest seeing a specialist periodontist. But that means more money. \nIf the dentist you currently see has been keeping records of your probing depths, ask to see these too and have them explain to you why the charges have suddenly lifted. rgevans871: I'm not looking for other opinions on whether the deep cleaning was appropriate. I'm looking for opinions on whether the charges for the deep cleaning are appropriate. My question more directly might be, does the dentist charge for the services of the hygienist depend on what procedure is being done by the hygienist and not simply for the amount of time spent? As an example, my recent deep cleaning on the left side took approximately 45 minutes and cost $440. A standard cleaning takes about 45 minutes and costs $105 (it may have went up some, post pandemic). Apparently this dentist does, based on my experience, but is that a typical practice. I doubt whether the hygienist is paid 4 times her wage when doing the deep cleaning vs a standard cleaning. \n\nRon. honestdoc: We in the US, bill SRPs in quadrants such as Lower Left (LL), UL, UR, LR. Depending on how severe and the experience level of the hygienist, within the hour, 2 quadrants can be completed, sometimes only one. It is very unusual to suspicious that all 4 quads are finished in the hour. SRPs are very labor & skill intensive which is which is why it is very expensive. rgevans871: Two quadrants on the left were completed in about 45 minutes. The deepest pockets in these two quadrants were 4 mm. The right two quadrants are scheduled to do next with some 6 mm pockets. honestdoc: 4 mm pockets should not be coded for SRP. If there are calculus (tartar) build up with pockets less than 5 mm, then there is a code (D4346) for \"scaling in the presence of inflammation.\" If a quadrant has 1 to 3 teeth with 5 mm or deeper pockets, then the code will be SRP 1-3 teeth (D4342). (D4341) is SRP of 4 or more teeth per quadrant. With 5 mm pockets, there will be some bone recession on the x-ray.\n\n3rd party dental insurance requires SRPs to have 5 mm or deeper pockets. Hyg and dentists may \"deepen\" the probings to 5 or deeper to get that code. I see too many scams. Also it seems suspicious when they charge you over $400 when the work seem quick and easy." + }, + { + "id": 87, + "title": "Advanced GD and loose teeth", + "dialogue": "Worriedme41: I have a very recent diagnosis of moderate to advanced gum disease with deep pockets, and 4 loose lower teeth with considerable bone loss and gum recession in that region. I've been scheduled for my first deep clean in a cpl of days. \n\nI know I have a poor prognosis regarding the saving of these teeth and that I'm looking at partial dentures soon but I'm very anxious to get this under control as much as I can to prevent things worsening elsewhere in my mouth. \n\nDespite regular dentist trips and hygiene visits it seems genetics are not on my side (according to my dentist) with mum, dad and sister all starting to lose their teeth in their 40s due to a particular health condition as well as gum disease. I'm now 41. They've all lost their molars though, mine are the lower front.\n\nPretty scared the teeth will fall out during the cleaning or get worse. They move when I tap them and when wiggled but sometimes they seem to firm up and barely move at all. \n\nI don't really know why I'm posting I just have so many thoughts and questions and feeling pretty low about it all. I've always been to the dentist and the hygienist so all come as a bit of a shock.\n\nCan there be any improvement? Could splinting help?\n\nThank you. Dr M: Good day\n\nThe first step would be to get that deep cleaning done. If there is an associated medical condition, make sure that medical condition is well managed.\nUsually the teeth won't fall out during the deep cleaning. Although it sounds like the 4 lower teeth will need to be removed at some stage, as part of the management of the disease. In certain cases splinting can be used to stabilize teeth, but if the bone loss is too severe, no amount of splinting will save these teeth. Worriedme41: Thank you for your reply. I was considering asking about splinting. I know it won't be long term but I'd like to try it before extraction." + }, + { + "id": 88, + "title": "Recurrent thrush centered around one tooth", + "dialogue": "baek43: Hi all,\n\nSee pic below, this has been a daily recurrence for 7months - 2 years or so now. Basically wake up to swaths of thrush that I have to wipe away each morning, and they regrow by the afternoon. My upper right furthest back molar has had a recurrent infection that spreads to other parts of the mouth. There is 6mm gum recession now on the molar, xrays look normal, no tooth pain or sensitivity to cold, just gum pain. I have tried 3 rounds of fluconazole (2weeks 100mg/day, hold in mouth + swallow) and 3 rounds of nystatin (2weeks, swish + swallow). The source seems to be this upper right, furthest back molar.\n\nI've seen 6 different dentists, 2 different clinics over the last 2 years about 8 visits. A periodontist suggested gum grafting, and the dentist yesterday concurred. They think the recession is causing this area to be prone to infection, and he likened it to patching holes in a boat. I'm not opposed to a gum graft, but personally I think it makes more sense to clear the infection first rather than graft healthy tissue on top of an infected area. At this point I would rather just pull the tooth out and do a deep clean of any infected gum tissue.\n\nI am scheduled for another visit a month from now, with instructions to use soft bristled brush + water pik (I have been water picking daily with 0.5% h2o2 + grapefruit seed extract as well as mouth rinsing with diluted mouthwash). I have also been working with a nutritionist / naturopath for over ten years, and fungal issues have been addressed numerous times. I'm hoping this tooth is the source of all my problems and can be resolved. The more 'work' I do on the tooth/mouth in general, the better my body feels overall so I'm hopeful this is making some progress.\n\nI appreciate any input, especially on if gum graft or clearing the infection is more important. Or if any imaging (CT scan?) or deep cleaning would be an option. honestdoc: I agree that the gum graft should wait until the situation is resolved. Has a medical physician evaluated you for any medical condition(s)? I believe your immune system is compromised because you should not be having thrush regularly. Your medication(s) may also play a part. I recommend a good visit with your medical doctor to best manage your overall health and further discussions with your naturopath/nutritionist to enhance your diet and well-being." + }, + { + "id": 89, + "title": "Gum Specialist questions", + "dialogue": "Rax76: Hi, im new to this forum and not sure if its UK based but here goes. So for many years iv suffered from gum disease and i have known this. Its now got to a stage where i need to save what teeth i have left. I have been advised now by 2 private dentists to take all my molers out to save the rest. \nI then came across a treatment offered in London called Duo-Laser Periodental Treatment at The Behrens Dental Practice i south Kensington. So i booked in a consultation and the potential solution is that this treatment will eliminate the cause of the disease and stimulate healing (saving teeth). The site states:\n'The Key to treating periodontal disease is to eliminate or significantly reduce the number of certain aggressive bacteria in your gum (pockets) and to stop them from coming back'.\n\nAfter speaking to a dentist at the practice they told me that even after having deep cleans done the gum disease doesnt go away becaseu there are certain pockets that a deep clean can never reach. So this Laser treatment will get to those pockets and eliminate the cause. \n\nAre there any dentists on this forum that have heard of this laser treatment, i also noticed on the colgate.com website they talk about laser treatment for gum disease but they dont mention what laser treatment.\n\nany advice on here from a dentist would be great as iv heard its not something many dentists know about. Dr M: Good day\n\nLaser treatment is a very new adjunctive therapy to conventional periodontitis management and studies is ongoing. The different types of lasers with different wave lengths has various degrees of success. In my opinion, laser therapy does not replace conventional treatment and is only an adjunct to normal treatment in order to have the best possible outcome. Periodontal disease in my opinion, is a disease that you have for the rest of your life, once diagnosed, and the main aim is to manage the disease. This means to prevent the disease from spiraling out of control, leading to fast bone and tooth loss." + }, + { + "id": 90, + "title": "Referred to a periodontist", + "dialogue": "farsyed0214: Hello I was never good with going to the dentist. I had tragic dentist appointment when I was little. Now I started going more like every 3 to 4 years. I went in 2019 Oct and then again today. My dentist said my deep pockets are more 6s 5s and 5s.so she didn't try to clean or anything. She had done x rays and pictures. She gave me a referral to the periodontist. I have horrible anxiety due to incident and my dad had oral cancer due to smoking. So I can't sleep and worrying. Should I get second opinion about the cleaning or referral? Dr M: Good day\nIt would be best to go and see the periodontist. Periodontal disease is not an issue to be taken lightly, and it sounds like you have it. If left untreated, these pockets could deepen, lead to alveolar bone loss and eventually tooth mobility and tooth loss. Go and see the periodontist and have it sorted out as soon as possible. farsyed0214: Thank you for replying. What will they do at the appointment? I have bad anxiety with this. Will they do rooting and scaling or something more? Dr M: Usually with the first appointment, they will mainly focus on diagnoses and the formulation of a treatment plan. Thereafter, they will mo forward with root debridement and/ or a scaling, depending on what the treatment plan states. farsyed0214: Dr M said:\n\n\n\n\t\t\tUsually with the first appointment, they will mainly focus on diagnoses and the formulation of a treatment plan. Thereafter, they will mo forward with root debridement and/ or a scaling, depending on what the treatment plan states.\n\t\t\nClick to expand...\n\nYah I did go see my husband's dentist for second opinion. She did new x rays and did deep cleaning. She said that they can monitor it and do routine 3 months cleaning. So for now I'm doing good. Thank you farsyed0214: I had one more question. I brush my teeths. I have nothing on palate or anywhere else. You know you get those dry spots on core of the lips from not drinking water. I get so busy with my little kids. I dont drink enough water. I been getting like a dry type patch feeling on my palate these days especially after having tea. Like almost like dry skin type feeling on my palate. But once I eat something. That rough patch thing is gone from my palate. I tried to explain it. It goes away and comes after right after I drink tea or something. Dr M: This could be a possible sign of xerostomia or dry mouth. Try taking frequent sips of water during the day and also chew some sugar free gum, to stimulate saliva flow. farsyed0214: Dr M said:\n\n\n\n\t\t\tThis could be a possible sign of xerostomia or dry mouth. Try taking frequent sips of water during the day and also chew some sugar free gum, to stimulate saliva flow.\n\t\t\nClick to expand...\n\nThank you for replying . Stay safe" + }, + { + "id": 91, + "title": "Spot on palatopharyngeal arch", + "dialogue": "bskuro85: Good Morning,\n\nHello, I have noticed this spot in the back of my mouth on the right side on palatopharyngeal arch , i've had the spot for over 6 years,. I have not had any swallowing, speech, or sore throat issues. The spot has not grown larger. I am just curious if this is just a darker vein, or just a spot. the picture is does not show the true color, its more of like a light brown. here is a link to the image https://ibb.co/vYZ9dcC\n\nthank you all MattKW: A blemish." + }, + { + "id": 92, + "title": "Connective tissue surgery open wound.", + "dialogue": "Eman: I had surgery Connective tissue harvested from the roof of my mouth and the flap stitches back. 3 days later one of the stitches came loose and the pain started on 4th day. It was the most excruciating pain I’ve ever went through. 2 days of pain I returned to my dentist and was told the flap had shrunk and left an opening where the extracted tissue hole was fully exposed. I was told there was not much I could do but wait for it to heal. I’m now day 8 and still in pain. The pain has subsided to only when I eat and at night when I sleep. I wake up with pain.\n\nfirst off is it common for this to go wrong like this ?\n\nis it possible for flap to shrink or is this crazy talk ?\n\nhow much longer will this pain last before healing begins.\n\nI was told to keep rinsing twice a day with perioxidin. Which is causing more pain so I stopped. They also gave me a gel form of it to place into the hole in the roof of my mouth. I stopped both of them because of the severity of the pain. I also read this can cause recover delay in tissue healing. Am I right to stop it ?\n\nthanks for any help as this is torture. Eman: Anyone ?" + }, + { + "id": 93, + "title": "Gum issues and alot of sharp pain", + "dialogue": "Mahikhan: Hi, I have been going through so much problems with my gums.What happen was ever since I was a young girl, I have had issues with my right bottom molar side area.It had became absess tooth and started to decay and cause pain which was extracted 10 years ago.After that I have been getting alot of pain in that area, remind you that there is no tooth in that area.It has got worst every year.Feels like a burning sensation and a bad sore that is waiting to heal.I got it checked out by a peridontist he said I had peridontal disease[ i am age 29].He performed laser surgery which after that he says my gums have became healthy but my damage still remains of gum recession from right side which is the side that usually bothers me alot.My gums do look healther but right side has still a burning sensation where I am loosing my focus due to burn feel even if i drink glass of milk.I would appreciate your reply.I have became helpless and its pain is irristable. honestdoc: This burning sensation may be autoimmune response to certain medications, supplements, tooth paste, oral rinses, cinnamon products, etc. It may be hard to isolate the source if you use many of the items I had mentioned." + }, + { + "id": 94, + "title": "Strange sores on tongue", + "dialogue": "Missa: Strange sores on tongue \n\nIve had these sores on my tongue for as long as I can remember. They come back each month and sort of make my tongue sensitive. Ive asked multiple doctors what they are and im always left with no answer. Ive looked it up and they resemble a little like geographical tongues. Any idea what they could be? Missa: Dr M: Good day\n\nThis is indeed a geographic tongue or migratory glossitis. Common in a lot of patients. These white stripes can sometimes change shape and size. It is thought to be auto-immune related, and can sometimes lead to a bit of sensitivity with certain foods. No intervention is required. Just good oral hygiene habits and the avoidance of spicy foods, if it causes sensitivity or a burning sensation. Missa: Dr M said:\n\n\n\n\t\t\tGood day\n\nThis is indeed a geographic tongue or migratory glossitis. Common in a lot of patients. These white stripes can sometimes change shape and size. It is thought to be auto-immune related, and can sometimes lead to a bit of sensitivity with certain foods. No intervention is required. Just good oral hygiene habits and the avoidance of spicy foods, if it causes sensitivity or a burning sensation.\n\t\t\nClick to expand...\n\nThank you" + }, + { + "id": 95, + "title": "Hpv on gums and tongue? Oral cancer?", + "dialogue": "Nrose2: Is this hpv or cancer? I have seen pictures similar that say this is papillomasis of the gums and now I’m freaking out.\nI have been dismissed by dentists who really just have no clue. No biopsied taken. Freaks me out guys." + }, + { + "id": 96, + "title": "Should I be concerned?", + "dialogue": "Chirping66: Hi, in Jan 2020 I had a small 2x4 mm white papillated plaque spot on facial papilla #3,4 removed for biopsy that had been there about a year. It came back as hyperkeratotic squamous epithelium exhibiting areas of verrucous hyperplasia. Negative for dysplasia.\nNo other recurring spots on that side since removal. \nlast month I noticed another circular white spot in the same area but on the other side of my mouth on the upper gums. It was removed for biopsy last week and I’m awaiting results. \nmy concern is this. My periodontist told me he was not concerned about the verrucous hyperplasia spot removed last year and he said he is not worried at all about the latest spot removed on the opposite side. There isn’t a lot of documentation on hyperplasia other than some studies saying it can be pre malignant. Should I be worried that my periodontist is not concerned about it? I’m worried it’s being under diagnosed and could be verrucous carcinoma.\nThanks Dr M: Good day\nIf the lesion is biopsied, the histological results will reveal if dysplasia is present or not. Although the periodontist cannot say from a clinical appearance only if dysplasia is present, there are certain clinical presentations which make a lesion more likely to appear malignant.\nWait for the biopsy report. Every report should give an indication of the lesion is dysplastic or not. If no dysplasia is present, then you don't need to worry. Chirping66: Dr M said:\n\n\n\n\t\t\tGood day\nIf the lesion is biopsied, the histological results will reveal if dysplasia is present or not. Although the periodontist cannot say from a clinical appearance only if dysplasia is present, there are certain clinical presentations which make a lesion more likely to appear malignant.\nWait for the biopsy report. Every report should give an indication of the lesion is dysplastic or not. If no dysplasia is present, then you don't need to worry.\n\t\t\nClick to expand...\n\n Thank you, I got the results today and it came back as verrucous hyperplasia. No dysplasia was found. I understand that means no dysplasia means no atypical cells which is good. But everything I have read says verrucous hyperplasia should be treated as verrucous carcinoma as they are both indistinguishable. Should I be worried since this is my second verrucous hyperplasia spot in two different places over the last year and a half?\n\nThanks Dr M: This is meant in terms of diagnoses. They look clinically similar, and this is why you do a biopsy.After the biopsy, they are distinguishable. If no dysplasia is present, observe the lesion for any changes in the future." + }, + { + "id": 97, + "title": "Strange spots in mouth", + "dialogue": "Nrose2: Any ideas what’s causing this? The stuff on upper gums are odd. The stuff on cheek comes and goes." + }, + { + "id": 98, + "title": "Strange spots on upper gums", + "dialogue": "Nrose2: Any idea what this might be? Had ulcers under tongue that went away but came back. Dr M: Good day\n\nEverything looks normal in the photo Nrose2: Than\n\n\nDr M said:\n\n\n\n\t\t\tGood day\n\nEverything looks normal in the photo\n\t\t\nClick to expand...\n\nthank you for your reply. I was just concerned about those white spots on my gums along with the tag in the frenulum" + }, + { + "id": 99, + "title": "Receding Gums - stressing me out.", + "dialogue": "Conker54: I have awful bottom teeth that have receded really badly over the years and I’m concerned they’re going to fall out. Would anyone have advice on this? I am seeing my dentist in July as they’re fully booked until then but want to make sure I don’t have to start saving for implants. I’m 30 years old and have not had the best oral hygiene in the pat but trying to be better. Dr M: Good day\n\nReceding gums could be related to various factors. This could be due to trauma such as excessive brushing with a hard toothbrush, or due to periodontal disease.\nDuring the consult, the dentist will most likely take x-rays, to determine bone loss, and also probe around the teeth in order to determine the amount of attached tissue loss. If the problem is related to periodontitis or gum disease, the dentist can refer you to a periodontist a specialist that deals with this exact issue. He will treat the main cause and might advise soft tissue augmentation, that is surgical procedure to treat issues such as gingival recession." + }, + { + "id": 100, + "title": "Hyperdontia or salivary stone ?", + "dialogue": "Bota Andrei: Hello guys , so i just posted a thread on the general disscusion that last night the wissdom tooth got chipped , well while looking in the mirror to see how is the situation i actually saw that behind it there is actually something .It s looking exactly like a teeth and is really hard , it's an circle quite small but didn t even left the gum yet.It s the size of a small bean,i would say the size of canines in diameter(17 year old ). So what is it actually ? Dr M: Good day\n\nCould you perhaps supply a photo of the area? It might be your second molar that chipped and the wisdom tooth that is erupting into the oral cavity. Bota Andrei: Dr M said:\n\n\n\n\t\t\tGood day\n\nCould you perhaps supply a photo of the area? It might be your second molar that chipped and the wisdom tooth that is erupting into the oral cavity.\n\t\t\nClick to expand...\n\n\n\n\nis it good enough? Dr M: That is your wisdom tooth that is erupting. Your chipped tooth is your second molar Bota Andrei: Dr M said:\n\n\n\n\t\t\tThat is your wisdom tooth that is erupting. Your chipped tooth is your second molar\n\t\t\nClick to expand...\n\nWell, that is some great news, but still, should i be concerned about the second molar or the growing wisdom? Dr M: I would visit a dentist. to restore the decayed second molar. During this visit, and x-ray can be taken to evaluate if the wisdom will have enough space to erupt fully into the oral cavity, or does it require removal. Bota Andrei: Dr M said:\n\n\n\n\t\t\tI would visit a dentist. to restore the decayed second molar. During this visit, and x-ray can be taken to evaluate if the wisdom will have enough space to erupt fully into the oral cavity, or does it require removal.\n\t\t\nClick to expand...\n\nTy very much sir." + }, + { + "id": 101, + "title": "Gum recession", + "dialogue": "EverE103: I have 2mm gum recession on teeth 4 and 5 and 1mm recession on some other teeth. My question is can I wait to have gum graft surgery or will I cause more damage? I of course do not want to loose any teeth. I do not have gum disease. I was an aggressive brusher and I grind my teeth at night. Just recently I have purchased a sonic care tooth brush and a night gaurd. Just hoping I can hold out a while longer on the need for surgery as anything surgical gives me anxiety." + }, + { + "id": 102, + "title": "What could i do to help recovering from periodontics", + "dialogue": "Evone: I had two deep gum cleaning treatment from my peridotites specialist. I notice when I consume sugar from fruit , potatoes, biscuit, milk, my peridotites conditions getting worse. It is suppose to recovering but why I consume food content sugar will cause the condition worse? What do I need to do to help to recovering? Evone: I had two deep gum cleaning treatment from my peridotites specialist. I notice when I consume sugar from fruit , potatoes, biscuit, milk, my peridotites conditions getting worse. It is suppose to recovering but why I consume food content sugar will cause the condition worse? What do I need to do to help to recovering?\nMy condition, does it mean the disease/ infections not total remove? honestdoc: When your teeth have sensitivity to sweets, it means your teeth have exposed roots (cementum) or dentin. If you have periodontal disease, it means you may have lost gum and bone attachments leaving your roots exposed. Talk to your periodontal specialist team how to best manage your condition after deep cleanings such as remineralization, desensitizing agents, Chlorhexidine rinse, etc. Evone: Hi Honestdoc,\n\nThanks so much your advice.\n\nI'm not too sure it is sensitive or the condition getting worse. I feel a sharp bite and minor ache in my tooth time to time. Base on the symptoms, it is sensitive tooth?\n\nBy the way, I want to take oral probiotics, does it help to keep my teeth in a healthy condition? Does it work? \nI had purchase a _Great Oral Health Advanced oral probiotics from USA. Please see the attachment.\nThey claim it can flight off Periodontics gum disease. Evone: Hi Honestdoc,\n\nThe inflammation in my tooth is not subside yet , my peridotites specialist give me three day antibiotic only, one table per day.\nThe last treatment was on the 31 March. I Finished the antibiotic on 2 April.\nIs there anything I could do to help the healing process faster? Reduced the inflammation prior recovering? Any Suggestion?\n\nRegards,\nEvone honestdoc: Ask your periodontist if Chlorhexidine rinse is right for you. Otherwise minimize irritation and keep the area plaque free. Evone: Hi Honestdoc,\n\nThanks for your respond.\n\nHow did I know the cleaning from the dental hygienist is done a good job to get rid of plaque and tartar around your gum line, as well as in between my teeth? \nIs the teeth suppose smooth in all area? There still have hard substance attach to the teeth in some area? Does it mean that area still have plaque and tartar ?\n\nPlease advice!!! Thanks in advance.\n\nRegards,\nEvone MattKW: Probiotics for gum disease is a load of nonsense; save your money. And taking antibiotics following perio therapy is unnecessary and a poor use of antibiotics. As honest doc suggests, use a chlorhex mouthwash and desensitizing t’paste. honestdoc: As Dr. MattKW mentioned, unnecessary and poor use of antibiotics can lead to its resistance. Evone: Hi MattKW / Honestdoc,\n\nThank so much for your advice!!!!\n\n\nRegards,\nEvone Evone: Hi Honestdoc / MattKW,\n\n\nHow did I know the cleaning from the dental hygienist is done a good job to get rid of plaque and tartar around your gum line, as well as in between my teeth?\nIs the teeth suppose smooth in all area? There still have hard substance attach to the teeth in some area? Does it mean that area still have plaque and tartar ?\n\nPlease advice!!! Thanks in advance.\n\nRegards,\nEvone" + }, + { + "id": 103, + "title": "5 and 6mm pockets", + "dialogue": "Jack Addis: Hello, I’m new to the forum.\n\nI’m 72 years old and I didn’t start having periodontal probe measurements done in my mouth until 8 years ago, after I changed dentists. My pockets were always 2, 3 and a few 4 mm’s.\n\nWhen the coronavirus occurred, I was afraid to go to the dentist. After 12 months I broke down and made an appointment. My pocket probe readings, taken by the hygienist, were up to 5 mm & 6 mm’s on my back capped molars, and more 4 mm’s than I had before.\n\nI’m meticulous about brushing, flossing, Proxa brushing, antibacterial rinsing, and wearing a night guard. I don’t what else care I could do at home.\n\nI’m worried and I don’t know what should I do next? MattKW: Sounds like you're doing a meticulous job of maintenance. Is this the same hygienist who charted 2,3,4s? Jack Addis: MattKW said:\n\n\n\n\t\t\tSounds like you're doing a meticulous job of maintenance. Is this the same hygienist who charted 2,3,4s?\n\t\t\nClick to expand...\n\nNo, not the same hygienist. In fact, my dentist sold his practice and retired. The whole staff is new. The dentists don't own the practice, it's more of a clinic now. honestdoc: Jack Addis said:\n\n\n\n\t\t\tNo, not the same hygienist. In fact, my dentist sold his practice and retired. The whole staff is new. The dentists don't own the practice, it's more of a clinic now.\n\t\t\nClick to expand...\n\nThere is a chance if you are in the US, the hygienist gets production pay for Scaling & Root Planing. If so, it is to his/her advantage to record deeper probe readings to justify those procedures. Get different opinions at another clinic if your last dentist sold his practice. The new owner may be hungrier. Jack Addis: Thanks for replying to my post. I am in the U.S. A second opinion is exactly what I'm going to do." + }, + { + "id": 104, + "title": "Tooth abscess and the infection is spreading", + "dialogue": "ZeyadAhmed: Hey I have a tooth abscess (two teeth), my dentist has been working on it for almost a month now and he just told me it's starting to spread.\n\nI'm taking antibiotics and he injected the root with antibiotic as well. But the infection got worse.\n\nHe told me he might have to pull the tooth which is scaring me. Is there anything I can do to kill the infection or prevent it from spreading?\n\nI don't smoke nor drink.\n\nThank you. Dr M: Good day\n\nHas he started a root canal treatment on both teeth? What antibiotics did he give you? Are you still in pain or swollen around the area? ZeyadAhmed: Yes he started a root canal treatment about 2-3 weeks ago. At first he didn't give me any antibiotic.\n\nSo the next time I went he gave me Flagyl + Tarivid 200mg.\n\nThe last time I went (2 days ago) he discovered that the infection is spreading and gave me Flagyl + Averozolid 600 mg.\n\nThe swell decreased a lot (a small bump) and there is virtually no pain. ZeyadAhmed: Dr M said:\n\n\n\n\t\t\tGood day\n\nHas he started a root canal treatment on both teeth? What antibiotics did he give you? Are you still in pain or swollen around the area?\n\t\t\nClick to expand...\n\nThank you for the reply. Yes he started a root canal treatment about 2-3 weeks ago. At first he didn't give me any antibiotic.\n\nSo the next time I went he gave me Flagyl + Tarivid 200mg.\n\nThe last time I went (2 days ago) he discovered that the infection is spreading and gave me Flagyl + Averozolid 600 mg.\n\nSince yesterday, I've been doing salt water rinse + bicarbonate water rinse + crushed garlic clove on the affected area.\n\nThe swell decreased a lot (a small bump) and there is virtually no pain. Dr M: I assumed he started the root canal on both. If not, then he has to initiate root canal treatment on the other tooth as well. During the first step of a root canal, nerve tissue as well as blood vessels are removed. The tooth is rinsed out and then a medicament is placed in the canals. If all the tissue wasn't removed or if the infection was very severe, this step has to be repeated, before the root canal can be completed. \nThe dark areas around the root tips on the x-rays, sometimes take 3 months to clear up. Sometimes even longer. Don't be alarmed if you still see dark areas around the tooth/teeth.\nIf the swelling has decreased and the pain has subsided, this is then an indication that the treatment is working. The root canal treatment can then be finished.\nThere is however some extensive bone loss around one of the teeth. You can see the bone levels dropping. This might be due to the infection, but it could also be due to a condition called periodontitis. If more than 2/3rd's of the bone is lost around a tooth, it has a poor long term prognosis and then unfortunately an extraction is the only option left. Periodontitis is something that has to be treated by a periodontist, which is a dental specialist. It might be worth seeking the advice of a periodontist, to evaluate the long term success of that tooth, as well as the condition of your other teeth, and then he can advise if a root canal treatment ( which can be expensive) is worth your while on that tooth. ZeyadAhmed: Dr M said:\n\n\n\n\t\t\tI assumed he started the root canal on both. If not, then he has to initiate root canal treatment on the other tooth as well. During the first step of a root canal, nerve tissue as well as blood vessels are removed. The tooth is rinsed out and then a medicament is placed in the canals. If all the tissue wasn't removed or if the infection was very severe, this step has to be repeated, before the root canal can be completed.\nThe dark areas around the root tips on the x-rays, sometimes take 3 months to clear up. Sometimes even longer. Don't be alarmed if you still see dark areas around the tooth/teeth.\nIf the swelling has decreased and the pain has subsided, this is then an indication that the treatment is working. The root canal treatment can then be finished.\nThere is however some extensive bone loss around one of the teeth. You can see the bone levels dropping. This might be due to the infection, but it could also be due to a condition called periodontitis. If more than 2/3rd's of the bone is lost around a tooth, it has a poor long term prognosis and then unfortunately an extraction is the only option left. Periodontitis is something that has to be treated by a periodontist, which is a dental specialist. It might be worth seeking the advice of a periodontist, to evaluate the long term success of that tooth, as well as the condition of your other teeth, and then he can advise if a root canal treatment ( which can be expensive) is worth your while on that tooth.\n\t\t\nClick to expand...\n\nThank you. Yes he did perform the root canal on both teeth. Though I don't know if he removed all the tissue. \n\nI was alarmed that the dark areas are the main problem I should look at. I didn't know it can take up to 3 months to disappear. So thank you for clearing it up for me. Do you recommend I go to an endodontist or a periodontist? or both? Dr M: You can go to an endodontist as well. He should also be able to determine if the tooth can be saved. It is important that a periodontal exam also be done. This can be done by your normal dentist." + }, + { + "id": 105, + "title": "Wanting referral for teeth extraction", + "dialogue": "Need2B_Gone: I've been in periodontal disease maintenance \"supposedly\" for going on 5 years. Was going for deep cleanings every 3 months like clock work & told things looked good. During that time at least every 3-6 months I would need a filling replaced or patched up, due to pieces braking off etc.. Even have a few teeth that are made up of just filling.. because Medicaid won't cover root canals. BTW \"all\" of my back teeth have been filled or refilled.\n\n Jump to a year ago with the virus shutting down/closing the Dentist Offices , I went 9 months with no work done. Finally got in & was told I have more bone loss & a wisdom tooth is loose. I have server anxiety attacks & hate needles so I went to a surgeon & was put under. Went back to dentist for 3 month cleaning & another tooth loose on opposite side. At this time I was very upset & told the Dentist if I had known my teeth was that bad I would of had that tooth pulled as well. Dentist tells me lets see if another cleaning will help it.. My teeth/gums are sore -sensitive to hot & cold . So many large fillings I can't enjoy eating either pain or afraid to chew & break fillings off. \n\nSo I've decided to have all my back teeth out & get partial dentures down the road. Only I need a referral to a oral surgeon & I'm pretty sure my Dentist won't give me one. Can my Dentist refuse a referral & if so what would be my alternative? I thought of changing Dentists , but seems they all want to save teeth. That's fine for someone that has good insurance or can pay for the work & want to keep up with the upkeep. For me I'm so done.. . Any Help will be apricated good or bad at this point!! honestdoc: You can lose functionality the more teeth you have removed especially on the lower. Partials and full dentures will never function as well. If you don' like or trust your dentist's opinion, by all means find someone you do." + }, + { + "id": 106, + "title": "Xray added- Does this look like peri implantitis?", + "dialogue": "Twohippoyen: Hello,\n\nI (mid-20, female) recently got my upper baby canine pulled and replaced same day with a zirconium implant and immediate temporary crown early Oct 2020. Here are the xrays of the tooth before the procedure and the most recent xray from my latest cleaning. I see there are some radiolucency around the implant. Is this normal? I have no pain/bleeding, but once in a while I feel a weird sensation that the gum on the palatal side on that implant is 'different' from the rest of them. Dr M: Good day\n\nUsually peri-implantitis only comes after a condition known as peri-mucositis. \nThis condition is usually characterized by pain and/or bleeding of the gums around the implant. On the x-ray it looks okay. If your gums are healthy and you don't notice any mobility on your implant or swelling, continue to go for regular check-ups and cleanings.\nThe bone around an immediate implant can sometimes take 4 to 6 months to fully mineralize again. Twohippoyen: Thank you docs, the last two xrays above were taken 4 month post op also so I wasn't sure the radiolucency toward the coronal and the adjacent premolar were normal. What could be the explanations of the bone density around that area, since it looks like I have pretty ok bone density pre op and the extraction was atraumatic? Dr M: Usually even after a atraumatic extraction, there is some bone loss that occurs. And then it can take six months for the immature or woven bone that fills the socket, to get fully mineralized again." + }, + { + "id": 107, + "title": "Dental Pro 7. Scam?", + "dialogue": "Sevrin: Hi folks,\n\nMy dentist in Australia has told me that I have the choice of getting a deep clean from her to slow down my gum disease with a cost of $300, or that I see a specialist and receive the 'gold standard' treatment for gum disease at a cost of $3000. She feels I would benefit from seeing a specialist, but I just can't afford $3000. \n\nI can afford $300, and I wondered if a combination of a deep clean and using a natural product like Dental Pro 7, would be effective. \n\nDental Pro 7 is a product that purports to prevent and/or greatly reduce gum disease by using natural ingredients. \n\nHas anyone tried this product? Any success? Is it a scam? Thanks in advance for replies. honestdoc: Did your dentist do gum probings? If you have any probings of 5 mm and deeper, and your x-rays show bone recession, you may need deep cleanings. If you cannot afford the fees, try a teaching facility like the Dental and Hygiene Schools and or graduate programs like grad periodontics where they train gum specialists. \n\nI don't see any legitimate articles in dental peer review journals supporting Dental Pro 7. When something seem too good to be true, be very wary." + }, + { + "id": 108, + "title": "Periodontics vs. dentistry", + "dialogue": "Jakobslander: Hello all!\n\nQuick question... Went for my checkup two weeks ago and the dentist found an infection right under tooth 15 (top left /second to last.) I was given various treatment options (money was not discussed) and went with the implant. I was basically explained that, due to the bone mass loss, they would have to extract the existing tooth, graft the molar cavity and, if all heals well, continue with the treatment. All is well... until I go to pay my copay and am told that the work (extraction + grafting) isn't periodontal in nature and that, due to that, they would have to charge me full price for the treatment. I looked at my insurance coverage and found out that if the work is periodontal in nature, they cover all the costs, if it's a simple extraction and grafting, they do not. My agreement to the treatment was that the extraction and grafting HAD to happen because of the infection.\n\nIs this correct?\n\nAny information would be greatly appreciated.\n\nCheers. honestdoc: Can you provide x-rays? Were you experiencing pain, discomfort, and or swelling? In general, insurance will provide the least financial benefits. Implants are usually not covered since they are so expensive and they are considered elective (non-essential). Jakobslander: honestdoc said:\n\n\n\n\t\t\tCan you provide x-rays? Were you experiencing pain, discomfort, and or swelling? In general, insurance will provide the least financial benefits. Implants are usually not covered since they are so expensive and they are considered elective (non-essential).\n\t\t\nClick to expand...\n\nHello Honestdoc.\n\nYes, they charged me for a periapical X-day and it was determined that the loss was severe enough for it to have gone through the bone and into the sinus cavity. I had no pain but I did have swelling.\n\nCheers." + }, + { + "id": 109, + "title": "Gum disease", + "dialogue": "Nick88: Hello my name is nick and im 32 , I went to the dentist yesterday and I have gum disease aka periodontis , its pretty obvious , my gum lines are low and one part my gum line is hanging off. My question is this , my insurance pays for the deep cleaning does that work and can my gums heal or should I go with the laser which I have to pay for for out of pocket, does the laser treatment work alot better? Pain and discomfort of the procedure does not matter i am willing to do whatever it takes to stop this and save my teeth, im freaked out someone please help me honestdoc: Gum disease unfortunately can be a life-long problem (until you lose your teeth). No treatment will work if you neglect your gums. I would go for the deep cleaning and get it re-evaluated after 6 -8 weeks with new probe readings. If the readings continue to be 5 mm or greater, then consider laser options. Ella White: When we use lasers, they will not irritate the patient's gums, so there will not be any significant swelling as a result of the procedure. This means that the gums will look far healthier after the appointment than with a traditional deep dental cleaning. I hope it helps. honestdoc: Ella White said:\n\n\n\n\t\t\tWhen we use lasers, they will not irritate the patient's gums, so there will not be any significant swelling as a result of the procedure. This means that the gums will look far healthier after the appointment than with a traditional deep dental cleaning. I hope it helps.\n\t\t\nClick to expand...\n\n\nLasers are not a substitute for deep cleanings. All the tartar (calculus) and debris must be removed in order for gum attachments to heal. If the gums are not healing well after deep cleanings in 6 to 8 weeks, then lasers can be beneficial to promote gum reattachments." + }, + { + "id": 110, + "title": "Dental Implant Questions", + "dialogue": "MsDee: Hello. My dad had all his upper teeth extracted a few months ago and is now in the process of getting implants. So far he has had 5 put in and is waiting for one more which will be put in on Nov 17. I am feeling very nervous because he has been losing a lot of weight. When he first had all his teeth removed they gave him temporary dentures and he started getting used to eating with them, but once they started adding the implants his periodontist said he needs to keep the dentures out all the time so the implant sites can heal properly. When he had the dentures there was only so much he could eat but now he has even less options. I just wanted to know if this was normal during this process? He has been drinking protein shakes as well to try and keep his weight up, although he hates them because they taste mediciney. Once he gets all his implants and the crowns are added, will he be able to eat normally again? I appreciate all your feedback. Thank you. Dr M: Good day\n\nI am sorry to hear about your situation. In some cases the temporary denture could have been relined or adjusted to accommodate the implants as they heal, but if this was the advice of the periodontist, I would follow it.\nOnce the crowns are all fitted, he should be able to eat normally again, more so than when he had the temporary dentures which were loose and movable.\nIf you are really worried about the weight loss, you could consider seeing a dietician, which might give more valuable advice on what softer foods to eat-especially if the final crowns are still a long way off from being placed . MsDee: Dr M said:\n\n\n\n\t\t\tGood day\n\nI am sorry to hear about your situation. In some cases the temporary denture could have been relined or adjusted to accommodate the implants as they heal, but if this was the advice of the periodontist, I would follow it.\nOnce the crowns are all fitted, he should be able to eat normally again, more so than when he had the temporary dentures which were loose and movable.\nIf you are really worried about the weight loss, you could consider seeing a dietician, which might give more valuable advice on what softer foods to eat-especially if the final crowns are still a long way off from being placed .\n\t\t\nClick to expand...\n\n\nThank you for your quick response and advice, Dr M. He didn't like wearing the dentures anyway because they would always fall off." + }, + { + "id": 111, + "title": "Gum Bone Loss", + "dialogue": "FrancIE7: Hi all,\n\nI need some advice on this. So I am 39 and have a lot of gum bone loss to the point that I have a front part denture for two teeth (1 incisor, 1 canine), now the other incisor has started to loosen abit so my question is should I wait a little longer and hope I can go an get bone grafting done and ultimately save that tooth, any advice would be of much appreciation as I feel very self conscious about this right now.\n\nThanks, Francie honestdoc: It's impossible to know your condition without full mouth x-rays and gum attachment probing depths. Bone graft only helps with vertical bone defects and acts as scaffold for implants. Bone graft does not help with horizontal bone loss. Are you in a location where there is a periodontist (gum specialist)? If so, you may have options depending on severity of your condition. FrancIE7: honestdoc said:\n\n\n\n\t\t\tIt's impossible to know your condition without full mouth x-rays and gum attachment probing depths. Bone graft only helps with vertical bone defects and acts as scaffold for implants. Bone graft does not help with horizontal bone loss. Are you in a location where there is a periodontist (gum specialist)? If so, you may have options depending on severity of your condition.\n\t\t\nClick to expand...\n\n\n\nHi\n\nMany thanks for the reply. I was actually thinking of that myself about an x-ray that would make alot of sense, it’s been a few years since I last had one so I should have another to see what’s going on, if I can get bone grafting done soon at my upper front (where my main problem is) thus saving my other incisor well and good I just don’t want to go ahead and have it extracted if there are is a chance it can be saved, in the meantime am going to take extra care daily by keeping my mouth super clean in preventing infection. I live quite close to Dublin so they would be many there am sure." + }, + { + "id": 112, + "title": "Bone graft cavity.", + "dialogue": "Patsyp: Hi I had bone graft 3 weeks ago on teeth number 8 and 9 on the front for lack of bone it’s healing up nicely.I’m going back to the dentist in two weeks to get a cavity filled on a tooth number 7 and it looks like I have a cavity too on tooth #8.My question is can it be done to even though the tooth had a bone graft will it mess it up if the tooth is filled to early and would the bone graft mess up.? Dr M: Good day\n\nThe fillings on the teeth should not have any affect on the bone graft. In fact, any infection resulting from non-treatment of cavities, could have a more negative effect. Patsyp: Dr M said:\n\n\n\n\t\t\tGood day\n\nThe fillings on the teeth should not have any affect on the bone graft. In fact, any infection resulting from non-treatment of cavities, could have a more negative effect.\n\t\t\nClick to expand...\n\nAwesome thank you so much I was worried about it since it’s only been 3 weeks I thought I had to wait a little till the bone heals around the tooth. honestdoc: Dr. M has a good point. I'm worried about the vibration of the handpiece during cavity prep affecting the integration of the graft. Ask the surgeon who placed the bone graft of his/her opinion on this. Patsyp: honestdoc said:\n\n\n\n\t\t\tDr. M has a good point. I'm worried about the vibration of the handpiece during cavity prep affecting the integration of the graft. Ask the surgeon who placed the bone graft of his/her opinion on this.\n\t\t\nClick to expand...\n\nWould you know how long does the bone graft harden around the tooth.?[/QUOTE] honestdoc: I don't know the exact answer and the timing depends on the individual and the severity of the case. Your surgeon would be the best source." + }, + { + "id": 113, + "title": "Bone grafting indication?", + "dialogue": "DrD: Hi, \nI just wonder if this is good case for bone grafting? ( GBR or something to help with this bone loss ) \nYoung 28 yr old female. Generalized none loss could be resulted from many orthodontics treatments before or hereditary. Oral hygiene is good. \nShe is now followed up by regular dentist. \nThank you." + }, + { + "id": 114, + "title": "Should I be worried?", + "dialogue": "Elle J: I had Damon braces since January this year. 2 months ago I noticed that a small part of my gums near my second upper molar is inflamed and bleeds whenever I brushed my teeth near that area. I am also using a water flosser (water irrigator). My dentist told me to gargle with warm salt water and it should be resolved on its own. Recently I went for my appointment but the dentist didn’t say anything about it so i assume that it was okay. However I am still worried about this. Can anyone tell me what it is and how to solve this problem? honestdoc: It's hard to tell. I suspect debris contamination and or autoimmune response to medication(s), herbals, new toothpaste, oral rinse, maybe cinnamon products, trauma, etc. Most lesions like that should resolve within 2 weeks like your dentist mentioned. Get a follow up if the lesion persists longer. MattKW: Looks like a granuloma, probably caused by some local irritation. Get your dentist or hygienist to thoroughly scrape out all around the gum of that tooth." + }, + { + "id": 115, + "title": "Gums constantly sore - recession", + "dialogue": "cuddylier: I'm a 24 male and I first noticed considerable gum recession on my front lower teeth at the end of February and made an appointment to see my dentist in March. They said the only thing I needed to do was make sure to brush the now exposed parts of the tooth and that's all I needed to do, at this point I had no pain, sensitivity or bleeding and the recession was only visual. My dentist mentioned that the recession was likely accelerated by the fact I have a permanent retainer on the back of my front lower teeth from orthodontics I had as a teenager, therefore potentially making the gums thinner. I've had a relatively bad brushing technique for most of my life up until this point where I brushed for too long (10+ minutes), and using incorrect methods, twice a day, not usually too hard though, this most likely contributed significantly to the recession occurring too as well as some recession on the front upper teeth.\n\nA few weeks after my March dentist appointment, I started to suffer pain on my gums everywhere (still zero bleeding) in my mouth, which was noticeable constantly and didn't seem to be affected by anything (food eaten etc), this was at the same time as I changed my brushing technique to small circles and brushed for 3 minutes twice daily along with starting to floss (something I'd never done before). When I flossed for the first time, there was only a tiny amount of bleeding for a few days and none after that however it did seem to make the soreness of my gums worse even though I was doing it very gentally and ensured I only went under the gums a little. I started to notice what looked like black staining appearing on my teeth around this time too, it was especially prominent in between my teeth and where the gums meet the teeth, areas that were more black seemed to hurt in between the teeth, and still do.\n\nI made an appointment to see a new dentist on 24th July to get a 2nd opinion on the recession (as it was slowly getting worse) and the gum soreness at the same time (also because my original dentist was still closed due to covid). They said I was cleaning everything okay, I didn't have gum disease and that they couldn't see any cause for my gum soreness, they gave me a few things to try, an ultra soft toothbrush (I had been using a soft toothbrush since March), to massage my gums with my finger daily and to use a different brushing technique; brushing down from the gums in strokes, like this. They also mentioned that in my case, I don't need to floss. They said that they didn't necessarily recommend any treatment for the recession and that in the future e.g. in 10 years time, I would start to have sensitivity on the front lower teeth.\n\nSince the appointment on 24th July, things haven't improved and have got a little worse, soreness is a bit more pronounced all around my mouth (especially when my brush hits my gums, even the slightest touch is sore, it feels like it's stinging), especially on the recession on the front lower and upper teeth. Small red patches have formed where my gums meet the teeth, especially in the areas where it's more sore. I will be soon revisiting my dentist as they asked me to get back in contact if things haven't improved.\n\nDoes anyone have any opinions on what this might be? I presume if my dentist cannot figure out the cause after a second visit then they may refer me to a periodontist (or I will myself if I see my Dentist and I not getting anywhere).\n\nI'm concerned my gums look a little sad and don't wish things to progress unnecessarily, my teeth and gums before this have historically always been totally fine and no fillings/decay, I've always visited the dentist every 6 months.\n\nTLDR: Gums are sore but do not bleed whatsoever, dentist has confirmed it's not gum disease, tried everything I can think of including an ultrasoft toothbrush, brushing for 3 - 5 minutes slowly and carefully with the brushing technique seen in this video that was also recommended by my dentist but soreness has not resolved.\n\nPictures:\n\nside\n\nFront lower 1\n\nFront lower 2\n\nFront lower 3\n\nTop upper Dr M: Good day\n\nOn the picture it looks like you have marginal inflammation. This could be because of a lot of things. Firstly, I never advise my patients to brush for 3-5min. Brushing too long, even using the correct methods, can actually damage your gingiva and teeth. 2 mins of brushing is usually enough.\nIf you changed toothpastes recently, it might also be that the tooth paste is causing a reaction with your gums. Although it is not often seen, certain patients have been known to show an auto-immune reaction to SLS or sodium lauryl sulfate in toothpaste. Try changing to a different toothpaste.\nChronic inflammation could also be sign of a bacterial infection. For this a short course of anti-biotics might be needed in order to clear it up permanently.\nDo you suffer from any system conditions? Diabetes? Smoking? cuddylier: Dr M said:\n\n\n\n\t\t\tGood day\n\nOn the picture it looks like you have marginal inflammation. This could be because of a lot of things. Firstly, I never advise my patients to brush for 3-5min. Brushing too long, even using the correct methods, can actually damage your gingiva and teeth. 2 mins of brushing is usually enough.\nIf you changed toothpastes recently, it might also be that the tooth paste is causing a reaction with your gums. Although it is not often seen, certain patients have been known to show an auto-immune reaction to SLS or sodium lauryl sulfate in toothpaste. Try changing to a different toothpaste.\nChronic inflammation could also be sign of a bacterial infection. For this a short course of anti-biotics might be needed in order to clear it up permanently.\nDo you suffer from any system conditions? Diabetes? Smoking?\n\t\t\nClick to expand...\n\n\nThank you very much for your response.\n\nI'll try restricting to only 2 minutes although I've been slowly brushing my teeth since my problems started, maybe 3 - 5 circles or strokes down for the top and up for the bottom, for each set of teeth my brush can reach, so this partially contributes to the time, I figured going slowly and gental may help but doesn't seem to have, I know I should remain gental most likely though and I'm always aware of the pressure I put on my teeth and gums. I try my best to do what I think is the bare minimum in an effort to avoid inflamating due to too much brushing, I've tried experimenting with different brushing techniques and times but nothing so far has really made a difference meaning I'm somewhat at a loss of what to do.\n\nMy toothpaste does have SLS in it but I've been using this specific toothpaste for years, long before my recession and gum soreness came to light so I presume it's likely I don't have a negative reaction to SLS but maybe it's possible to develop one.\n\nI wouldn't say my inflamation is 'chronic' in the sense that I'm in major pain constantly but the moderate pain and inflamation feeling/stingyness is there all the time, I'd guess it's maybe a moderate case. The pain does seem linked with brushing though, pain usually becomes worse after brushing although it can inflame itself randomly later in the day, especially a few hours after taking mouthwash, which seems to calm it down a bit until it wears off.\n\nI don't have any health conditions apart from anxiety in the past, I don't have diabetes nor smoke. Dr M: I would maybe then consider getting yet another opinion from a dentist or periodontist. The brown marks look like extrinsic staining which can be polished off, or removed with an ultrasonic scaler.\nIt is normal that gums bleed when you start flossing, but this should become less and less.\nA periodontist will most likely be able to do more advanced tests, if your condition does not improve. cuddylier: Dr M said:\n\n\n\n\t\t\tI would maybe then consider getting yet another opinion from a dentist or periodontist. The brown marks look like extrinsic staining which can be polished off, or removed with an ultrasonic scaler.\nIt is normal that gums bleed when you start flossing, but this should become less and less.\nA periodontist will most likely be able to do more advanced tests, if your condition does not improve.\n\t\t\nClick to expand...\n\n\nThanks again. I will probably go back to my dentist if things don't improve soon and then see if they can refer me to a peridontist if they're out of ideas. It's interesting that I have the extrinsic staining as I don't eat/drink anything that I've read typically causes it. Sadly cleaning isn't available from dentists at the moment in the UK due to covid-19 but I guess it's nothing very urgent, my last cleaning from a dentist was in March.\n\nDue to the state of my gums, I assume you'd agree that it's probably best visiting a peridontist in the near future regardless to see what they can do for me to help rebuild my gums (even in the case where I no longer have pain), especially on the lower bottom, to avoid issues with my teeth in the future, right? My thought is better doing something about it now before it's too late. cuddylier: One other thing, my lower canines are quite receeded as you can see from my pictures, this makes them quite difficult to brush as there's more gum exposed on the sides of the tooth to the toothbrush, this seems to have resulted in the gums on the side of the lower canines becoming red and as a result, more sore than other areas of my mouth. I've tried the brush up and small circles technique on these teeth, being very gentle and using little pressure, but sadly it hasn't improved. Do you have any tips on cleaning my lower canines? The upper ones are fine, they seem much less receded. Dr M: I would advise continue using the circular method, with an ultra soft toothbrush, but actively try and limit the amount of time you spend on brushing in general. If the dentist could do a professional scale and polish during this Covid period, the condition of your gingiva might improve drastically as soon as they are able to do so. cuddylier: Thank you for all of the advice.\n\nI went to my dentist on the 16th September and they found that my gums bled relatively easily, especially on the top front when prodded with a tool, they said it was the beginning of gum disease which makes sense. I was told to brush more thoroughly using small circles up to the gums and when I did, the top front gums improved considerably within a few days and were no longer bright red (which they were by the time I went to my appointment), I was focusing already on brushing right up the gum but obviously not enough.\n\nMy dentist recommended a scale and polish (without me mentioning it) so I'm going back for that in a week or two which I hope to improve my overall condition.\n\nI will be asking my dentist for more detail on my next visit but do you have any recommendations about brushing my lower front teeth (where the recession is greatest) and the front bottom canines? I seem to struggle with these areas as they're quite vulnerable due to the already considerable recession. I'm currently doing a mix of small circles and using a single tuft brush on the recessed parts of the front bottom incisors to avoid brushing the gum itself too much away from the edges of the tooth as it seems to irritate it a lot if I do. The lower canines in particular seen to be pretty irritated with small circle gentle brushing, I've pretty sure plaque isn't a problem there (and therefore hopefully not an irritation source) as I've checked with a plaque disclosing tablet but hard to be certain, especially below the gum. Dr M: Good day\n\nIt seems like you are using the correct technique. Just make sure to use a soft toothbrush. In cases of severe recession, it is important to note that specialist intervention might be required, such as tissue grafts etc, since severe recession won't improve by itself." + }, + { + "id": 116, + "title": "Am I going to lose my tooth ( the one with the cavity filling in it)", + "dialogue": "Rnsparks: Hello I am a 25 year old female with periodontal disease. I have a past of neglecting my teeth and gums. Fortunately I have changed my ways and take care of them now but there is damage that was already done. One tooth in particular is worrying me. The gum has receded the most in this tooth exposing the root a lot. It like dips in the middle . I know this is my own doing. I have a bad habit of eating sugary things in the middle of the night ( night munchies ) which is weird and not good for my teeth. I’m afraid that this had caused the disease to progress faster . I am scheduled to go see my dentist but I’m going to post a photo here and if anyone has seen worse or can tell me I’m not going to lose my tooth if I stop these bad habits and continue my oral hygiene care. . Rnsparks: How far down can it recede before I lose the tooth? With proper care can I keep the tooth ? honestdoc: Realistically, you can still keep the tooth if there are no immediate disease and or hidden deterioration. Without x-rays, gum probings, and full exam, I'm unable to give you an accurate diagnosis. It's very hard to break bad habits and start good ones. I had an unreported Meth user who promised to take better care of her teeth. However, she didn't comply with any home care as her teeth deteriorated beyond my control." + }, + { + "id": 117, + "title": "Do i have periodontist:/?", + "dialogue": "tetris1990: hi, I have always grinded my teeth i have a guard now and I'm 30 how do my gums and teeth look :/?\n\nDoes there look like much gum disease or recession honestdoc: I can't see the gums behind the teeth. You have to understand, we can't diagnose gum disease without full mouth x-rays showing the amount of bone levels around the teeth and a full mouth gum probe to detect any attachment loss. You may have some areas that are good and some areas we don't know." + }, + { + "id": 118, + "title": "Periodontitis getting worse", + "dialogue": "oxyflex: I was diagnosed with periodontitis about 5 years ago, my dentist then did a deep clean and said my pockets weren't too bad. I have had regular hygenist appointments since then and she has always said they are ok, in fact, last time I saw her she said they looked good. Then lockdown hit and I feel they have deteriorated dramatically I suddenly have massive gaps either side of my two front teeth and just know things aren't good. I did have them cleaned by a hygenist ( a new one)on Monday and she didn't really say anything except come back in three months instead of six. My dentists in the last few years have been next to useless and I can't see one at the moment anyway. I think I need to see an expert but am terrified they will say there is nothing they can do. Anybody had similar and been saved? I am in the UK by the way , near Birmingham. honestdoc: It is important to know how stable your probing readings are. The lower the number, the better. Also, it is important to see how much bone support your teeth has. Are there a lot of bone loss (recession)? Bone loss cannot be regained so it is important that bone levels remain stable. If possible, have the same hygienist probe your gums every time to establish consistent readings. Any readings greater than 5 mm can be a problem. Also, bleeding during probing indicates active disease. If you can provide probe readings as well as full mouth x-rays, we can better assess your gum and bone status." + }, + { + "id": 119, + "title": "Dentist said its too late and I will lose teeth", + "dialogue": "sarahpjay: Hi Im 44 and today have been told I will lose 4 maybe 5 of my teeth I am absolutely devastated as my dentist has said my gum disease is too advanced and that I will need dentures. As of now I have all my teeth and only 1 is very slightly wobblily. I am planning a visit with the hygienist soon to save my other ones but is there anything more I can do to prolong this. Also should I get a 2nd opinion ( my dentist is very young ) Any advice would be very appreciated. MattKW: Unfortunately, gum disease can progress slowly without symptoms and then they start falling over like dominoes. I would be asking for a referral to a periodontist for an opinion and treatment. sarahpjay: Hi thank you for reply, I was wondering do they fall out naturally or will they need to be removed. I ask this as I am private and am trying to get my head around all the cost. Also can the bone regrow back after the tooth is gone, this is for a hopeful future dental implants. honestdoc: Please provide xrays. No, bone CANNOT grow back. Teeth may become so loose, they may not be able to function. Also, your gums may become swollen and infected. Hopefully with xrays, I can see your remaining bone and provide some options. Like Dr. MattKW mentioned, get an opinion from a periodontist. Beware, many periodontists in the US particularly in expensive cities see dollar signs and only want to stick implants. I would avoid the young ones who are exactly that because they have stacks of school loans and heavy initial overhead to pay.\n\nAbout 3-4 years ago, I attended a lecture given by an older periodontist who would save teeth with compromised bone. I was so impressed that people could still keep their teeth for over 10 to 15 years after initial diagnosis similar to yours. Not everyone will be successful. If you are a smoker, quit. If you are diabetic, get it under control. You need to be meticulous with your oral hygiene and committed to recalls every 2 to 3 months. sarahpjay: Hi thanks for reply I only wish I had that periodontist as my dentist who was willing to try. Im from the UK so as far as I know they don't let us have x-rays. \n\nI have a deep clean up with my periodontist in 2 days and have been brushing, flossing and even oil pulling to keep my mouth as clean as possible. \n\nMy biggest hurdle is giving up smoking. Im ashamed to admit until 3 days ago I was a 30 to 40 cigarette a day. I have overnight cut it back to just 10 to 12 a day and am 100% in the process of giving up. I have booked doctor as need help with this filthy habit as its been almost 30yrs and engrained into me. May I ask is even cutting back helping even just a little bit and would switching to herbal be better for weaning me off? honestdoc: Any little steps help. Eventually it is best if you quit totally. Hopefully you feel comfortable with your periodontist. If so, follow all recommendations and recalls. Tolkienista: Just read your post and can I just say that I see a Periodontist in Birmingham UK and he transformed my mouth.......I've been with him since 2002 and he's so meticulous and in turn I too am meticulous with my cleaning regime. Just decided early on that I wanted to keep my teeth. Hope everything is ok with you. oxyflex: Tolkienista said:\n\n\n\n\t\t\tJust read your post and can I just say that I see a Periodontist in Birmingham UK and he transformed my mouth.......I've been with him since 2002 and he's so meticulous and in turn I too am meticulous with my cleaning regime. Just decided early on that I wanted to keep my teeth. Hope everything is ok with you.\n\t\t\nClick to expand...\n\nI feel mine are about to fall out as well, I am near Birmingham, could you give me the name of who you see" + }, + { + "id": 120, + "title": "Does it have to be a root canal?", + "dialogue": "Iro: I have a molar that doesn't hurt. The gum on one side of it is sore. At the last general visit the dentist said the (old amalgam) filling has to go and - if when he opens it he sees it needs a root canal, he'll do that. X-ray is fine. He tested the tooth with cold (nitrogen?) and it was painful. \nCould it NOT need a root canal? Could the pain be because of another issue, like my gums (I have some problematic areas), not pulp infection? How does a dentist know if it's infected? \nThank you. Dr M: Good day\n\nIt is difficult to give an exact opinion without an x-ray, but it can be possible that the issue is gum related and not related to the tooth itself. If the area is prone to food impaction, it can cause a chronic irritation of the gum in this area, resulting in pain, or if the old filling is chipped or rough, below the gum line, this could also cause this irritation.\nIt is normal for the tooth to feel pain with a cold or heat stimulus. The key is that the pain should go away as the stimulus is removed, and should not linger for longer that 10-15 seconds.\nDo you perhaps have any photos or x-rays of the relevant tooth/region? Iro: Thank you very much for your answer. I don't have any photo or x-ray that I can post here. They stay at the dentist. I'll ask if I can have copies. My feeling of pain stayed longer with that tooth than the others that were checked. I like the dentist but he is young and I just started going to him, so I want to do my homework before agreeing on significant procedures." + }, + { + "id": 121, + "title": "Multiple external root reabsorption", + "dialogue": "Jzablotny: Hi I went to the dentist with pain during flossing about a year ago, he discovered on x-ray that I had 4 external cervical root reabsorption. I am 45 years old I have very healthy teeth I have only ever had one cavity and no other dental work in my mouth. The teeth had to be pulled and I had implants put in. Fast forward a few months after my crowns replaced during a check they found another tooth had absorbed. Had another surgery with an implant two weeks ago went back for postop check another tooth has reabsorbed I am up to six now. I have seen my family Doctor Who is referring me to see if there is any underlying causes. None of the dentists and doctors or periodontist seem to know what is causing this or how to stop it. Has anyone experienced this Or have any insight I am desperate to find a way to not lose any more teeth. Dr M: Good day\n\nDo you perhaps have an x-rays or cbct scans of the relevant teeth, just for some more information? Jzablotny: This is the most recent tooth affected. The others have been removed. And the full mouth series was the very first before any implants. Dr M: From the pictures you provided, it is difficult to determine if the area was caused by a cavity due to decay or due to resorption. Sometimes if food gets stuck in between teeth, and we don't clean it out, a cavity can form that begins to \" eat away \" at the tooth and it can resemble resorption. This would have been picked up by a periodontist.\nHowever, we do get something called idiopathic external root resorption, which is rare and of which the cause is still not completely understood. I would rule out any underlying health factors, or deficiencies just to be on the safe side.\nBut in the end, the only treatment would eventually be extraction with implant placement, since root canal treatments would be no guarantee that the resorption would stop.\nI am sorry that this information isn't all that helpful. Hopefully you won't have any more teeth affected. Continue to go for your check-up visits every 6 months, to monitor the situation in your mouth. Jzablotny: I have already had 5 teeth removed with implants due to multiple external root reabsorption by a periodontist. It has now spread again to another tooth. This would be 7 now." + }, + { + "id": 122, + "title": "Is it safe to repeat an antibiotics course for the 3rd time in the same year?", + "dialogue": "Freelilly: Got tooth abscess on first molar the beginning of the year, took antibiotics (metronidazole and amoxicillin together) for it with the intention of getting the tooth treated as soon as the infection cleared.\n\nFinished the course and had to travel before I could get it treated.\n\nAbout 2 months later, infection started again on same tooth. Gums, face swollen. Again I took the same course. Infection cleared. Lockdown started. No dentists.\n\nNow it started again. Gum infection (It seems like). Is it safe to start the same antibiotics course again without risking resistance? Im going to a dentist this time.\n\nOr should I start another antibiotics? If so, which ones? No dentists operating where I am, which is rural. So I'll have to travel for this. Good times ahead Dr M: Good day\n\nIt is never a good idea to take too much antibiotics, since there is a growing trend of antibiotic resistance. Amoxicillin and Metranidizole are luckily not broad spectrum, so the risk-especially if spaced-is low. \nI would recommend however that you switch to a different antibiotic, since this will help combat resistance.\nAlways remember, antibiotics is never a solution to a problem. The source of the infection should be removed. In this case your rotten molar.\n\nHope this helps Freelilly: Dr M said:\n\n\n\n\t\t\tGood day\n\nIt is never a good idea to take too much antibiotics, since there is a growing trend of antibiotic resistance. Amoxicillin and Metranidizole are luckily not broad spectrum, so the risk-especially if spaced-is low.\nI would recommend however that you switch to a different antibiotic, since this will help combat resistance.\nAlways remember, antibiotics is never a solution to a problem. The source of the infection should be removed. In this case your rotten molar.\n\nHope this helps\n\t\t\nClick to expand...\n\n\nThanks for your input Dr M! What's considered the best alternative to a Amoxicillin and Metranidizole combo course for periodontitis/tooth abscess? Dr M: You can maybe try Augmentin or you can try a short course of Azithromycin." + }, + { + "id": 123, + "title": "Molar Infection + Gum Abscess + Risk of Losing Tooth", + "dialogue": "ps10019: Hello, \n\nSee attached photos. My dentist says she needs to remove this bad tooth because of a severe fracture in the root. I have a huge bump on the gum on the outside of the tooth.\n\nThis tooth had a root canal and crown many years ago. The xray shows the tooth from earlier years and the most current photo from a couple days ago.\n\nI really dont want to have this tooth pulled + implant. I currently have no pain. \n\nAm I losing this tooth or is their anything I can do to save it? honestdoc: Sorry, that bump is an infection the mouth is trying to drain/rid due to the bad tooth. The post that was placed after the root canal is fractured/displaced and perforated. There is no saving that tooth unfortunately." + }, + { + "id": 124, + "title": "Scared for periodontal cleaning", + "dialogue": "veohstew112: I have to do a specialty cleaning to prepare for my dental plan treatment. I am scared and embarrassed because the top right of my tooth has a little bit of black plague on it. I am expecting I need some type of root canal to get the black plaque out if it's possible. If you have bad teeth do you have any tips for anxiety. Would I need to inform the front office of my issues first or the dentist themselves. Lastly do you feel comfortable with multiple dentist crowding you because I don't. Is there a way I could have that accommodated or is that possible. \n\nIf you have issues with your back teeth what dental treatment did you receive? I am hoping to get implants. Dr M: Good day\n\nA little area of \" black plaque \" could only be some staining or arrested caries. If it staining, it could be removed with a scaling. If it is arrested caries, a small filling could be done, if a dentist deems it necessary.\nIt is best to inform your dentist about your concerns. The front office won't really be able to address your concerns fully.\nAnd finally.\nUsually a dentist is accompanied by one dental assistant. Sometimes two.\nIf too many faces makes you feel uncomfortable, raise your concerns with the dentist, and maybe he could offer an alternative, for example only one dental assistant instead of two.\nIf your usual dentist is a dentist, that trains other dentists, it is still within your rights not to have too many \" dental students \" crowded around you.\n\nHope this helps. veohstew112: Dr M said:\n\n\n\n\t\t\tGood day\n\nA little area of \" black plaque \" could only be some staining or arrested caries. If it staining, it could be removed with a scaling. If it is arrested caries, a small filling could be done, if a dentist deems it necessary.\nIt is best to inform your dentist about your concerns. The front office won't really be able to address your concerns fully.\nAnd finally.\nUsually a dentist is accompanied by one dental assistant. Sometimes two.\nIf too many faces makes you feel uncomfortable, raise your concerns with the dentist, and maybe he could offer an alternative, for example only one dental assistant instead of two.\nIf your usual dentist is a dentist, that trains other dentists, it is still within your rights not to have too many \" dental students \" crowded around you.\n\nHope this helps.\n\t\t\nClick to expand...\n\n\nI'm assuming the dentist that will clean my teeth is going to tell the other dentist in the back. Do you know how I would approach the topic? I'm assuming casually? Dr M: Yes, you can just approach it casually. The dentist will understand" + }, + { + "id": 125, + "title": "Should i trust my dentists despite my worries", + "dialogue": "Violet: I try to keep my oral hygiene routine as thorough as possible, despite my efforts the gums on my bottom teeth seem really low. I dont feel any pain or discomfort and my gums dont bleed any, but I'm still concerned. The last time I went to see a dentist he didnt comment on it, if he hasn't mentioned it as a concern should I just stop worrying? MattKW: Ask him if you're unsure." + }, + { + "id": 126, + "title": "Connective Tissue Graft?", + "dialogue": "Sophie18: Hi! I’m a female in my early 20’s, have never had a cavity, never missed a cleaning, and take decent care of my teeth. I’ve been going to the same dentist my whole life, he took out my wisdom teeth, my brother’s wisdom teeth, my parents are his patients as well. I’ve always had semi-sensitive teeth, but I’m never in any pain. Sometimes when they clean by the roots, it’s uncomfortable, but that’s it. 6 months ago (my previous cleaning) my dentist told me that I grind my teeth and I should consider a mouth guard, because I was shaving some teeth down, and that it would cause my gums to recede over the years. There was no rush, though, he was casual about it. Fast forward to my cleaning a couple days ago (6 months later), and he randomly dropped the bomb that I need a connective tissue graft for 2 sections on my bottom teeth in the next 6 months, tops. He said I had 0% gum tissue left and that irreparable damage will be done if I don’t get it. I started asking questions and got a strange vibe, he was very cavalier about it. I understand that for him, it’s a fairly simple surgery, but to me, it’s a $3,000 (this includes the mouth guard, we don’t have dental insurance) procedure that came out of the blue. How could my gums get so bad, at such a young age, and go unnoticed? Or in a 6 month period? It did not seem like an emergency back in December. I don’t know if he’s scamming me, but I feel like something is off here and would love some feedback before scheduling the surgery. Should I get a second opionion? Or is this normal? If I need it then I will do it, but it’s just weird to me how this is suddenly a situation, when gum recession is typically gradual. Thank you! Dr M: Good day,\n\nDo you maybe have some photos of your gums and teeth in the areas that he mentioned so that we can have a clearer picture of the situation? MattKW: Never hurts to get a second opinion, possibly from a periodontist." + }, + { + "id": 127, + "title": "Restoration after perio treatment", + "dialogue": "Dr M: Hello there Colleagues,\n\nI would just like some advice on a case I am currently treating. Patient was referred to a periodontist for chronic generalized periodontitis. He is an alcoholic and a smoker.\nAccording to the patient, treatment was done and completed about 2 weeks ago by the relevant specialist. It sounds like it was only normal root-planing with a few extractions of teeth that had a poor prognosis. No report was sent by the specialist to indicate the treatment was completed, but the patient reported that he only had to go for regular cleanings at checkup visits.\nHe then said the periodontist advised that we crown the 6 anterior teeth, close the necks of the posterior teeth with class V fillings. The patient insisted that this be done ASAP, because he wants \" a white smile \".\nMy question is this-what is a suitable waiting time after \"completion\" of periodontic treatment before starting prosthodontic rehabilitation?\nThe right lateral incisor has minor mobility with which I was not happy, and if crowns were to be done, I would prefer doing all 6 anterior teeth, simultaneously. I advised the patient to come back in 6 months, to see if there was any improvement, and plan to get a report from the specialist regarding the patients' treatment and if it was indeed \"completed\".\nI know it is difficult to give an exact time frame since cases differ, but I am hesitant to do crowns on a patient with periodontitis, because I do not want to build a house if the foundation is not solid.\nIs 6 months enough usually? Should I wait for the periodontist to give an official go ahead before I start? Would you advise doing crowns on a periodontally compromised patient at all?\nAny advice or ideas welcome honestdoc: I agree with you on needing solid foundation. What were his relevent probings? Tooth #7 has class 1 mobility? Is that due to poor crown to bone ratio? How is his occlusion? How is his compliance to home care and making to his appts? I live in an area where patients are quick to sue and someone of poor to questionable compliance may deter me from big cases. MattKW: Yes, sounds a bit unlikely to me. I'd email the periodontist and get his info. I doubt a periodontist would \"advise\" a patient to get crowns and buccal restorations for aesthetics.\nI would also be very wary of crowns because with more necks showing after perio treatment, then the longer and deeper crown preps might really weaken the teeth plus come close to pulps. What will be the eventual crown:root ratio? I would be more inclined to investigate possible composite additions so that you don't have to cut away good tooth structure. \nDon't get bullied into risky treatment by pushy patients. As honestdoc says, if it fails (tooth snaps off, tooth devitalises), the patient will blame you and you'll need good reasons to defend your treatment plan. honestdoc: A Dental Assistant told me a dentist she used to work for was bullied to do a cantilever bridge in the posterior (doomed to fail despite any best attempts). The pt later reported him to the licensing board and he was disciplined. I'm not sure if the pt filed for lawsuit. I have numerous pts bully me. About 5 yrs ago, I had this young lady with severely rampant caries like in a Meth mouth. She denied using any substances and was in constant intense pain. I could not keep up with her deterioration and all my work failed. She bullied me into doing crowns but I refused. She later sued me (naming my employer) for her teeth deterioration. I looked her up and found 2 meth related arrests, one of them during our time of tx. She initially filed for $995k and because of those of those arrests, dropped to a $35k settlement due to my poor record keeping. Afterwards, I learned to take better records. MattKW: Ouch! And because of people like that and their attorneys, our indemnity insurance keeps increasing. Sometimes you get a bad feeling about patients and you have to make voluminous notes just in case." + }, + { + "id": 128, + "title": "Why no dentures?", + "dialogue": "Maysun: So I have a question about parodontitis and taking dentures.\n\nI know that the common treatment for parodontitis and deep pockets is to regularly clean them by the dental hygienist and of course brushing, flossing and such yourself. And if that doesnt work then there is flap surgery. \n\nBut I wonder why are dentures not recommended? Wouldnt that solve the issue? Why do dentists all are of the opinon that keeping your own teeth is so important? honestdoc: Taking teeth out can be very traumatic. Once the teeth are taken out, the bone will continue to flatten throughout you lifetime and that makes dentures not fit as accurate or lose retention (loose denture). Your facial profile will change...think of grandma and grandpa. Dentures will never function like teeth. Try to ask people with dentures what struggles they have to go through. Modern times we have the technology and knowledge to save teeth and improve your quality of life.\n\nIf you think we dentists just want to milk as much money out of you as possible, I'm sorry. I never force anyone to do any treatment. I always provide options and alternatives. There are numerous law suits in the US against dentist because we didn't fully inform or provide options for deteriorating gums and bone. \n\nIf you were to come in to my office just to rip out all your teeth with no justification and put in dentures, I won't do it." + }, + { + "id": 129, + "title": "Rough flaky inner gums and roof of mouth", + "dialogue": "Ingabella: Hi\n\ni have very rough feeling gums on the inside of my upper teeth. It feels like sandpaper when I run my teeth over them. I’m currently using steroid gel on the front of my gums to treat Lichen Planus." + }, + { + "id": 130, + "title": "The ultimate project case...", + "dialogue": "Big R: I have advanced periodontal disease. Everyone I have seen or spoken to want to take my teeth. I have never had a cavity, but I have significant bone loss around several teeth. With all of the \"advancements\" in dentistry, I don't see why I have to give up my teeth. No one can tell me on whether or not there has been a case like mine treated. If there hasn't been, I am willing to be the first! I have x-rays for whomever my be interested. They were taken on May 22nd in 2019. I know I will need more taken, but these will give you an idea of what I am dealing with. If you can help me with my mouth in the state that they're in, in these x-rays, you can help me in the state they're in now.\n\n I am looking for that true innovator. Someone to see my x-rays, and say \"I have never done this, but I am willing to try.\" \n\n I have no health problems/conditions that may complicate my recovery. I have never smoked or drank alcohol. I am not taking any prescription medications. My doctor said I was healthy and had no problem with me having the surgery. \n\n I believe when I find the right doctor, I will make a full recovery. If the right one is out there, please let me know. Thank you for your time. honestdoc: Can you post your x-rays? Bone loss will never be regained. Your dentist/periodontist may be able to maintain them. Big R: honestdoc said:\n\n\n\n\t\t\tCan you post your x-rays? Bone loss will never be regained. Your dentist/periodontist may be able to maintain them.\n\t\t\nClick to expand...\n\nI respect your opinion, but have seen cases to the contrary. I will send my x-rays to the doctor who is willing to help me. Big R: Big R said:\n\n\n\n\t\t\tI respect your opinion, but have seen cases to the contrary. I will send my x-rays to the doctor who is willing to help me.\n\t\t\nClick to expand...\n\nAre there any periodontist on this forum, or do they have their own?" + }, + { + "id": 131, + "title": "Help Please! Receding gums", + "dialogue": "redheaded_princess: Hi everyone, I have noticed that my gums have been receding over the years. I realize that some recession is normal with age, but feel like my gums should not be receding this much at 29. I am really self conscious about this and have been having mild sensitivity. I really do not want this to get worse and am desperate to determine the cause so I can prevent further recession. In the past, I started using a soft bristle tooth brush (recommended by my general dentist) but the recession continued. I would like to fix the damage that is already done. Is this from poor oral hygiene/ gingivitis? What treatment options would be more beneficial at this point? Would scaling and planing improve this or should I be looking into gingival grafting? I don't have dental insurance, so pinhole surgery is out of the question at this point. Thank you! MattKW: Too blurry, and it's only ~70kB. Need at least 1Mb resolution. From what I can see, there is some minimal recession on the teeth that protrude, but nothing to be concerned about. redheaded_princess: I retook the picture but still appears somewhat grainy. Do you think that there is anything I can do to \"reverse\" this? MattKW: It's more a result of your misaligned teeth. That is not the degree of recession you need to worry about." + }, + { + "id": 132, + "title": "Swollen and bleeding gums for more than 10 years", + "dialogue": "abmjed: I am suffering for a very long and need your help/advice. I have deep pockets in my gums. My Dentist thinks food particles get stuck in the deep pockets and cause my gums to inflame. This inflammation results in a bad breath that is taking a toll on my social life. My dentist cannot offer any permanent solution and is asking me to come for cleaning every two months. My gums have receded substantially. I floss, brush and even use a water pike after eating food but the inflammation does not go away. Food seems to inflame all teeth except the front and bottom teeth. I will appreciate any advice for a permanent solution to my persistent issue. MattKW: Go see a periodontist (gum specialist). The best money you'll ever spend." + }, + { + "id": 133, + "title": "Wife gums and bone level question.", + "dialogue": "lost_in_translation: Hi\n\nMy wife was looking at her medical records and her dental appoints were tagged with \"chronic periodontitis\" but she said no dentist has ever mentioned that she has that to her. As I had a bad experience with our last dentist (getting a wisdom tooth pulled) and we were due for a checkup we made an appointment with a new dentist. We are in a non English speaking country so it is harder for me to speak to the dentist. \n\nI did some research online before the appointment and we asked and were told that my wife does not have periodontitis. I asked about why her bone levels seem low, they did some quick probing and told us based on the x-ray, probing (no bleeding) and how the gums look that my wife doesn't have periodontitis. They did not say why her bone levels seem low. \nThey did say that she has some risk for developing periodontitis though and she needs to floss. \n\nMy wife is now flossing almost every day (misses the odd day every so often) and brushing twice daily 3 minutes with a sonic toothbrush along with a anti-cavity rinse 3 - 4 times a week. We have also committed to seeing the dentist every 6 months. \n\nThey also said that she has a cavity between her teeth (I didn't catch where) but that it was small and would be a shame to have to fix it as it needs to be drilled from the top. They said that they would keep checking if it progresses. I don't know which tooth it is but have circled the two possible locations I can see based on what I learned from the internet.\n\nI have attached the recent X-rays and a different x-ray from 6 months ago along with a picture showing my wife's gums. We know that my wife has notches near the gums on some teeth but she says they have been like that for more than 10 years and haven't got worse. \n\nCan I get your opinion on my wife gums, bone level and cavity? My wife is kind of freaking out about things currently (not so much about the cavity as she has had many before but her gum issues). My wife is 36 and we don't want her to end up losing her teeth at 50 or something. MattKW: Yes, her bone levels are lower than I'd expect to see. It is possible that she had chronic periodontitis in the past but that it has stabilised. No sign of calculus deposits on the xrays. I'd be cautious and go see a periodontist for a good assessment. \nWith gaps between her teeth like that, I'd recommend interdental brushes because the floss may not get it effectively. If you can find them wherever you are, Piksters are a good brand - maybe a size 3 or 4 for her.\nThose are small holes that don't require fillings. They should be reviewed every 2 years with Xrays and shouldn't progress with a good diet and hygiene. lost_in_translation: Thanks for your reply.\n\nI did think about that but as far as I know she v had v\n\n\nMattKW said:\n\n\n\n\t\t\tYes, her bone levels are lower than I'd expect to see. It is possible that she had chronic periodontitis in the past but that it has stabilised. No sign of calculus deposits on the xrays. I'd be cautious and go see a periodontist for a good assessment.\nWith gaps between her teeth like that, I'd recommend interdental brushes because the floss may not get it effectively. If you can find them wherever you are, Piksters are a good brand - maybe a size 3 or 4 for her.\nThose are small holes that don't require fillings. They should be reviewed every 2 years with Xrays and shouldn't progress with a good diet and hygiene.\n\t\t\nClick to expand...\n\n\nI did think about that but as far as I know or she knows she has never had any special treatment for periodontitis (other than the regular scaling they give everyone) before and my understanding is it doesn't just stabalize by itself.\n\nI will mention to her about seeing a periodontitist.\n\nWe tried interdental brushes a while ago but she had trouble positioning them at the back as she has all four wisdom teeth things go back a long way and ended up stabbing herself.\n\nI thought her gaps don't seem that bad or much different than mine although mine are probably caused by aggressive brushing as a teen as my gums are fine.\n\nDentist told her to floss and make sure to floss all the way down between the tooth and gum. Would a brush clean that area? I can see it would be good to clean the space though.\n\nIt's good to know the cavities aren't an issue yet, the top one looks visible in the previous x-ray but I wasn't sure the size because of the overlap in the new one. Hopefully the improved care at home (flossing etc) and diet (not sure how much has changed there) will keep it stable.\n\nDentists here get a bad rap from foreigners as either slack and not treating until severe or overtreating due to health insurance. It's nice to know that we seem to have found a good one\n\nThanks lost_in_translation: Is the top molar actually have a cavity and how deep is it? I am trying to look up details online about remineralization but it depends how deep it is. MattKW: The lesions are monitored these is by Xrays; that's the only way to see if it's active or inactive. So the next set of Xrays should be in 12 months, then maybe stretch it to 2 years but no longer. They don't always remineralise to the point of disappearing from an Xray - think of them like a scar. lost_in_translation: Thanks,\n\nThey told me their policy is they will take x-rays every 12 months unless there is a reason to take more frequently.\n\nWith my wife's history of cavities every couple of years (as can be seen above ) we will make sure they keep a close eye.\n\nHopefully her improved cleaning routine and diet will put an end to them as my wife still thinks cavities are pretty much inevitable." + }, + { + "id": 134, + "title": "What are these lumps next to my canker sore", + "dialogue": "LizO65: Hey, i have a canker sore that hurts extremely bad. i’m not so sure what to do about it or if i should go to my doctor about it but is it anything to worry about? Anon1234: I get these very frequently and they are quite painful. That looks like a large sore and they usually heal within 2-3 weeks depending on how severe the canker sore is. 2 suggestions for you.. a warm saltwater rinse 2-3 times a day will help relieve pain and avoid acidic foods as they will irritate the sore more. Overall, I don’t think there is any need for you to visit the doctor unless the pain is unbearable. Often they will prescribe cream or a rinse that will relive pain. Just rest up and consider my suggestions, then if the sore is still persistent or getting worse, then it would be wise to visit the doctor." + }, + { + "id": 135, + "title": "Partial or dentures?", + "dialogue": "MaryKay: I'm 73 and my teeth have always been in good condition. I have had many bad experiences with dentists so regular visits have not been done.\n\nLast May, I had a gum abscess and went to my husband's dentist. He's a good dentist and seems gentle...which means a lot to me. I was told I have 2 upper back teeth on the right that are loose due to bone loss so implants are not an option. He suggested a partial. I also have periodontal disease and he wants to scrap my gums and root plane. I can't tell you how traumatic this all sounds to me! I did not get the teeth pulled and now I have another infection in my gum where those teeth need to come out. Alongside those teeth I have a tooth that has the whole back missing. It was filled 20+ years ago and it broke off and it's close to the gum. The front of that tooth is fractured. My front tooth on the same side is nothing but filling. It's been ground down so much over the years that a filling is almost impossible to stay on. I didn't get a crown on that tooth because of the cost.\n\nBasically, my upper teeth are starting to fall apart. I have fractured teeth on the left side that will probably break in time.\n\nI will be seeing him next week to get antibiotics for the infection and talk to him about options when I get the 2 back teeth removed. I'm looking for any additional input. Thanks MattKW: You shouldn't get antibiotics unless you have a severe and spreading infection. Talk to the dentist about the state of your teeth, the options available, then make a move to sorting it all out." + }, + { + "id": 136, + "title": "Sore gums", + "dialogue": "Maxmax: I am a 66 year old female with excellent teeth and gums. Recently I have been experiencing sore gums. I went to my dentist and he could not find any reason for the pain. He prescribed Chlorhexidine (Peridox) rinse 2x a day for 3 weeks. The pain went away but after a week off the rinse the pain is now back. My dentist suggested using the Chlorhexidine for another 30 days. Anyone experienced anything like this issue? Thank you honestdoc: If there is no explainable source of pain, it could be from an autoimmune response. Did you use any new toothpaste, cinnamon products, new medications, herbal & other daily supplements, etc.? Are you on any hormone replacement therapy or any details that may explain any changes in your daily routine that may have coincided with the gum pain? Maxmax: honestdoc said:\n\n\n\n\t\t\tIf there is no explainable source of pain, it could be from an autoimmune response. Did you use any new toothpaste, cinnamon products, new medications, herbal & other daily supplements, etc.? Are you on any hormone replacement therapy or any details that may explain any changes in your daily routine that may have coincided with the gum pain?\n\t\t\nClick to expand...\n\nNo new anything so you may be right. Any suggestions as what to do next? honestdoc: Hopefully the gum pain can heal. If still present after 10 days, have your dentist prescribe Kenalog in Dental Paste. However, it is so important to rule out any possible infection because Kenalog although mild, will suppress your body's ability to fight off infection. It is best to identify the source of possible autoimmune response. I can't analyze your daily routine or habits. If you use cinnamon products or anything listed previously and don't or forget to tell me, I can only guess. Maxmax: honestdoc said:\n\n\n\n\t\t\tHopefully the gum pain can heal. If still present after 10 days, have your dentist prescribe Kenalog in Dental Paste. However, it is so important to rule out any possible infection because Kenalog although mild, will suppress your body's ability to fight off infection. It is best to identify the source of possible autoimmune response. I can't analyze your daily routine or habits. If you use cinnamon products or anything listed previously and don't or forget to tell me, I can only guess.\n\t\t\nClick to expand...\n\n\nThe only other trigger that I can think of is my cholesterol medication. Have you heard of this causing a autoimmune response? Thx honestdoc: I don't know for certain. It may be the inactive ingredient such as any fillers, dyes, etc. Have your dentist evaluate it and ask if Kenalog in dental paste is appropriate. If so, the affected area should clear up." + }, + { + "id": 137, + "title": "Thin red line in gums", + "dialogue": "melisa: Hello, I'm in treatment for gingivitis (specially in my upper front tooth) and periodontits and after a few days of dentist appointments and cleaning I have seen a real improve in my gums, they are not bleeding anymore when I brush my teeth and the red color has almost gone, but there is stil a very very thin and red line but not exactly in the gum line but a little over it, in the border between the healthy zone of my gums and the zone where it was more red (and now almost pink after the treatment), as if it were limiting the two zones. I had the gingivitis untreated many years and I have there a very old bridge that needs replacement. \n\nThis red line it could be because the chronic inflammation or the bridge? Or I will be worried that it could be a more serious thing? I have no pain at all.\n\nThanks! MattKW: Photos?" + }, + { + "id": 138, + "title": "Exposed roots. What will fix this?? On both canine teeth!", + "dialogue": "Mbaker9: Please see photo. What will fix exposed roots on canine teeth? MattKW: Go see a dentist. The rest of your teeth could be revealing, but I see poor oral hygiene as a possibility. Drdbp1984: Mbaker9 said:\n\n\n\n\t\t\tPlease see photo. What will fix exposed roots on canine teeth?\n\nView attachment 2815\n\nClick to expand...\n\nYou would need good general dentist who can do Class V composite ( tooth colored)restorations for those teeth and prescribe you Prevident 5000 tooth paste and go over some home care instructions." + }, + { + "id": 139, + "title": "Healing tooth", + "dialogue": "AVM: Hello,\n\nThis 3.6 molar after an infection 1 year ago:\n\nHow it looks? Can I do bone addition? I'm also slowly moving it with the ortho to cover the gap. Please give an opinion on how to take more care of it.\n\nThanks! MattKW: Looks OK there. (What is the point of an inverted image?) \nBone addition? Why? That's something to consider after ortho is finished anyway. Unusual-looking bracket placement.\nYour orthodontist will instruct you how to maintain your dental health. AVM: MattKW said:\n\n\n\n\t\t\tLooks OK there. (What is the point of an inverted image?)\nBone addition? Why? That's something to consider after ortho is finished anyway. Unusual-looking bracket placement.\nYour orthodontist will instruct you how to maintain your dental health.\n\t\t\nClick to expand...\n\n\nThanks for replying. Well, the second molar root looks much stronger then the first one. The first one I see some black lines on the roots?\nI think I need bone adition because of the missing pre-molar. Also I have lost some partial bone on the molar during 10 years... MattKW: You don't need bone addition at all." + }, + { + "id": 140, + "title": "Multiple Extractions of the few teeth I have...", + "dialogue": "Blue Bonnet: Should I go ahead and let my dentist pull my last upper 6 teeth and lower 9 bottom teeth?? He recommends a full upper denture because my bone loss will not take implants and on the bottom to pull these as well and get a denture with 2 implants for the denture to adhere to. I'm just curious... I have a hard time doing a full extraction - hard to accept because I can't believe this is where i'm at at 62. What should I do ?? I've been pulling one tooth at a time thus far and I have had to have 2 upper partials made and just haven't ever has a lower partial and have made do with upper only. Insurance of course will not cover a new partial except for in a certain time frame so I obviously have to consider do I really want to spend the money or do I just pull them all and get a full top denture and have 2 lower implants for a full denture to adhere to... Don't know what to do. honestdoc: Are you having pain and swelling? Are you having difficulty chewing and functioning? Are your remaining teeth loose? Maybe you can provide images and x-rays." + }, + { + "id": 141, + "title": "Cleaning order for teeth?", + "dialogue": "Tolkienista: I'm new to this forum, so hi everyone! Anyway just a quickie. What order should I be cleaning my teeth at the end of the day. I've generally gone with 1 electric toothbrush 2 flossing and 3 interdental brushes. However on a recent visit to my dentist he said, wrong order. It should be 1 flossing 2 interdental brushes 3 electric toothbrush. Who is right? Had an appointment this evening with my hygienist based at my periodontist and forgot to ask her opinion. Many thanks. honestdoc: Your dentist is right and your hygienist will confirm. The electric toothbrush will be last as a final clean of all the debris and plaque loosened by the floss and interdental devices. Tolkienista: Thank you for your reply honestdoc. I must admit I prefer doing it in the order you're confirming. I spend a lot of time on my cleaning regime and though time consuming, I'm hanging on to my teeth and my periodontist is happy too." + }, + { + "id": 142, + "title": "Do dentists always mention receeding gums ?", + "dialogue": "Hiyaa: I have a feeling my gums on my bottom front teeth are receeded because they look lower than my other teeth nearby and theres a gap . I visited a dentist in early september and she didn't mention it she only told me they were really inflamed after being cleaned . Am i just being paranoid ? MattKW: Pic? Hiyaa: I'm sorry, it's really hard taking a decent picture of your own teeth . I sont know if this is useful but I tried MattKW: You have a labial frenum which is attached at a high position between those incisors. It's not so much that your gums are receding but that the attachment is pulling the gums away. I would go to a periodontist for a possible frenum release. Hiyaa: Thank you for responding, why would my dentist not mention that ? Is it an issue MattKW: It can become more of a problem as you get older, and is well worth seeing a periodontist now. Hiyaa: Thank you , I'll ask about it" + }, + { + "id": 143, + "title": "Swollen gums and lymph nodes overnight from no problem day before", + "dialogue": "TimGoodwin: I have had some problems in the past with my gums such as repetitive bleeding and soreness but after doing root planing and scaling four years ago and a strict dental hygiene routine I have had no issues at all and no bleeding whatsoever. Until now. Three months ago my gums overnight inflamed and started to bleed across three teeth and my lymph gland under my jaw also swelled on the same side. The inflammation and bleeding spread to all my gums over two days before I managed to see a dentist. From one day no problems or bleeding to so sensitive I could not touch them and bleeding a lot. My Dentist said that I had very mild gingivitis but no idea why the gums and lymph glands would have puffed up so much. I took antibiotics and it cleared up for two months. Then the same thing happened again completely fine gums and brushing when I went to sleep to bleeding swollen gums along with the lymph gland in the same place as before. This time I got a deep cleaning done and used chlorohexadine and it went away for another month. Then yesterday gums around a different three teeth on the opposite side puffed up and my lymph gland swelled up as well. Inbetween these occurrences I have no bleeding sensitivity or any other problems at all. I know I have receeding gums in a couple of places and 1-3mm periodontal depth. I really want to have some idea what is causing these issues and how it can go from nothing to so severe in the space of an evening. I have never had swollen lymph nodes before with any of the previous gum problems in the plast which were much worse than now. If anybody has any suggestions of what may be causing it as I am now starting to think this is a symptom of something else. Thanks for any help Busybee: What sort of diet do you have? Do you drink or smoke? Are you taking any medications? honestdoc: Please provide x-ray images of your bone levels. I'm suspecting you have attachment loss and you may be getting debris stuck underneath the undercut areas (such as root bifurcation, etc.) initiating the acute inflammation. TimGoodwin: Busybee said:\n\n\n\n\t\t\tWhat sort of diet do you have? Do you drink or smoke? Are you taking any medications?\n\t\t\nClick to expand...\n\nI don't smoke and never have done. Drink yes sometimes wine or beer but probably no more than a couple of glasses a week. I did have wine the last time it happened and beer the first time but I don't remember for the second time. My diet is good probably not amazing but its good. I eat lots of vegetables and some fruit. Red meat a couple of times a week, chicken and a few days vegetarian. I am trying to cut down on bread as I know its bad for people with problem gums. TimGoodwin: honestdoc said:\n\n\n\n\t\t\tPlease provide x-ray images of your bone levels. I'm suspecting you have attachment loss and you may be getting debris stuck underneath the undercut areas (such as root bifurcation, etc.) initiating the acute inflammation.\n\t\t\nClick to expand...\n\nI only have a CT scan of my teeth no X-rays unfortunately. I am going to the dentist again today to talk about this maybe I will get some x-ray pictures done then Busybee: Have you had a normal blood test result recently? honestdoc: With further information on your diet, I'm really suspecting you get a lot a food debris trapped under your gums (no x-rays to confirm attachment loss). Have your hygiene team discuss waterpik and other hygiene devices to manage such areas. When you have attachment loss, you tend to accumulate more debris due to increased undercut areas (I have this problem myself). TimGoodwin: Do you get this with the swollen glands under the jaw as well? The main concerning thing for me is this as well as the speed with which the gums seem to react\n\n\n\n\n\nhonestdoc said:\n\n\n\n\t\t\tWith further information on your diet, I'm really suspecting you get a lot a food debris trapped under your gums (no x-rays to confirm attachment loss). Have your hygiene team discuss waterpik and other hygiene devices to manage such areas. When you have attachment loss, you tend to accumulate more debris due to increased undercut areas (I have this problem myself).\n\t\t\nClick to expand... honestdoc: It's hard to answer some questions even with a thorough exam, x-rays, health history, etc...much harder without. I can't explain the speed and the cause at this point. Maybe if you had some medical conditions such as diabetes or some debilitating condition, attachment loss, and deep gum probing depths, then maybe help confirm my suspicions. I've been a dentist for over 21 years and I can see the patterns and tendencies but cannot predict or answer all questions. A_s: Do you have any past/current medical conditions or medical conditions that you are unaware of? Do you take any medications? Do you have any drug allergies or other allergic reactions before? Do you take any supplements? Do you have a regular general health check-up with the doctor? When was the last general checkup? What was the recent blood exam like? Did you have any recent infections? Would recommend to see a doctor." + }, + { + "id": 144, + "title": "Wisdom Tooth Infection", + "dialogue": "Dizzian: Hi There,\n\nI have had this ongoing wisdom tooth problem for a month now. Around 1 year ago I woke up one day with the flap of gum hanging over my wisdom tooth very swollen and incredibly painful, I went to my dentist who said I have an infection so he cleaned it and gave me antibiotics, first a dose of amoxicillin which didn't work and then metronidazole which seemed to clear the pain and the infection for around a year.\n\nMost recently I felt a bit of pain in the area so I went back to the dentist as I didn't want it to end up like the first time, he cleaned out the area which seemed to reduce the inflammation and pain, a week later I noticed I was still getting pus coming out of the flap, although no pain or swelling, I went back to the dentist and he gave me amoxicillin again this didn't clear the pus, I then got metronidazole which didn't do anything either... he then decided to cut the flap of gum hanging over the tooth off in hope that cleaning and saltwater will resolve the problem, for the first weak I wasn't able to clean it really due to the pain during the recovery however now that the gum has healed I can do so.. yet I am still getting pus coming out when I press on the side of the gum? My tooth is actually coming out in the correct position so I'd rather avoid extraction if I could?\n\nAny help would be great,\n\nThanks, MattKW: No, your tooth doesn't have enough clearance to prevent infections from getting in a round the back of the gum. That's why you still have pus. Have it extracted; you've had 2 \"warnings\" so far, next time it may be worse. A_s: The best option is to extract the wisdom tooth. Or can still have recurrent pain in the future." + }, + { + "id": 145, + "title": "Implant Bone Loss", + "dialogue": "CynthiaZ7: I have had an implant in a molar for several years. Good packs around this tooth. Recently, I have had soreness in this area. Dentist says I have bone loss and should see periodontist for possible bone graft. However, I have Osteoperosis. What would you advise. Is there an alternative to bone graft. MattKW: It may be that the periodontist simply stabilises your condition. You will have to discuss your issue with them; the general dentist won't know for sure what will happen. go for a consultation and take xrays from time of implant and intervening periods." + }, + { + "id": 146, + "title": "I need advice ?", + "dialogue": "Question?: So, my front teeth are really spaced out in general and I want to get braces to fix this . But my gums in the front are really low , especially considering I'm not even 18 yet it's not supposed to happen to people under 40 ? I'm worried that If i did get braces it would really badly damage my already low gums ..would my teeth have a better chance when I get older if i didn't get braces ? honestdoc: Receding gums usually results from some kind of trauma as well as deteriorating gum disease. Having braces can potentially introduce more trauma or stress. Have this conversation with your dentist and orthodontist. Question?: honestdoc said:\n\n\n\n\t\t\tReceding gums usually results from some kind of trauma as well as deteriorating gum disease. Having braces can potentially introduce more trauma or stress. Have this conversation with your dentist and orthodontist.\n\t\t\nClick to expand...\n\nThank you I'll make an appointment with my dentist for more advice Nandhini K M: Braces might worsen your present condition. Firstly, sort out the cause for receding gums by consulting the dentist because you are too young to have spaces between teeth and lowered gums. If it is not because of local factors like gum infection or something, check your calcium, thyroid and parathyroid levels as well." + }, + { + "id": 147, + "title": "Receding Gum Line Behind my Lower Front Teeth?", + "dialogue": "Kehoecolin01: I'm not entirely sure if my gum levels are normal or not, and it worries me, because I realized in the mirror the other day that I can see lower bits of my teeth.\n\nI've tried attaching the best photos I could get (it's kind of difficult). Every other part of my mouth is perfectly normal.\n\nAm I worrying for nothing? Are my gum lines perfectly normal? Or should I see a periodontist? MattKW: Looks good to me. Kehoecolin01: MattKW said:\n\n\n\n\t\t\tLooks good to me.\n\t\t\nClick to expand...\n\nOkay, I am also going to attach some more pictures for a maybe clearer view. I plan on going to a general dentist soon anyway. My front teeth in general worry me, but maybe I'm just paranoid. MattKW: You're overstressing, and you're not paranoid, you're just a bit neurotic." + }, + { + "id": 148, + "title": "Gum Graft Surgery", + "dialogue": "Peter2019: Hello everyone,\n\n It is now day nine since I had my gum graft surgery. Alloderm was used and stitched onto the gum around about seven teeth on my lower jaw . My concern , that has brought me here , is that the gum is not attached to my teeth . Will it attach with more time ? If it stays like this then bacteria will collect inside the pocket between the gums and teeth. That would be worse than it was before because my gums were attached to my teeth and there was no pocket. I hope you can understand what I am saying ? The gums are flush with my teeth but can pull away because it is not attached. honestdoc: Go back to your surgeon. The graft should be attached and have full blood supply nourishing it. Peter2019: honestdoc said:\n\n\n\n\t\t\tGo back to your surgeon. The graft should be attached and have full blood supply nourishing it.\n\t\t\nClick to expand...\n\n\nThe graft is attached to my gum and it does have a full blood supply. The issue is that I don't see it attached to my bone (teeth) . The surgeon saw me just two days ago when he removed my stitches. honestdoc: I'm thinking you had a connective tissue graft or a free gingival graft. It does not cover your teeth. When you have severe gum recession, you have inadequate keratinized tissue (attached stronger tissue) next to movable mucosal tissue (not as sturdy). The graft is to reinforce the inadequate attached tissue. Unfortunately the graft will never cover the teeth. Peter2019: honestdoc said:\n\n\n\n\t\t\tI'm thinking you had a connective tissue graft or a free gingival graft. It does not cover your teeth. When you have severe gum recession, you have inadequate keratinized tissue (attached stronger tissue) next to movable mucosal tissue (not as sturdy). The graft is to reinforce the inadequate attached tissue. Unfortunately the graft will never cover the teeth.\n\t\t\nClick to expand...\n\n\nOkay, but won't bacteria collect and multiply between the teeth and the \" movable mucosal tissue \" ? I am surprised that there isn't a glue that they could use, to attach it to the teeth, to prevent bacteria from collecting in the pocket ?" + }, + { + "id": 149, + "title": "Just had a dental implant ... complications.", + "dialogue": "route415: Question! I'm an active healthy 42/F and had a reabsorption issue on my front tooth, leading to an impromptu implant 2 months ago. The tissue on my upper palate is receding around the implant (pic attached). I also have been feeling a bit flu-like since last week, and experiencing continued achiness up in that area & my lymph nods around my throat have been off & on swollen since the procedure ... I was just rolling with it ... but i'm not getting better and just booked an apt. for a follow-up ... after spending $4614 on this procedure (no medical insurance). Not sure if I'm experiencing rejection, thus the symptoms ... what should I be asking? Attached the tooth + recession for reference. I could really use some insight. honestdoc: Did your dentist place a temporary bridge over the implant site? From the image, there may be some bony dehiscence/fenestration. I don't see a healing cap. It is unusual to quickly place an implant on a resorption site without having solid bone. Please provide an x-ray image. (I had 2 of my dentist colleagues look at your picture). MattKW: Looks like a temp composite abutment over an implant. Go back to dentist then repost here with any further info. An xray would be helpful." + }, + { + "id": 150, + "title": "Arestin???", + "dialogue": "John Anthony: Our local dentist retired a few years ago and sold the business. Never once did he administer or even talk about Arestin. Neither did the guy that bought the business, but he resold it within a year. The new owners are pushing Arestin.\n\nMy wife is 78 and has a couple minor issues, but as far as we can tell, no bleeding gums, etc.\n\nHer second visit with them (without warning), they applied one dose of Arestin and I was presented a bill for $165. I asked the receptionist if there was a cheaper drug they could use that would be 90% as effective, joking to her that we aren't made of money.\n\nShe took me back to discuss that with the hygienist, who said no, we use this because it works.\n\nShe was back in the chair today for cleaning of another quadrant and repair of a broken molar. I dropped her off, then went to the post office. When I returned, I was presented a $330 bill for two applications of Arestin, code D4381. Procedure D4921 and the office visit were covered by insurance.\n\nBut, they didn't have time to repair the broken tooth, so we had to reschedule. She also has a chipped front tooth that she wants repaired, so they warned us there will be another application of Arestin in THAT area next time. The appointment card notes we will be charged $165 next visit, for another D4381.\n\nA young guy came in while I was paying my bill. The receptionist greeted him and said it's been a while. I returned to my chair, and I could hear her working up a quote for him. I am pretty sure she was giving him the hard sell on Arestin, asking him if he wanted to go forward, and was he prepared to pay this today, etc. I'm not in sales, but I thought, this sounds like a sales pitch, complete with closing lingo.\n\nIn the car, I told my wife I don't have a good feeling about this, so I went on line when we got home and found a lot of complaints about Arestin at dentalbuzz (dot com)/2014/09/05/arestinredflag/\n\nYou know what to do to fix the above link. I don't know if it's ok to post links, so I did that.\n\nShe wants to go back and talk to them about using this, but of course they are going to say you need it, etc. Other than that, they are very caring and seem to do good work, so it's hard to chuck them over a suspicion.\n\nBefore speaking to them, I want to discuss this with our insurance, DeltaDental. \n\nOne more thing, about my bill. The appointment card for today's visit shows procedure D4342. When we made the appointment last month, the hygienist said she wouldn't be doing D4381, so we wouldn't have to worry about that. Today, the receptionist said no, I told you. Well, she didn't, and it's not noted on the appointment card. The only procedure listed is D4342.\n\nIs today's bill disputable?\n\n\nOff topic a bit, maybe not, though. We have both been on the ketogenic diet for eleven months. She has lost over 50 pounds, I'm down over 40. Shazam! I noticed my gums no longer bleed when I brush or floss or use toothpicks! I have a descending front tooth that the previous owner of the clinic said would have to come out. It's a bit unsightly, but is no longer loose. Apparently, my previous high sugar diet was feeding all the bacteria. Busybee: We don't have this product in the UK which says a lot because our medicines are carefully screened. But if you don't want it I don't understand why your wife should have to keep having it. It appears to be a topical antibiotic. Sounds like your surgery doesn't have any treatment protocols around this product. If you don't want it just say so. Your dentist should talk you through the treatment plan before you turn up. You should sign it and agree to it having been briefed on the risks and benefits. It's your treatment not the dentist's. Carbs and sugar are known to be bad for your teeth and gums so I'm sure cutting down helps all round. A good toothpaste and floss helps too as do regular hygiene appointments. John Anthony: Busybee: Thanks for your reply. honestdoc: You and your wife are getting scammed. Most likely the hygienist is getting production compensation...more she produces, more money she gets. A lot of dental offices unfortunately upsells unnecessary work especially in expensive cities where housing and rents are sky high. John Anthony: Thanks very much.\n\nI'll let you know how it goes. MattKW: Waste of time and money in your case. You have a right to say NO, and they should back down. If they don't, then get out of there." + }, + { + "id": 151, + "title": "Periodontal disease.", + "dialogue": "Raina: A few weeks ago, I noticed that some of my gums for one of my bottom teeth had receded. I looked online and believe that I have periodontal disease. I have an appointment with my dentist next Thursday but am scared to find out what he says. I apologize for posting pictures of my teeth, but this is the only way for you to get a pretty good indication of how much gum has been lost. So I am just asking how bad it is. I have both health and vision insurance, but never got dental insurance. How much would it be to get a gum graft for this? Also, does it look like some of the gum from my other two teeth is beginning to recede? Thank you for your help. calcium48: most teeth are lost through gum disease, rather than tooth decay drmins: It looks like your gum recession is due to an improper bite and needs an orthodontic intervention along with periodontal care.\n\n(Desclaimer: Online consultations are never equivalent to a detailed physical examination.The actual diagnosis may differ based on clinical findings that cannot be read from the photographs.) Aspatria: See a periodontal specialist as soon as you are able. I have to wait 3 weeks to see one here in the UK as the appointments are so booked up everyone where.\n\nI was seeing my dentist for nearly 10 years. He didn't refer me to a periodontist and subsequently I have now advanced bone loss at the top right of my right jaw and in other places. I only went in for a minor filling and came out in gnawing pain from the dentist last week - I have no idea how the problem (pain) got triggered during the appointment as I was totally pain free before I went it.\n\nI was shocked when the dentist's colleague saw me last week and said she can refer me to a periodontal surgeon. Why didn't the other dentist (her colleague) do this years ago when it was obvious the problem was getting worse?\n\nI feel ashamed to say I didn't know what a periodontist was until she explained it to me! I didn't even know they existed!" + }, + { + "id": 152, + "title": "Tooth fracture on tooth and pimple-like bump on gum? Extraction?", + "dialogue": "Ren2day: Hi,\n\nI was experiencing little pain when chewing / biting on that side that prompted a visit to dentist. I was sent by my dentist to an Endodontics for evaluation for a lower right second molar tooth (#31), as she believed it may need root canal to save tooth. There was also pimple-like bump that showed on the buccal side of gum on said tooth. \n\nThe Endodontics said there was deep vertical defect/crack on distal aspect of tooth observed on radiography and bone loss; and recommended extraction for implant or partial denture versus root canal. The vitality test conducted was normal response. I am attaching the x-rays taken. It was not specified how deep the crack was, if beyond the gum line.\n\nCurrently, there is no pain when chewing on this tooth after my regular dentist advised me to not chew on that side for awhile. I also popped the pimple-like bump on gum and gum seemed normal for about a week, then flared up again with pimple-like bump today after lunch. \n\nCan this tooth be saved with a crown? Or can the crack be bonded/sealed? Or will a visit to a periodontist help resolve the pimple-like bump that seems to resurface after a few days when tooth is used for chewing? Though, there were ocassions the gum looked normal even after chewing on said tooth. Am not on any antibiotic, other than prescribed to gargle with peridex mouthwash. \n\nThank you for any input.\n\n\n-Ren MattKW: An endodontist took those X-rays? They're not good enough for a general dentist be proud of.\nThe signs and symptoms doesn't make a lot of logic. If the tooth was vital, then the pimple-like bump (with pus?), can't come from that 2nd molar. Was the 1st molar tooth in front tested for vitality too? And there's a darkness between the roots of the 1st molar that isn't totally encompassed by the X-ray.\nCertainly there is some bone loss around 2nd molar, but not enough info to judge more. You need vitality test of both molars, and better X-rays. Ren2day: The first molar has a crown on it. The endo did a tapping of tooth test on a few teeth before the second molar, and I did not feel any pain except for when tapped and poked the bump on gum of toothe #31.\n\nThe endodontist said that food might have lodged into the crack on distal aspect of tooth, that caused the gum problem. When I poked the bump, there was little bit of light creamy substance (pus I think) and blood came out. During this time, whenever I run floss on the back of this tooth or touch the edge of this tooth, there will be slight pain felt. Below was the finding by endodontics on March 13:\n\n\"normal response to vitality testing, lamina dura at apex appears intact, deep vertical defect on distal aspect observed radiographically, draining sinus tract on buccal keratinized gingiva, 12mm probing depth on distal aspect, crack on distal aspect.\"\n\nThis morning, there is no pimple like bump on gum on buccal where tooth 31 is. I have not made appt to extract tooth yet, as the pain when chewing on that side went away. Also, the pain when running floss or touching edge of tooth went away these past couple days. I've also started drinking a cup or two of milk every day since my visit to endodontics on March 13. And, added taking vitamin K2, Curcumin, Coq-10 daily. I've also made a mixture of coconut oil, calcium bentonite and calcium carbonate and rub/brush it on back of this tooth. So, not sure if these help why pain seems to have dissipated when running floss or touching edge of this tooth. The pain when chewing was gone too, after a month of not chewing on the right side of mouth. \n\nThe main problem I am having now is the on and off resurface of pimple-like bump on buccal side of gum where toothr #31 sits, usually when I heavily use this side for chewing. There was, however, no bump for 7 days, after I had popped it. And it resurfaced yesterday after a meal, albeit smaller bump than when I first popped it. What is happening on this tooth? To extract or not? Ren2day: Here is the defect highlighted by the Endo office when I requested to highlight where the vertical clefting defect shows in the x-ray. Endo said, \"You can see it on the original image as a darker area adjacent to the root. It goes far below your gum line and extends to the very tip of your tooth\"" + }, + { + "id": 153, + "title": "Dentist error", + "dialogue": "Aspatria: Hello,\n\nI've been under the care of the same dentist for the past 9 years or so. It's a reputable private practice here in the UK.\n\nI went in to the first appointment with Whoopi Goldberg syndrome - totally unaware of gum disease - around 8 years ago or so. I thought my teeth were fine and that a filling would be needed. It turned out they were not fine and I had early signs of gum disease, with pocketing in a few teeth, up to 4mm in two of them.\n\nThat dentist, who was the most senior dentist at the practice, more or less wrote off my teeth there and then, some 9 years ago. He didn't create any care plan, nor refer me to periodontist but in the subsequent years that followed more or less managed the decline of them without intervention, except the odd filling or deeper clean of just one of my canines and a visit to the hygienist (when you could get an appointment).\n\nAfter a few years of this coming and going, he was concerned about the tooth behind the canine as it appeared the poor workmanship centred on a filling in it around 20 years previous in another practice had caused trapped spaces and was causing tracking into the bone and thus bone loss. He decided to protect the canine, he would extract the tooth behind, thus removing the bacterial trap. Unfortunately, despite minor bone loss over those 20 years from the original work on the now extracted tooth, rather than slow up the bone loss, the gap that was left resulted in a massive acceleration in bone loss thereafter as the gum went into melt down. \n\nIn other appointments, I visited their hygienists. They cleaned my teeth and after several appointments over some months, I managed to steer my teeth back to some stability The dentist appeared shocked about their recovery. \n\nHowever, over time, the relationship deteriorated with that dentist as he kept returning to the futility of my teeth treatment but I kept confounding him on later visits. Yet he didnt refer me on to deeper treatment.\n\nThe hygienist at the practice was difficult to book appointments with, taking 2 months or more to be able to book a slot for cleaning. When I attended the appointments, the cleaning appeared inconsistent. I didn't feel they were being cleaned consistently as they appeared rushed at times to do the same routine. Despite my efforts, my teeth would start bleeding again after 6 weeks or so, and by the time the next hygiene appointment came some months later, they were back to square one\n\nThe dentist was his usual doom and gloom on all visits. He really made me feel like some second rate citizen and very uncomfortable, in fact so much so I really didn't want to go but persisted anyway.\n\nI was not aware, as it was not flagged up to me in those subsequent visits, but my two lower front teeth suddenly came lose. He said bridges needed to be fitted. I gave him the job to fit them. He fitted them a week or so later (around 3 years or so ago). Unfortunately, he must have rushed the job since he let the adhesive/cement drip on setting thus creating two pin-like points on the inside of my mouth. I didn't notice until the anaesthetic began to wear off in the evening. By next day I was climbing the wall in pain, and the blood in my mouth scared the life out of me. To cut a long story short, to get rid of the pain, I ended up bracing my front teeth with a wooden stick and with the other hand I reached down with a pair of long nose pliers and snapped off the spikes of cement. Within a hour the pain was gone and the bleeding stopped. The experience frightened the life out of me as I've never known pain like it and pain that couldn't be controlled with analgaesia of any description.\n\nI couldn't bring myself to trust that dentist again and left the practice as a regular patient.\n\nLast year I had a brush with prostate cancer. The condition had left my kidneys badly damaged and the other related organ damage. This meant I was off work for around 12 months due to the poor diagnosis of my local hospital and the preamble with severe urinary retention and other issues. Subsequently I ran out of money and my life was on hold. I was so ill, I was planning my funeral last summer. However, I recovered after surgery and my whole body homeostasis found balance again but only fairly recently.\n\nAfter building up funds again, after returning to work, I needed a filling. I made the mistake of going back to the same practice but was under a different dentist.\n\nI panicked in the treatment room and more or less wanted to leave immediately, as all the experiences from the other dentist came flooding back. I also explained about all the above to the dentist. She became very defensive of the other dentist and started to become less helpful. She said she could refer me onto a periodontal surgeon as my teeth had once again deteriorated. I panicked again since again reminders of the experience from the other dentist further rattled me. It didn't help as she got very shirty with me and then abruptly retorted \"Oh, they won't be able to do anything with those, the bones gone up around them!!\". It was a brutally insensitive statement to make and unwholly called for in that way. Frankly that dentist frightened the life out of me.\n\nI left the appointment. However, later in the day, the work she had carried out on my teeth had resulted in a poor bite and pain. On revisited in the following afternoon, where she was unpleasant and untalkative, she used high pressure water or a drill to excavated in between the teeth and without anaestesia. I almost hit the roof in pain! By this time I wanted out. \n\nThe upshot out of all this is that I was advised to see a periodontist. Yet, why wasn't I referred to a periodontist by the other dentist years ago? The sudden shock of realising that all this time had been lost, when I could have been treated much earlier on, was a total bolt from the blue and has totally knocked me for six. I dont know what to do.\n\nIn my opinion, since understanding the role of the periodontist, I reckon I've been carrying an untreated gum infection for years, and which has led to the deterioration of my gums. I feel very disappointed by this as I now feel I should have been referred much earlier.\n\nI tried to make a complaint to the practice but the practice management have 'closed ranks', so to speak. They have been awful to deal with and obstructed my dental records after I requested them to take with me to the new periodontist that I had self-referred myself to last week. The former practice have been absolutely awful, really uncooperative and caused me really great distress over this past week. I've never felt so isolated.\n\nMy appointment with the periodontist is not for another 2 weeks and I fear since complaining to the above practice, about their two dentists in my previous treatment, they will once again close professional ranks and isolate me by somehow tipping off the other clinician as a sort of inner circle of professional self protection. Maybe I'm being paranoid here but the dentists have left me feeling very distrustful of them.\n\nI fear the only treatment that will be offered will be dentures to shut me up. But after looking at my dental xrays and comparing it with other people with much worse apparent bone loss, it seems to me that my bone is not anywhere near the level of deterioration to right it off. Therefore, I feel bone grafting and implants could be an option. But again, I worry greatly about the other dentists influence in telling the other new dentist/periodontist to stay clear of me. Maybe I'm being irrational but the management of the old practice really were very difficult people to deal with over the past week.\n\nI'm sorry about the long story, which is actually abridged, but I'm hoping that someone can shed some light for me on options and advice, if any.\n\nThank you if you can help as I am deeply worried." + }, + { + "id": 154, + "title": "Gum disease?", + "dialogue": "HealthStatus: Hello! Can anyone please help me with my problem? To start off, I'm 20 years old and I think I could have gum disease although I knew it usually starts much later in life. Nobody in my family has any history of periodontitis or any issues aside from some cases of trauma induced tooth loss. I've had an appointment back in December for a tartar removal and my dentist noticed some localized inflammation of my gums. He said it's nothing too bad and it should heal, however my gums are still red in those areas to this day:View attachment 2359\nMy gums don't bleed at all when I'm brushing. I don't floss but I use mouthwash and interdental brushes and I brush my teeth twice a day." + }, + { + "id": 155, + "title": "Swollen gums", + "dialogue": "bettyboop63: I use oral b electric brush with sensydine toothpaste and brush three times a day. Is brushing too much irritate the gum? The gum with discomfort on one side. I use plaque mouthwash. I use warm salt water. Do I have gingivitis? My gums don’t bleed. Any recommendations? Oceansightdental: Hi there. Brushing too hard can damage your gums, but if you're using the right technique then brushing 3 times a day is acceptable. Using mouthwash and salt water is great, so long as you are flossing your teeth regularly. Just cause your gums don't bleed does not mean you don't have gingivitis. Some people have gingivitis but don't clean their gums properly, so they don't notice bleeding gums even though they suffer from gingivitis. A thorough dental exam, X-rays and probing is required to determine if you have gingivitis and what stage. My recommendations are: (a) don't brush hard, (b) floss, (c) get a check-up and cleaning regularly." + }, + { + "id": 156, + "title": "Bleeding gums, and some bone loss", + "dialogue": "Suziemfd: Bleeding gums have been an issue of mine for over 40 years. When I have prophylactic treatment, my gums bleed. I’ve been told by my current dentist that it’s not normal and is a sign of infection. But I’m convinced this condition is just hereditary as it has affected other females in my family. My medical history is essentially unchanged, and I take a single prescription for hypertension. My daily home care is above average. I brush with Sonicare after every meal, use dental floss and a Waterpik, interdental brushes, plaque remover picks, dry mouth oral rinse, etc. What else could I possibly do?\n\nMy former dentist was “old school” and used hand instruments to scale. Back then, I went for cleanings every four months. The hygienist was rough but I felt she was very thorough. My current dentist for the last five years is very much state of the art. At each cleaning, a pocket depth probe is done and they mainly use an ultrasonic scaler. Dental experts state the vibration of the ultrasonic cleans and the constant water spray flushes away debris. This supposedly leaves a smooth tooth surface for less plaque to accumulate. I’m finding, however, that calculus appears much sooner now. How can that be?\n\nI feel the dentist has a genuine concern for my teeth and what he deems to be mild to moderate bone loss. When he suggested root planning in June, 2017, I had the procedure done. This has been followed up with periodontal maintenance every three months. Upon the dentist’s recommendation, I also visited a periodontist. A saliva test was recently done but the result was inconclusive. I was advised to repeat root planing. There’s been no real answers. Has anyone else had a similar experience?" + }, + { + "id": 157, + "title": "Periodontics and saving a a broken tooth", + "dialogue": "calex75: Sorry for the lengthy post. Those who could be able to answer me may want to read 2 paragraphs and skip to the question at the end.\n\nI recently moved to a new country (Canada). Unfortunately, last Sunday a piece of the tooth #3 broke while eating a pie. This tooth had been filled with an amalgamate about 25 years ago.\nAbout 3-4mm of the enamel detached on the upmost cheek face (if you look at it, roots down). At one point the broken part completely detached and I could clearly see the amalgamate and something reddish below which made me freaked out. I quickly rinsed my mouth (water was not colored by blood) and put back in place the broken part of the tooth (the slight pain vanished within minutes. Miraculously, the broken piece held until I could have an appointment 3 days later on Wednesday.\n\nThe dentist told me that the XRay showed the tooth died (probably from bacteria) and she had to extract it. I managed to keep all my teeth until now (47) in spite of my periodontics disease, and could not take it so I insisted for an alternative. She explained, that in a normal case she would have cleaned the root canal but in this case she couldn't due to my periodontics disease. - On this tooth I would say that somewhere between 50-80% of the bone was missing but the tooth was not loose and my periodontics disease has been stable for the last 5 years-. I started crying and begging for an alternative even temporary. She answered that the only other alternative would be to let me go without doing anything and risk an infection. But that I should not be sad to have it removed, she was going to introduce me with her boss who is extremely experienced and it was not an issue.\nI knew that if for any reason the detachable part would be gone missing I would suffer and would be in trouble so I felt I had no other choice than to trust her and accept.\n\nACT II\n\nTwo days later (last Friday), I met this “exceptional” dentist, and things started badly when he explained me that the best for me would be to have all my teeth pulled off and replaced with an implant. He finished : “Not now, rather in 5-10 years”. But continued : “However, the earlier, the better, one of my tooth was already missing” - I was shocked, never ever in France a dentist told me anything else than : we will do whatever it takes to save my teeth -. He then showed me an advertising with an old man saying how he was happy with his white weird looking implants. He continued and told me that for now he would do a $2000 bridge but I could also stay with a missing teeth. I enquired about the consequence of a bridge for the adjacent tooth (#2 and #4) and he reassured me they would be more solid than before because that would be a big tooth with 2 roots... which is better than one. I was not convinced and answered that 3 roots would be probably even better. And that’s a shame because her workmate had a hard time pulling my missing tooth off. It looks like it really did not want to be extracted. He nodded.\nI pretexted I had first to call my insurance and I would come back toward them.\n\n\n\nBack home I grew suspicious about this bridge. My guts were telling me that my tooth #2 and #4 wanted to be left alone (tooth 4 is loose and missing 60% of the bone). So I googled \"periodontics disease and bridge\". Horror, I can't find a single site not saying that a periodontics disease is a contraindication to a bridge. That my bone would deteriorate hence losing both tooth faster.\n\nHow can this dentist ignore that (he would have a specialty in periodontics according to his resume [removed resume]). Would these dentists pull off my tooth thinking they would be able to pull off all my remaining teeth to sell me one of their fancy prothesis?\n\nNow I feel worse and worse. I barely can eat with my missing teeth. I feel that I was stupid to let her extract my tooth without even googling her name. She has 8 months of experience : [removed removed] .\n\nA question is going back and forth in my head. And I am looking for an answer. Did she do whatever she could to save my broken tooth? Is a periodontics disease really a contraindication to root canal cleaning?\nI also read that if do nothing, my bone is also going to deteriorate (due to the tooth no longer stimulating the bone). On which timeframe should I absolutely meet a periodontist and dentist.\n\nPS: if anyone has a trustful periodontics specialist and/or dentist to recommend on Vancouver, I need help.\n\nEdit : I removed the links to my dentists resume. Although I think they help understand the story. I don't know if the forum rules allow it. honestdoc: Could you provide x-rays? Vancouver is a beautiful city with plenty of great dentists. You may ask your friends, acquaintances, coworkers, etc who they recommend. Unfortunately, more & more dentists are selling you work you may not need or not to your best interest. calex75: I may have some xray tomorrow.\n\nI was right, again , she admitted my tooth could be saved when I announced I was done with them :\n\"[...] Thanks to Ms Bxxxxx, I now know how dentistery was practiced in the middle age, but I don't need a dentist who has not the skills to fix a stupid broken tooth. Neither do my kids.\n\nBest,\"\nShe has too much ethic to listen to her patient, that's why she extracted my tooth:\n\"[...]The only other option to attempt to save that tooth would have been to do a root canal and put a crown on the tooth (which would cost upwards of $2500). Because there was also so much bone loss in that area and the prognosis was so poor, it would have been unethical for Dr. Bxxxxx to attempt this.\n[...]\nI believe Dr. Kxxxx did give you some options on Friday to put something there so you can eat normally[...]\"\n\nBut her boss could only convince me that the only possible option was to keep my tooth and its bone. - A bridge : I doubt my #4 teeth could support it. It is so loose...\n- Nothing : her boss told me that I could stay like that but I don't believe him. My teeth 2 and 4 are going to be extremely vulnerable to efforts perpendicular to their roots.\nConclusion : there was no other option than crowning my broken tooth. Keeping it would continue to stimulate my bone, provide some longitudinal support to my #2 and #4, divide the pressure on the other teeth.\n\nAm I wrong? I really hope they were right to extract this tooth. Whatever they say it sounds like lies and does not make sense to me... calex75: Here, the xray of my teeth.\nWhat do you think about extracting it?\n- Would it be YES.\n- No WAY\n- Or not sure?\n\nAnd more importantly, which option do I have now? What would be the deadline to have an appointment in order to keep all the possible options? 2 weeks, 2 months? 2 years?\n\nThank you, honestdoc: You had mentioned #3 (UR side) broke. The x-rays show UL side so maybe it is flipped wrong? I would never do a bridge 2-4 because of inadequate bone especially #4 being mobile. If #3 has no pain, no swelling, no mobility, leave it and restore it with a conservative filling on the fractured area. \n\nThere was a periodontist that presented a case similar to yours. The patient was able to keep her teeth with meticulous home care and frequent hygiene recalls for over 10 years. All to often dentists and specialists want to sell you expensive treatment in an expensive city like Vancouver BC. Find a dentist/periodontist that share in your best interest of wanting to keep your teeth as long as possible. You will know if the provider is right for you. calex75: Thanks a lot for your answer Honestdoc,\nSorry, I miss-read https://en.wikipedia.org/wiki/Universal_Numbering_System.\nThe broken tooth, which was extracted,was rather #14. The #13 is mobile.\nActually :\n- Although I was not feeling any pain. If I attempted to chew something it would be very painful. Then the pain would vanish within minutes\n- The first time I saw her, she told me she saw some blood so she was suspecting the tooth died;\n- 2 days latter she did the XRay above and told me the absence of a \"white cloud\" in the bone bellow the broken tooth, confirmed the tooth was dead so she extracted it;\n- A few days latter when I cancelled my appointments, she wrote : \"The only other option to attempt to save that tooth would have been to do a root canal and put a crown on the tooth (which would cost upwards of $2500). Because there was also so much bone loss in that area and the prognosis was so poor, it would have been unethical for Dr. Bxxxxx to attempt this.\"\n\nWould you have done that?\nNow that my tooth is extracted, what would you do?\n\nThanks, honestdoc: I am very conservative and many other dentists would disagree with me. My thoughts are...we can always do a root canal, extract, crown, drill, fill, etc as needed basis. We can never undo dental work. \n\nUnfortunately, you do have a lot of bone loss and the longevity of your teeth is questionable. I would never restore your teeth with questionable periodontal condition. I would leave it alone for now...no bridge, no root canal, no implant. I would establish stability in your gums and bone first by deep cleaning (scaling/root planing), frequent recalls like every 3 months to establish stable gum attachments (probing). Once your gums are stable...no bleeding, no deep pockets, reassess how you are functioning in that area. Do you need an implant, partial denture, or leave a space? I would never do a bridge there. calex75: You're right, I wish my tooth could be put back where it was but this can't be undone...\nAnyway, thanks a lot for your time and advice. At least none is going to sacrifice my other teeth with a bridge. joss: It's terrible you got such bad advise. A bridge is a bad idea if adjoining teeth are loose. That's common sense. A Implant would be more expensive than you think, because it cannot be done normally because of your bone loss. You would have to have a piece of bone grafted to your existing bone structure,hope and pray it would take, so there would be something to screw into. They didn't tell you that, did they? \"honest doc\" is correct in that you have to get your gums healthy before making a decision. Too bad you didn't get a second opinion before getting that tooth pulled. Maybe a third or fourth. Once it's gone, its gone forever. \nI do not understand why implants are being pushed so hard. Any reputable doc should try to save your teeth if at all possible. That's my experience, anyway. honestdoc: joss said:\n\n\n\n\t\t\tIt's terrible you got such bad advise. A bridge is a bad idea if adjoining teeth are loose. That's common sense. A Implant would be more expensive than you think, because it cannot be done normally because of your bone loss. You would have to have a piece of bone grafted to your existing bone structure,hope and pray it would take, so there would be something to screw into. They didn't tell you that, did they? \"honest doc\" is correct in that you have to get your gums healthy before making a decision. Too bad you didn't get a second opinion before getting that tooth pulled. Maybe a third or fourth. Once it's gone, its gone forever.\nI do not understand why implants are being pushed so hard. Any reputable doc should try to save your teeth if at all possible. That's my experience, anyway.\n\t\t\nClick to expand...\n\nUnfortunately I am observing a lot of dentist who sees dollar signs and over treat. Many do not have your best interest." + }, + { + "id": 158, + "title": "How bad is my periodontitis? (X-ray)", + "dialogue": "Justsomebody: I’ve been to 2 dentist and the first one who had cleaned out my clean said I have periodontitis and require surgery and the surgery still wouldn’t be able to remove it 100%.\n\nThe second dentist who did the x-ray on my jaw said I don’t require surgery and said “how would the first dentist know without an x-Ray” and gave me antibiotics and to come back in a week.\n\nI can still see tartar under my gum line when I try to pull it down and there’s still a little pus coming out when I press hard against my gum here and there.\n\nWho should I believe ? honestdoc: To diagnose periodontitis, you do need x-rays to see the bone levels and you need gum probings to check for attachment loss. I don't believe in surgery so early especially without x-rays. It may be indicated when the gums haven't responded to deep cleanings and medications. There are many dentists that are production hungry and will over-diagnose & treat you." + }, + { + "id": 159, + "title": "Abrasion or Erosion problem", + "dialogue": "Eddie121212: I have some serious gum loss and tooth Abrasion or Erosion (really don't know the difference) on my lower side teeth and a couple back molars. I think it is from clenching my teeth at night (I wear a mouth guard at night) but doesn't seem to help. My dentist wants to fill the deep pits but I'm wondering if I shouldn't have the gums repaired since there is so much gum loss. I don't even know if that is possible since the pits are pretty deep. I read once that once a filling is put in right above the gum line then the gum can not be repaired because the grafted gum tissue can not adhere to a filling. Is this right? but is gum surgery possible since the pits are so deep? I don't know what to do. Any advice? Busybee: Do you have a photograph you could post?" + }, + { + "id": 160, + "title": "Gum disease or teeth problem", + "dialogue": "Irisekiev: After feeling migrating pain between teeth 4 and 6 (sometimes feels like pain in gums, sometimes in teeth) went to a dentist. Plus 4th tooth changed color to grey. He noticed gingivitis and did xray. After that i was told that there is nothing he can see wrong with teeth. Just grey 4 needs a crown. And all pains are coming from periodontitis. So he prescribed penicillin. 3 weeks ago I had deep cleaning. So far there is no difference and no signs of gum healing. Pain is still there. More between 3 and 4. And higher gums (almost where cheeks are). Gums are red and swollen. I'm brushing, flossing and rinsing with chlorhexidine twice a day. Is possible that dentist missed something? Thank you MattKW: Normally periodontitis doesn't cause pain except in acute phase with lots of swelling. The Xrays are hard to see well, but I wonder if there is decay in upper right wisdom tooth #1? The RCTs seem acceptable. Irisekiev: Thank you for your reply, sir. I'm going to see an another dentist. honestdoc: What kind of pain, what triggers your pain and how intense is your pain? Dr. MattKw is correct that gum disease does not cause pain. Possibilities may be trauma to gums by brushing too hard and or from deep cleaning. Other possibilities may be sinus pain when you have more pronounce pain bending forward, going up & downstairs and or grinding/clenching. Irisekiev: Thank you for your reply. Pain is pulling, comes and goes very fast. Mostly triggered by movement. For example - turning head or looking down. Sometimes feels like a needle goes up under gum. Only one spot does it - front side of gums over 6 (one with crown). And i don't jump though the roof but it can be strong." + }, + { + "id": 161, + "title": "2 periodontist 2 opinon", + "dialogue": "s0022jh: so I've seen two periodontist for opinion due to my 2nd molar on bottom left had root canal done years ago, potentially had fracture near root now, sometime its sored/hurt. also gum pocket about 7/8mm deep on that molar had some bone loss. both periodontist agree with this diagnosis. \n\nBut 1st one recommend me for a dental implant to save the trouble for future fix, the other one said my gum near molar is in good shape, and the tooth is not wiggling, recommend to open the gum, fix the fracture and any other issues(such as deep gum packet issue).\n\nI don't know which one I should choose, I would like to keep my tooth, I brush twice daily, use floss + mouth wash every night, so my gum everything is good, except that molar issue. But I don't want fix it now only have to have it replaced with implant few years later. \n\nBase on my symptom, any dentist on this forum has any opinion on this? How would you even fix fracture that's near root, and how to fix the deep gum packet issue, so no future bone loss occur? MattKW: I don't believe you can fix a fracture using a periodontal approach, unless you're removing a root (hemisection). honestdoc: I think the tooth in question needs extraction. I agree with Dr. MattKW that you cannot repair root fracture. Usually the 2nd molar roots are more fused together than first molar making hemisection less predictable. \n\nWhat are the treatment options for the missing tooth? My opinion is either leaving it alone (less traumatic, less costly) or placing implant. A lot of my patients cannot afford implants so they usually leave the space. The consequence is if you have an opposing molar, it may hyper-erupt down. s0022jh: well its either dental implant(from 1st doc) or fix the fracture and bone loss(from 2nd doc), I prefer latter but don't want complication in few year, and then have to do the dental implant anyway. the tooth is not wiggle at all, gum is good, just some bone loss, deep gum packet and potential crack near root. I guess for most crack root means take out the tooth? not fixing it?\n\nso its better to do implant vs hemisection(or whatever surgery needed to fix the tooth)? not worry about the cost, but like to have done it once surgery and forget it about it. s0022jh: i attached my xray, couldn't really tell if there is a crack root. hopefully someone know how to read it could tell me more about it. i had a crown and root canal done years back, the soreness only happen in recent year. honestdoc: I cannot diagnose root fracture from the image. One way to diagnose is to perio probe for attachment loss. If probe readings are Withing Normal Limits, it may not be a root fracture. What kind of pain are you experiencing? Maybe you maybe grinding/clenching? The tooth in question is the first molar not 2nd. MattKW: That is not a deep enough X-ray for me to comment. I need one that shows the full length of the roots so I can look at the quality of the RCT and if there is any pathology at the tips of the roots. From that bitewing Xray you appear to have good bone levels at all other teeth, so I have to wonder why just this one tooth is troublesome.\nIt could be from the RCT that is mimicking a perio problem (an \"endo-perio\" lesion). The RCT looks as though it has been done by a general dentist. More X-rays at greater depth please. s0022jh: ok thanks from xray do you guys seem any other issues? the soreness is occasionally not all the time, but when I bite down hard stuff, my 1st molar become sensitive.\n\nhere is another xray. I notice a vertical dark area near the right side of tooth? could this be the deep gum packet issue or something else s0022jh: honestdoc said:\n\n\n\n\t\t\tI cannot diagnose root fracture from the image. One way to diagnose is to perio probe for attachment loss. If probe readings are Withing Normal Limits, it may not be a root fracture. What kind of pain are you experiencing? Maybe you maybe grinding/clenching? The tooth in question is the first molar not 2nd.\n\t\t\nClick to expand...\n\ndoes grinding/clenching cause soreness/tenderness issue? if so why only that tooth. MattKW: s0022jh said:\n\n\n\n\t\t\tok thanks from xray do you guys seem any other issues? the soreness is occasionally not all the time, but when I bite down hard stuff, my 1st molar become sensitive.\n\nhere is another xray. I notice a vertical dark area near the right side of tooth? could this be the deep gum packet issue or something else\n\n\n\n\n\nClick to expand...\n\nThat's just another Xray taken slightly more forward, not deeper. The root fillings look suspicious even at this shallow depth. s0022jh: I'm curious from xray of that 1st molar, can you tell if there are bone loss? it seem its same as my other tooth?" + }, + { + "id": 162, + "title": "Am I Being Scammed By \"New\" Dental Office?", + "dialogue": "George304: We moved from Houston to Austin about 9 years ago and I went looking for another dentist here. I found one and they recommended scaling after doing the gum measurements and finding some were 4 etc. They also put the little tablets in my gums. At that point they wanted me to come back every three months and the charges were racking up. I went back to my old dentist in Houston and they did the same measurements about six months later and I think I had a few 3s and they just cleaned. Since then I've been driving back to Houston for my 6 month cleaning and I think once they found some 4s and did a \"deep clean/scale\" but usually its just the regular cleaning. The one time they had to do the deep was still fairly inexpensive. I went in January of this year and again nothing was wrong, they just told me to floss more, but then traveled a lot and finally went back last week (so well delayed at 11 months). In that time I understand the practice was sold to another company. This time I got my exam and xrays (I've never had a cavity and just turned 50) and the hygenist did the poking gum routine and said she found a few 4s and one 5 at which point she made me sign several new forms about having early periodontal disease and told me that I would need to be back every 3 months. She then sent me out to talk to their billing person who printed out all I needed that day and a follow up a month later - $377 that day which included $50 for Prevident 5000 and $50 for Chlorhexidine (found out later they were toothpaste and wash). I have Safeguard so normally I get out with a small co-pay. It didn't seem like the scaling took any longer than a normal clean, but now I am supposed to go back for \"gingival irrigation and the regularly scheduled prophylaxis\" next month for another $130. I'm a little suspicious at the addition of the pricey toothpaste and mouthwash. I've had this scaling etc done before and I assumed the few pockets I had this time (which were a couple 4s, one 5 and the rest normal just as they have been some times in the past) were probably due to me not being in for 11 months. Should I be wary of this office now? Janet Two Hawks: It sounds like a proper perio protocol to me. You could consider getting an evaluation with a periodontist, which is a specialist in gum disease and gum surgery. They have very skilled hygienists too. Get a second opinion. John Roberts: Second opinion. I am trusting dentist less and less. Uptown101: Look for another specialist and have second opinion for that. h1430640: I had a similar story with you , but may not be exactly the same experience. I got second (third and fourth...) opinion, but they were all general dentists. Going to a perio every time is a heart-attack to my wallet, but at the end of the day I did the deep scaling treatment. I was also told by the perio specialist that I had early periodontal disease. But the other general dentists ALL said NO, I don't have periodontal disease. I don't know, from the extensive Google search I have done, I still couldn't reach a consistent answer with the dentists and the perio. \n\nBut my GUESS after my extensive Google learning is , although periodontal disease is often theoretically classified as three stages or more but most of the professional dentist won't classify your stage clinically. Instead, by their experience, if they think your condition can be managed, they then manage, because in most cases periodontal disease progresses very slowly, and if managed, it won't progress or progress even more slowly. What's more Perio will do is they will clean out more deeply and practically a \"better\" clean, while the general dentist is doing a \"normal\" clean. Maintenance at the Perio office is about helping you to deep clean again at lower price but rougher job done because they want to keep you coming back . Theoretically, from book, maintenance will keep help , it's true, But realistically , I don't think it helps a lot. But I keep going to general dentist for routine cleaning.\n\nNote: I am NOT a dentist and what I say about is only my guess from my experience and anyone should NEVER trust it fully Busybee: I am sure the dental industry is no different to others in stretching what is clinically necessary in order to generate revenue. My vet had this down to a tee, using guilt to make you spend more on your pet. Happens a lot in general healthcare too. Unnecessary tests, etc. DrPhilHellmuth: I would say, hard to say! Sit down with a periodontist to check on that!" + }, + { + "id": 163, + "title": "worried about periodontitis.", + "dialogue": "h1430640: Hello\n\nA few years ago I visited a peridontitis specialist for detailed examination and x-ray, the specialist suggested that I had early periodontal disease where deep scaling is necessary. After that, I went for maintenance a couple of times every 1 to 3 months but then I stopped because of high cost and I did not have insurance. I've stopped now for three years, but I still visit general dentists every year for routine cleaning. But I have to confess that sometimes I am getting lazy and don't use interdental brushes to clean between tooth every day. Today between some of my tooth it bleeds when I use interdental brushes, it didn't happen before in the last 3 years. \n\nIs my peridontal disease coming back ? Is it enough to visit only general dentists? Will they overlook the early periodontal disease? Because here the general dentists NEVER use probe or x-ray to me.\n\nI really don't want to go to the specialist it's really a lot of money honestdoc: Where are you located? It is standard of care to probe your gums and provide treatment like scaling & root planing. Going to the specialist would be your general dentist's call. Many clinics have periodontal hygienists that can deep clean (scaling & root planing) severe periodontal disease. calex75: I am in no way a specialist but I have been fighting this disease for 17 years now.\nBoth specialists I saw minimized their role and told me I was the main actor on this fight.\n- Brush you teeth 3 times a day if you can (bacteria would start to be pathogen after 8 hours for some reason)\n- Use a proper technique (\n\n\n\n), if it is too hard for you, acquire an electric brush,\n- Use soft brush tooth and change them every months.\n- Each teeth has 5 faces, use an inter-dental brush for the 2 you can't\n- Quit smoking if you smoke\nThese points are simple, inexpensive, and would be key to success.\n\nWhen it comes to descaling (in the country I lived, descaling was no done by hygienist but by the dentist)\n- The first dentist I had for 10 years who diagnosed my disease insisted that I came every 6 months for some deep descaling which was each time very painful. A few months after each descaling, bleeding was coming back , at the end I had often some parodontium abscess (not sure if it is the proper translation). 50% of my bone melted and my teeth started to be loose...\n- Then I moved to Luxembourg, and in 2013, I decided to see a specialist. He started by some kind of deep clean (would it be a root descaling, I am not sure. All I remember is that I spent 2600 euros and it was so painful that I could barely eat for 2 weeks).\n- But strangely after that, I have seen him every 6 months for 2 years and he barely descaled once between some tooth so my inter-dental brush could pass. When I asked him about descaling, he was answering no... During this time, I have not seen a single drop of blood when I was brushing my teeth. But my gum retracted a lot, which is not really aesthetic, but avoided me any surgery.\n- Back in France. Next specialist insisted to do a gentle descaling every 6 months... Still no blood no abscess...\n- Now I live in Canada, new country, new custom. Here plaque would come within 21 days so a descaling would be required every 3 months and it is 3x more expensive than in France or Luxembourg. (I know It does not make sense to me to do a descaling every 3 months if the plaque comes back every 3 weeks but it is what I was said, and I won't see this dentist again either). Anyway my teeth have not been cleaned for more than 1 year, I can no longer brush my teeth 3x a day (so I am down to 2), and I have seen some blood while rinsing my mouth. I could not see where the blood was coming from but blood there was). I really have to contact and hygienist and a specialist because the fight is not over.\n\nConclusion\nIf you're bleeding that's no good... Keep cleaning between teeth and if it does not stop withing weeks, I'd see a serious specialist (if he does not measure each of your pocket he is not serious). And then brush brush brush each of your facet. It is the only way to go.\nWhen it comes to descaling... Each country/specialist looks to have a different approach. But I doubt everyone really need a $175 cleaning every 3 months as I have been told here." + }, + { + "id": 164, + "title": "Is This Gum Disease?", + "dialogue": "Teeth-Man: So my teeth recently started feeling \"loose\" a few weeks ago, maybe around 6 or 7. \nI would push on the back of the top front four teeth and I would get a bit of a popping feeling, like it was subtly shifting forward.\nI'm not sure why it started, but I was clenching my teeth really hard around that time so possibly that.\nOver the last few weeks, I've found that drinking coffee makes it worse, but the feeling has been going away.\nHowever, in that same time, it seems my left most top incisor has shifted forward and kind of twisted.\nBut here's what's complicating things, my wisdom teeth are growing in and I was at the dentist 2 weeks ago and they didn't see anything wrong and said my teeth/gums were healthy, BUT, I didn't actually ask any questions about these problems with my teeth because I'm stupid. I brush and floss daily, and am probably going to schedule another appointment soon to actually get this cleared up, but in the meantime, can anyone tell me what's going on? Do I have periodontitis and are my teeth imminently going to fall out or is this 70% mental?\n\nPosting another version of this in orthodontics, so apologies if you see it twice. honestdoc: Previously thoughts on wisdom teeth pushing on anterior teeth were \"myths.\" However later studies have concluded that it is possible. Grinding an clenching can be very destructive. Your dentist/hygienist can diagnose gum disease by reviewing your bone levels on x-rays and measuring attachment loss on your gums. If your dentist didn't find any gum disease/bone/gum attachment loss, you may be experiencing anterior crowding and grinding/clenching. Consider having your wisdom teeth removed and use a bite guard." + }, + { + "id": 165, + "title": "Extracting only one of three tooth roots - procedure name?", + "dialogue": "BeenThere: My molar (upper left #7, beside an empty wisdom tooth socket), has really deep pockets (> 18mm, which is deep enough to reach between the roots, so cannot be properly cleaned - an absess was noted during this week's cleaning). This tooth has been problematic for about 15 years due to deep gum pockets. \n\nMy periodontist appears to think only one of my 3 roots for that tooth is involved so is suggesting extraction of just the problem root (after: root canal treatments and a crown), to end up with a weak yet functional molar for that location.\n\nWhat is the name of this partial extraction procedure? Has anyone had it done? My first thought is: what's to stop the area where the root's been cut off, from decaying? Or, is that concern a non-issue below the gumline Busybee: I'm not a dentist but didn't realise it was possible to do such a thing. I'll be fascinated to hear how it turns out if you go ahead. Are you in the US? BeenThere: no\n\n(this forum design allows you to 'watch' threads, by being updated when they've fresh content) Busybee: I just wondered where in the world they attempt such a procedure. BeenThere: yes, I deduced that was your intent earlier MattKW: BeenThere said:\n\n\n\n\t\t\tMy molar (upper left #7, beside an empty wisdom tooth socket), has really deep pockets (> 18mm, which is deep enough to reach between the roots, so cannot be properly cleaned - an absess was noted during this week's cleaning). This tooth has been problematic for about 15 years due to deep gum pockets....\n\t\t\nClick to expand...\n\nHemisection. You have to be fairly desperate to try this on a 2nd molar, especially an upper 2nd molar; the roots are not always well separated, unlike a 1st molar. If you still have a 1st molar in good condition, maybe you should just let the 27 go. And it would depend which root was badly affected - if it's the palatal to be extracted, then the chances of the buccal roots being of any use are zilch. \nAnyway, if you first do a good RCT, then section off the dodgy root, then place a small crown (gold alloy), you might get away with it. It'll be hard to clean due to the odd shape, and there will be an increased risk of fracture. I'd like to hear from you if this goes ahead. BeenThere: Thanks to receiving that term from you, I was readily able to google the procedure to get a better sense of its history and assorted risks. It sounded like a new and speculative approach on first hearing of it last week. I remember all too well the early days of dental implants where so many of them failed (great improvements thankfully have followed in that field).\n\nhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812084/ appears to be a good overview of an example that highlights the assorted concerns along with providing an estimate of the likely outcome. It's useful to have the facts and hazards pointed out as material to query and confirm, and part of reaching an informed decision (my background's chemistry & health care, I have had much dental work done but have no training in that field).\n\nI'm considering it only because I'm apprehensive about an extraction so close to my sinus cavity and possible complications. My (former, now retired) dentist referred me to an oral surgeon a couple of years ago regarding the extraction approach, whose treatment plan included/insisted upon \"deep I.V. sedation\" (a scary concept to me) so I backed off. There was no abcess back then. \n\nI'm coming to see this hemisection approach as an expensive, (perhaps more than) somewhat iffy way of postponing a full extraction, my new dentist and I will review the periodontist's treatment plan within the coming couple of weeks. If I conclude the health risks appear lower than a full extraction (over the long term), I'll likely give it a try. The improved chewing function from retention is seen as only a modest benefit for me, my motivation is safety oriented.\n\n[I retained my much earlier extracted #7, lower right tooth on the other side of my mouth, and find it helpful having a visual aid to help picture dealing with such a small object so awkwardly placed. A larger than life model would be even more useful so I'll see if my dentist has one in her office. Meanwhile I'm seeking out a second periodontist so I can obtain a second opinion from someone not actively involved in performing elements of the procedure. MattKW: If your main concern is the sinus, then I would downplay this significance in your decision making. The most troublesome upper 2nd molars to extract are those standing alone, usually with bulbous roots and solid bony surrounding. Then there's a risk of fracturing the tuberosity and creating an oro-antral fistula (OAF). In 35 years, I've fractured a fair few tuberosities, but only ever had 2 OAF occur - the sinus lining is fairly tough. In your case with perio damage to the bone, it would be even less risk (without benefit of Xray). It's been said that a lot of OAFs aren't even noticed, and heal spontaneously. BeenThere: attached, my latest x-ray: 20180510 (last week) MattKW: BeenThere said:\n\n\n\n\t\t\tattached, my latest x-ray: 20180510 (last week)\n\t\t\nClick to expand...\n\nYou have bone loss well in between the roots, so even if you section the tooth and try to hang onto any roots, they are already compromised badly. There is no point trying anything fancy on this tooth. And your first molar looks good, and is already crowned, so that's very good. I see nothing difficult about extracting the 2nd molar at all; get rid of it. BeenThere: Thank you, I agree that bone loss is the major issue, and may well prove insurmountable. \n\nI'm hopeful the problem root (at the rear, cheek side) is the only root with that problem, so I expect my focus will be on local opinions on how the remaining roots sit (eg. >50% bone support is desired if not essential according to http://www.endoexperience.com/userfiles/file/root_resection.pdf). \n\nI'm a senior, non-smoker and (now) have excellent oral hygiene (if dental hygiene along with its benefits were more carefully explained much, much earlier, I believe I could have avoided most of the current dental problems I've faced decades later). MattKW: BeenThere said:\n\n\n\n\t\t\tThank you, I agree that bone loss is the major issue, and may well prove insurmountable. \nI'm hopeful the problem root (at the rear, cheek side) is the only root with that problem, so...\n\t\t\nClick to expand...\n\nThanks for the article link, very interesting, and I've filed it away. Resections used to be more common before the advent of implants, but the statistics in the review are better than I expected, comparing favourably with implants. Good luck with the path you choose. And yes, we all have 20/20 vision in hindsight... BeenThere: Well, the procedures have been completed successfully and the site's had a few months to fully settle down.\n\n(~$4,700 Cdn in total, as $2,020 for the surgery itself [including some bone graft material], preceded by $1500 in root canals [temporary crown added], and followed by $1,175 for a full gold crown). Seeing a couple of youtube videos of the surgery beforehand was greatly reassuring (puts the process in better perspective, else it's hard to get a sense of it when it's impossible to see the area).\n\nReading up on it, I noted emphasis for success was placed on: using an expert/experienced practitioner (that eliminated the initial periodontist suggesting the procedure). She quoted me a rate of less than 1/3rd of our province's suggested fee rate for the surgery (well, you gotta practice somewhere I suppose, but not on me, thank you, and certainly not where I've read articles that emphasize practitioner experience makes a notable improvement in outcome). As well, excellent after care hygiene is needed (the long term failures are attributed to periodontal issues).\n\nI've been diligently using: a sulcrabrush, waterpik, flossing and the larger size mini-tapered brush head meant for between dentures & larger tooth spaces to keep the back of my rear molar spotless. By far the most effective in removing missed debris for that location is the waterpik (heated cold tap water with or without some dissolved rocksalt added). Using a sulcrabrush is new to me, I'm finding it surprisingly effective when used on other gumline areas that are sensitive and where chlorhexidine rinse wasn't helping much. \n\nI sure wish I'd started life with a far more thorough education in proper dental hygiene, along with they whys and consequences of not adhering to a good habit pattern." + }, + { + "id": 166, + "title": "White dots on gums", + "dialogue": "LauraElena: Hello,\n\nI noticed for a time now, about 3months(i dont know for sure since when those spots were there)...that i have 2 bigger spots on teeths and a couple of little ones smaller. Really small...\nI have to mention that an year ago i had a treatment made for gums bleeding(periodontisis)\nThe spots look like\n that white one from picture. They are like little points, hard at touching, doesn't bother me.\nDo you know what it can be? I read about cancer sore, leoplakia, hpv..\nIt could be caused by braces ?\nThanks! honestdoc: Most likely they are harmless fordyce spots. I'm not sure what the bigger spots look like if you can provide images. LauraElena: honestdoc said:\n\n\n\n\t\t\tMost likely they are harmless fordyce spots. I'm not sure what the bigger spots look like if you can provide images.\n\t\t\nClick to expand...\n\n\nHello! I have 2-3 of the size from the picture and about 10 smaller, like needle point.\nApparently this one from picture it s there for about an year i guess. I asked my orthodontist to check the pictures from thr day i got my braces :/\nCan it be hpv? Can fordyce spot be found also on gums, not only on lips?\nThanks! honestdoc: Go to google and compare fordyce spots and papillomas. Fordyce spots can be on the gums. Research HPV vaccine if it is appropriate for you." + }, + { + "id": 167, + "title": "Serious Bone & Gum Recession Around Multiple Implants", + "dialogue": "OligodontiaMan: Hi, I am in my mid 40's and have had multiple implants placed years ago in the upper and lower jaws. The ones on the bottom have serious bone and gum recession around them. I was wondering if anyone has had this issue and had it treated successfully? A Periodontist wanted to do gum grafting, but what didn't make sense to me was how would that treat the serious bone loss around the implants? Another Periodontist wanted to use the Lanap laser procedure on me. Are bone grafting and gum grafting ever done together? That would seem to make sense. Or to have them done separately. I would appreciate hearing from anyone that has had to deal with this issue. The x-ray shown here is just one example of what my other implants look like.\n\nThanks! honestdoc: You will encounter different opinions. Do you have certain medical conditions such as diabetes, immune compromised, etc.? Are you a smoker? Has anyone mentioned to you about possible grinding/clenching? If you have any of these factors, implants may not integrate as well.\n\nIf definitive treatment is planned, I think it would be more predictable to replace the center one and consider replacing the right one as well if finances can be accommodated. The right one is marginal with poor integration around the bone level. OligodontiaMan: I have none of these issues other than than the grinding/clenching being mentioned to me by the dentist. \nThose implants were placed in 1999 or so. But since there is so much bone loss wouldn't there need to be some grafting, especially if I would be replacing the implants?\nthanks. MattKW: OligodontiaMan said:\n\n\n\n\t\t\tHi, I am in my mid 40's and have had multiple implants placed years ago in the upper and lower jaws. The ones on the bottom have serious bone and gum recession around them. I was wondering if anyone has had this issue and had it treated successfully? A Periodontist wanted to do gum grafting, but what didn't make sense to me was how would that treat the serious bone loss around the implants? Another Periodontist wanted to use the Lanap laser procedure on me. Are bone grafting and gum grafting ever done together? That would seem to make sense. Or to have them done separately. I would appreciate hearing from anyone that has had to deal with this issue. The x-ray shown here is just one example of what my other implants look like.\n\nThanks!\n\t\t\nClick to expand...\n\nDoesn't look good to me. I can't see that any bone grafting will make any difference to the implants that are still in place. Once the implant surfaces have been exposed, they're contaminated. You won't get any meaningful reattachment with bone (or gum) surgery. I would sever the middle crown, remove the implant, and replace it as a free-standing single implant. I don't know how well the others will go in time. OligodontiaMan: Can the surfaces be decontaminated with cleaning or laser? All of the other implants I have have bone loss around them as well. MattKW: No reliable treatment is available, although many have been tried. Your best bet might be to try and halt progression on the better implants, but be prepared to lose some like the central implant in your Xray. You can't retreat implants to the same perfection as the industrial treatment. You've only shown a small part of your bridges and implants. If the other areas are similarly affected, maybe you should consult a prosthodontist about the best path to follow. OligodontiaMan: Thank you for your response. If that implant or another has to be removed, could bone grafting help before possibly putting in a new implant? Would consulting a Prosthodontist make more sense than seeing a Periodontist? Or should I see both? MattKW: OligodontiaMan said:\n\n\n\n\t\t\tThank you for your response. If that implant or another has to be removed, could bone grafting help before possibly putting in a new implant? Would consulting a Prosthodontist make more sense than seeing a Periodontist? Or should I see both?\n\t\t\nClick to expand...\n\nA periodontist is the first to assess the gums. If you're in need of long-term replacement options, then a prosthodontist would be good, and they would work in conjunction with the periodontist. I wouldn't suggest you worry about bone grafting till a perio has had a look, and also a prosdo. You need an idea of where this is all going, and what your options could be before you make any steps." + }, + { + "id": 168, + "title": "Mouthwash question", + "dialogue": "JoeR1234: Hi,\nI have a situation where I'm trying to ensure a sterilized mouth prior to flossing and brushing. I have significant mucosa erosion in the vestibule due to what I believe is from a silicone chin implant that I intend on having removed. I made an appt with a Periodontist in early August to have gums etc. evaluated and plant to have the implant removed in January. \n\nMy question is related to opinions on mouthwash before flossing and brushing to sterilize and if it should be alcohol based. I've been using Listerine in this capacity for a couple years but recently thought that maybe the alcohol can contribute to the tissue erosion. I used Crest clinical with hydrogen peroxide and had a bad reaction where I actually had pieces of tissue in my mouth as if it had burned the inside of my mouth. Would like to get the opinion of some of the great contributors here as to whether an antiseptic based mouthwash would even sterilize the mouth prior to brushing - is it even worth it for that purpose with the potential tradeoff being negative affects on the soft tissue?\n\nThanks! MattKW: Most mouthwashes have removed alcohol because of a tenuous association to mouth cancer. Some of the \"burning\" mouthwashes (yes, I'm looking at you, Listerine!) have caused my patients to shed skin. It appears as white strings; not harmful but it makes you wonder. Those sort of mouthwashes also only have limited working time, despitre their marketing. The best mouthwashes contain chlorhexidine gluconate. But you have to brush and floss first to clean off the plaque so it will stick to clean tooth surfaces for best effect. If you don't like the taste, studies have shown that even diluted with water 50:50 it is still very effective. JoeR1234: MattKW said:\n\n\n\n\t\t\tMost mouthwashes have removed alcohol because of a tenuous association to mouth cancer. Some of the \"burning\" mouthwashes (yes, I'm looking at you, Listerine!) have caused my patients to shed skin. It appears as white strings; not harmful but it makes you wonder. Those sort of mouthwashes also only have limited working time, despitre their marketing. The best mouthwashes contain chlorhexidine gluconate. But you have to brush and floss first to clean off the plaque so it will stick to clean tooth surfaces for best effect. If you don't like the taste, studies have shown that even diluted with water 50:50 it is still very effective.\n\t\t\nClick to expand...\n\n\n\nThanks Matt - you're very helpful. What do you recommend to sterilize the mouth before flossing/brushing relative to concerns about microcuts/possible infection due to particular circumstances (I'm the chin/cheek implant guy from the other thread). I just stopped the alcohol mouthwash pre-rinse and my current routine is to first do a quick swish with no alcohol listerine, floss - brush and final rinse with no alcohol 1x per day ACT 1 anticavity flouride mouthwash. This combo still feels intense and seems to dry the mouth ......I just read that a warm water & salt mouthwash has effective anti-bacterial properties - do you think this would be a better option than the Listerine I'm using as a pre-rinse? Or, is doing anything pre floss/brush an exercise in futility in terms of trying to prevent potential infection from flossing/brushing? (of course I know I'm over the top here - I'm having these implants removed in March of next year and won't be concerned after that point. I'm just trying to avoid infection before than because I would have to get them removed immediately and I'm unable to because of allowable time off from work & sole custody of a special needs child).\nThanks again - really appreciate your help. Busybee: Why do you need to sterlise your mouth with chemicals? Saliva does that already. If you want to promote healing, saliva is better than listerine. What you eat and drink will make the difference. The only mouthwash I've found helpful (for short term use only) is peroxyl. By that I mean one or two days. It should only be for acute conditions or for people who have long term health problems where the body doesn't create healthy saliva. MattKW: JoeR1234 said:\n\n\n\n\t\t\tThanks Matt - you're very helpful. What do you recommend to sterilize the mouth before flossing/brushing relative to concerns about microcuts/possible infection due to particular circumstances (I'm the chin/cheek implant guy from the other thread). I just stopped the alcohol mouthwash pre-rinse and my current routine is to first do a quick swish with no alcohol listerine, floss - brush and final rinse with no alcohol 1x per day ACT 1 anticavity flouride mouthwash. This combo still feels intense and seems to dry the mouth ......I just read that a warm water & salt mouthwash has effective anti-bacterial properties - do you think this would be a better option than the Listerine I'm using as a pre-rinse? ...\n\t\t\nClick to expand...\n\nNo harm in salty water, and can use as much as you like. Not as effective as chlorhexidine (CHX) mouthwash for length of time or range of bacteria. The beauty of CHX is that if you use it after brushing, it stays working for up to 12 hours (good substantivity). honestdoc: You cannot sterilize the mouth. It has natural bacteria called oral flora. Once the flora forms biofilm/plaque around your teeth, you must remove it by brushing & flossing if you want to keep your teeth.\n\nI prescribe CHX for short term use only. Like Dr. MattKW mentioned, it continues to work and according to various periodontal sources up to 10 days after 2 weeks of use. Long term use of CHX can lead to potential teeth discoloration.\n\nI don't like mouth rinses for everyday use. I had a discussion with a periodontal instructor in dental school over 20 years ago. Rinses cause mouth irritation. The mouth wants to protect itself by making abnormal (hyperkeratinized, precancerous) tissue. This takes weeks/months of constant irritation. Depending on risk factors such as tobacco, recreational alcohol use, and/or unresolved irritation, about 3% of precancerous lesions can potentially lead to Squamous Cell Carcinoma which is the most common cancer in the mouth. Like Dr. MattKW mentioned, companies are removing alcohol and adding proprietary ingredients. We don't have enough information about irritation potentials with these. Here in the US, there were numerous cases of severe mouth trauma from Peroxide use.\n\nAnother reason I don't like daily rinses is people think they don't have to brush and floss now that they have this \"magic\" rinse. JoeR1234: honestdoc said:\n\n\n\n\t\t\tYou cannot sterilize the mouth. It has natural bacteria called oral flora. Once the flora forms biofilm/plaque around your teeth, you must remove it by brushing & flossing if you want to keep your teeth.\n\nI prescribe CHX for short term use only. Like Dr. MattKW mentioned, it continues to work and according to various periodontal sources up to 10 days after 2 weeks of use. Long term use of CHX can lead to potential teeth discoloration.\n\nI don't like mouth rinses for everyday use. I had a discussion with a periodontal instructor in dental school over 20 years ago. Rinses cause mouth irritation. The mouth wants to protect itself by making abnormal (hyperkeratinized, precancerous) tissue. This takes weeks/months of constant irritation. Depending on risk factors such as tobacco, recreational alcohol use, and/or unresolved irritation, about 3% of precancerous lesions can potentially lead to Squamous Cell Carcinoma which is the most common cancer in the mouth. Like Dr. MattKW mentioned, companies are removing alcohol and adding proprietary ingredients. We don't have enough information about irritation potentials with these. Here in the US, there were numerous cases of severe mouth trauma from Peroxide use.\n\nAnother reason I don't like daily rinses is people think they don't have to brush and floss now that they have this \"magic\" rinse.\n\t\t\nClick to expand...\n\n\n\nI really appreciate your responses - thanks. My main concern is staph opposed to the plaque causing bacteria (not that I don't worry about plaque ....I have always religiously brushed and flossed so my teeth are in great condition). My concern is that I had a staph infection last year and have facial (cheek&chin) implants which are being removed next March....a worst case would be if they get infected prior which is what I'm trying to prevent). My thinking was to the effect of \"If I cut myself while flossing the staph has an entry in my bloodstream so I need to \"kill\" the bacteria prior to brushing & flossing. After being educated here I think my error was thinking that I can \"kill\" the bacteria. It seems from the answers here that the bacteria would only be temporarily killed (if even that) while a gum cut from flossing might take days to heal and the bacteria continually regenerate. Not to mention - as mentioned in this thread for all I know the mouthwash might be weakening the mucosa making me more susceptible to bacterial entry. Depending on if you guys disagree, I think going forward it makes sense to do a salt water rinse first, brush & floss and finish with my standard ACT flouride rinse. (I did obtain Clorhexedine though I'm not sure it will be worth using for my purposes (no perio disease,etc) due to the staining and temporary use recommendations which would put my back in the same place. Plus, as Matt mentions the directions are to use after brushing & flossing where my concerns are what could happen while brushing & flushing (and as mentioned this is where my understanding of bacteria might be way off)\nThanks a lot guys - you do the board a great service! honestdoc: Staph bacteria generally resides outside the mouth like your skin. In a normal oral flora, it is generally Strep along with 700 other species which about 50% have not been cultivated according to a source. It is difficult to assess risk of infection to your implants. The general protocol for joint implants is usually antibiotic premedication before dental procedures up to 2 years after implants placed. Unfortunately, there are growing cases of antibacterial resistance due to overexposure. According to another source, there have been no evidence of artificial joint infection due to bacterial species from the oral flora. JoeR1234: honestdoc said:\n\n\n\n\t\t\tStaph bacteria generally resides outside the mouth like your skin. In a normal oral flora, it is generally Strep along with 700 other species which about 50% have not been cultivated according to a source. It is difficult to assess risk of infection to your implants. The general protocol for joint implants is usually antibiotic premedication before dental procedures up to 2 years after implants placed. Unfortunately, there are growing cases of antibacterial resistance due to overexposure. According to another source, there have been no evidence of artificial joint infection due to bacterial species from the oral flora.\n\t\t\nClick to expand...\n\n\n\nThank you for the information - I feel like myself and some of the other \"free info recipients\" on here should be writing checks to you guys. Thanks again" + }, + { + "id": 169, + "title": "Can someone please tell me what is this?", + "dialogue": "FulhamCF: This part of gum is constantly bleeding..." + }, + { + "id": 170, + "title": "Do you believe this is Periodontitis or Gingivitis?", + "dialogue": "Vangelis1337: From a quick search on Google Images, It seems to me that it's well into the Periodontitis side of the spectrum. What do you think? How greatly do you believe my gums have been damaged? MattKW: Not too bad, very early periodontitis in lower teeth. If you get them cleaned up by a dentist or periodontist, and mend your wicked ways you'll be OK. Vangelis1337: Thank you for your reply. And how do you see my upper teeth? Both my upper and lower regions are sensitive to cold/hot beverages.\n\nAlso, I'm relatively young (23); is there a chance that it will come again after treatment, on its own, even if I maintain good hygiene measures?\n\nBy the way, I neither smoke nor drink coffee or alcohol. I got it from tonnes of sugar and zero brushing, to be honest, but I have already began to change that.\n\nI upload a third photo that I believe is crisper than the previous ones:\n\n\n\nSpoiler MattKW: It won't come again if you brush and floss. Vangelis1337: Very good. I take it that my upper teeth are not periodontal, then? MattKW: Not that I can see. But this is all without perio probing, charting, and X-rays. The photos are real good, I can simply see that lower gums are more swollen. Vangelis1337: I see, I shall have them all checked ASAP. \nThank you for your responses" + }, + { + "id": 171, + "title": "35 year old woman with bone loss", + "dialogue": "SunnyDayzWI: I am writing in desperation, as I have seen over 7 specialists in the past 3 months trying to address my condition. I have (what I've been told is significant) bone loss for a woman in her mid 30s. I have seen orthodontists, perios, my general, implant specialists, and more recently a TMJ expert to help me. I have notoriously had impeccable hygiene since a young age, but no matter, I have experienced bone loss and recession. I have pain along the gum lines and a slight cross bite and open bite. I grind heavily at night and wear a nightguard. As I approach my 40s, this pain has increased. I'm being pulled in so many directions. Do I have enough bone to warrant orthodontic work or would that be risky? Should I consider bone and soft tissue grafting? Should I consider a full mouth extraction with all on 4s for both arches? I am at a loss. Please, any advice would be much appreciated. The pics are a little old, but the condition is relatively the same. MattKW: It appears to be significant bone loss for your age. I wonder what the periodontist thinks about it and the possible cause? You will achieve nothing with orthodontics, and it would be a brave orthodontist who would even want to touch your teeth - and to what end goal? Bone and soft tissue grafting is neither indicated nor wise, and I wonder who would suggest that to you. You should continue to maintain your teeth as best you can under regular review with a periodontist, and you'll be fine for years. You don't appear to have active periodontitis. Avoid implants for as long as possible - if you have bone loss with normal teeth, you're liable to get the same problem with implants. SunnyDayzWI: Thank you for that feedback. I guess the whole intent with orthodontics is to get me out of malocclusion in hopes that my bite will improve to reduce forces on some of the teeth. After seeing numerous specialists, no one has been able to explain the bone loss to me. It appears to be a mystery that no one wants to touch : ( honestdoc: Your lower anterior teeth appear very compromised. How is your health history? Do you have diabetes or any immune compromised conditions? One possibility is to obtain a bacterial culture & sensitivity to determine the species and proper antibiotic. It is still possible to maintain the lower anteriors as long as there are no bleeding upon probing. Any bleeding indicates active periodontitis.\n\nI see toothbrush damage. Make sure you are using a soft bristled brush and the brush head is not getting destroyed. Your brush head should look like new when you throw it out after 3-4 months. Orthodontics will worsen your bone loss. Any torquing and pressure will cause further damage. Make sure your night guard is custom made and wear it as much as you can even during the day if you are by yourself. You may have an anterior open bite in which your lower anterior teeth may be hyper-erupting. This may be minimized with a custom guard. SunnyDayzWI: Thank you both kindly for the feedback. I have another appointment with a different perio in about two weeks down in Chicago in hopes he can provide some solutions. My biggest fear is that since it's horizontal bone loss, that there may be nothing they can do in terms of bone grafting. honestdoc: Bone graft will not work for horizontal bone loss. The periodontist may want to splint the lower anteriors to minimize torquing. The unfortunate situations with periodontists are they do not make money by \"maintaining\" your lower anterior teeth. They make more money pulling your teeth and sticking implants in. I saw a trust worthy older periodontist present cases where teeth just like yours lasting over 10 years. The key is frequent 2-3 months recall visits and no bleeding upon probing.\n\nUsually younger periodontists wants to put implants in you mouth. They have a lot of student loans to pay. Find a teaching periodontist at a dental school near you. SunnyDayzWI: Thank you again for the counsel. This is why I sometimes turn to anonymous forums. After meeting with all these specialists, I'm being pulled in so many directions, it's just difficult sometimes to see who has my best interests in mind. Thanks for the tip about dental schools. We do have the Marquette School of Dentistry here in Milwaukee, so I'm going to look into that : )" + }, + { + "id": 172, + "title": "Is this periodonititis?", + "dialogue": "Suhda: So I had my lower wisdom tooth removed a month ago and developed dry socket which then closed up but then i developed this small pocket where the dry socket was and it does throb a little (its red but there no pus) and the gum around it hurts. Got it checked by two oral surgeons they said its part of healing but im not entirely convinced bwcause i still have mild pain and headache everyday. So is this periodontitis? honestdoc: As stated in my last post, removing lower wisdom teeth can be very traumatic and require a lot of healing time and effort. Periodontitis is a severe form of gum disease where bone around the teeth are getting destroyed. Many times periodontitis does not hurt and people neglect their gums until severe bone damage/bone loss occurs. It is not because of the surgery. Suhda: honestdoc said:\n\n\n\n\t\t\tAs stated in my last post, removing lower wisdom teeth can be very traumatic and require a lot of healing time and effort. Periodontitis is a severe form of gum disease where bone around the teeth are getting destroyed. Many times periodontitis does not hurt and people neglect their gums until severe bone damage/bone loss occurs. It is not because of the surgery.\n\t\t\nClick to expand...\n\nI understand. Sorry I meant pericoronitis not perpdonitis. honestdoc: Pericoronitis is usually gums surrounding wisdom teeth getting infected/inflammed. Your wisdom teeth are removed so the gums will be closing up. You can try over the counter numbing gels like Colgate Orabase. Suhda: Thanks so much for your reply. Ill try that" + }, + { + "id": 173, + "title": "Exudate", + "dialogue": "Pluto: I was told that I have exudate on my gums. What are the causes and how do I get rid of it? honestdoc: Exudate is a general term for discharge such as blood, pus, excess saliva, or mix. Usually in periodontal (gum) charting, documentation of exudate is required indicating disease.\n\nWhen a dentist or hygienist performs a periodontal probing to measure your gum attachments, he/she needs to record if a particular site has exudate. Bleeding upon probing is very indicative of gum disease as well as numbers greater than 4 mm which mean the gums are losing attachment to the tooth and possible irreversible bone damage has occured. \n\nFollow your trusted dentist and hygienist's recommendations such as deep cleaning, periodontal maintenance, medications, and hygiene aids such as waterpik, proxybrush, and motorized toothbrushes.\n\nFor some hungry dentists and hygienists, they may falsely document greater readings and exudate to extort more money and treatment because deep cleanings can be expensive." + }, + { + "id": 174, + "title": "over 90% bone loss", + "dialogue": "Anon_7898: I have been diagnosed with localised, aggressive periodontitis for my upper right canine and the prognosis is extremely poor. I have no idea how this has happened but for my age it is practically unheard of. I have been attending regular dental visits since I was 17, and it feels like this has literally happened out of the blue. My gums have been bleeding since I was a teenager, and my dentist always brushed it off and just told me to floss. I used to floss RELIGIOUSLY but they still continued to bleed whenever I brushed (really badly). This carried on until i was 21, and I had a dental abscess. It was at that point my dentist referred me to see some student hygienists (didn't even know what a hygienist was prior to this, i was very young and naive). Eventually, my gums stopped bleeding but by then it was too late for my upper right canine. the periodontitis is now localised, but the bone loss is absolutely ridiculous. Is bone regeneration surgery worth having? it is very expensive and if the odds are really low then there's no point wasting my money. Are implants even an option at this stage? If i get a bridge, will it change my facial shape? (as i know my jaw bone will resorb itself even more) Anon_7898: that is an actual x-ray of my tooth btw lol. MattKW: You've obviously had an RCT for this tooth, so it is much more likely that the bone loss is due to the RCT, rather than perio disease. To get me started, why did you get an RCT for this tooth? Do you have any other general X-rays of your other teeth. Anon_7898: I had a tooth abscess, as i mentioned lol Anon_7898: And all my other teeth have normal bone levels etc. Don’t have any x-rays, need to request them from my dentist Anon_7898: Also I had root canal on my front tooth due to trauma, and the bone levels are normal. Why would root canal resorb the bone so badly for my canine? Anon_7898: MattKW said:\n\n\n\n\t\t\tYou've obviously had an RCT for this tooth, so it is much more likely that the bone loss is due to the RCT, rather than perio disease. To get me started, why did you get an RCT for this tooth? Do you have any other general X-rays of your other teeth.\n\t\t\nClick to expand...\n\n\nalso, 2 specialist periodonstists have both diagnosed me with localised periodontitis. are you saying they have both incorrectly diagnosed? MattKW: beckyyc17 said:\n\n\n\n\t\t\talso, 2 specialist periodonstists have both diagnosed me with localised periodontitis. are you saying they have both incorrectly diagnosed?\n\t\t\nClick to expand...\n\nOK, so I can understand that the 13 might've died from trauma, but it is extremely unusual to get localised periodontitis for a canine. I'm wondering if the RCT is the problem. \n\nIn what year did you need the RCT? If you get X-rays of this tooth over time, perhaps it will show if the abscess started at the root (RCT problem), rather than the gums (periodontal problem). It is a much more likely cause, and the X-ray indicates more bone loss at tip of tooth rather than top of gums.\nWas the RCT done by a general dentist, a student, or an endodontist? Anon_7898: MattKW said:\n\n\n\n\t\t\tOK, so I can understand that the 13 might've died from trauma, but it is extremely unusual to get localised periodontitis for a canine. I'm wondering if the RCT is the problem.\n\nIn what year did you need the RCT? If you get X-rays of this tooth over time, perhaps it will show if the abscess started at the root (RCT problem), rather than the gums (periodontal problem). It is a much more likely cause, and the X-ray indicates more bone loss at tip of tooth rather than top of gums.\nWas the RCT done by a general dentist, a student, or an endodontist?\n\n\nClick to expand...\n\nThank you for taking the time to reply. I got the RCT in 2016, as I had a tooth abscess on the canine which led to facial swelling. An endodontist performed this RCT as my usual dentist wasn't available and it was an emergency. At this point there was 80% bone loss, and it is now over 90%. I don't have an x-ray of my canine 2 years ago I will have to see if I can get hold of one - I am planning on requesting my dental records soon. Since a teenager though I have had about 5 gum abscesses on this canine, and then I had one which actually affected the main tooth so needed RCT. Since the RCT I have also had three gum abscesses in the area. The only explanation I can come up with is that inbetween my canine and molar there is a massive gap, and I do not have this gap anywhere else in my mouth. I want to get braces to fix it, but because of the bone loss I am unable to Anon_7898: MattKW said:\n\n\n\n\t\t\tOK, so I can understand that the 13 might've died from trauma, but it is extremely unusual to get localised periodontitis for a canine. I'm wondering if the RCT is the problem.\n\nIn what year did you need the RCT? If you get X-rays of this tooth over time, perhaps it will show if the abscess started at the root (RCT problem), rather than the gums (periodontal problem). It is a much more likely cause, and the X-ray indicates more bone loss at tip of tooth rather than top of gums.\nWas the RCT done by a general dentist, a student, or an endodontist?\n\n\nClick to expand...\n\nhow comes it is so rare to get periodontitis for a canine? Anon_7898: MattKW said:\n\n\n\n\t\t\tOK, so I can understand that the 13 might've died from trauma, but it is extremely unusual to get localised periodontitis for a canine. I'm wondering if the RCT is the problem.\n\nIn what year did you need the RCT? If you get X-rays of this tooth over time, perhaps it will show if the abscess started at the root (RCT problem), rather than the gums (periodontal problem). It is a much more likely cause, and the X-ray indicates more bone loss at tip of tooth rather than top of gums.\nWas the RCT done by a general dentist, a student, or an endodontist?\n\n\nClick to expand...\n\nAlso, before the dental abscess and RCT this tooth was noticeably loose MattKW: beckyyc17 said:\n\n\n\n\t\t\tAlso, before the dental abscess and RCT this tooth was noticeably loose\n\t\t\nClick to expand...\n\nYes, but a history is essential. How did the tooth get traumatized? Did the tooth get trauma first, then develop an abscess requiring an RCT, then become loose, ...? Anon_7898: MattKW said:\n\n\n\n\t\t\tYes, but a history is essential. How did the tooth get traumatized? Did the tooth get trauma first, then develop an abscess requiring an RCT, then become loose, ...?\n\t\t\nClick to expand...\n\nI have never had trauma to the canine Anon_7898: MattKW said:\n\n\n\n\t\t\tYes, but a history is essential. How did the tooth get traumatized? Did the tooth get trauma first, then develop an abscess requiring an RCT, then become loose, ...?\n\t\t\nClick to expand...\n\nI mentioned that I had trauma to a front tooth, in which I had normal bone levels. I was using that as an example, sorry for the confusion MattKW: beckyyc17 said:\n\n\n\n\t\t\tI mentioned that I had trauma to a front tooth, in which I had normal bone levels. I was using that as an example, sorry for the confusion\n\t\t\nClick to expand...\n\nOK, but why did canine develop an abscess that was treated by an endodontist? They are very rare teeth to require RCTs in someone so young. Anon_7898: MattKW said:\n\n\n\n\t\t\tOK, but why did canine develop an abscess that was treated by an endodontist? They are very rare teeth to require RCTs in someone so young.\n\t\t\nClick to expand...\n\nGenetic Overactive immune system response maybe? My grandma had bone loss in her teeth at a very young age MattKW: OK, getting nowhere. Canines don't require RCTs for that sort of reason. I'm finding it hard to believe your story. Bye." + }, + { + "id": 175, + "title": "bone loss after periodontis abscess 1month pus", + "dialogue": "AVM: Hello,\n\nPlease help! I stayed with this abscess 1 month, I thought it was gingival...One night I wanted to clean the pockets with a small chopstick but the other day got infected. The doctors here said that this tooth should be extracted. After 5 days of antibiotics the pain is no longer there and the gingival looks much better. Still I feel some bone loss. What do you think from the tomography image. I also have orto braces on it.. MattKW: Great set of Xrays. Well, the tooth (36 FDI) has had some RCT started on it that hasn't been finished. Either stop braces movement immediately, do RCT, and hope bone reheals (minimum 6-9 months) before even thinking about restarting ortho; or extract 36 and look at doing implant at later date. And get rid of the useless 38 while you're at it. When was the RCT started on the 36? The ortho shouldn't've been started with a tooth in that condition. AVM: Hi Matt,\n\nThanks for the feedback. Well 2 days ago I just finished RCT with rotative instrument. Too bad I haven't got the chance to use a laser on also.\n\nThe thing is that last year on june the tooth was ok like this XRAY is showing:\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n(The 3.5 premolar didn't grow anymore at age 10...)\n\nBut after I've played one day with a chop stick on it after 3 month of orto, it got infected....I blame me here.\n\nAnd yes probably I should have done also bone graft for 3.6 and RTC back then.\n\nAs for the 3.8 the tooth is healthy, just shown up two years back. The orto treatment initially was to move all three molars in front. That's why I kept it. Problems is know that I lost because of delaying the RCT treatment and antibiotic treatment...some bone....due to the paradontal abscess triggered. In the worst case the orto said we will probably need to extract 3.6 and move the 3.7 and 3.8 a little in front and do bone graft and implant.\n\nToday after 9 days of antibiotics I don't feel anymore the conjunctive tissue. Seems that the gum healed and the tooth also has strengthen up a bit.\n\nOn other hand I feel optimistic, hope after stopping the antibiotics will not get again infected. I will stay a couple of month see what happens, due also a laser pocket cleaning on those molars and pray to be ok. Anyway in these time I will have to correct my mouth bite so...for me it's ok waiting. It's better to have a tooth then an implant I guess.\n\nI'm taking also a very strict hygiene, not eating on that side, cleaning after every soft meal, no sugar, and I have oral irrigator, mouth water, inter dental brash etc.\n\nThank you very much for the support! MattKW: The earlier OPG shows a deep filling on distal of 36, which means the abscess is probably endodontic in origin. I don't understand why any perio treatment with laser would even be considered. AVM: MattKW said:\n\n\n\n\t\t\tThe earlier OPG shows a deep filling on distal of 36, which means the abscess is probably endodontic in origin. I don't understand why any perio treatment with laser would even be considered.\n\t\t\nClick to expand...\n\nThanks for the reply, well I lost some bone on the lateral of the tooth because of pus that gattered it's path threw the bone (after the jaw was inflamated I also had a paradontal abscess with pus). And I think it's good if I also clean the gum very well with laser..." + }, + { + "id": 176, + "title": "Bone Lost? What to do?", + "dialogue": "MrJohanson: Hello!\n\nCan I ask for help and advice?\nI have Receding Gum on one tooth on lower jaw and my bone tooth is reduce little itself.\nI saw on internet about bone graft, but dont know is there enough space to put bone graft, so the bone graft can turn into bone?\nHere is rtg picture of tooth.\n\nIm asking this because, its small place and little room to put bone graft, and if bone graft is put in this place bone graft will be in contact with my bone only by one side - bottom part. Because bone lost is happening between two tooth. MattKW: The real question is, why the bone loss in the first place? The bone level of adjacent teeth looks OK. Get to a dentist or periodontist. I doubt a bone graft is a viable solution anyway, but maybe you can prevent further loss. MrJohanson: Hello MattKW ! Thank you for your answer!\n\nI have two question for you. Thank you for bone graft opinion.\n\nHow should this tooth be cleaned, because bone bacteria is probably close to bone or on bone? Does gums need to but cut and open to get to root of tooth close to bone to clean it?\n\nWhat do you think about puting there Periodontal Splint? My tooth are not loose but should I put splinter to prevent tooth to become loose ?" + }, + { + "id": 177, + "title": "Will LANAP make gums grow?", + "dialogue": "Eric2005: I need a straight and simple answer to a question: Will LANAP regenerate severely recessed gums, i.e.make the gums grow back? I have had mixed answers on this. \n\nA LANAP specialist wants to do LANAP. Another periodontist wants to do traditional surgery. Says LANAP will not regrow gums. \n\nWHAT is the truth? \n\nThanks. MattKW: No, it won't regrow recessed gums." + }, + { + "id": 178, + "title": "whats the main reason of cause periodontal diseases?", + "dialogue": "stanly: my friend suffers tooth pain last month..he visit local dental doctor but he said just tooth decay problem..and a famous doctor told may it is periodontal disease..i was shocked whats the main it causes? Busybee: Gum disease can run in families or can be down to bad diet, smoking,poor dental hygiene. Same for tooth decay. Some people are more prone to it, but others don't look after their teeth. Regular appointments with a periodontist help manage the condition. Uptown101: The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that forms on your teeth. Bacterial plaque isn’t the only cause though. Other factors, like the following can also affect the health of your gums like Smoking or Tobacco Use, Genetics, Pregnancy and Puberty, Stress, Medications, Clenching or Grinding Your Teeth, Diabetes, Poor Nutrition and other Systemic Diseases that interfere with the body's immune system." + }, + { + "id": 179, + "title": "Failed CTG gum graft....help!", + "dialogue": "Alice Potter: Hi there,\n\nI had a connective tissue gum graft surgery two weeks ago, and I just looked at the tooth and it looks like it didn’t work. I don’t see the periodontist for another week, however I’m obviously very upset and have huge amounts of anxiety. Does this mean my tooth is dead and didn’t accept the graft? What are my options if so? I’m really worried and have no idea what to do. Any help is much appreciated. niceone: Hello\nSo sorry to hear of your dental issues.\nUnfortunately, gum surgery is a waste of time and money.\n\nThere are some other things you can do to heal your gums.\n\nThanks" + }, + { + "id": 180, + "title": "Candidate for Gum Graft Surgery?", + "dialogue": "JJ_8613: Hi all.\n\nI have a question for dentists and periodontists.\n\nLet me include a bit of background here. In 2014 I had double jaw surgery for an overbite and crossbite on the upper jaw and severe underbite on the lower jaw. I had little to no chin before the surgery because the underbite was so bad.\n\nNow I'm told by my dentist that I have gingivitis and begining signs of periodontal disease. I'm concerned because all of my gums hurt despite my efforts to do good oral hygiene. The biggest concern is my lower front gums especially around the 6 front lower teeth. The teeth appear long to me and some areas are white. It looks like there is very little gum tissue covering some of them. I'm guessing this is probably related to my jaw surgery.\n\nI've included a couple of photos.\n\nSo here are my questions:\n\nAm I a candidate for gum graft surgery?\n\nWould the gum graft surgery help or take away the gum pain?\n\nDoes it look like the teeth have exposed roots due to thin gum tissue?\n\nCan exposed roots cause pain and even root canal type symptoms?\n\n \n\nThank you.\n\nJJ MattKW: The photos are indistinct. It looks like you have average gingivitis, which you should be able to get under control with regular 2x daily brushing, flossing, and use a chlorhexidine mouthwash nightly. Gum pain? Normally only happens in late stages of periodontitis, which does not appear likely from photos. Gum graft doesn't appear necessary unless you denude the roots. If you're really not sure about the gums, get referral to a periodontist for an opinion. niceone: Gum graft surgery is waste of money and time." + }, + { + "id": 181, + "title": "Lump releasing pus near a root canal treated tooth with a crown", + "dialogue": "skyfall: I need your advise. I always had gum inflammation and bleeding but around a week back a red lump suddenly appeared near a tooth that had root canal treatment and crown since around 20 years. When i press the gum pus is coming from the lump. Went to periodontist and he said a surgery is needed to open the gum for 3 teeth and it would cost around 1200 AUD. He did not want to give me antibiotics and I am trying home treatments like salt and baking soda rinse, garlic over the lump,... nothing seems to be working. There is no pain only I became obsessed with this lump and am afraid the infection will spread.What shall I do? Janet Two Hawks: You have an infection. Go back to your dentist. That type of infection will only get worse and can lead to serious health problems. Oral infections can get in to your pericardium and cause heart inflammation. PleSe seek help. Salt water rinse will not make that go away. Garlic will only ward off vampires, I’m afraid. Good luck to you. MattKW: Why did you go to the periodontist? Were you referred or just go of your own volition? Do you have any Xrays? Home treatments will do nothing." + }, + { + "id": 182, + "title": "Pericoronitis Paaaaain.. ow.", + "dialogue": "Rachel Holmes: Hello everyone!\n\nRoughly two weeks ago I woke up with a sore throat... In my mouth. Weird, right? Went away after a couple of days. Came back, went away again. Now it's been back for a full week and getting worse. It spread to my ear. \n\nI went to a dentist on Tuesday. They did x-rays and an exam and said I need to have my wisdom teeth pulled. He gave me amoxicillin, cool. \n\nWent back yesterday so they could do a cleaning. Also cool. \n\nToday I wake up and it's like the pain has doubled, maybe even tripled. My ear no longer hurts, that's good. But I can't even chew without being in pain. I can't close my mouth all the way, wiggling side to side hurts. Any pressure hurts. When I talk it's like I have to talk with my mouth barely moving because the up and down motion creates more ouch. \n\nI'm taking the amoxicillin and also 800mg of ibuprofen every four hours. It barely helps. \n\nI have no idea when I can get in to see an oral surgeon about removing my teeth. What can I do for the pain? \n\nSincerely, \nOuch-face." + }, + { + "id": 183, + "title": "fillings in gum pockets", + "dialogue": "lou82: I went to a new dentist today and the hygenist found some pockets in my gums that are a little deeper than 4. The dentist wants to put fillings in the pockets, five of them. I have never heard of this kind of proceedure. Is this a legitimate proceedure?" + }, + { + "id": 184, + "title": "Furcation symbol", + "dialogue": "ArmandsUX: Hello everyone!\n\nI'm currently working on a dental charting tool and I'm stuck at Furcation. The question is - which is the most commonly used symbol for furcation? Some research materials display triangles (outline, filled) and some display circles. Wondering which one would be most commonly used in Europe.\n\nThank you for the help!" + }, + { + "id": 185, + "title": "I'm 13 And Don't Know What To Do", + "dialogue": "Daisy king: So here's the thing, I'm 13 and have noticed that my gums bleed when I brush my teeth. They also seem to be receding and pulling away from my teeth (especially the bottom ones). Whenever I brush it is tender and hurts. I've poked around on the internet and I think I may have gum disease.. I'm not quite sure how to act on this as all the advice on gum disease tells you to get medicine or visit the dentist, but I can't buy things like antibiotics because (obviously) they are not allowed to sell them to me. I don't know how to get an appointment at the dentist on my own either. I'm scared to tell my mum though.. I'm extremely worried that if I carry on keeping it quiet, it will get worse and I could lose teeth. I don't know how far through the stages of gum disease I am. I really could do with some advice. Thanks, Daisy. Janet Two Hawks: You need to see a dentist. Can you show your school nurse and see if he/she can help you? KVMCruces: Hi doll,\n\nFirst of all I'm super impressed that as a 13yr old you're doing all of this research on your own! \nFrom what you're describing, it's urgent that you go see a dentist. You shouldn't be afraid to tell your mother, you did absolutely nothing wrong.. but if you're that uncomfortable then perhaps you could seek help from an adult at school or maybe another family member (aunt, uncle, grandparents, etc..) ?\n\nIt's better to try to get to the root of the problem and take care of it before your oral health worsens. Waiting won't get you anywhere and I'd hate for you to continue being in pain." + }, + { + "id": 186, + "title": "Gum swelling", + "dialogue": "Spencer1h: Hello, I've been having a loose tooth issue for a few days due to what I imagine is teeth grinding at night (increased recently by stress from college which is what I assume caused the looseness). For a few days I touched it a lot and obviously this only made it more loose. Recently, my tooth has begun to tighten up because I was careful not to touch it and made sure I wouldn't grind at night using a mouth guard. However, just in the last day, there was a large amount of swelling of the gums around the loose tooth. Now, I would take this immediately to a dentist but I'm low on cash and I would like another opinion on whether my gums are simply irritated from me constantly messing with it, or if it is something more serious like gum disease. I have started flossing and gurgling salt water but if it's more serious I'm sure that won't help. The gums don't hurt and dont bleed when brushing, so I'm wondering what the deal is. Picture provided below. Just a lot of swelling. Janet Two Hawks: Sensitive to heat? Spencer1h: Janet Two Hawks said:\n\n\n\n\t\t\tSensitive to heat?\n\t\t\nClick to expand...\n\nNope. I was eating stew earlier today and although it gets irritated when food brushes against it, it's not due to the heat. Janet Two Hawks: Can you get an X-ray of that tooth? I’m wondering about an infection. I know you’re short on cash, but I’d try to find a way to check it out. Spencer1h: I should clarify, it does feel irritated at times like when I eat, but other than that nothing. Spencer1h: Janet Two Hawks said:\n\n\n\n\t\t\tCan you get an X-ray of that tooth? I’m wondering about an infection. I know you’re short on cash, but I’d try to find a way to check it out.\n\t\t\nClick to expand...\n\nThank you for your opinion. If you think that it could likely be an infection I'll go in. KVMCruces: Being short on cash is never easy especially when something like this comes up.\nA lot of dentists offer new patient specials ($50-$75 cleaning with a free exam/xray, etc...) it might be worth it to call around and ask or just browse websites of your local dentists." + }, + { + "id": 187, + "title": "Does dental scaling have proven clinical benefits", + "dialogue": "TallPoppy: Is dental scaling and periodontal pockets cleaning one and the same? if so does scaling have proven researched benefits to the patient or is it just clinical evidence not supported empirically.\n\nI find it difficult to look for unbiased information of scaling on the net, any links would be great. For example if an article starts praising scaling slowly it veers to being a proponent of ultrasonics.\n\nThanks all for your help!" + }, + { + "id": 188, + "title": "Horizontal bone loss treatment / GTR", + "dialogue": "andy8370402: I have significant horizontal bone loss across most teeth caused by periodontitis.\n\nA few teeth are very sore, and the dentist recommends extraction.\n\nI've been advised that because it horizontal bone loss, that Guided Tissue Regeneration is not suitable.\n\nThe bone loss is so severe that implants would not be an option, requiring dentures.\n\nIs there any good news /research on the horizon that might make GTR and option? Janet Two Hawks: Without seeing X-rays, I’d have to say that the advise sounds well thought out and in your best interest. Have you sought a second opinion? andy8370402: Hi Janet, yes I've had two opinions.\nIt's not that I don't trust the dentists, or am in denial. \nReally just wondering if there was any new technology coming through.\n\nWhen you say \"in my best interest\" are you suggesting there is an option, or that there is no possible treatment available? Janet Two Hawks: I am not aware of anything available for the amount of bone loss you describe. Because your teeth are sore and in light of what you report with the bone and tooth loss, it is in your best interest to get rid of the remaining teeth, get out of pain for your dental health. I don’t want to sound like a commercial, but get your life back! You can have a beautiful smile you are proud of and teeth you can function with, why spend ten years waiting on research? Truly, I wish you well with your journey. andy8370402: Thanks Janet, all sensible advice.\n\nBecause the bone is gone, I can't have implants, and because the issue is widespread I can have bridges, so the only option is dentures.\n\nEveryone I know who has dentures hates them, and it doesn't sound like getting my life back, hence the wishful thinking \n\nI hoped that if they can build people's jaws from bone transplants, or already use stem cells to regrow bone, maybe we weren't that far away from a solution. It doesn't seem a huge leap to go from repairing vertical bone loss to repairing horizontal bone loss - just some better scaffolding?\n\nI much appreciate you dipping in to this thread, and taking the time to help." + }, + { + "id": 189, + "title": "how long does it take to get rid of bleeding gums", + "dialogue": "malchienne: im relatively new here so please tell me if i posted on the wrong board\n\nmy dentist said i have a little bit of gum disease but he never mentioned it after. my gums are very swollen and red and i want to start brushing properly (ive never paid it too much mind i always just brushed straight across and i know youre supposed to do it in circles) and i want to know how long it will take for results to start showing thank you Busybee: You should ask your dentist to refer you to a periodontist for a full assessment. It really depends on lifestyle factors too such as diet, smoking, drinking, exercise. Vitamin C should be in your diet and you should stop smoking if you do. You should floss and I'd recommend a good electric toothbrush rather than a manual. I've found a sonic brush to be really good for gums. Anything that improves the circulation and healing of your body will benefit your gums. But some people need regular attention from a specialist to do a deep clean and help the gums heal. Healthy gums are incredibly important so do look after them. It would take a week or two to see an improvement if you are doing the right things and don't have a more serious problem. If you don't see an improvement after 3 weeks of eating healthy foods, not smoking, flossing and good brushing technique, then ask for a specialist referral." + }, + { + "id": 190, + "title": "im worried", + "dialogue": "adjderb: I noticed a little swelling on my gums at the back of my front teeth. it is not painful but when I brush my teeth It sometimes bleeds. I am worried that it could be gingivitis. I have just bought oral b pro expert and was wondering if this would help get rid of this. Robin Pandey: If you can upload a picture it would be much better. Talking about your problem anything in the mouth that is not a medical emergency should be checked for 2-3 weeks. If the problem is not resolved then appointment with a dentist is must. \nAnd googling about it is the worst idea." + }, + { + "id": 191, + "title": "Chronic periodontal disease", + "dialogue": "Aqeel Rasheed: I have been suffering from chronic peridodont disease for last 20 years and my gums and teeth are very week and in worst condition. It is a genetic disese because my mother had same disease.\nDoctor advise me keep your clean with scalling as long as you can or implantaion is the only way after OPG Xray seen." + }, + { + "id": 192, + "title": "Cosmetic periodontist?", + "dialogue": "Sara Smith: I have been going through orthodontics for the last year via invisalign. Near the end, I felt my teeth looked 85%. I asked my orthodontist if having laser contouring to lengthen #7 would help make my smiler better. He suggested a dentist in his own office, \"an artist.\" I had it done, and, in my opinion, it was botched. He said he would contour me to a 9mm crown length, but I'm actually now at 11mm with a contour that looks nothing close to the other side (#9 is 10mm crown length). I went to get an opinion from a periodontist - he said give it time to heal, and if in 8 weeks I want to do something about it he offered a minimally invasive gingivoplasty. It sounded fairly easy with minimal pain, but he also mentioned that it would move the gum down with the adjacent teeth as well. Well, my two front teeth have an uneven gum line so to me this doesn't sound like the best option. I am wondering what it a good option to fix a botched gingivectomy on a single tooth." + }, + { + "id": 193, + "title": "Loose tooth", + "dialogue": "Sne34: Hello,\n\nI had flap surgery two years back on front lower tooth. Reason was loose tooth.But now again I am feeling that tooth is loose. I have taken appointment . But just curious to know if I can have laser treatment now ? Or only option is to loose that tooth?\nThanks in advance ." + }, + { + "id": 194, + "title": "Biotene", + "dialogue": "Comfrey: I've recently started going to a periodontist; I've got fairly severe gingivitis (deep pockets and receding gums) and am undergoing scaling/root planing.\n\nThe periodontist strongly encourages all of his patients to use Biotene oral rinse. I've been using Listerine (or equivalent) for 20 years, based on the evidence that it may help control gingivitis, though I am aware that there is some controversy about long-term use of Listerine (in part because of the impact of alcohol).\n\nHowever, the information I see publicly about Biotene indicates that it is designed to address dry-mouth. I haven't found any claims from the manufacturer, or studies indicating that it is helpful in addressing periodontal disease. When I asked the periodontist for his rationale in urging me to use Biotene, he mentions that it controls pH, and that acid wears out tooth/root enamel, and that he thinks his patients fare much better with Biotene than they used to do with Listerine.\n\nI do not have dry mouth. In fact, I tend to over-produce saliva. \n\nAt his urging, I've stopped rinsing with Listerine, but am now just not using mouthwash - I'm skeptical of advice just based on anecdotal evidence, and somewhat reluctant to start rinsing with a mouthwash that is intended to stimulate salivary glands.\n\nIs anyone aware of any published scientific (controlled) studies indicating that Biotene should be used to address periodontal disease? Is there a good reason for all periodontal patients (regardless of whether they have dry mouth) to use Biotene oral rinse?\n\nThanks! Uptown101: Hello Comfrey,\n\nIf your dentist advice you to use that as oral rinse then do what you are told.\nBut if your looking for a good rinsing try coconut oil as mouthwash." + }, + { + "id": 195, + "title": "Black lines on surface of teeth", + "dialogue": "Nisha: Hello, I have some black lines on two of my teeth and I am worried that this will cause severe decay and being unable to save my teeth after that. May i know what the condition is and what treatment i need? It looks exactly like this. Zuri Barniv: This is mostly staining with possible decay, but if there is decay, it is not deep. Nisha: Zuri Barniv said:\n\n\n\n\t\t\tThis is mostly staining with possible decay, but if there is decay, it is not deep.\n\t\t\nClick to expand...\n\nThank you for your reply. \nI had it checked with my dentist and he said it was stain and there was nothing he could do about it except for me to brush my teeth" + }, + { + "id": 196, + "title": "Receded gums at 27", + "dialogue": "CHaynes: Hi guys,\n\nJust thought I would post to see if I can get some advice and support on some dental issues I have.\n\nBasically I didn’t go to a dentist for many years for various reasons, partly as my personal circumstances were quite tumultuous but also because it just didn’t occur to me.\n\nA few years ago I started brushing too hard but didn’t realise as wasn’t in pain and didn’t really notice any symptoms and this has caused the gums on some of my teeth to recede a bit. I have no tooth decay although my teeth are a bit discoloured from the heavy brushing.\n\nMy dad has severe periodontitis and extremely receded gums on lower jaw causing loss of 4 teeth so far and will eventually need dentures as he used to not bother brushing his teeth.\n\nMy mum has some slight receded gum from brushing too much. This has happened in a different way so that it goes deeper into the tooth so she requires fillings in these areas and also she has to have an extraction due to decay etc.\n\nI have since started using an oral b electric brush with sensitive head and floss every day. I have no problems eating food or pain and only my teeth are visible when I smile or talk due to low lip line.\n\nIs there anything I can do about this dental issue I have or just make sure my oral hygiene is really good from now on? I read about gum grafting but the recession is on quite a few teeth.. I was thinking I could have grafts on the worst areas in future as some of the teeth are a little harder to clean effectively due to where the gum receded?\n\nI appreciate that a lot of people have at least one kind of health issue and am just trying to make sense of this a little\n\nThanks Busybee: Gum disease is often hereditary so you may be unlucky but have you seen a dentist for advice on brushing etc? Having a healthy diet, not smoking, eating the right foods for your teeth should all help as does exercise because it gets the circulation going to your gums. Anything that will improve oxygen levels in the gums. But if you see an expert then they may be able to bring your gums back to health with regular deep cleaning etc. CHaynes: Hey Busybee,\n\nThanks for your reply\n\nI have seen a dentist and they have said it is not related to gum disease per se but due to heavy brushing, although they did say that plaque build up and slight gum inflammation makes it more vulnerable to being pushed back with poor brushing. They instructed me to use an electric brush with sensitive rotary heads and I use an anti bacterial floss as well.\n\nI have always had fairly healthy diet with plenty of fruit and vegetables and never smoked, always exercised well also. Although I have suffered from stress and low mood at several times in my life which may have contributed.\n\nA big part of the problem was that I never went to a dentist for a number of years due to bad personal circumstances and other reasons as they most probably would have picked up on my bad habits during regular visits.\n\nI have been to see the experts a few times and they said that I should not have any further issues leading to tooth loss or decay although the damage to my gums is done unfortunately. I might look into tissue grafts on worst areas in future as in some areas the teeth are slightly harder to clean now. I go to dentists every six months now for checkup and then a professional cleaning after this appointment to keep everything monitored. Also I don’t have any other health or medical issues.\n\nThanks again for reading Busybee: I would not blame yourself for not visiting a dentist. I didn't go once for 7 years and only needed a filling. I am not sure I really needed that. I didn't go again for 7 years and I didn't need anything done. But then we were shown by a nurse at school how to clean our teeth effectively. If you went to the dentist as a child they should have shown you how to look after the gums. It's worth going for regular hygienist visits but I don't think there is much value going to the dentist every six months other than psychological reassurance. Having your teeth professionally cleaned 2-3 times a year should help you. But try not to worry about your gums. You are really lucky not to have decay so it seems you caught it in time and maybe just have the gums checked regularly. CHaynes: Busybee,\n\nThanks for your kind words.\n\nI did go to the dentist regularly as a child but stopped when I was in my teens as was no longer available on NHS and nobody explained to me that I needed to go back to a private dentist at some point.\n\nI received good education on the subject as a child and was shown how to brush and went for regular cleanings but unfortunately I think this level of understanding disappearead over the years where I never went and switched between different types of brushes etc or paid not enough attention to products I was using. Actually a while ago my brother volunteered at a dental practise in South America and he said everyday there were people having half their teeth extracted due to decay, that should have been a catalyst for me to start going back lol\n\nOk yes I see your point as the dentist has already explained what I need to do now so I could have cleanings 2-3 times a year and checkup once per year of teeth and gums.\n\nAlso apparently it is fairly common for people to have some areas of gum that have receded as there are various reasons it can happen. For example some people when they smile very broadly and their top lip lifts up you can see that they have a few teeth where the gum pulled back.\n\nDo you think I should consider seeing a periodontist about tissue grafts on some of the areas where gum receded in the future or maybe just focus on practising good oral hygiene as I am doing now? Busybee: I think you should see a good hygienist a few times a year. A good hygienist will check your gums really carefully and make recommendations. There isn't much point in having invasive dental work if a dentist has said you are ok as you are. Gums have an amazing ability to recover if you are kind to them. If you keep up your hygiene regime and get hygienist advice you may find that at your next dental check up they give you a more positive prognosis. Don't overdo the brushing or obsess, your body does most of the work if you give it a chance. Nothing wrong with seeing a perio for an opinion but maybe you should wait and do some hygiene appointments first? CHaynes: Yes they have said I am ok and will not have other issues now with my oral hygiene regime although they said the gum does not heal back to where it was it can just remain clear of inflammation and won’t recede any more.\n\nOk yes I think I will have some hygienist appointments first as you say and see how that progresses. Maybe seeing a perio for their opinion is something I can consider in future.\n\nActually my dad was recently told he has to be fitted for top and bottom dental plates due to teeth lost from gum disease. At least I will not be losing my teeth for whatever reason.\n\nAlso on a trip abroad I went on recently with a tour operator I saw that it is really common for people to have some kind of health issue, for example one of the people there had diabetes and injected insulin during meals sometimes and somebody else had a damaged shoulder from bike accident and couldn’t put much pressure on it. I think that was psychologically helpful for me to understand that these things happen and it’s how you adapt and learn that matters mostly" + }, + { + "id": 197, + "title": "bump/pain even dentists don't know", + "dialogue": "rkang: Hi all,\n\nSo about a month+ ago, I started having small pain->terrible pain in the left bottom gum where my wisdom toothused to be (got my wisdoms out about 3 months ago). When it got to bigger pain, it moved on to my entire left jaw so I thought it was something in my jaw. Went to the dentist, took some antibiotics, it got better but didn't heal completely and then some white bumps and this gross colored infection circle thing started to form around my last/back tooth. Went to the dentists who gave me some type of cleaning on the gross colored thing and told me to go to the bigger hospital dentist bc they couldn't do anything more besides give me antibiotics. Taking the antibiotics, I went to a big hospital dentist and 2 of the dentists there couldn't figure out what was wrong. Told me to come back in 2 weeks if after taking more antibiotics it didn't heal so I could take a CT scan of the area (and pay a lot of money). \nSo NOW/CURRENT SITUATION/CURRENT SYMPTOMS- Finished antibiotics, the white bumps and redness around my back tooth are gone, but there's a new gum-colored bump forming behind that tooth/where my wisdom teeth used to be. I also feel discomfort in general, pain after I eat, and I think the discomfort/pain stretch to my left chin area (i can point to a specific area) as well as my left jaw as I keep wanting to crack my jaw....\n\ndoes anyone know what these symptoms are??? cyst? infection? gingivitis? foreign body? tumor? cancer???\nI'm currently using listerine twice a day and washing with salt water as much as I can but it's hard to do it so often because of work \n\nthanks for any inputs!!! calcium48: you've done the right thing by going to the hospital\nyour age?\nwhen the lower wisdom tooth was removed it may of damaged the nerve there.\nhope you get well soon. Zuri Barniv: You need to get a panorex x-ray and upload it to get any help. Your descriptions are not enough. rkang: Zuri Barniv said:\n\n\n\n\t\t\tYou need to get a panorex x-ray and upload it to get any help. Your descriptions are not enough.\n\t\t\nClick to expand...\n\n\nI took one general X-ray (probably the panorex X-ray according to google) and a more specific one in the area I’m hurting, but nothing showed up. That’s why they are telling me my next step is the CT scan. \nMy descriptions are all pretty much it! Bumps/pain sometimes is really it and the chin and jaw discomfort. Really confused and nervous... rkang: calcium48 said:\n\n\n\n\t\t\tyou've done the right thing by going to the hospital\nyour age?\nwhen the lower wisdom tooth was removed it may of damaged the nerve there.\nhope you get well soon.\n\t\t\nClick to expand...\n\n\nWould nerve damage cause physical bumps in the gum? I’m 23! calcium48: If x-ray didn't show anything that may be good news that its not anything serious like cancer..." + }, + { + "id": 198, + "title": "Very sore gums", + "dialogue": "Stephen: Hi, I am new to this forum and I am (obviously) looking for advice. I am 61 yrs of age and have advanced periodontitis. I have had it for approximately the last 10 years and have tried to keep it under control via interdental brushing and a water pick. Anyway, I got made redundant and because I now have the time, I am devoting time to try and get on top of the problem.My teeth have lost all their enamel and I would like some work done on them but it is obviously no use unless I can get on top of the gum problem.I am in the process of having my teeth cleaned and have been advised that interdental brushing is the most important process and that the water pick not so useful. I have also been told that I haven't been using the correct size brushes (too small) and so now use different size brushes for different teeth. I have now been brushing between the teeth with bigger brushes for the last two weeks. Now I get to my question. Since using the bigger brushes my gums bleed a lot but this is not the main problem. My main problem is the pain. My gums are so sore when I brush them, they feel raw, like brushing an open wound. I was told this would improve but it is showing no sign of improvement yet. Anyone with any advice would be much appreciated.\n\nRegards\nSteve" + }, + { + "id": 199, + "title": "Scaling & Root Planing Pain", + "dialogue": "Tsakanie: Hello! I had scaling and root planning (by a student at dental school clinic) yesterday and it was very painful for my gums. I'm wondering if the amount of pain I felt was normal and whether the experience is worth mentioning to his instructor. My gums and teeth are not in horrible condition, with my dental pocket measurements being 2s and 3s with no bleeding. I thought this meant the cleaning would be relatively painless. For 30 minutes it felt like my gums were being forcefully scraped and jabbed, as he performed the procedure with hand tools. I bled to the point he had to stop and apply (too much) pressure to stop the bleeding. He then used the Cavitron, and I'd had enough! I told him I did not want him to use the machine, but he said he'd be gentle (which he was for 1 minute). Is it typical to use both the hand tools and the cavitron? It's seemed like overkill. Anyway, I'm having intense anxiety about having cavities filled by him. I'm not sure if I'm overreacting and not sure how to handle my next visit because I'm not familiar with the protocols at a dental school clinic." + }, + { + "id": 200, + "title": "I am 40 and am losing my teeth due to bulimia when young help!", + "dialogue": "ZARA1976: I am 40, when i was 16 - 25 I had bulimia. My gums were receding before then anyway. I had another stress related breakdown 4 years ago and im on a pretty good road to recovery (just getting back to my wonderful marketing world self employed p/t) when i was 16, my gums were receding. I cleaned my teeth always. i did have terrible experiences with dentists at boarding school, where i was made to brush my gums with bleach. i believe this is partly hereditary, my grandma was stunning and had full dentures at 40 ( and was stunning until she passed in her 80's )\nmy issue is that ive FINALLY got a wonderful nhs dentist, and the breakdown clearly meant i neglected my teeth for a while Im losing them. \nim only 40! I truly want another good 40 years of my life. i brush my teeth left 4 times a day with oraldene toothpaste, mouthwash, and i am trying to give up smoking also. \nim happy to share images of my mouth taken today also\n- will i still be able to have a denture?\n- will if i give up smoking and move to a vape will that help my gum disease? ( i'm struggling with giving up totally but i'm on like 2 a day now)\n- how long will it be after giving up smoking will i be able to be considered to have bone grafting?\n- is there anyone else out there i can talk to? Its unnusual i know to be losing my teeth at my age these days and its not that i havent looked after them.. i feel so alone\n\nBTW! IM POSTING THIS IN COMPLETE TRUST AND FAITH AND THE INTERNET DOES WORRY ME THAT MY PICTURES COULE END UP ONLINE SOMEWHERE SO ID RATHER SEND PRIVATELY HaleyBB2002: I can relate unfortunately. I am in my 40’s also and all my gums on my bottom teeth are receding uniformally not just in one area or one tooth. Areas that were once covered by gums are not and gums have thinned. I have practiced good oral hygiene always, just smoked when I was younger but not recently. This past year I have watched my gums recede and have been to dentist, perios, and oral surgeon with no real answers or solutions.\nIt does cause me anxiety and has affected how I eat. I have lost weight due to eating less. I fear I will loose my teeth and don’t understand how this is happening. \nI am sorry I don’t have an answer or solution." + }, + { + "id": 201, + "title": "Pain after periodontal probe", + "dialogue": "jackthehack: So I had no pain at all for quite a while, and then I went to the dentist, who then proceeded to measure the socket depth (bone loss) with a periodontal probe and now my gums feel sore and one location specifically is so painful that I can't eat on that side. It's been two days and it's not getting better. Anyone else had this experience? Jilly j: jackthehack said:\n\n\n\n\t\t\tSo I had no pain at all for quite a while, and then I went to the dentist, who then proceeded to measure the socket depth (bone loss) with a periodontal probe and now my gums feel sore and one location specifically is so painful that I can't eat on that side. It's been two days and it's not getting better. Anyone else had this experience?\n\t\t\nClick to expand...\n\n\n\n\njackthehack said:\n\n\n\n\t\t\tSo I had no pain at all for quite a while, and then I went to the dentist, who then proceeded to measure the socket depth (bone loss) with a periodontal probe and now my gums feel sore and one location specifically is so painful that I can't eat on that side. It's been two days and it's not getting better. Anyone else had this experience?\n\t\t\nClick to expand...\n\nOnly just read your post but i now have exactly the same problem. Did you finally get any relief from the soreness? If so how long did it take?" + }, + { + "id": 202, + "title": "its on bisposphonates", + "dialogue": "regular student: Can we perform scaling root planing for its on oral bisphosphonates or get medical clearance?" + }, + { + "id": 203, + "title": "Love to hear your views on Emdogain", + "dialogue": "catherine t: Would love to hear your thoughts on why Emdogain by Straumann is such a dominant player in the tissue regeneration products, any other products you feel better?\n\nbest\nCatherine" + }, + { + "id": 204, + "title": "Help", + "dialogue": "Clarks: Hi I have a few cavities on my front teeth picture attracted does it look like I have periodontitis or will i need to have my teeth pulled out I'm so scared if that is the case" + }, + { + "id": 205, + "title": "Scared Of Receding Gums", + "dialogue": "hcitar: so i have braces but even before i have had a tiny pocket in my bottom front teeth and i am scared it will go deeper and i will have gum disease and it will fall out. i also kind of clench (not grind) my teeth i have realised and 'click them' and im trying to stop it.\n\nmy dentist said to brush harder with a soft toothbrush but my ortho said it was because i was brushing too hard!! plz help calcium48: You need to stop grinding your teeth.\nSometimes a mouth guard can help" + }, + { + "id": 206, + "title": "Something stuck in gum?", + "dialogue": "Saraah: Hello, I am an eighteen-year-old who admittedly dislikes visits to the dentist. Therefore you can imagine my hygiene is very good; I have brief and few periods of pre-gingivitis due to being captive in braces for three years. Having removed my braces over a year ago and lucky for me I don't have wisdom teeth (none in x-rays due to premature birth), the end of my dental pain seemed over. \n\nHowever, about five days ago all the sudden I woke up and the very back of my mouth around the last left molar is swollen. It is sore and irritable. I kept brushing and using salt water, there is no bleeding or puss, but it started to feel more irritable and tender as if it was an infection. It hasn't gotten worse in swelling or pain, but it hasn't gotten better either. My Mother predicts a piece of food of some sort got wedged in the gum line, near my tongue. We've tried using Orajel to numb it enough so I could use floss or a pick to work around the gum but it still is very painful to touch, and it's in a very hard to reach area.\n\nSadly for me, I start Invisalign, and I get impressions tomorrow, as well as a regular cleaning on Wednesday. I'm petrified. So this leaves me with three questions:\n\n1.) Do you think a piece of food is the problem? Is there something I can do to remove the food before my appointment tomorrow?\n\n2.) What will the dentists do (if it can't be withdrawn myself) tomorrow when I ask them to address the situation?\n\n3.) What are the chances this is a bigger infection and is not food related, what will dentists do then? Will I have to have surgery or procedure done or antibiotics?\n\nPlease respond, as I am horrified. This is my worst fear. ganeshkumar: Saraah,\n\n Don't worry too much about your problem. I think there is nothing serious.Its just a infection. Dentist will solve your problem. priyakumar: Don't worry Saraah, there is nothing serious. please don't imagine that your having serious issues.It will be alright" + }, + { + "id": 207, + "title": "Help with Gum Desease", + "dialogue": "Francis Hodgkins: I have gum disease, and want to get the best possible gum health. When I ask my hygienist about a treatment plan, I am told she will do her best to prevent bone loss, and that she is doing this. I get a cleaning with lazer in the deep pockets (typically now 4 or 5) every three months. I floss daily, use a waterpic and electric tooth brush every day, and use therasol and Closys. I am told my pockets are all 3 or less except for the back molars in each quadrant, where I have the 4s and 5s. However, I believe my gums are still receding as I can now see the bottom of caps that were not visible 6 months ago, and there are 3 places where a strip of gum is gone over my front incisors. \n\nHere are my questions:\n\n1, Is Therasol effective in controlling gum disease. I use a dilute solution in my water pic with an orthodontic tip to brush the gum margin hoping some of the therasol gets into the pockets. I hold the standard solution in my mouth for at least 3 minutes every evening. \n\n2. Are all lasers LANAP lasers? In SACRAMENTO, a few periodontist advertise the use of a LANAP laser. My dentist does not and my treatment is done by a hygienist not a dentist. Is there an advantage to the LANAP laser? calcium48: how old are you? Francis Hodgkins: 73 years young. Parthadental: Dear Sir\n\n1.Based on the information that you have provided, we can conclude that you are suffering from localised periodontitis. To further confirm it we may need a full mouth radiograph to confirm your periodontal health. Any mouth wash just helps in keeping your mouth fresh and few may help in acting against the bacterial activity. So using a mouth wash is always advisable but a break in using the mouth wash every 3 months should be given so that it is still effective.\n2.Now a days almost all lasers are LANAP. It is any day advisable for you to meet a dentist and not a hygienist as dentist would be able to provide perfect diagnosis and treatment plan for your oral health condition. We suggest you to take a Periodontist appointment at the earliest and get an advanced gum treatment done using lasers which would help you to recover. Also we would suggest you to use a soft bristles tooth brush and brush gently and a mouth wash preferably after meals. \n\nWe wish you good health.\nRegards\nPartha Dental." + }, + { + "id": 208, + "title": "Very Scared!! Am I going to loose teeth?", + "dialogue": "help!: Hi guys\n\nI am very scared. I was brushing my teeth the other day and noticed in the mirror my bottom gun line looked weirdly low. I don't have the best oral hygiene , always brush on the morning but never at night really. (Which will definitely now change!!)\n\nMy gums sometimes bleed when I brush and I flossed for the first time in years today and they bled quite a bit. Now I am convinced I have periodontitis and am scared I am going to lose my teeth. I have no pain to speak of, teeth don't feel loose, gums are colour in the picture and tartar build up on front teeth.\n\nI have an appointment with dentist for check up on Tuesday but I am so scared he is going to say I will lose all my teeth.\n\nSorry for the grossness but I have uploaded an image and wondered if anybody can advise me if I am imminently losing teeth..etc Plaza Dental Group: Thank you for posting your question. Don’t be scared. During tooth movement ( straightening) the bone around the teeth remodels and that causes the teeth to be loose.I highly recommend addressing your concern with the orthodontist who has access to your x-rays or can take an x-ray to see if there is anything going on with the root or bone support. If you are concerned or notice significant mobility changes in the teeth, please speak with your treating orthodontic specialist. Good luck and I hope that this helps. calcium48: so what happened?" + }, + { + "id": 209, + "title": "Bone loss but no gum disease?", + "dialogue": "Ander36: I am paranoid about receding gums because I have anxiety so I went to the dentist. They said I am good I have mostly 3mm pockets and no bleeding or problem but I have some bone loss but no bid deal.\n\n5 months later I went back to another dentist because I began to worry again. They said yeah I have mostly 3's. She mentioned the bone loss and said it was like 20% bone loss.\n\nIs this \"ok\" or normal for age 45? And if I have no gum disease, why do I have bone loss? Mr. ABC: I heard that 15mm is when you start to risk loosing your tooth. I also heard that if you wash your teeth regularly and properly, and use listerine every time, any pockets you have will start normalizing.\n\nAlso, I don't think that \"gum disease\" causes bone loss, but vice versa? calcium48: bone loss will cause your teeth to go loose, and then they will drop out." + }, + { + "id": 210, + "title": "Periodontal treatment", + "dialogue": "Chimp27: yesterday I had to undergo root planning / debridement - a treatment I've been enduring every 3 months for the past 5 years and have always had a local anaesthetic with the procedure. Yesterday however, I was told by my dentist that NHS no longer covers the cost of the local anaesthetic and that I would have to go through the treatment without it, or pay for it privately. As I am a pensioner receiving only a state pension, I had no choice but to sit through the excruciating pain. During the past 3 months I've been on 3 courses of penicillin for tooth and gum abscesses, I am fed up with the pain and discomfort and asked the dentist if she could remove my remaining, loose, ugly and misplaced teeth and I was told that the NHS wouldn't cover the cost of removal of teeth without a medical need ? and if I wanted it done, I would have to pay for that privately too. There is no point in changing my dentist again - as I've changed 4 times in 4 years. I also went for an assessment at Guys and St. Thomas hospital last year and received a letter 3 months after the appointment saying that I didn't qualify for treatment. No explanation was given, but I suspect that the funds would be considered a waste if spent on a pensioner.\n I am devastated that I have worked hard for 48 years, always paid my dues and despite being a young divorcee with 2 boys to raise on my own, not once did I claim benefits, or ask for help. But now that I am retired and finally have the time to do the things I enjoy, instead I have turned into a loner and never go out, all due to major complexes about the state of my mouth. Thanks to the NHS - I guess this is my life now. calcium48: i can feel your pain in your post.\n\nHow many teeth have you got left?\nhow much will it cost to remove the teeth? Chimp27: calcium48 said:\n\n\n\n\t\t\ti can feel your pain in your post.\n\nHow many teeth have you got left?\nhow much will it cost to remove the teeth?\n\t\t\nClick to expand...\n\n\nI only have 3 missing teeth, so practically a full mouth. I haven't got around to getting a quote to have them removed, but a set of false teeth with built in contoured gums would cost approximately £1000. calcium48: how many teeth do you want removed? Chimp27: The two top and 2 bottom ones are the worse looking teeth, but as I can't afford to better the look with Caps - let alone implants. The only choice would be is to have all 29 remaining teeth removed. calcium48: a photo would be good." + }, + { + "id": 211, + "title": "Infection or other causing pain.", + "dialogue": "luke92: So i have been suffering from one of the worst pains ive ever felt over the last 4 days. last night i had an emergency dental appointment (out of hours) i was so hoping that would be the end of it thinking they would just give me a temporary filling or something. \n\ninstead they gave me a round of 500mg amoxicillin every 8 hours for 5 days. saying i have an infection. the pain remains and im not talking a small tickle i mean the devil himself has crawled into my tooth and started gabbing his pitchfork on what i assume is the cause of all pain and suffering. its totally debilitating at its worst i shake in agony and im unable to talk. \n\nthe only thing that eases the pain ive found. is strangely brushing my affected teeth with toothpaste this stops the pain almost totally for about 15mins but it soon returns. i must of brushed my teeth atleast 70 times in the last couple of days just to stop the pain, ive taken paracetamol nurofen and other stuff to stop the pain nothing even comes close.\n\nmy concern is that the infection is not causing the pain, why would brushing help something like that? and if its not then what is? also i cant go to my dentist yet as ive only just registered with them and that takes a week before i can make an appointment. and to top it all off ive brushed my teeth so many times to stop the pain i think im doing damage to my gums and the inside of my cheek. \n\nHelp!!!!\n\nand thank you in advance. luke92: just to add i went out and bought some sensodyne toothpaste to try. it works even better its now been about 4 hours. although there is still pain its liveable. and mostly from the damage i did myself to the gums from brushing." + }, + { + "id": 212, + "title": "Should I proceed with cutting open a painful lump on my gums?", + "dialogue": "Mr. ABC: This lump (the size of a finger nail) first appeared a few months ago, and because I literally could not eat due to the pain, I went to the dentist who said that it was caused by an infection which came due to a pocket with a depth of 9 mm. He cut the lump open and removed the contents, then he told me that if I wash my teeth often and use listerine, the pocket should start normalizing and that I should avoid eating on that side of the mouth for some time.\n\nSo when he had removed the contents inside this lump, the pain completely disappeared. I was happy, until yesterday, when the lump appeared once again, on the same spot. I have to admit that I haven't been following the advice of the dentist very closely, so I have no one else but myself to blame. But the difference this time is that I know exactly what it is, and perhaps I could avoid taking another visit to the office if I can do the procedure myself, since it's such a minor one. \n\nThis would provide me immediate relief instead of having to order a visit, and pay the money for that visit. So here is my question... what are the risks associated with trying to do this on my own? I know that I should be careful so I don't drop the needle down my throat, I know that I should sterilize the needle, and I know that I should not swallow anything that comes out. Anything else that I need to know, or have not mentioned? Thanks in advance" + }, + { + "id": 213, + "title": "Black line and bleeding gums", + "dialogue": "Ren: I noticed this a month ago, I never flossed in my life and never went to the dentist once, until 2 months ago. Anyway, I got this black line and I read it is serious so I started flossing everyday, but can someone tell me how serious it is,please I am actually scared. Like I know you are going to be like , duh, you never had good dental health. And I know, but now I want to change that but I don't really know if this can be cured. I am visiting my dentist in 1 week btw." + }, + { + "id": 214, + "title": "White area on X ray", + "dialogue": "rebecca92: hi i had a consultation with the orthodontist where he took a full x ray of my mouth/teeth. He noticed a white area around my molar at the root of my tooth. He stated this is not infection or tumor as this would turn up dark area. he stated that this is a rare condition where my tooth is literally growing continuously in my jaw bone. he is going to refeer me to a med oral specialist. I am worried as he said more than likely it will need to be removed and worried will braces work now and I dont have over crowding on my lower jaw.Anyone else had the same problem?" + }, + { + "id": 215, + "title": "Beware of false diagnoses!", + "dialogue": "amlmt: I recently went to the dentist because I was long over due for a check up and cleaning. I was well aware of a couple cavities and have had some gum recession on front lower tooth. After my x rays and consultation with the Dentist the Dental Hygienist gave me a periodontal exam. She said that the test came back positive because my gums had a little bit of bleeding, but she failed to mention any of my measurements. She told I must come back in to have root planing and scaling done with this cutting edge laser treatment. The cost of this would run me $1100. I found it odd that the Dentist wasn't the one talking to me about the treatment and just had an overall bad vibe from this woman. Shortly after leaving the office I decided to search for a local Periodontist because I believe if it's at all possible always see a specialist! During the exam while he was probing he said out loud all of my measurements (unlike the dental hygienist) there was one tooth that had a 4mm reading but all others were in the 1 to 3 range which is in the normal range. He recommended a good cleaning and to floss more. Also my receding gum had nothing to do with gum disease but the facial muscle tissue that pulls on that area. Based on my experience if you or anyone you know gets diagnosed with periodontal disease and are given vague information, meet with specialist before beginning treatment!" + }, + { + "id": 216, + "title": "will it be very risky to have dental treatment in less developed countries", + "dialogue": "kenny siu: or is it all just a matter of luck or marketing thing and most dentists everywhere are likely to be very educated, helpful and skillful? I am living in an expensive city but close to a developing country , the price difference is very very large" + }, + { + "id": 217, + "title": "Tooth #18 has new decay and a 9 mm pocket. Treatable?", + "dialogue": "Lucubrate: HELP PLEASE!\n\nThree years ago my left lower molar had a root canal treatment then a crown. It's been fine. Last Xray a year ago (see below). Last dental exam was four months ago and normal. No pockets. I brush three times a day, get fluoride applications twice a year, and floss often.\n\nA week ago there was pain in the tooth, slightly increased if the tooth were to be moved. Xray taken (see below). Dental exam shows that there's now a 9 mm buccal pocket.\n\nStarted using a WaterPik squirter 4x/day vigorously around the tooth, and within a day, the tooth felt fine. Two dentists told me the tooth should be removed. A third dentist thinks the tooth has a crack (? small line seen on the Xray in the center with maybe bone loss.\n\nWhat would be wrong with my simply continuing to use the WaterPik and do nothing for now?\n\nShould this tooth be removed ASAP?\n\nWhy does a pocket appear? If there's swelling any pocket should get smaller.\n\nWhat's wrong with having a pocket as long as it's cleaned often? Will this pocket go away?\n\nHow often should I get X-rays done? Every six weeks on my three crowned teeth?\n\n. jackthehack: I have the same and I can answer your question as to why it matters if you have the pocket or not, out of my own experience. I also thought it didn't matter, until I got an infection to the point of not being able to swallow without incredible pain, I lived on soup for a week while waiting for the appointment.\n\nThey did a cleaning and now I have no pain, but they say that in the future, it can happen again as bacteria can fill up there, it's a good place for them. Dentists didn't suggest that I have the tooth taken out, they instead said that I should get an artificial bone placed there, but hey, I also heard from some that it can naturally close up if treated well at home, but I don't know much about that. liza_1984: I have a tooth decay.last night I had a really painful toothache..but one thing I noticed was my gum is red but the inside of my cheek are swelling.what act happened?\n\nsorry if I post to the wrong thread." + }, + { + "id": 218, + "title": "Is there COL in the Central Incisor area?", + "dialogue": "Aditya pawar: Col consists of facial and lingual papilla with a shallow depression between the connection of these two papillae. In a textbook or there was col referred to central incisors.. Is that right?" + }, + { + "id": 219, + "title": "8-9mm pocket... any hope?", + "dialogue": "jackthehack: I have a pocket of 8-9mm... I heard that they could place artificial bone inside in some kind of surgical procedure but I have not had any surgeries in my life and I would rather avoid it if possible. So I browsed the internet and I read testimonies of the pockets closing themselves over the course of several weeks with proper home treatment, even down to 3-4mm. Is this true? If so, what do I need to do? I really want to avoid any invasive stuff... don't want pain. And yes, anesthetics don't really help when they shove a pin all the way inside, it hurts like hell. At least that was my experience...\n\nI also read somewhere that it can close after \"ultrasonic cleaning\"? What are the non invasive options?" + }, + { + "id": 220, + "title": "Two options for periodontal treatment", + "dialogue": "Troubled Jane: I have advanced periodontisis and have lost a lot of bone in the lower front gum and two loose front teeth. It has been advised that I either have a bridge or a splint. I am in a quandary as to which is the best option. Before this can take place I have to have deep cleaning. I would appreciate any advice as to which is the better long term solution." + }, + { + "id": 221, + "title": "Advice Needed: Failed Gum Grafting Procedure", + "dialogue": "Tim_DC: I live in the northern Virginia region, and my dentist had advised me to a gum grafting procedure due to gum recession. I was operated on 2 months ago by another in-house doctor there. Instead of using the tissue from my palate, we used artificial tissue. \n\nMy tooth has been sensitive for the past 2 months, and now it hurts whatever I eat or drink (even room temperature water). The exposed part of my tooth also looks much lower than pre-surgery. \n\nThe doctor told me everything looks \"great!,\" but I feel awful. She tried putting fillings over the exposed area above the roots, which helped a little until it came off after 2 weeks.... It also seems to defeat the purpose on why I got the grafting procedure in the first place. So I'm seeking advice on what's the right next step for a resolution? \n\n1. Should I go back to talk it through with my dentist on ways to treat the sensitivity? Or at least get me back to a state prior to the surgery? \n\n2. Should I visit different dentists in the area and get their opinions? Does anyone have recommendations on dentists in the DC/Northern Virginia area? \n\nThanks!" + }, + { + "id": 222, + "title": "Gum Pocket", + "dialogue": "shaimaa: I had a deep cleaning procedure 3 weeks ago after my dentist suggested would help my gum pocket that i have complained about for the last two months. He recommended saline water and mouthwash regularly every day. It got a little better but I still cannot eat on that side and I am wondering if anyone can help me decide on what to do. Is it supposed to take that long to heal? My dentist also suggested a very weird solution, which is to cover that tooth with a crown which will cover the gum pocket area so I can eat on it normally. I do not want to scrape of a perfectly healthy tooth just for the gum pocket! Please advise, knowing I take excellent care of my teeth." + }, + { + "id": 223, + "title": "Gums look awful", + "dialogue": "Ig0psycho: This is a tooth that had a root canal and a bridge. As you can tell from the bridge, I grind my teeth very badly. Now the gums are enflamed and I think I have bone loss. Is it possible the tooth is shifting under the bridge?" + }, + { + "id": 224, + "title": "Root canal tooth/gums", + "dialogue": "Veekey: So two years ago, i needed a root on one of my front teeth. This particular tooth used to be a peg when i was younger and then got it bonded a few years ago. \n\nThe past 2 weeks my teeth were in pain. My gums were very inflammed and red. I went to the dentist and they did a good cleaning. However, i have a few cavities in one area- which is near the root canal tooth. \n\nI can't tell if the pain i'm feeling near the root canal tooth is because of my gums/ cavities or it's the actual tooth. I had xrays taken, so i'm sure they would have noticed if anything is wrong with that tooth.\n\nMy one bottom tooth also seems to keep hitting the root canal tooth when i smile or close my teeth together. And when i close that's when it seems to hurt the most." + }, + { + "id": 225, + "title": "Can I avoid dental x-ray for deep cleaning treatment?", + "dialogue": "kenny siu: I was advised by the periodontal specialist that deep cleaning treatment was necessary for me, although I was determined to have mild to moderate periodontal disease without much bone loss after taking the first full mouth x-ray.\n\nThe nurse explained to me that the deep cleaning treatment will involve taking further x-ray to investigate the parts of teeth during or after the treatment. I'd like to know if I can avoid taking those x-rays since I have already taken a lot of x-rays recently (full mouth for two at different clinics within a month). I know the dose is small, but radiation is real, is it really necessary after deep cleaning treatment to take further x-rays? Plaza Dental Group: You’ve asked a really great question and one that most dentists wish their patients understood – cleanings vary depending on the health of a patient’s mouth. There are typically two types of cleanings: preventive and periodontal. A preventive cleaning is your routine cleaning that accompanies an exam, x-rays, oral cancer screening, periodontal screening, and oral hygiene instruction. Periodontal treatments involve deep cleanings or maintenance cleanings due to deep areas of bone loss, tissue detachment, and buildup that is inaccessible to patients during normal oral hygiene, requiring more attention by the hygienist." + }, + { + "id": 226, + "title": "Acute Untreated Periodontal Disease", + "dialogue": "PANate83: I am suffering from pretty severe inflammation of my gums in conjunction wiith loosening of my teeth. I've been unable to brush my teeth for over a year without significant bleeding and pain which has caused me to stop brushing entirely. I take medications which dry my mouth as well which in conjunction with not brushing has lead to severe tooth decay and tooth erosion. \n\nI'm unemployed, and see no future here of that changing with blasted teeth. In any case, I realize treatment is not possible due to the extreme cost. Is this even fixable, or do I just have to pull the decayed teeth entirely before they break or become painful? At this point the tooth decay and likely bone issues with the periodontal disease seem to indicate that treating this is a lost cause, even if it didn't cost $40-50K I suspect this would end up costing to fix over the course of years of weekly major dental work appointments. \n\nI get it that it's my fault and I'm a bad person - no need to shame me as I'm fully loaded on the guilt. I'm just hoping someone tells me it's a futile effort so that I an add this to my rapidly growing list of personal failures. Ander36: It idnt your fault at all. Have you done sntibiotics? I think that is how it is treated though I am not a dentist.\n\nFind out how it is treated. If it is antibiotics you need go get it online and take it as recomended." + }, + { + "id": 227, + "title": "Dark spot on gum line", + "dialogue": "E.Pete: I just noticed this dark spot on my gum line this morning. I'm not sure what it is and wanted to see if a dentist or someone else with a similar issue could give some feedback. I would rather wait to see if it's serious before shilling out money at the dentist. AF05: Hello....\n\nIt is hard to tell from the picture if its at the tooth portion at the gum line Or actually in the gum!! If its on the tooth, it could be a cavity or calcified plaque ( calculus) Either way, you need to get it checked by a dentist .\n\np,s Let me know if you think its on the tooth or the gum" + }, + { + "id": 228, + "title": "Gum recession keeps getting worse", + "dialogue": "smucker45: I'm a 20 year old guy. \n\nFor some reason, my gums keep receding more and more every single day and there doesn't seem to be much I can do about it. \n\nI am even developing gaps between all my front teeth which is even affecting my speech. I am developing a lisp because of it. I can't believe this is happening to me. \n\nI've always kept excellent oral hygiene, brushing and flossing religiously at all the recommended intervals, using mouthwash, etc. I'm also doing \"oil pulling\" 1-2 times per day. \n\nI believe the gum recession was triggered due to occasional cigar smoking habit. I smoke 2-3 cigars per month, nothing serious that should be affecting my gums in this manner. I've seen people who smoke 5 cigars per day and have healthy gums, seems like I smoke only a couple every now and then and my gums get obliterated. \n\nAnyway, I've stopped the cigar smoking habit for a while now and there doesn't seem to be any improvement. Besides that, my oral hygiene is top notch, I maintain a perfectly healthy diet, and I exercise on a regular basis. My teeth look white and my gums don't look diseased. \n\nIt really bothers me that my gums are receding and that there is nothing I can do about it. I'm going to be stuck with nasty holes between all my teeth for the rest of my life and it feels all completely out of my control. What is causing this and what should I do? I made a dentist appointment, but not until next week. PlacidWay-US: Hi @smucker45 you really need to see your dentist and depending on the cause of your gum recession they can determine what particular treatment you need. If in case you need to undergo surgical treatment your dentist will work with a periodontist, a gum specialist, to decide on the best course of action. But still the most important part here is how you take care of your oral health. Good luck and post some updates here." + }, + { + "id": 229, + "title": "Tobbaco stains", + "dialogue": "Quinton: I just decided to cut off smoking. I thought i made out scot free, but I just found some tobacco stains on the back of my lower front teeth. It doesn't seem too bad, but what are my options? Can I brush it off? Can a dentist clean it off?" + }, + { + "id": 230, + "title": "Plaque and Receding Gumlines", + "dialogue": "Laurenashley010: I have always done a diligent job of brushing my teeth and go through flossing \"phases\"... However, within the last year or two, I've noticed my gums receding, exposing a very, very sensitive area of teeth. There is also a thin line of what appears to be build-up along the gum line on the teeth. At my last dental check-up, I pleaded with them not to scrape those areas as it was one of the most painful things I've felt (as I've tried to pick at it before for investigative purposes) I hoped they would advise me in SOME way (Maybe that they could administer some sort of deadening agent and proceed to save my teeth) but they simply smiled and said they would avoid the sensitive areas and these areas of build-up were never touched. Is there ANYTHING that can be done to remove this without causing so much pain?" + }, + { + "id": 231, + "title": "Could it be cavities?", + "dialogue": "Bruli: Hello, sorry if this is wrong section. I have a strange hole in my tooth i have uploaded a picture and marked the spot in blue. I also have small \"cracks\" in some teeths when i touch them with my nail it's a very sensative sharp-like pain. I would like to know if this could be cavities. Random: You should consult your dentist about it." + }, + { + "id": 232, + "title": "How long to wait after prophy to SRP?", + "dialogue": "Marisela: This mainly applies to existing patients at a practice. Say you’re seeing a patient for his/her 6mrc and they end up needing SRP (not full 4341, but maybe 1-2 quads 4342). Typically, my office has me do the prophy then bring them back for SRP on a different day, so that the patient doesn't leave without having anything done. However, I’m told that with some insurance companies, if you do SRP the day after a prophy, insurance won’t cover it. Sometimes you even have to wait 3 months after a prophy to do SRP. Does anyone have more info about this? Mainly insurance info? For example, with Delta, I’m told that the insurance company won’t cover SRP until 3 months after a prophy.\n\nI would like to know if anyone has any details about this. I'm not necessarily looking for clinical answers, but more insurance based answers." + }, + { + "id": 233, + "title": "after deep cleaning treatment, could it lead to root canal problem?", + "dialogue": "kenny siu: I had deep cleaning treatment half a year ago, the specialist said I had mild periodontal disease\n\nAfter the treatment, I have got lots of ''holes'' between my teeth and I have been using interdental floss \nevery night\n\nHowever, one of the hole at the back of my teeth, it likes to trap food, it is almost the only hole that will bleed every time I push the floss into it, I also feel painful\n\nMy question is\n1. Is it likely to be root canal problem?\n2. I never had root canal problem ， does gum recession or the ''hole'' increase the likelihood of getting root canal problem (because of the exposure of the bottom part of the teeth to the air) JJ_8613: Hi.\n\nI don't know if the deep cleaning would be the cause of a root canal problem.\n\nI'm concerned that the hole in your tooth/teeth may make you more likely to get cavites/root canal problems in the future. A hole can leave the tooth exposed to air and bacteria. Bacteria can cause infections, cavities and eventually root canal treatment if not dealt with properly.\n\nI'd ask your doctor what they recommend to do for it. Maybe they can seal up the hole or something.\n\nGood luck.\n\nJJ" + }, + { + "id": 234, + "title": "gum graft following crown lengthening", + "dialogue": "noflies: Why do I need to get a gum graft 2 months following crown lengthening of the same teeth? Did my periodontist lop off too much in the crown lengthening procedure?" + }, + { + "id": 235, + "title": "do I need to add toothpaste to interdental floss", + "dialogue": "kenny siu: My dentist didn't say anything about using interdental floss with toothpaste.\n\nHowever, I suddenly wonder if I should add some toothpaste to the interdental floss when sliding the brush into the ''holes'????\n\nEspecially for the teeth at the back, they are big, and if I do not add toothpaste to the interdental floss, and electric brush couldn't clean the hole, and only interdental floss does the job. Wouldn't it cause tooth decay to start at those bottom surface of the teeth?\n\nSorry for my English hope you guy get what I mean\n\nMy dentist never mentions about that." + }, + { + "id": 236, + "title": "Laser gum surgery", + "dialogue": "marip: I have periodontal disease and may need gum surgery. Has anyone had the laser? newdhw: Yes, I have a few years ago. One deep pocket that was always infected when I came in for my 3 month cleanings.\nFor after care, i followed the Dentists reccomendations completely but the pocket just kept getting worse. \nI swear, everytime I would go in for cleaning, they would tell me I need to do more brushing, flossing, use a sonicare, a waterpic, a oral rinse.\nEverytime I followed their instructions, my teeth only got worse. \nNow I still have that big deep pocket and the gums have not grown in at all.\n\nI believe there must be a better way. Do more research online and make up your decision. But please, try and find a dentist who will check out your teeth with a microscope. I wish I had known about my options at the time.\n\nGood Luck" + }, + { + "id": 237, + "title": "Gums & lip piercing", + "dialogue": "zinc_acetate: Hi there, I've had my lip pierced, on the side of my lip, for ~10 months. Anyway, I have taken it out because I noticed it catching on my gum too often, and rubbing against my gums, despite jewelry changes to stop excessive movement/rubbing. The gum that being latched onto is now a bit loose in between two of my teeth. I've noticed that there are a few minute cuts in the same area. I have not gone to see my dentist yet, but I am curious whether there is anything I can do to encourage the gum to tighten up in between my teeth in the meantime, or any way to get the minute cuts to heal fully. Enrique: It's great that you have removed the piercing, otherwise the problem must have gone worse. You might be facing gum recession, therefore in gum recession which is irreversible and can only be corrected with a surgical procedure commonly known as a gum graft, and clinically known as a connective soft tissue graft. See a periodontist who specializes in the treatment of gum disease and correcting gum related problems like gum recession. \nDon't worry this can be cured but provided to visit the dentist as soon as possible." + }, + { + "id": 238, + "title": "is Periodontitis something recovered very easily???", + "dialogue": "kenny siu: Hello I don' t speak English very well. What I mean ''recover'' is that a disease is cured, but it returns sometimes later.\n\nI once thought Periodontitis can be cured with either deep cleaning treatment or surgery (for more advanced periodontits) for ONE TIME and later on keep high quality hygiene and the disease should not return, until I read somebody on other forums / chat rooms saying that their periodontitis returns after deep cleaning for three months and their periodontists advise them to do the deep cleaning again.\n\nIn Hong Kong, deep cleaning is SUPER expensive, from USD 2500 to USD 5500 for full mouth deep cleaning. There is no insurance coverage. \n\nI am so worried, is it really that easy for the disease to recover???? even daily oral care (brushing + interdental brush????\n\nI can't afford every three months or every year for USD 5500 or USD 2500.\n\nCould the disease return that easily???????????? I am so frustrated drmins: dear kenny siu,\nunlike root canal or a any other cosmetic treatment, periodontitis need regular check ups and maintenance or perio treatments on a long term.\n\nnot always you need a deep curettage or scaling,but you need to check with your dentist periodically, that your oral hygiene is well maintained and that your periodontal health is sound. if needed during these visits,he will advise you for a deep scaling or advise just a simple scaling. Enrique: dear kenny siu,\nGoing by the advancements in the dental nowadys people with demanding careers or those who do not have hours and hours to spend in surgery are choosing over traditional gum disease surgery. So where a traditional gum disease surgery can take several one hour sessions with many visits to your dentist. On the other hand takes only two 2-hour sessions and a couple of follow up appointments. This means fewer days off for treatment and an immediate return to work in comfort. Regular dental and periodontal maintenance appointments will help prevent the need for future treatment of periodontal disease. Research has found that bacteria can accumulate to the point of causing bone loss within three months." + }, + { + "id": 239, + "title": "How fast does periodontitis progress?", + "dialogue": "Dave001: I have been recently referred to a periodontist as I have deep pockets and bone loss on at least one tooth. I have brushed twice a day, floss daily and get dental cleanings twice a year. I even recently had two root canals. Yet, all these trips to the dentist and now I have serious dental problems? I'm feeling like my dentist and his hygienists dropped the ball. Should they have caught it and treated it earlier? How fast can periodontitis progress? I thought I was doing what I needed to for oral health and now...Any input is greatly appreciated." + }, + { + "id": 240, + "title": "Mild Periodontitis: a few questions. Thank you :)", + "dialogue": "jamesondentistryforums: Hello, I'm really nervous. I need scaling and root planing, two crowns, and four fillings (white). Should I have the tooth whitening done after the scale and root planing? Can a general dentist do the root planing or must it be a specialist Periodontist? Can I delay some treatments because of finances? Thank you, James DanyRoden: I think for a root canal you have to concern Periodontist, If it wants to be done in a proper way, it will give a pain for rest of your life. About teeth whitening only your dentist can give an answer. Good Luck." + }, + { + "id": 241, + "title": "Research", + "dialogue": "Dr.incase: Hello,\nI'm doing a research project about the Interdental papilla and would like some thoughts about what you guys think is better. Would the research be more interesting if it has to deal with the management of the Interdental papilla surgically?, or cosmetically like fillings, etc..?. or is there is something I could focus on other than the management of it, or something that could make the research very interesting.\nYour help is highly appreciated, Thanks" + }, + { + "id": 242, + "title": "Perio Scale and Gingival Irrgation - effectiveness", + "dialogue": "Owen: Hi All,\n\nI'm scheduled for a deep cleaning with the Periodontist next week because a routine exam found some inflamation and 2 pockets. My Dental Insurance covers Perio Scale but not the Gingival Irrigation (45$ per quad extra). The Periodontist explained that the Gingival Irrigation fee was for a topical treatement post-cleaning that helps with healing and kills bacteria. I asked what product they used in which I received this response: \nActive ingredients: Diphenyl 1% / Tetracyclin 125/5ml\nCarbamide Peroxide 10% liquid\n\nShould I get the Gingival Irrigation treatment which I need to pay extra for? Is it effective?\n\nThank you!" + }, + { + "id": 243, + "title": "Periodontal sensitivity to UV", + "dialogue": "Richard Marsh: Hi all,\n\nI am currently researching the exposure limits and sensitivity of the gums and oral tissue to UV. However, I am struggling to find any articles, journals or publications with results or studies in this area. Would anybody know of any or a good place to start looking?\n\nThank you for your time.\n\nRegards,\nRichard" + }, + { + "id": 244, + "title": "Filling Trouble", + "dialogue": "BlueWarrior: I went to a horrible dentist who performed a filling on my upper front molar. the filling was filled with a white composite filling.\n\nHere are my issues:\n\n1.) The filling is very dry. When I wake up in the morning I feel the filling with my tounge and its very dry. \n\n2.) I have pain in my gums between the tooth that was filled and the tooth in front of it. I went to another dentist and she cleaned the area out with floss and the pain went away for a few days but it came back. I notice when I eat stong things like Spearmint/Peppermint gum or Beef Jerkey, it irritates the area if it the flavor makes it way in that area. The \"pocket\" or space between the two teeth stings and gets irritated.\n\n3.) The dentist lady said she could redo the filling if need be but I don't see how that would take the pain away in that area! Please explain sir!\n\nI would like to thank you for reading this rather lengthy message and I hope you have a great day and can get back to me! Peace!! Zuri Barniv: Fillings can't really be \"dry\" or \"wet\", it is more likely the filling is not well-polished which makes it feel like extremely fine sandpaper. There may be a problem with the way the filling touches the tooth next to it and the filling may not have been done in a way that minimizes post operative sensitivity. I would consider re-doing the filling, but I would also consider trying a new dentist or making sure the dentist offering to re-do it for free has a good understanding of what is wrong with it. Without that, she is just guessing and the problem may not be solved. Without knowing more, it's hard to say for sure, but it seems re-doing the filling by a competent dentist should resolve your issues. Hope that helps.\nDr. Barniv" + }, + { + "id": 245, + "title": "Do I have receding gums and mouth in pain", + "dialogue": "Natalie Davies: Hi \nI don't have an appointment to the dentist until middle of October but my mouth is in so much pain. \nI had a brace on the back of my front teeth that was supposed to be there for life however it came off a couple of weeks ago, and since then I've had pain. I've noticed the small black dark triangles on my front teeth and not sure if I have gum disease etc. I brush and floss regularly and use corsadyl however my gums still bleed when I brush. Please can someone help or advise me what I should do?\nThanks" + }, + { + "id": 246, + "title": "Help my gums pls...", + "dialogue": "Stamat Ionut: Hello. I really have a bad period with my mouth.. 12 days ago I was at the dentist because I had a problem when I was eating sugar or chocolate, my right bottom teteths was hurting., so I payed a visit to the dentist. he told me that my last moral from the upper part in the right was decayed. He got it out and I was bleeding for like 2-3days... After that, my gums started to get so pupped up and so infected, that it hurts. Its constant bleeding from a part or another part. I cant eat to much, Its hard for me to speak because it hurts me. Every morning I wake up my mouth is full of blood and saliva. I drool alote I don't know why it started to drool alote and my breath is killing me. I went to doctors and dentist and they all refused me I don't know why. the last doctor told me 3 days ago to get Elugel and Eludril mouthwash. The medic system in Romania is just incompetent... Please help me. My eyes are hurting and my head, I cant rest at night I sleep like 2 hours.. and I just keep swallowing blood. Please tell me what to do... I will upload photos soon" + }, + { + "id": 247, + "title": "Re-treated root canal or dental implant?", + "dialogue": "grace: About two years ago I had a root canal procedure done on one of my second premolar teeth. The gums around the tooth is now red and infected, and I have been told that there is bone loss around the tooth. My first dentist told me that I would have to go see a periodontist for an extraction/implant to replace the tooth altogether. Then I went for a second opinion and the second dentist said that since I am young, (30) and the previous root canal was not done on the entire root of my tooth, that he would re-do the procedure correctly. \n\nI then began to do some research on my own and found an extensive study that was done which showed how root canals lead to degenerative diseases later in life. Now I am completely confused and not sure what choice is the best one. Do I just do the implant and deal with not having a tooth for 7 months, or do I go through with the second root canal and hope for the best for my future health?? JJ_8613: Hi.\n\nI've never had a root canal re-treatment before, but I'm also looking into the possibility of needing one currently.\n\nMy understanding is that the success rate for a re-treatment is not always great. I'd have an endodontist check the tooth. They are specialized in dealing with this and may be better equipped to handle it than a regular dentist. If I need a re-treatment I'm getting it done by a specialist.\n\nFrom what I've heard it's always better to try to save the tooth if you can. Implants are expensive, especially if it's not absolutely necessary.\n\nIt's up to you, but typically I think a re-treatment is recommended, unless the tooth isn't strong enough for the treatment.\n\nDo you have a crown on this tooth? Is the tooth causing you any pain?\n\nGood luck and please keep us updated.\n\nJJ" + }, + { + "id": 248, + "title": "Gingivitis and Deep Cleaning", + "dialogue": "JJ_8613: Hi all.\n\nI was recently told that I need a deep dental cleaning. I think it's also known as root planing and scaling.\n\nMy dentist told me that I have gingivitis and I need the deep cleaning within a month, but preferably as soon as possible. This way we can keep it from becoming periodontal disease.\n\nI can't have the deep cleaning done yet, as I have adult braces on. Should be getting them off in 3-4 weeks.\n\nI just wondering if anyone knows, will it hurt me to wait until the braces come off? I really don't want my teeth to get worse because I waited too long.\n\nAlso, if anyone's had the deep cleaning done before, would you mind sharing your experiences?\n\nThanks.\n\nJJ Zuri Barniv: You don't need a deep cleaning for gingivitis (inflammation of the gums). A good quality simple cleaning and proper home care with an electric tooth brush, water flosser, etc, should be sufficient. If you had periodontal disease (bone loss around the teeth), that is a different matter. JJ_8613: Hi.\n\nThanks for your reply. I'm not really sure. He said I have gingivitis and they also did a periodontal check on me at that appointment. The numbers were 3s, 4s and a couple of 5s.\n\nI don't know if that helps.\n\nThanks.\n\nJJ Zuri Barniv: I recently wrote a long and detailed post on this topic on my blog. I would recommend you read it. I think it will answer all your questions, but please comment there if you have additional questions. Jordan: Zuri Barniv said:\n\n\n\n\t\t\tYou don't need a deep cleaning for gingivitis (inflammation of the gums). A good quality simple cleaning and proper home care with an electric tooth brush, water flosser, etc, should be sufficient. If you had periodontal disease (bone loss around the teeth), that is a different matter.\n\t\t\nClick to expand...\n\n\nEssentially this. I had early stages of gingivitis and my Dentist told me to start flossing as much as possible. Like Zuri mentioned, a water pick/flosser may be needed depending on how much plague and germs are between your teeth. Even a regular tooth brush will do the trick. JJ_8613: Hi all.\n\nI'm feeling relieved right now. Just got back from my dentist's appointment for my deep cleaning. I'm having a little gum tenderness and soreness, but this is normal and to be expected.\n\nThe hygienist showed me before and after pictures after we'd finished. I can't believe it. My teeth went from yellow to a shiny white. They look like they're brand new again. My gums went from a puffy red to a healthy pink. This was all just from one appointment.\n\nI had the nitrous oxide even though I paid out of pocket. That stuff works miracles. I went from an anxious, nervous, fearful mess to completely relaxed. Honestly it feels like you've had too much to drink, but my anxiety was gone in just a few minutes. The hygienist told me that the procedure actually took 2 1/2 hours instead of two like we though it'd be. I couldn't believe it though, because it only felt like 15 - 20 minutes. I guess the nitrous makes you lose sense of time temporarily and they said that's how it is for some people.\n\nI'm just so glad I went. That appointment prevented me from getting periodontal disease, which is irreversible and causes lots of problems.\n\nThank you all for your support.\n\nJJ" + }, + { + "id": 249, + "title": "Why I can eat after root planing and scaling treatment?", + "dialogue": "kenny siu: The periodontist said to me that I could eat and drink anything with another half of my teeth (but not the half just after treatment), but I can't brush with toothbrush for a week.\n\n. I was wondering if the tiny food particles or sugary particles would go into the healing gum and affect the healing result. I asked him if I should delay eating for 24 hours or drink only water. My periodontist laughed and said NO. He said as long as I avoid alcohol, smoking and I could eat and drink almost anything immediately.\n\nBut, why? Even if I eat with another half of teeth, I guess it's unlikely for the part of teeth to be 100% free from contamination of food and drink right? won't it get trapped inside the gum again and affect the healing??\n\nThank you all!!" + }, + { + "id": 250, + "title": "Genetic gum disease", + "dialogue": "Frank48: I'm 31 years old. I've been told I have a genetic gum disease, and that I have several gum pockets, some 10mm (two I think). I've been told that I need to have gum surgery, including bone regeneration.\n\nBut if this is a genetic disease, does that mean that these operations are only a temporary solution? If so, how long can I expect this to last? I realize that it's different for different people, but I'd like a rough estimate. I don't think I can afford surgery every 2-3 years, but if it's every 10 years, that would be more reasonable.\n\nThanks." + }, + { + "id": 251, + "title": "any recommended book for understanding periodontal disease?", + "dialogue": "kenny siu: Hello, is there any title of paperbook or ebook recommended for someone who wants to better understand periodontal disease and its treatment in a more complete and logical sense which is not too difficult for non-dentist to understand?\n\nI am currently reading a kindle book about periodontal disease for dentists and the specialist , but there are just too many professional terms which is too difficult to understand and is too difficult to check up all the meanings." + }, + { + "id": 252, + "title": "Gum disease surgery", + "dialogue": "marip: I'm going to need gum surgery because of my gum disease. Has anyone here have had it done?" + }, + { + "id": 253, + "title": "how many treatments are there for beginning peridontal disease?", + "dialogue": "kenny siu: Hello, I don't want to bore people by repeating my long stories. If you are interested please read the following links.\n\nvisit dentist and periodontist for three times in 2015\nhttps://www.dentistry-forums.com/th...d-periodontist-for-three-times-in-2015.20880/\n\nplease help look at my teeth and make a rough estimation\nhttps://www.dentistry-forums.com/th...t-my-teeth-and-make-a-rough-estimation.20898/\n\n\nMy question now is\n\n1. How many types of treatments is for beginning periodontal disease? I have asked different doctors, looking at different websites with all the different and confusing terms. Is it really a secret? or a kind of marketing skills so that patients cannot compare prices easily and then less business competition between doctors??\n\nDeep cleaning? Deep scaling? Root Scaling? Root planning? Depth pocket reduction? What are their actual differences?\n\n2. None of the dentists I visited recommended deep cleaning for me. They all recommended simple surface cleaning and ignored talking about deep cleaning and periodontal disease when I asked them. Is it because they tend to overlook the problems before it's getting serious enough? or is it because they are not good enough to detect early periodontal disease? and only periodontist specialized in that area will tell you?\nor is it because regular simple cleaning and daily oral hygiene is good enough to keep my teeth there for life?\n\nstill worried and depressed man" + }, + { + "id": 254, + "title": "??? help me??", + "dialogue": "ririzzy17: on the right side of my mouth my first moller going to the back, has had a porcillian crown on it for at least 4 years now.. i never had any problems with it bothering me until recently when i noticed a bump, a hard bump on my jaw line....not on my gums but on my jaw line...it feels like bone.... i dont know what it is or what it means!!! and ever since i have noticed that my tooth also seems to be sensitive to the touch as well....does anyone know what this might be??? or anything similar to it?? NemesisLQ: ibuprofen..works wonders LADentalclinic: It sounds like a tooth infection or abscess. A dental x-ray will let you know for sure. If it is an infection and the tooth is restorable, a dentist may recommend a root canal. If not, they would recommend an extraction. James Michael David: Go to your dentist and let your teeth be examined or x-ray to see the inner part of your teeth and gums...it can be infection that can lead to extraction" + }, + { + "id": 255, + "title": "is deep cleaning a simple and easy task for most dentist/periodontist?", + "dialogue": "kenny siu: hello\nI know that different surgery or treatment might have different level of difficulties which might require different levels of skills and experience.\n\nI'd like to know if deep cleaning is a simple and easy task for most dentists and periodontists? Does it depend very much on the carefulness of the doctor? What is the possible difference between a high-cost deep cleaning and a low-cost deep cleaning? In my country there is no insurance for deep cleaning and the prices for deep cleaning can vary from USD 750 to USD 5500. I don't know if it will make a real big difference in terms of the results.\n\nThank you so much." + }, + { + "id": 256, + "title": "a couple of questions about deep cleaning", + "dialogue": "kenny siu: Hello\n\nI'd like to have a couple of questions that make me confused.\n\n1. Is ''Root planing and scaling '' effectively the same thing as ''Deep cleaning'' ?? Could they refer to different things sometimes??\n\n2. Is the 'Deep cleaning' offered by a general dentist different from the that of the periodontist? In my city, the deep cleaning service offered by a general dentist and a periodontist have a 4 to 5 times difference!! A general dentist asks for $1200 USD but the periodontist asks for $5500 USD!!\n\nI asked the periodontist about the difference, he said periodontists have ''different'' skills and ''different'' levels of cleaning, and more professional..... but they didn't tend to explain how different they are and how more professional they are.\n\nIf they really make a big difference, I may spend a bit more. drmins: Scaling is the other name for tooth cleaning.\n\nIt can be done to clean the calculus or stains attached to the teeth at :\n\nAbove the gum line (Supra-gingival) and\nBelow the gum line (Sub - gingival)\nWhen it is done below the gum line,it can be called a deep scaling to some extend. Infact, almost all scaling cases are done at subgingival and supragingival levels.\nIn further advanced cases, root planing is done to do scaling at a level as deep as a part of the root.\n\nIf the curettage is done without reflection the gums surgically,its called a closed curettage and if its done after reflecting the gums for better exposure,its called an open curettage.\n\nSo,depending upon the type of treatment mentioned above,the cost can vary.In short,what is determining the cost here is \"how deep\".\n\nAnd, periodontists are the dentists who are specialized in this kind of treatment.But that DOES'NT really mean that a advance trained and experienced general dentist CAN NOT offer the treatment at the same 'skill'.\n\nThanking you\ndr.mins kenny siu: drmins said:\n\n\n\n\t\t\tScaling is the other name for tooth cleaning.\n\nIt can be done to clean the calculus or stains attached to the teeth at :\n\nAbove the gum line (Supra-gingival) and\nBelow the gum line (Sub - gingival)\nWhen it is done below the gum line,it can be called a deep scaling to some extend. Infact, almost all scaling cases are done at subgingival and supragingival levels.\nIn further advanced cases, root planing is done to do scaling at a level as deep as a part of the root.\n\nIf the curettage is done without reflection the gums surgically,its called a closed curettage and if its done after reflecting the gums for better exposure,its called an open curettage.\n\nSo,depending upon the type of treatment mentioned above,the cost can vary.In short,what is determining the cost here is \"how deep\".\n\nAnd, periodontists are the dentists who are specialized in this kind of treatment.But that DOES'NT really mean that a advance trained and experienced general dentist CAN NOT offer the treatment at the same 'skill'.\n\nThanking you\ndr.mins\n\t\t\nClick to expand...\n\n\n\nThank you Doctor\n\nI have consulted by my periodontist if I can look for a general dentist elsewhere to practice deep cleaning, he didn't answer directly but he said something like - '' we can provide a better skills and we will also use some medicine and we might do some small surgery to your gum'\n\n(sorry he didn't speak English and I might not translate very correctly)\n\nBut he emphasizes that the advanced type of treatment like open surgery with GTR or GTB is definitely NOT applicable to me, because my periodontitis is in the middle of ''Beginning\" and \"Moderate\"\n\nI am a bit confused.\n\n1. Does deep cleaning require ''some medicine'' ? Could deep cleaning offered by different people have different or no medicine??\n\n2. Could a periodontist provide better deep cleaning by providing better or more special medicine or injection during the process??\n\n3. While deep cleaning is a non-surgical type, why he said he might do some ''operation'' to my gum?? His usage of words something means ''surgery'' but not very exactly.\n\n4. Does the procedure, medicine used, and other details of deep cleaning vary very much between different doctors/dentists/periodontists????\n\n\nDoctor, I hope you can understand my concern , Of course I want to receive the treatment from my periodontist/ his helpers, since he is very professional, but the price he quotes to me is 2-2.5 times more expensive, that is up to USD 3000 difference, but if it REALLY could make MORE difference, I will always put health at first place. \n\nThank you drmins: Deciding which doctor to consult is completely your choice.Once you decide about it,have trust in his treatment.As your periodontist has already stated that your periodontitis is just in the \"beginning to moderate\" level,proper care can restore it back to health.Kindly post a pic of your OPG x-ray image for further comments.\n\nDon't be panic or confused. Your dentist can surely explain things to you in a better manner to avoid the confusions.\n\n\n\nkenny siu said:\n\n\n\n\t\t\tDoctor, I hope you can understand my concern ,\n\t\t\nClick to expand...\n\nSure, if you have still any doubts, you can dial me on +91 9895 390 730. But i always feel that,discussion on the forums can help educate more people,as many others do read the discussions here. kenny siu: drmins said:\n\n\n\n\t\t\tDeciding which doctor to consult is completely your choice.Once you decide about it,have trust in his treatment.As your periodontist has already stated that your periodontitis is just in the \"beginning to moderate\" level,proper care can restore it back to health.Kindly post a pic of your OPG x-ray image for further comments.\n\nDon't be panic or confused. Your dentist can surely explain things to you in a better manner to avoid the confusions.\n\n\nSure, if you have still any doubts, you can dial me on +91 9895 390 730. But i always feel that,discussion on the forums can help educate more people,as many others do read the discussions here.\n\t\t\nClick to expand...\n\n\n\nThey have talked to me and explained that it's USD 5300 for 4 quadrant of deep cleaning, that include some checkups, followups and some xrays.\n\nIs it a bit overpriced?\n\n of course I trust this periodontist, if I were very rich, I wouldn't hesitate going for him, but now I am not, and I don't know if USD 5300 for deep cleaning is very much overpriced drmins: dear friend,\nPricing at ones practice depends on various components and i feel it quite un-ethical to comment on the price tag of another dentists practice.\n\nAnd more over,the prices abroad can never be compared to that in India. Here,the usual treatment charges for the above said treatments will be lesser than 1/10th of what you had been quoted with - a reason why, the field of dental tourism is emerging in India.\n\n(If you can't really afford it in Hongkong, you can think of having a vacation for a week or two at the scenic hill tops or green health ayurvedic resorts of kerala, and get your periodontal treatment done mean while. The complete package including air tickets would cost lesser than the quoted amount.) kenny siu: drmins said:\n\n\n\n\t\t\tdear friend,\nPricing at ones practice depends on various components and i feel it quite un-ethical to comment on the price tag of another dentists practice.\n\nAnd more over,the prices abroad can never be compared to that in India. Here,the usual treatment charges for the above said treatments will be lesser than 1/10th of what you had been quoted with - a reason why, the field of dental tourism is emerging in India.\n\n(If you can't really afford it in Hongkong, you can think of having a vacation for a week or two at the scenic hill tops or green health ayurvedic resorts of kerala, and get your periodontal treatment done mean while. The complete package including air tickets would cost lesser than the quoted amount.)\n\t\t\nClick to expand...\n\n\n\nhi, in general, how is the hygiene standard of dentistry in India?\n\nand I wish to know, not only in Hong Kong or India\n\nIs it possible or is there any known case that dentist or periodontist does not deep clean his patient very completely (because of they are lazy , they are busy, they are without patient, and still let a lot of dirty shit left inside???? )\n\nThis might be something I concern most drmins: Every good artist tries to give the final touches on his work,to make it look better. \nStop worrying. Keep smiling" + }, + { + "id": 257, + "title": "please look at this xray", + "dialogue": "kenny siu: My periodontist said I was OK . This is my x-ray, I'd like to know why the gum or bone on the x-ray (red circle area) is a bit darker in color than most other part ?? Does it mean gum or bone loss?" + }, + { + "id": 258, + "title": "why general pain, heat and loss of function are not marked signs of inflammation in gingivitis?", + "dialogue": "Muneeb: why general pain, heat and loss of function are not marked signs of inflammation in gingivitis like swelling and redness? Galagya: As far as I knew, pain was a symptom...? If that's what you meant." + }, + { + "id": 259, + "title": "Altered Passive Eruption?", + "dialogue": "Ashley Forero: For some time now, I have wondered why my teeth were so small and why they barely showed when I smile. I looked into it and found a problem with the gums called altered passive eruption. My teeth and gums look similar to others who have been diagnosed with this issue. However, I want to make sure I'm not crazy before I go into the dentist's office complaining about this. Lol. \n\nLooking at my pic, do you think I'm rightfully concerned about this? Thanks for any input." + }, + { + "id": 260, + "title": "Laser root scaling and cost and other things - Rant warning", + "dialogue": "tappedinarizona: I've been reading through a number of forums and finally have come across this one which has some useful information other than justifying the cost of dental work.\n\nI've read some statements like\n- how to educate the blue collar on the importance of dental work\n- can we get patients to sign a form that they understand by forgoing this treatment we aren't held liable for the decline of their gum disease? \n\nNot the most helpful stuff. Having just visited a periodontist a few weeks back, I can honestly say that I have the mental capacity to fully understand that by not getting a laser root cleaning done that it wasn't going to be good for me. I think most, even the 'Blue Collar' workers can understand this simple truth. My toothies hurts - take away pain please\n\nThe problem is that from a patient standpoint, the industry has changed quite a bit over the last 20 years since I first had braces done in my early 20's. A few things that come to mind. \n\nLet me say that the assumption that someone is STUPID or POOR because they can't afford or have to take a few days to consider an 8k procedure without getting a second opinion is nuts. \n\nI truly hope this isn't the attitude of the entire industry and I was only reading articles from minority of the community. \n\nTo be fair, I hadn't been to the dentist in years. Once I had children, they become the priority. My dental work took a back seat to braces and checkups for the kiddos. At 44, I went back to see the damage. I didn't have a single cavity as I brush regularly but I did have some terrible gum issues which required a scaling. The Periodontist recommended Laser scaling as otherwise I would end up with long teeth and wouldn't heal well if I had normal scaling and gum surgery. The cost was 8k. My dental rider didn't cover it. None of it. I told her than I needed to think on it and it would be a few weeks. I was told to decide quickly as it was important. \n\nWhat I wanted to know is if 8k is pretty much the industry standard for this kind of treatment? If so, how could anyone be surprised when a \"blue collar\" worker, as I mentioned above, could forgo the treatment? I don't know about most people but after the last few years of this economy, 8k in cash isn't something most people have laying around, poor, blue collar or otherwise.\n\nThe financing. Sometimes it feels like the dental community acts more like the plastic surgery industry. I had some hand surgery last year which was done by a plastic surgeon. I noticed the medical financing pamphlets available for patients. Same pamphlet I received at my last dental appointment and at the periodontist. Financing available...at a high interest rate from some bloodsuckers that pay us up front so we don't have bother with you in case you don't pay. Of course, most people that are low income or have sub-par credit, aren't going to be able to get a loan. I understand this must be for a good reason. I'm sure it's difficult to collect from patients so the 3rd party is a better option but there has to be a few other options that that one company for all dentists, orthodontist, periodontists and plastic surgeons.\n\nYears ago, when I had braces, I financed through my orthodontist. Every time I had a visit, I paid him. When the work was finished, my debt was paid. If I hadn't had the case to make a payment, I would have to rescheduled an appointment. Like I said, I'm sure there's a reason for the switch from in house to 3rd party lender but if that's the only option, other than cash, why a dentist be surprised when a patient would forgo financing if they can't afford cash? \n\nRant over. \n\nMy point. Is 8k pretty much average for a laser root cleaning? Is there a cheaper option? If there a way for me to finance without having to have a perfect credit score so I can get the work done? I'm asking because nobody has had any answers at my dentists or periodontists office. They are having a hard enough time collecting the money from my dental insurance company.\n\nWill a standard root cleaning where they have to cut off some gums leave me with hideous \"long\" teeth? This is what I was told. Look long in the tooth or get the lazer treatment.\n\nIs most of the dental industry oblivious to the fact that most folks, even ones that make a decent living, can't always afford dental treatment? I have to think this is not the case but it can feel that way sometimes. \n\nWithout medical insurance, most people, even ones that make over 6 figures a year, couldn't afford medical care. I have great medical insurance. My hand surgery ran about 75k. Glad I was paying a ton of money for my health insurance plan. Unfortunately the same doesn't go for dental. Being self employed, there really isn't much out there for dental insurance other than riders that you can add on to the medical insurance plan. Most dental plans are terrible, rarely pay and make it nearly impossible to navigate the system. If having healthy teeth is so important, why is it treated by the medical community more like getting a nose job than something that's medically necessary to remain healthy?\n\nThanks,\n\nRobert" + }, + { + "id": 261, + "title": "Gum recession on lower tooth", + "dialogue": "David Moran: I am 31 years old and am in good health, except for having Cerebral Palsy. I don't smoke or use any tobacco products. I started seeing a periodontist about 2 years ago because I have recession on one of my lower front teeth (front lower center). This is the only tooth I have recession on. I had my first gum graft in February 2013 and it failed. My periodontist did a frenectomy in April of this year and then did another graft this past August. It also failed. Both grafts were done with alloderm. My periodontist doesn't understand why my graft hasn't taken and says that I've followed instructions to the T. He also said he's seen patients not follow any instructions and they had better results than I've had. I'm frustrated because I don't like how it looks and I'm also concerned about the long term health. My periodontist says as of right now, I am not in danger of losing the tooth, but I still want to get this taken care of. He's out of ideas and we're searching for other ideas. I am wondering if anyone has any ideas. \n\nThanks,\nDavid Aki Yagami: I have gum recession on one tooth a lot and some mild recession on some teeth and like in my country there is no such thing like gum graft surgery so i started to do some oil pulling and i changed how i brush my teeth and go to dental cleaning try baking soda and some similar stuff and gels.I don't have much choice so if this things work it will be good and i am not into surgery kind of person so i trying to heal natural for like some time and i changed my diet i started to eat more healthy foods like organic.I don't know what will happens in future with my gums but i am trying to heal it every day. drmins: Dear David and Aki Yagami,\nRegarding Davids case, a picture and an x ray are must to assess the extend of the recession. So pls provide those. And do maintain better oral hygiene to prevent further recession.\n\nAnd Aki Yagami, i advise you not to use things like baking soda and similar stuffs on your gum. However,eating more of organic food will help you and your health,if not of much help to your gums.Please take an opinion with your local dentist,than treating with self medication and stuffs like baking soda.\n\nThank you both" + }, + { + "id": 262, + "title": "Teeth Problem Refrain Me from Eating my Favorite Food", + "dialogue": "Oliver Webb: Hello everyone , I have a serious issue to share with you. I have a sensitive teeth and believe me its quite painful. This problem has refrain me from eating my favorite food. I am very fond of eating ice-creams and hot veggie noodles, but due to the sensitiveness of my tooth area, I always avoid eating it. Sometimes it is very painful as soon as I eat something very hot or cold. If you have any remedy please help me out. Thanks! drmins: Are you experiencing this for a single tooth? Is there any decay on it ? Do you have gum problems?\nKindly upload a pic of the complained tooth with the gums attached." + }, + { + "id": 263, + "title": "The teeth are not my only problem", + "dialogue": "jamesebjr: First post here so please forgive me if this a rehash of other post. For starters im 36 and smoked for about 20years. My dental problems are massive. I have been to three dentist and three periodontist. All three dentist basically told me they couldn't help and made it clear they didn't want to. My numbers are between 7 and 9 all around. So they said pull all your teeth. Get dentures, screw that i only have a few loose ones. The last periodontist wants to do the flap surgery wick i agreed to but now that i have agreed to it they done seem interested filming me in on the process. I went and got fitted for partials and my surgery is next week but i don't have anything about what i should do before. Other than the stuff i found on the Internet. Should i be concerned as to why I'm being left in the dark. By the way I'm not saying is a race thing but at this point i can't place or on anything else. Please help me drmins: Pls post an OPG x-ray film image of your case." + }, + { + "id": 264, + "title": "Do i have Paradentosis", + "dialogue": "Aki Yagami: I went to a dentist and he told me that i have paradentosis.As a child i had poor oral hygiene and i have some filings need to repair and fix some cavity.i have reducing gums on front lover jaw there i had plaque that he cleaned and on the molars up and down some gum reduction.He told me that i have to do flap surgery to stop the process and some other dentists not to do what should i do?I never plan to do surgery on gums later in life is with good oral hygiene and dental cleaning stop gums to reduce? Here is an X-Ray" + }, + { + "id": 265, + "title": "white gum", + "dialogue": "vbsr2014: I noticed that my gum is painful and have white color in one place in my mouth, other my gums are pink. What does it mean? gersson: There are so many reasons are available for white gums. I think a collection of food and other debris along the edge of your gums may cause discoloration. Better consult with the nearby dentist to find the exact answer for your question." + }, + { + "id": 266, + "title": "temporarily inflammed gums or something worse?", + "dialogue": "stephencookie: Hi, I just got my braces off today and I've noticed the gums of the bottom teeth are swollen and some parts bleed a little when flossed. When I had braces it was very hard for me to brush and floss and I often got frustrated and gave up. Will this go away over time with good brushing and flossing or is this permanent or a disease or something. Thanks for taking your time to help me out. danielhermann: This kind of gum issues does occurs specially with braces, i would recommend you to notice other issues as well, if the same recedes then its well & good. But if not i would recommend you to take help from another dentist who can actually check out went wrong after taking off the braces. LADentalclinic: Dental hygiene can be difficult when wearing braces. Some orthodontic patients have their teeth professionally cleaned more frequently because of this. You should definitely make an appointment with your dental hygienist. A professional cleaning and at home maintenance will return your gums to normal. MarkSummers: While you are having orthodontic treatment, you need to continue to have regular check-ups with your family dental professional to ensure little problems don't become big ones." + }, + { + "id": 267, + "title": "Receeding Gum on one tooth", + "dialogue": "Christian: Hi,\n\nLooking for some initial advice before I book an short notice day off work (hard to get at my job) and an urgent dentist appointment.\n\n2 - 3 days ago the gum around my lower right back tooth has completely pulled away leaving a decent sized gap. Picture attached.\n\nI had a dentist appointment about a month back and some work done on 2 of the other back teeth (other side top and bottom) due to some decay near the gum line - my jaw sits very close and tight to the back teeth so I struggle to get a brush round the back of the teeth.\nMy dentist advised me to brush more thoroughly at the back due to the difficult angle and also use my finger with toothpaste on to get more round the back teeth. I don't think I brush too heavily and I use a soft-bristle brush, but I might have been subconsciously brushing harder than before because of the dentist warning me I need to get behind the teeth more to prevent any more issues.\nI've also had to pull back the cheek when using my finger to get toothpaste behind the tooth and rub it in, so concerned this may have strained the gum until it has been pulled away.\n\nUp until a few days ago I'd not noticed any discomfort or signs of change in the gum and I've just woken up one morning and found the gum had pulled away when I went to brush.\n\nI'm really looking to get some advice as to if this looks like a case of me brushing to vigorously and putting strain on the gum by forcing my finger round to the back teeth, and if it is whether there is something simple/over the counter I can do/get to nurse it back to health, or if it is more likely to be some level of gum disease that needs proper dental/medical treatment. \nWorth noting none of my other teeth show any sign of this (and I've started checking really carefully the last 48 hours), although this seems to have appeared very quickly.\n\nAs it stands food and saliva is getting in there and while I can kinda get the brush bristles in the gap and can gargle water/mouth wash in the area it goes deep and I know I'm not getting everything out, which just means more risk of decay below the gum line.\n\nI'm hoping by getting this some advice in the first few days I can try some preventative measures or get an emergency appointment with my dentist if it is something serious.\n\nCheers for any advice.\n\n\n\n \nChris LADentalclinic: Hmm. That's quite a pocket. I think it's definitely worth a visit to the dentist to determine if this is just a tissue problem or if the bone underneath is involved. No over the counter remedy will be able to address this.\n\nBest of Luck Christian: Thanks for the advice.\n\nI went to the dentist yesterday, no sign of tooth/bone problems or gum disease and no increased sensitivity. I've got quite a packed mouth of teeth so they think the gum may have simply become fatigued from the wisdom tooth straining the gum at the back, and just slipped loose. Nothing they can do about it, so just a case of keeping it as clean as possible and see how it goes between now and my next check general up in a couple of months.\n\nIf anyone else sees my pic and has something that looks similar do go to the dentist, mine talked me through possible causes/potential issues and how best to clean it.\n\nTips that they gave me, if you struggle to get an appointment straight away - \n\n1. Get an 'Interspace' Tooth Brush - they have a long thin handle which curves at the top and has a tiny tough set of bristles, so you can get into the pocket and behind the wisdom tooth to scoop any debris out and clean below the gum.\n2. Dunk the above brush in a strong mouthwash, so that you can get that right down behind the gum.\nI've been doing this the last 48 hours and it actually works really well at cleaning out the pocket.\n3. If the above doesn't work for you my dentist recommended getting a medicine syringe, like what you use for putting medicine in babies mouths, and use it to flush mouthwash deep into the pocket and clear out anything stuck in there.\n\nIf the above doesn't help and you start getting pain then it's possibly a case of wisdom tooth removal, which is obviously a last resort and not just a little painful if tooth is still very secure. Dr. Harris Rittenberg: This looks from the photo to be a wisdom tooth. Healthy teeth have a layer of gum around the collar of the tooth called “ keratized tissue”. It is pink in color, thicker, and stronger and you can see it around the neck of the tooth or two in front of your wisdom tooth.\n\nBy the time you get that far back in the mouth, you often only have the thinner “mucosal” tissue, which is vulnerable to detaching from the tooth. In my opinion, chances are this will always be an issue. Of course I would want to see an Xray first, but I suspect it would be more prudent to sacrifice the wisdom tooth than to try to deal with this situation as it recycles every so often. My recommendation would be to visit an oral surgeon to discuss and confirm the need for removal and what all is involved with this procedure." + }, + { + "id": 268, + "title": "Questions about tooth loss?", + "dialogue": "hateneedles: Is is possible that tartar and plaque are the only things holding teeth in? I have some bad build up of plaque/tarter behind my lower front teeth( else where too but as you'll read why this area is my main concern). On this past Friday(May 2nd) I went to a clinic(London,Ontario,Canada) and was told the only thing holding my teeth(front 4 on lower level) was the build up of these 2 issues, I'm scared about this!!!Is this at all possible? Will getting this necessary work done make them loose or need to be pulled because that could be the only thing securing them in because of possible bone loss that could be unseen. I wonder and ask myself if the clinic is just trying to make extra $$$ off me? Will they become loose, can they be saved even if there's bone loss? I have the early signs of gum disease, but none of my teeth are wobbly, in pain, or hurt. I'm hoping that's a good sign?In fact I have no problem eating corn on the cob or a apple so this was a huge shock to me,although having been a type 2 diabetic for 7 years now & not seeing a dentist(very scared of them) for at least 4+ years does make me wonder if this is true.Going for a second opinion in the next week or 2! Given from what I've asked and told you, do you think there will need to be costly surgery or pulling of teeth. Thanks! LADentalclinic: You would need to post an x-ray to get a satisfactory answer. An x-ray would show how much bone you have left supporting your teeth. Sometimes teeth that have a lot of bone loss can be saved with bone and tissue grafts. A second opinion in dentistry is never a bad idea. Make sure your dentist explains to you why you need the recommended treatment. Be sure to ask questions if you don't understand." + }, + { + "id": 269, + "title": "periogard and loss of taste.", + "dialogue": "pbmann: I recently had deep a cleaning and laser treatment and was given Colgate PerioGard to irrigate with twice a day. I have had a fair amount of loss of taste. Mainly bitter foods. I have read very few cases this can be permanent. I stopped using the PerioGard last night and called my Dentist but was only able to speak with the dental hygienist. She was dismissive of my concerns and unable to connect me to the dentist. I left a message with the dentist but in the mean time does anyone know if there are effective alternatives to PerioGard? I don't want to compromise my treatment, but also an concerned with continuing to use the PerioGard. LADentalclinic: That is a common side effect of perio rinses. It is not a permanent problem. Once your treatment ends your sense of taste should return to normal. These rinses are very effective,so I wouldn't be quick to discontinue using it." + }, + { + "id": 270, + "title": "Receeding gums", + "dialogue": "oew: Hi, does anyone have any useful experience of collagen grafts for areas of the mouth where the gums have receeded and causing tooth pain ?\n\nhttp://www.dailymail.co.uk/health/ar...treatment.html" + }, + { + "id": 271, + "title": "Gum recession, still young", + "dialogue": "Why: The past few years i've noticed some gum recession, but haven't really taken it seriously until today. I was looking in the mirror and noticed I could actually see the top of my canines, both of them, just barely. It kind of freaked me out.\n\nI'm 28, male, brush regularly 2-3 times a day. I've always been annoyed by flossing, but will start doing it more often, also will switch to a soft brush.\n\nWhat else can I do? Is it possible they will grow back? I can't afford dental insurance. kellogg9: sadly they wont grow back. What i find baffling is that the field seems very behind compared to others. I've been researching periodontics and there isn't much one can do with recession besides snipping away more of it. huh? LADentalclinic: No. I too have gum recession. Once we lose the gum tissue it will not grow back on its own. You can have a tissue graft to replace the lost gum tissue. Definitely keep up the good work of regular brushing and flossing. Don't brush too aggressively and try a soft toothbrush." + }, + { + "id": 272, + "title": "Sudden bad breath problem", + "dialogue": "Brett Lynch: Hi,\n\nI'm 18, just recently developed a bad breath issue. Never had a problem with this until a month ago. Right after it started I went to my dentist for a normal 6 month cleaning, told the hygenist and dentist about it. They took a full set of xrays, did a cleaning and exam, they said they found nothing wrong, minimal plaque and tartar buildup, no cavities, no infections, no gum disease, gingivitis or anything, xrays were good. The dentist gave me a couple of new toothbrushes, told me to use 'colgate total' toothpaste because it has an antibacterial action, said to throughly brush and floss twice a day and also to throughly brush my tongue and add some paste to the brush before i do it. He also gave me a couple of bottles of therasol mouthwash and told me to use that twice a day when done brushing and flossing, rinse for 30 seconds and gargle for 30 seconds with it. I have seen no improvements in the bad breath problem, since i started this new routine a month ago. I even tried adding a cap full of hyrdogen peroxide to the therasol before i use it for the last week, still no improvement.\n\nAny ideas what may be causing this? Marialeiah: Brett Lynch said:\n\n\n\n\t\t\tHi,\n\nI'm 18, just recently developed a bad breath issue. Never had a problem with this until a month ago. Right after it started I went to my dentist for a normal 6 month cleaning, told the hygenist and dentist about it. They took a full set of xrays, did a cleaning and exam, they said they found nothing wrong, minimal plaque and tartar buildup, no cavities, no infections, no gum disease, gingivitis or anything, xrays were good. The dentist gave me a couple of new toothbrushes, told me to use 'colgate total' toothpaste because it has an antibacterial action, said to throughly brush and floss twice a day and also to throughly brush my tongue and add some paste to the brush before i do it. He also gave me a couple of bottles of therasol mouthwash and told me to use that twice a day when done brushing and flossing, rinse for 30 seconds and gargle for 30 seconds with it. I have seen no improvements in the bad breath problem, since i started this new routine a month ago. I even tried adding a cap full of hyrdogen peroxide to the therasol before i use it for the last week, still no improvement.\n\nAny ideas what may be causing this?\n\t\t\nClick to expand...\n\nHi Brett, \nSorry to hear about your condition. I have the same problem and it was my diet. You can read up on dental blogs to find different things. I realized it was my diet this way!!! even after many dental visits and paying out for the best mouth washes. A good one that come to mind was one i looked at recently on a site called TourMedical. They had a lot of tips!!! MarkSummers: The key to fixing the problem of bad breath is to locate its source. The most common source is the mouth itself: it’s the location of the smell-producing bacteria about 85% of the time. Since the mouth is regularly filled of food, the bacteria in there can get an all-you-can eat buffet under the right conditions. .. danielhermann: Well i too agree with the above suggestion as you need to find out the source of bad breath issue, it is due to our eating habit which mostly leaves a bad essence. That is why it is better to brush your teeth after the meal, also do use mouthwashes after brushing. stevengoldy: brush twice in a day, then gargle and floss with cold water on regular basis\nto keep your mouth always fresh.\nit will definitely improves your breathe. LADentalclinic: Are you taking any new medications? Many medications can cause your mouth to be dry. Bacteria flourishes in a dry mouth. If you've ruled out other causes you may try one of the many over the counter products for dry mouth (xerostomia) Fredde B: Alcohol-based mouthwashes like Listerine and Scope can often cause bad breath. A dirty tongue too -- do you brush your tongue? Your gums may need irrigating too. Denis Smith: Bad Breath is often caused by a buildup of bacteria in the mouth that causes inflammation and gives off noxious odors that smell like worse.Everybody has nasty breath at some point, like when you get out of bed in the morning.You must schedule an appointment to Dentist in every three months to get out of this problem." + }, + { + "id": 273, + "title": "Gingivitis: how doomed am I?", + "dialogue": "Saturn Moriya: I've been dealing with depression for years. With depression comes lack of personal hygiene. I've been terrible about cleaning, despite having braces. My gums have been infected for years. Now I haven't been diagnosed, but I think it's pretty clear that I have Gingivitis. My teeth feel a bit loose as well. I'm only soon turning 19 years old. Going to the dentist later today. I'll include some pictures through links (disclaimer: they're bad, vague pictures, but still gross):\n\nhttp://nl.tinypic.com/view.php?pic=303d6ok&s=8#.U0JhrKJZCSo\nhttp://nl.tinypic.com/view.php?pic=2wqx4w3&s=8#.U0Jh-6JZCSo\nhttp://nl.tinypic.com/view.php?pic=2dkwso2&s=8#.U0JivKJZCSo\nhttp://nl.tinypic.com/view.php?pic=sqmckz&s=8#.U0Ji_KJZCSo\n\nSo how doomed am I? What/how much can be done for treatment? Do I need surgery? What's going to happen to me? I'm scared. Saturn Moriya: Just came back from the dentist, they didn't even mention gingivital recession. So am I crazy paranoid or are they rubbish? It looks really bad to me.. LADentalclinic: Your photos are fuzzy, but your gums actually don't look bad. If the dentist didn't alert you to any abnormal conditions I wouldn't panic. Since you admit that you don't practice good oral hygiene, now would be a good time to start. You don't want to wait until you do have gum and tooth problems." + }, + { + "id": 274, + "title": "Wisdom tooth cavitation and chronic fatigue", + "dialogue": "taniamama: Hi,\n\nI have 20 years of dealing with jawbone cavitations in all 4 of my wisdom teeth sites. I am 38 and had all 4 pulled when I was 18. I became gravely ill in my mid 20s. Discovered by 25 that I had jawbone cavitation in all 4 sites causing digestive issues, depression, fatigue, and food allergies. Had surgery done, but the dentist used bovine bone grafts which my body rejected at age 29. At age 33 I had the surgeries redone. All 4 healed with no grafts or antibiotics. However I continued to have symptoms. I tested positive for heavy metals so did chelation for 9 months with EDTA. After last session I became pregnant and had a health baby. My symptoms in my jaw persist. Thought it was just TMJ. I had a splint made for night time wear. Still no relief. I went and had CT scan which revealed a cavitation in the # 17 site. Dentist did not want to do surgery. I went to another dentist which did a digital xray and found a root tip deep in there near the nerve canal. Talked to an oral surgeon who said it was good no one has tried to take it out and said that nothing was wrong with me. Went back to the dentist that did the CT scan and showed him the digital xray. He said that the broken tip needed to be taken out. Talked to another old time dentist who said that it needed to be taken out. My question is, Why do some dentists recommend removal and others say my symptoms are caused by something else and that to leave the root tip in the jaw? Does anyone have experience with this kind of surgery? I would SOOOOO appreciate feedback as my health has been compromise for the last 20 years. (Now mind you, I have gorgeous healthy teeth - at least that is what is said to me every time I go into a dentist....so other than cavitations I have great teeth. The dentist who took out my wisdom teeth just did a horrible horrible job and I have been suffering and dealing with this ever since. I am so ready to be done with all this!!!!) I also find it amazing that after all these years and surgeries, one little digital xray revealed the broken root tip which went undetected all these years...... Diane: taniamama said:\n\n\n\n\t\t\tHi,\n\nI have 20 years of dealing with jawbone cavitations in all 4 of my wisdom teeth sites. I am 38 and had all 4 pulled when I was 18. I became gravely ill in my mid 20s. Discovered by 25 that I had jawbone cavitation in all 4 sites causing digestive issues, depression, fatigue, and food allergies. Had surgery done, but the dentist used bovine bone grafts which my body rejected at age 29. At age 33 I had the surgeries redone. All 4 healed with no grafts or antibiotics. However I continued to have symptoms. I tested positive for heavy metals so did chelation for 9 months with EDTA. After last session I became pregnant and had a health baby. My symptoms in my jaw persist. Thought it was just TMJ. I had a splint made for night time wear. Still no relief. I went and had CT scan which revealed a cavitation in the # 17 site. Dentist did not want to do surgery. I went to another dentist which did a digital xray and found a root tip deep in there near the nerve canal. Talked to an oral surgeon who said it was good no one has tried to take it out and said that nothing was wrong with me. Went back to the dentist that did the CT scan and showed him the digital xray. He said that the broken tip needed to be taken out. Talked to another old time dentist who said that it needed to be taken out. My question is, Why do some dentists recommend removal and others say my symptoms are caused by something else and that to leave the root tip in the jaw? Does anyone have experience with this kind of surgery? I would SOOOOO appreciate feedback as my health has been compromise for the last 20 years. (Now mind you, I have gorgeous healthy teeth - at least that is what is said to me every time I go into a dentist....so other than cavitations I have great teeth. The dentist who took out my wisdom teeth just did a horrible horrible job and I have been suffering and dealing with this ever since. I am so ready to be done with all this!!!!) I also find it amazing that after all these years and surgeries, one little digital xray revealed the broken root tip which went undetected all these years......\n\t\t\nClick to expand...\n\n\n\nI have an immune issued and have figured out over the past four years that this is all due primarily from root canals not being done properly, which left infection, and pieces of root tip, and from wisdom tooth extractions that were not cleaned out properly, leaving infection. I have been pulling each tooth affected and am actually going in tomorrow to open up a cavitation from upper right wisdom tooth. As each tooth is extracted I'm feeling better and better. Fredde B: Go back to the oral surgeon who botched your wisdom teeth and have him go back in at no charge and fix the problem visa vi that last poster's recommendations -- and you won't pay either. 20 years? You should sue him for actual and punitive damages -- he's insured, and he sounds like a quack too." + }, + { + "id": 275, + "title": "Please help me out here, losing my mind...gum issues", + "dialogue": "Neville86: Ok so back in December I noticed under a flash light in the dark, my gums looked like this:\n\nhttp://www.flickr.com/photos/1127806...in/photostream\n\nNaturally, being a 27 year old non smoker non drinker, I freaked out, well, because that's what I usually do. \n\nI've seen a Periodontist, an ENT, and an Oral Surgeon. Im seeing a Dentist on Monday. \nHere's what each of them said.\n\nPeriodontist--said it looks hyperkeratotic and benign. Said by looking at it he was 99 percent sure it was benign and would only biopsy if I requested it. Said it could have been caused by open mouth breathing at night/dry environments and a gingival reaction to these. Said I should use a humidifier and nasal strips and brush the gums lightly and to check back in with him in May by phone if I wanted. \n\nOral Surgeon--Said it was normal. And that was really it. \n\nENT--Said it was a \"common stress reaction of the gingiva\" and to get a cleaning from a Dentist--which I haven't had in ten years. \n\nSo, as you can see I am worried. Three different professionals are sort of telling me three different things and you all here are telling me it's an infection. So yeah, what kind of an infection? What's more, it burns off and on now between my two front teeth, although this could be psychological cause it's so varied. \n\nHelp me, I am literally losing my mind over this." + }, + { + "id": 276, + "title": "Root Planing & Irrigation", + "dialogue": "Jeffrey A Bilger: Root Planing is covered under my Delta Care USA CA10A plan but irrigation is not.\n\nThe office wants to charge $51 / quadrant. All they do is use a small syringe and squirt a antibiotice solution on the quadrant they just performed PSRP on. Seems very costly to me.\n\nMy questions are:\n\n1. What is the solution that they use ?\n2. What is the active ingredient in the solution ? chlorhexidine gluconate 0.12% ?\n3. Is the dentist using Peridex for this solution ?\n4. Can the issue a prescription for Peridex ?\n5. For further reading on Peridex indicates that it may cause brown or black stains on teeth after repeated use.\n\nI just don't want to be ripped-off for $204 when maybe I can buy a prescription from a pharmacy for about $10 if Peridex is accomplishing the same thing as their one time irrigation at the dental office.\n\nI also have 6 abrasions ( 2 deep, 4 are moderate ) that they indicated might need to be fill at $203 / tooth..... that's $ 1,218 ...........ouch.........I am considering at least the 2 deep ones so that it may prevent a root canal down the road.......\n\nIs $203 / tooth a usual,customary, & reasonable fee ( UCR fee ) excessive........???\n\nWhy is it that everytime one goes to the dentist...it cost a hell of a lot much than going to a doctor's office......something about dental vs medical insurance is not right here ......\n\nYour reply is greatly appreciated......" + }, + { + "id": 277, + "title": "They're trying to cheat or not?", + "dialogue": "federico: Good morning.\nI am 27 years old, I am writing to a problem of periodontitis .\nI am writing you from italy to have an opinion and I hope foreign impartial.\n\nI've always had problems with gingivitis and gingival rescission , even with good dental hygiene .\n( In my family, my father and my uncle lost year for periodontitis teeth very early \"no diabetes or cardiovascular disease \" )I recently neglected hygiene and in a short time I got gingivitis .\n\nSo I went to two dentists , both very expensive and are listed , one in Milan and one in Genoa where I live .\nWhat milano told me that I have gingivitis , which I already rescission bone , and the pockets in some places and I have to deal with a laser treatment :microbial analysis , 4 mechanical cleaning , laser cleaning 4 , 4 partial laser cleaning , and even surgical displacement of frenula for a total of almost $ 7000 !\n\nto Genoa , where I was then , without saying that I was the first dentist in milan, he prescribed a simple mechanical cleaning and told me that was enough.\nWhen I told him that I was from that of Milan, and I showed him the quote that made me , I said, we do not use the laser treatment , and it is not necessary in your case .\nThe first dentist specializing in the treatment of paradontiti , the second in implantology , I have to go to a third dentist?\nI should care with the laser ?\nCan you give me some advice?\nThanks in advance.\n\ngreetings\nFederico" + }, + { + "id": 278, + "title": "Chronic Abscess", + "dialogue": "Phil: Hi\nNew to forum and as a last resort for advice.\n\nFor maybe now 8 months I have what I have been told is a chronic abscess that started at tooth 21. It is not painful and hardly bothers me at all. It started at the gum level outside the tooth and quickly moved up under the nose. I am only barely aware of it if I apply pressure to the gum area (no pain). Applying any pressure to the tooth is just a regular sensation and not indicating any issue.\n\nEvery few weeks I become aware of it draining (assumption) to the sinus. This is when I feel a very mild head discomfort as well as a little sinus activity, like a very mild flu symptom. This will last a couple of days but in no way constant.\n\nI have seen a few dentists now as I also want implants. Teeth 11 and 21 were capped about 30 years ago and had the bare minimum of tooth left for that procedure. A root canal on 11 fifteen years ago snapped the natural tooth and the crown was posted back on. This has now failed and the tooth is below the gum and beyond repair, so I would now like implants for 11 and 21.\n\nDentists want to do the implant for 11 and don't seem too concerned about the adjacent abscess, except for one. I'd rather forget about 11 for the moment and resolve the abscess. The abscess did not show up on the x-ray the last dentist did.\n\nDentists seem to think (except another one) that 21 can just be re-crowned. I very much doubt this tooth can withstand the removal of the existing crown and stay intact, so I don't mind it being extracted.\n\nThis is what I need advice for, I don't want to see a periodontist to be told extraction of 21 will resolve the abscess issue when I already think it needs removal anyway (implants to 11 and 21). Another concern is that the professional who deals with this could well end up running a 'round trip' of unnecessary investigative procedures to resolve something that has such a mild symptom. I don't know if this thing can heal itself (and it only ever seems to get better rather than worse) or if it will continue to drain to the sinus. I am also unaware if this draining is causing other problems down the track.\n\nBy the way, there is no bad taste, swelling or anything external to indicate this abscess. I did reluctantly try an anti-biotic but it had zero effect.\n\nI would also appreciate some additional advice about the method of implants to 11 and 21 done simultaneously (convenient). I was told a better outcome for the gums would be if they are done at separate times, being adjacent teeth (inconvenient).\n\nWhat to do is doing my head in!\nregards\nPhil" + }, + { + "id": 279, + "title": "do I need surgery", + "dialogue": "kylefoley76: My periodentist recommends osseous surgery for three quads which will cost 950 per quad. And also thinks osseous graft, gingival flap and gem 21 for the lower left whhich will cost 1450, but he's not very insistent on it. I don't see why if the lower left is healthier why it costs more money to fix. \n\nThese are the size of my pockets. I am 36 years old. \n\nUpper Right, starting from the back \n\n5 4 8 4 8 8 7 5 5 5 4 4 3 3 3 3 4\n\nLower Right, starting from the back\n\n5 7 6 6 6 6 5 5 5 4 4 4 4 3 3 3 3 \n\nUpper Left, starting from the back\n\n5 7 7 6 6 5 6 5 4 4 4 3 3 3 \n\nLower left, starting from the back. The dentist doesn't want to do surgery on this one.\n\n6 5 6 5 5 5 5 4 5 4 3 3 3 3 3 3 kellogg9: yea it looks to be..those 8s are nasty Gordon Wilson DDS: kylefoley76 said:\n\n\n\n\t\t\tMy periodentist recommends osseous surgery for three quads which will cost 950 per quad. And also thinks osseous graft, gingival flap and gem 21 for the lower left whhich will cost 1450, but he's not very insistent on it. I don't see why if the lower left is healthier why it costs more money to fix. \n\nThese are the size of my pockets. I am 36 years old. \n\nUpper Right, starting from the back \n\n5 4 8 4 8 8 7 5 5 5 4 4 3 3 3 3 4\n\nLower Right, starting from the back\n\n5 7 6 6 6 6 5 5 5 4 4 4 4 3 3 3 3 \n\nUpper Left, starting from the back\n\n5 7 7 6 6 5 6 5 4 4 4 3 3 3 \n\nLower left, starting from the back. The dentist doesn't want to do surgery on this one.\n\n6 5 6 5 5 5 5 4 5 4 3 3 3 3 3 3\n\t\t\nClick to expand...\n\n\nHi Kyle,\n\nIn my office, we would be able to treat this non-surgically, but I would use my laser on the three 8mm pockets. DentalSave: kylefoley76 said:\n\n\n\n\t\t\tMy periodentist recommends osseous surgery for three quads which will cost 950 per quad. And also thinks osseous graft, gingival flap and gem 21 for the lower left whhich will cost 1450, but he's not very insistent on it. I don't see why if the lower left is healthier why it costs more money to fix. \n\nThese are the size of my pockets. I am 36 years old. \n\nUpper Right, starting from the back \n\n5 4 8 4 8 8 7 5 5 5 4 4 3 3 3 3 4\n\nLower Right, starting from the back\n\n5 7 6 6 6 6 5 5 5 4 4 4 4 3 3 3 3 \n\nUpper Left, starting from the back\n\n5 7 7 6 6 5 6 5 4 4 4 3 3 3 \n\nLower left, starting from the back. The dentist doesn't want to do surgery on this one.\n\n6 5 6 5 5 5 5 4 5 4 3 3 3 3 3 3\n\t\t\nClick to expand...\n\n\nThe surgery is def needed.. and it is very expensive.\n\nhave you looked into a dental plan you could be saving lot of money for as little as 100 a year..\n\ngood luck Libra: kylefoley76 said:\n\n\n\n\t\t\tMy periodentist recommends osseous surgery for three quads which will cost 950 per quad. And also thinks osseous graft, gingival flap and gem 21 for the lower left whhich will cost 1450, but he's not very insistent on it. I don't see why if the lower left is healthier why it costs more money to fix.\n\nThese are the size of my pockets. I am 36 years old.\n\nUpper Right, starting from the back\n\n5 4 8 4 8 8 7 5 5 5 4 4 3 3 3 3 4\n\nLower Right, starting from the back\n\n5 7 6 6 6 6 5 5 5 4 4 4 4 3 3 3 3\n\nUpper Left, starting from the back\n\n5 7 7 6 6 5 6 5 4 4 4 3 3 3\n\nLower left, starting from the back. The dentist doesn't want to do surgery on this one.\n\n6 5 6 5 5 5 5 4 5 4 3 3 3 3 3 3\n\t\t\nClick to expand...\n\nyeah surgery is required to prevent loss of teeth. Libra: Gordon Wilson DDS said:\n\n\n\n\t\t\tHi Kyle,\n\nIn my office, we would be able to treat this non-surgically, but I would use my laser on the three 8mm pockets.\n\t\t\nClick to expand...\n\nhow will you treat it non-surgically.\ncurious to know about it" + }, + { + "id": 280, + "title": "Gum graft", + "dialogue": "sl0888: I had a frenectomy and gum graft on tooth 24 about two and a half weeks ago. When I went back for follow up the periodontist said he wished he had been able to cover more of the root. So I'm just wondering, what would have prevented him from covering the root more? Libra: do u knw what type of gum tissue graft ur dentist has used? did he tk the graft from palate or from the gums surrouding the site whch needed repair? sl0888: Libra said:\n\n\n\n\t\t\tdo u knw what type of gum tissue graft ur dentist has used? did he tk the graft from palate or from the gums surrouding the site whch needed repair?\n\t\t\nClick to expand...\n\n\nIt's an alloderm graft so it's donor tissue, not from my own mouth. Libra: volume persistance and availability always remain a concern in alloderm surgery.. surgeons themselves determine the degree of volume and use larger pieces of alloderm or multiple layers, depennding upn the degree of gums recession." + }, + { + "id": 281, + "title": "Gum Disease", + "dialogue": "JamesSteele: My grandfather had gum disease for many years. He has been treated with Arestin every three months for the past 10 years with success. He is interested whether he can reduce or eliminate the Arestin without the disease recurring (as the treatments are very pricey). \n\nJamesSteele marrkarnell: you can visit your resident dentist and ask him what is the best alternative for Arestin. You may also choose to use systemic antibiotics in some cases. frankinheadly: Make an appointment with Dr.Neesha Patel from Pure Periodontics,she takes gum disease seriously and each patient undergoing a full examination is provided with gum assessment. danielhermann: hi\nBacteria causes gum diseases.These bacteria, along with mucus and other particles, constantly form a sticky, colorless “plaque” on teeth. Brushing and flossing help get rid of plaque.when it harden form tartar which can remove only professional dentist by deep cleansing.Deep cleansing helpful to remove bacteria that contribute to the diseases.if you have problem,never ignore the gum diseases.it is harmful for your health also.you have need to go to dentist to recover the diseases as soon as possible. atulmishra: You need to take advice from one of the experience dentist who will check your Grandfather’s root cause of disease, as you are saying this is a plaque problem you also need to aware your grandfather about how to take care of gums.. Gordon Wilson DDS: JamesSteele said:\n\n\n\n\t\t\tMy grandfather had gum disease for many years. He has been treated with Arestin every three months for the past 10 years with success. He is interested whether he can reduce or eliminate the Arestin without the disease recurring (as the treatments are very pricey). \n\nJamesSteele\n\t\t\nClick to expand...\n\n\nJames. Your grandfather can completely eliminate the use of Arestin by using Perio Gel in Perio Protect Trays." + }, + { + "id": 282, + "title": "Periodontal Irritation Question", + "dialogue": "Teeth: I have an area near #12-14 that keeps on becoming irritated. The Periodontist says he doesn't see anything going on with the teeth after doing X-rays. He's not certain why this area keeps on becoming inflamed. They have given me two products that I can use when there is a problem (chlorhexidine gluconate & a pink rinse (it appears they make this in their office). They both seem to correct the problem after I use them twice a day (only use 1 at a time) for about a week. Sometimes the irritation will come back after a few days. My question is how long can you use these products for? Are they safe to use on an on-going basis? kellogg9: i was going to suggest chlorhexidine too. You know what try salt water and rinse and see if that helps. If not maybe a good ole fashion root scaling might help Gordon Wilson DDS: The reason that the irritation keeps coming back is because bacteria called a biofilm are constantly forming below the gum line. Your toothbrush and floss can only reach about 1mm below the gums. If you want to eliminate it forever, you will want to use Perio Protect Trays. Perio Protect Trays are custom-fit medical appliances that allow you to place an antimicrobial gel below the gums. After 15 minutes of wear time, the antimicrobial gel kills 99.9% of the bacteria in the biofilm, and it's safe to use every day." + }, + { + "id": 283, + "title": "Can Periodontal Ligaments tighten up?", + "dialogue": "kellogg9: My apologies for not knowing the right terms but the ligaments that keep the gums attached to the teeth and provide a sort of dampner (shock) absorbant...are there ways for them to tighten up to help reduce chances of gum disease such as ostioblast/clast process (bone absorbing and depositing) which would then stimulate the perodontal tissue to grow better?" + }, + { + "id": 284, + "title": "Scaling-induced Gum recession", + "dialogue": "Jkarnaki: I have to be honest and say that I don t really trust dentists so much...in my life I have 2 horrible life-long consequential mistakes due to them. Since I have went to really only the best dentists, often forgoing the insurance plan.\n\nNow I have some periodontal disease which is wose around some teeth more tha others. Frankly, my doc never told me that more than 50 percent of people have periodontal disease, they kind of scared me.. I now floss on a daily basis and don't see anymore blood ever. \n\nThe issue I have is that my dentist is suggesting that before I change my crowns, on the front, that i do deep cleaning there. Well the problem is that deep cleaning has always non-surprisingly resulted in a recession of the gum. While if I had to do it, it would be smart to do this before the new crowns, I am just not sure how important this is. I am scared that the recession will lead to funny looking crown, longer teeth on the inside of my mouth if you see what I mean... My doc never told me that I had a really bad case of periodontitis. I am thinking of telling him no, and that I won t do deep cleaning until I see that I really really need it. Meanwhile I will just floss everyday and take care of them....\n\nThoughts are much much appreciated...thanks\n\nPs: if there are some measurable parameters that you want me to ask him pls let me know danielhermann: hi \nPracticing good oral hygiene is usually enough in the majority of cases, either caused of improper toothbrushing or by gum disease, to provide natural cure for receding gums. non-surgical treatments for gum recession may include desensitizing toothpastes. There are several toothpastes against tooth sensitivity, with agents such as sodium chloride or potassium salts .Tooth scaling and Root planing. Professional deep cleaning of the tooth surfaces below the gum line may be required to treat gum disease and stop the gum recession." + }, + { + "id": 285, + "title": "Can i put off scaling for a few weeks?", + "dialogue": "majic28: My periodontist said my pockets are all 5-8 but said he can\nsave them all with scaling except my wisdom tooth number 1\nwhich had a painful cavity and to much bone loss. I had\nThat tooth out a few days ago and missed a day from work, \nMy appointment for scaling is next week, could I wait 2\nmore weeks so I can take off again or can damage of gum\ndisease make it a lot worse in a few weeks? Sorry\nFor any grammar issues, using small phone. Thanks danielhermann: HI majic28\nscaling is good treatment to cure gum disease.it will work very efficently ,we feel improvement in a few week.Take advice of your dentist to pull off scaling because your dentist know your problem very well." + }, + { + "id": 286, + "title": "Unexplained long-term pain/discomfort", + "dialogue": "Orion: Hello,\n\nI'm reaching out here in the hope that someone has come across this situation before or has some ideas as to what might be causing this and how to resolve it.\n\nOn the last day of February this year, my wife fainted and hit her mouth very hard on a work-surface on the way down. When she came to 15 minutes later, she found that she had broken off part of her upper left tooth. Obviously, I rushed her to the local hospital who checked her out and then her regular dentist who put a temporary cap on the tooth and said to come back in a couple of weeks.\n\nThe cap popped off the very next day so we paid to go to another local dentist, who put a semi-permanent cap on it. This has stayed in place fine.\n\nThe problem is that, ever since the accident, she has experienced dental pain. The pain is primarily around the broken tooth and the neighbouring front tooth, however it has moved around her mouth at times. It ranges from stabbing pain to a dull ache and everything in between.\n\nShe is a trumpet teacher and, like me, plays in a successful local brass band. The pain means that she cannot play her instrument and this is understandably causing great frustration and heartache.\n\nShe has been to see a specialist, whom her parents know very well, and whilst he has diagnosed the pain as being in the periodontal layer (I'm not knowledgeable in this area, so I hope I've got that right) he doesn't understand why it is still painful nearly 4 months later.\n\nAny advice and thoughts would be very welcome at this point. Thank you in advance for your input.\n\nBest wishes\n\nOrion" + }, + { + "id": 287, + "title": "Past Treatments for Gum Diseases", + "dialogue": "1socalgal: Hello...I was curious about past (or present) treatments for gum diseases, specifically what was/is called 'trench mouth.' When I was 3 yrs old in the late-60's I was diagnosed with this oral disease by the doctors on a Naval base. The doctor told my mom that the only way to treat this disease was to break all the bloody blisters. The doctor proceeded to hold me down and scrubbed my mouth with a toothbrush until all the blisters were broken, and my mouth was bleeding. Needless to say, I have no recollection of this event, but apparently it was so traumatic, I stopped talking for months and developed a withdrawn personality years after. But, that's not my point. I was wondering if that was standard practice back then (or now?) or was that method the only means to 'cure' such a disease back in the day? I can't imagine dentists/doctors *still* doing something like that to a child, much less adults nowadays." + }, + { + "id": 288, + "title": "Periodontics in wisconsin", + "dialogue": "pattyw831: All Periodontics, I need advice, Please,\n I don't know where to begin. I guess from the beginning. Back in 2003 I decided to get veneers on my 6 bottom front teeth...biggest mistake in my entire life. They looked nice but soon realized there was a serious problem with my bite after getting the veneers installed. Since then, I've spent 2 years of going back to the dentist that put these veneers on in the first place, in which he had done at least 20-25 adjustments which still didn't correct the problem. After that, I've been to 4 more dentists to try to fix my bite and none of them could help me. I've been in pain now for several years and can't deal with it anymore. Does anyone know what it is to have a toothache for just a few days, it is something I wouldn't wish on my worst enemy. My pain has been on going because there doesn't seem to be even one dentist that knows how to help me, nor is there one that even cares about what I've been going through all these years. Believe me, I have the dental tape here at home and can clearly see that the teeth are still hitting on eachother, very hard, which is why my teeth have been aching me ever since them veneers. I even went to a dentist that teachs at marrquette and he couldn't even help me. This dentist took of the veneers and made all 6 teeth into crowns, so he could make more room for my biten or as he put it \"open up my bite\" and that didn't even help. So, here I am, all these years later suffering everyday of my life because now that these dentists drained my bank account, I can't afford to go to a dentist. So at this point the only option for me is to go to Mexico and get every last tooth on mine pulled because I can't afford to keep going to Dentists in hopes of finding one dentist out there, that might be able to help me. How many dentists does one person have to see, in order to get help. I can't believe this nightmare I've been going through. So now that I'm disabled and spent my last dollar on trying to get my teeth fixed by going to at least 5 dentist. They depleted my life savings of over 100k and gave me nothing in return, not even any glimmer of hope to relieving my problems with my teeth, that was made by the dentist who put the veneers on my 6 botton teeth in the first place. I see nothing ever getting better, there doesn't seem to be a dentist that is able to help me gets my teeth to being just comortable again. Everyday is spent in agony, I'm ready to go to Mexico to get them all pulled because there isn't a dentist here that was able to help me. that seems to know what to do for me. I went for a free consulation the other month to a dentist, that I was told about as being possible able to help me but when I asked him what should I do, he told me I need to go see a bite specalist. So, here I am all these years later, going to start over at the beging again, the only difference now is that I can't because I'm broke after the first round of no help. I'm here to possibly find a dentist that will now make me a pair of dentures, being that's all I can afford now by using a credit. Then, at least I won't have anymore pain to deal with. While at the last dentist I asked him if he could pull my eye tooth because is was hitting on the lower tooth, he says to me, oh no, I couldn't do that, it would be unethical. But I guess letting the eye tooth that is causing me so much pain...contuinue to hit on the other tooth isn't unethical? I don't understand his reasoning. What am I suppose to do, contuine to suffer for the rest of my life?" + }, + { + "id": 289, + "title": "How many appointments to treat severe gum disease?", + "dialogue": "mjar109: I was diagnosed with gum disease and referred to a periodontist. I had the initial consultation which showed where I had bone loss. The first step would be to do a deep cleaning with four appointments (one for each quadrant). After that, I know I will need gum flap surgery and bone grafts. My question is would this most likely be done across 4 appointments also (one per quadrant)? What about gum graft surgery? Will this be done after the gum flap surgery is complete?\n\nI'm just curious. I would like to hear from others who have gone through this as well as other dentists. I just want to know how many appointments that I can expect to be looking at after the deep cleaning is done and over what period of time (i.e. number of weeks or months).\nI know after that, I will be coming back for maintenance every 3 months. \nI just want to know how many visits I can expect this to take. Part of me would like to do everything at one time and be done with it, but I know that it is not that simple. Bert: Hello,\nI am sorry to hear you are going through all that.\nIf you need a surgery in each quadrant, most likely you will have at least 5 more appointments after done with the debridment/scaling (the deep cleaning you refered to).\nBut each professional thinks slightly different and each scenario is also very particular. So that is just a guesstimate.\nThe most important thing, is after healing from all the procedures, you take responsibility for your health and take good care of your oral cleaning so you won't ever have to do it again.\n\nshould you need some info:\n\nGum Disease Treatment Bert The Dentist\n\nbest of luck!\nBert" + }, + { + "id": 290, + "title": "perio endoscopy", + "dialogue": "Tdub: I need to find a dentist. I would like to find out what dentists in my area (Chicago) do endoscopy when doing profys and evaluations. I want this because past dentists (not perios) have not been able to get to the bottom of my gingivitis problem (and I have some 4 pockets in the back), despite good homecare (daily: 1X floss, 3X water floss, 2X ultrasonic brush; occasional stimudent) and frequent profys/visits. Is this a good line of reasoning for me to follow? If so, what percentage of perios do endoscopy? What is the proper name (if other) for referencing this procedure? TIA, Tdub." + }, + { + "id": 291, + "title": "yellow/brown saliva", + "dialogue": "noonmoon: Hi, Im 20yr old\n\n My wisdom tooth came in last year on my upper left side. For some reason my whole left face was swollen really badly. I went to the dentist and he gave me antibiotics. I took them for 1-2 weeks, they didn't help much with the swelling, but eventually the pain went away aswell as the swelling.\n\nBut ever since then, some kind of yellowish/brownish leakage occurs from the upper left side of my mouth where the tooth came in, and I can feel a tiny opening with my tongue, where the tooth came in(outter side) and im pretty sure thats the source of it since that spot is always bitter. I've had xrays done and the dentist could not see any openings what so ever.\n\nthe taste is very sour/bitter.\n\nSome things I've noticed when the leakage occurs:\n\nI never have to clean my nose a lot, and its never filled with any \"boogers\"\nWhen I do blow my nose the bitter stuff comes from the same spot, upper left.\nrarely there is also leakage that is brownish/red which i think is blood, but it never hurts.\n\nI'm planning to go see a periodontist, but first decided to try google.\n\nThank you,\nIf anyone has some answers it would be greatly appreciated. crankit: Sounds a little bit like post nasal drip(I think thats the name). I have polyps in my sinuses and at times this causes some kind of fluid to run down the back of my throat from my sinuses. At the moment I'm on a nasal spray to help control this called nasonex. Randy Nolf: Good idea see a periodontist. Sounds unusual but based on your description there could be a communication to your sinus. The foul taste can be associated with a low grade smoldering type of infection. X-rays don't show everything, it sometimes requires quite a bit of interpretation.\nI think you will find that once there is a diagnosis the solution will be clear.\nBest of luck webpiter: Yellow saliva can be caused by a number of factors, including bacteria or acid in the mouth. It can be a sign of other problems as well, such as infection or acid reflux. These conditions may require treatment by a doctor or dentist.\n\nThe presence of yellow saliva early in the morning may result from the buildup of bacteria on the teeth, tongue or other tissues in the mouth. This often results in halitosis, or bad breath, and can increase the likelihood of tooth decay. Bacteria in the mouth can usually be controlled by good oral hygiene practices, such as brushing and flossing regularly. Brushing or scraping the tongue is especially important for halitosis sufferers. If these measures are not sufficient, a dentist may be able to provide other suggestions for getting rid of the bacteria that cause halitosis and yellow saliva. Surgident: SurgiDent\n\nAOA, Hi, without proper chechup and targetted radiography, yet doubtful though not misleading, The sequence of your condition might've been as follows\n1. dental decay-caries \n2. severe pain in a tooth and associated area for some days and then Pus starts collecting along with friability of the area surrounded by the pus in the roots of the tooth\n3. Swelling developing suddenly long after the severe pain had gone\n4. the swelling goes down and the yellow stuff (pus and blood) starts flowing out of that opening you described\n5. dull pain in the area\n6. the tooth may feel elevated campared to the neighbouring ones\n&\n7. Tx is either extraction or endodontics along with removal of the pus route." + }, + { + "id": 292, + "title": "Opinion on Resorption (extract and implant reccomendation)", + "dialogue": "jonnyob: I had a root canal on #19 in 1999. In 2009 I had to go in for re-treatment. Recently it has been hurting and a small swollen abscess emerged and went away on the inside gum. \n\nI went to an Endo who said he thought the root was fractured and that it had to be extracted. \n\nI then went to the Perio who said he didn't think it was fractured but that I was suffering from external resorption, and he recommended extraction and implant. \n\nI have attached the 2009 xray (left thumbnail) and the xray taken 2 days ago. Does this look like an obvious extraction case?\n\nAny input would be greatly appreciated." + }, + { + "id": 293, + "title": "Receding Gums - What am I doing wrong?", + "dialogue": "Bennuendo: I've been having issues with inflamed and receding gums for a while, and I've tried to correct the problem myself, but it still persists. I notice the inflammation more on the lower gums, but the gums on top and bottom are both receding.\n\nHere's what I do on a daily basis, two times a day... tell me if you can spot an issues.\n\n* First I use a Right-Angled Whitening Plackers and floss all of my teeth\n\n* Then I use a Perio-Aid (that you put a toothpick in) and gently scrape the plaque away from my gum line\n\n* Then I use an Ora-Brush and brush then scrape my tongue\n\n* Then I gargle and swish around some CloSYS mouthwash\n\n* Then I grab my Dr. Collins Perio toothbrush, which is extra soft and specifically for people with gum issues\n\n* I put on some Kiss My Face Triple Action toothpaste, wet it with warm water to soften the bristles even more, and then I brush with soft circular strokes\n\nDoes my order of operations throw up any red flags for anyone?\n\nI figured what I was doing would be pretty helpful in resolving the problem, but perhaps I'm just too stressed. I work a lot and sometimes my sleep schedule gets all out of whack, and I know that doesn't help at all." + }, + { + "id": 294, + "title": "can periodontal scaling damage root?", + "dialogue": "rturnbull: Can periodontal scaling spread bacteria deeper into the gum and eventually damage the nerve of a tooth? \n\nLast year scaling was performed between teeth 12 and 13 – the gum was slightly inflamed, and would occasionally bleed when flossing. The gum had marginally separated from one tooth, but produced no pain. The procedure was performed by a hygienist, rather than the dentist, and appeared to go well. However in the weeks to come increasing deep pain began - deep bone pain at the center of a bicuspid, which would radiate outward into other teeth, the skull, the eye; the lymph nodes on the left side of the face also swelled. \n\nThe first dose of cephalexin did not entirely remove the pain, which progressively grew again. The separation between tooth and gum had by then healed, and a specialist was sought while a stronger dose of cephalexin undergone. Despite good digital x-rays, the specialist could find only swelling of a ligament. These x-rays are available for review. The pain and related symptoms have since intermittently returned for the last six months and recently began very deeply at the bicuspid again, which shows a thickening of the ligament under new x-rays. The pain has spread up again into the left eye and the lymph nodes are swollen again. A cold test for # 13 indicates increased sensitivity. Amoxicillin reduces the pain. Root canal therapy has been proposed.\nWhich is the more accurate cause and effect in this scenario? \n\nA: the patient would experience no pain from an infected tooth root, which eventually slightly swelled and separated the gum from the tooth, and only after the separation was repaired through scaling the patient began to experience ongoing profound pain for six months in the root of the tooth followed by the related symptoms of swollen lymph nodes, etc. \n\nB: during the scaling bacteria was pushed deeper into the gum, which then closed, locking and spreading the bacteria against the tooth; eventually, due to prolonged infection, the tooth root was irreparably damaged.\n\nThank you and kind regards,\n\nRT" + }, + { + "id": 295, + "title": "Bad Odor Months After Tooth Extraction !", + "dialogue": "cpotts28: I had 2 teeth beside each other extracted about 3 months ago and ever since I've noticed a foul odor 24 hrs a day. I've never had bad breath in my life and never noticed this until these 2 teeth were extracted. I have an appointment scheduled to my dentist but wanted to get some opinions on here as well. What could have caused this to happen?" + }, + { + "id": 296, + "title": "Help! Should I get a second opinion??", + "dialogue": "bluesun: I am a 43--year-old healthy woman and I just returned from a dental appointment. My first time with this dentist who came highly rated. I'm paying out of pocket and on a very tight budget so I'm trying to do some research before having any treatment.\n\nI went in for a cleaning/exam/x-ray and was told I have periodontal disease. I was shocked since I have taken good care of my teeth my entire life. I don't smoke or take any medications. Both my parents have good teeth. I have had no pain, discomfort or bleeding from my gums when I brush.\n\nThe only negative is that I haven't flossed much the past eight months, which is not normal for me. My husband passed away and I just blew it off and was lazy about it. So....that is the only weakness I can think of in terms of missing some steps in my dental care. I also had two very mild decayed areas which he wants to fill in the next three to four months.\n\nSo...they want me to do a deep cleaning, which they say will take 2 to 3 appointments and require numbing, etc. It took my initially $300 bill to around $1000 (this includes the two fillings).\n\nIf I really need it, fine. But I'm so suspicious because I have had no symptoms and, although I'm no expert, my gums look slighly red but nothing alarming. \n\nAny thoughts? Should I get a second opinion? Or can you have this disease with few symptoms? Randy Nolf: ask for a PreViser report or find a dentist who can do one. Often they will do it at no charge. Randy Nolf: Actually you can start on line Take The Dental Test That Assists In Better Oral Health. What's Your Score?. It's free. Toother: If you ever feel like you need a second opinion it is within your rights. But just as an FYI your teeth can look good and you can still get periodontal disease." + }, + { + "id": 297, + "title": "being charged twice for scaling", + "dialogue": "jlgibson79: Had my first visit with a new dentist today. Getting lined up for scaling of 4 quadrants. The guy in charge of billing was extremely rude, insulting my insurance. He seemed upset that it was an HMO instead of a PPO. My scaling must be done in two sessions so they are charging me twice. \n\n To clarify, they are doing all 4 quadrants, charging me. Then I go back 2 weeks later, they finish all 4 quadrants and they charge me again. Is this just a way for them to get more money out of me since as he explained, with an HMO they dont bill insurance for the difference? dustinn: jlgibson79 said:\n\n\n\n\t\t\tHad my first visit with a new dentist today. Getting lined up for scaling of 4 quadrants. The guy in charge of billing was extremely rude, insulting my insurance. He seemed upset that it was an HMO instead of a dental mexico PPO. My scaling must be done in two sessions so they are charging me twice. \n\n To clarify, they are doing all 4 quadrants, charging me. Then I go back 2 weeks later, they finish all 4 quadrants and they charge me again. Is this just a way for them to get more money out of me since as he explained, with an HMO they dont bill insurance for the difference?\n\t\t\nClick to expand...\n\n\n\nI would check your claims to see if it specifically says 2 or 4 quadrants. Randy Nolf: jlgibson79 said:\n\n\n\n\t\t\tHad my first visit with a new dentist today. Getting lined up for scaling of 4 quadrants. The guy in charge of billing was extremely rude, insulting my insurance. He seemed upset that it was an HMO instead of a PPO. My scaling must be done in two sessions so they are charging me twice. \n\n To clarify, they are doing all 4 quadrants, charging me. Then I go back 2 weeks later, they finish all 4 quadrants and they charge me again. Is this just a way for them to get more money out of me since as he explained, with an HMO they dont bill insurance for the difference?\n\t\t\nClick to expand...\n\n\nSounds like they are 2 quads one visit and 2 the next. Standard procedure. 2 are charged one visit and the remained the next." + }, + { + "id": 298, + "title": "bone grafting done...i'm not so sure.", + "dialogue": "benners1980: I had a tooth extracted a few weeks ago, and was billed for an extraction and bone grafting. They did not mention the bone grafting until I got my statement and was billed for it. I since have been back and they mentioned that I didn't have a bone graft, followed by awkwardness when I started asking questions. They now confirm that they cannot tell me whether there was a bone graft done unless I purchase a CT scan from them at a cost of $200. I guess I feel that if they can't prove it, then they should refund me. When I had the tooth extracted initially the tooth came out and was instantly sewn up and I was out on the street within 10 minutes. Is it possible for a dentist to do a bone graft in less than one minute and then sew it up with no assistance? This dental office has a habit of overcharging for things and double billing. Needless to say I will not be going back, but I want to know if I should pursue a second opinion and if the answers I am getting from them sound truthful. \n\nThanks in advance for your help! Thomas Bird: This is just disgusting. Whenever I think American dentists cannot be more crooked I hear another story like this one. They are ripping you off 100% sure. \nI gave up on American dentists years ago and have received by far and away the best and cheapest dental care of my life here in Thailand. If you ever need major work done I would not even consider going to a dentist in America. Randy Nolf: Sounds like a mix up someone needs to clarify. It is possible to be fairly quick placing a graft into an extraction site. The error may be more in the handling of your question. Sorry you had this happen." + }, + { + "id": 299, + "title": "Question about Gingivitis", + "dialogue": "questionasker01: Last spring I had a nasty case of gingivitis...my gums bled off and on (they would stop for a week or two and then start again) for about 2-3 months.I increased brushing (and did a better job), starting flossing regularly, using mouth wash more often, replaced my tooth brush, etc. \nMost of the bleeding occurred around areas where my retainers touched my teeth/gums. My orthodontist guessed that maybe hormones were playing a role in it. My gums did stop bleeding once I got the new toothbrush and my hormones got back in check (happened around the same time).... Unfortunately I don't have dental coverage and was not able to see a dentist about my problem\n\nMy gums have been healthier since then...in the last year or so only one or two teeth have had a little blood along the gumline during brushing (only once or twice over the last year; extra brushing and mouthwash take care of it so it's not bleeding by the next morning). Otherwise, I have kept up my routine and have had no problems...\n\nI noticed I've had some gum recession which was from the infection I think (I can't be sure since I did use some hydrogen peroxide and didn't dilute it well enough once). One one or two of the teeth the area is a little bit whiter. Two other teeth have little notches along the gum line, but only on one side of the tooth. I'm not sure if the one notched tooth has been there awhile or not...I just noticed it tonight, but it's possible I may have missed it.\n\nI guess I'm asking that if my gums are pink and my teeth do not hurt or bleed when brushing or flossing, my infection is cleared right?\nJust asking for a little peace of mind \nThanks to all who answer JPGDental2: I have been fighting gingivitis since I was 12. I just never liked to brush my teeth as a kid and thought that Listerine was a cure all for teeth. Last winter my mother paid for me to see a dentist for the first time in years. It took some serious cleaning sessions, but oddly enough, I haven't been this proud to smile in a long time. The real bonus has been that all my gum recessions have tightened back up and my gums are no longer bleeding. gels: I'm like more than a year late with answering this but... better late than never! \n\n\n\nquestionasker01 said:\n\n\n\n\t\t\tI noticed I've had some gum recession which was from the infection I think (I can't be sure since I did use some hydrogen peroxide and didn't dilute it well enough once). One one or two of the teeth the area is a little bit whiter. Two other teeth have little notches along the gum line, but only on one side of the tooth. I'm not sure if the one notched tooth has been there awhile or not...I just noticed it tonight, but it's possible I may have missed it.\n\t\t\nClick to expand...\n\nIf you have notches on your teeth near the gumline it may be due to toothbrush abrasion. That means you have been brushing too hard. Make sure you are using a soft bristle tooth brush and are using the Modified Bass Technique when brushing. If you are not sure what it is then you should look it up. \n\n\n\nquestionasker01 said:\n\n\n\n\t\t\tI guess I'm asking that if my gums are pink and my teeth do not hurt or bleed when brushing or flossing, my infection is cleared right?\n\t\t\nClick to expand...\n\nYes, It means your gums are back to health. Pink gums and no blood while brushing and flossing is a good sign of health! crankit: I think there maybe electric toothbrushes out now with a sensor that will switch off when there is to much pressure applied. pahd: Brushing too hard\n\n\n\ncrankit said:\n\n\n\n\t\t\tI think there maybe electric toothbrushes out now with a sensor that will switch off when there is to much pressure applied.\n\t\t\nClick to expand...\n\n\nThat would be awesome. I've never heard of that. I have the problem of brushing my teeth too hard. I got a Sonicare toothbrush for Christmas and I try to not brush so hard but just move the brush along as it does the brushing for me. Hopefully this will reduce the receeding gums which I've already had two grafts (well two surgeries of three grafts each) on." + }, + { + "id": 300, + "title": "mucogingival surgery", + "dialogue": "olle: I was searching for app on AppStore for my new iPad2 and just found this iPad application on mucogingival surgery or more exactly surgical treatment of gingival recession : iMuco-gingival recessions\n\nIt looks pretty good but have you ever heard about it or already experienced this application ??" + } +] \ No newline at end of file