All journeys start with the first step

[carole]

GOOD LUCK FOR TUESDAY

 

[blackhound]

There is a distinct possibility that I have developed oral thrush. White coated tongue that is sticky and bright white patches on my gums.

Methinks it is a bad confluence of events. Apparently this can be a side effect of antibiotics. I know it is a risk with my steroid inhalers (I have asthma) which is why I rinse my mouth after taking my dose. But the two together? Plus not being able to really clean half my mouth outside of the chlorhexidine. UGH.

At least I only have to put up with it for two more days as my appointment is on Tuesday. Then I can find out what is really going on.

 

[blackhound]

The waiting is horrible. Just ... horrible. I am spending my time pacing around like a nervous cat and I still have 4 hours to go.

This is just so unlike me in many ways. I was on the crew of a tall ship. I am part of an 18th century artillery team. I have lived all over the USA and have had all sorts of adventures. Most people would describe me as fearless. Little do they know! Brought low by DENTISTRY. omg what.

I. hate. this.

BH

 

[blackhound]

LANAP Part 2 is finished.

This side was way more intense than the other side because this is where all the big pockets dwell. There is one on the lingual side of #15 that is 11mm. Hopefully LANAP will do its thing and reduce that down by at least 50%. My mouth was mildly sore after the right side. My mouth was very sore after the left. Oy. There was some serious digging going on. Very nice of the doctor to call me at home later in the evening to make sure I was okay.

He said the left side was interesting. (That's always a potentially dangerous comment.) Some teeth had almost no calculus, others had a metric ton, and several had small bits of calculus that were practically welded to the tooth. Very difficult to remove. But they are gone, gone, gone. He said I have basically had a whole mouth disinfection process between the lasers, the DEEP cleaning, the oral antibiotics, and the chlorhexidine. He also adjusted my bite on the left side.

I wondered why he needed to adjust the bite when every time I get a restoration the dentist checks it and I don't have any high spots. What they are doing is taking away the heavy occlusion. His assistant explained that when the teeth are locked in for chewing they have a pretty tight lock if all is as it should be. That chewing motion is rocking the teeth in the sockets. If you have healthy gums, no problem. But with perio disease the weakened perio structure can't take the rocking. It literally starts to loosen the teeth even more in the sockets. I also asked why some teeth have a 3-6-3 perio score. He said the larger number is where the occlusion is so heavy that the force is making a bad situation worse.

My bite feels a whole lot .... lighter? My teeth still meet and mesh and if you look at the you couldn't tell where anything was removed, but there is definitely a difference in a good way.

The right side which was done 2 weeks ago? I thought there was thrush. WRONG. Apparently it was just gunk from not being able to brush that side. Clearly I never went to dental school. Clearly.

I thought the gum tissue on the right side looked sorta anemic. Too pale. Apparently that is what healthy gum tissue looks like. Who knew? *facepalm* He said the right side looked just as it should at this stage of healing. GOOD NEWS. Now I need the left side to follow suit.

I can now start careful brushing on the right side. No flossing. Left side is now off limits. Chlorhexidine continues. Another course of doxycycline. Liquid diet for 3 days. This time I don't think that's going to be much of a problem because I REALLY don't feel like chewing.

I have my fingers crossed that this will finally get me some control of the perio problems!

 

[carole]

Well done and I am really pleased to read how well things are going for you too.

 

[blackhound]

Thanks Carole. I really appreciate your support. (Big hug)

 

[blackhound]

My next visit with the perio is on Tuesday for a post-op checkup. The left side was a lot harder than the right side. A lot more soreness after the procedure which I should have expected since the pockets were deeper on that side.

I'm sick of soft food but I better get used to it because I still have a few more weeks to go.

The left side of my mouth is GROSS because it hasn't been brushed in 2 weeks. I should get the green light on Tuesday for at least some semblance of normalcy when it comes to my oral hygiene. I have to brush the right side carefully because certain spots are tender if they get rubbed by the toothbrush.

The antibiotics were hard for me. They made me very sick to my stomach but fortunately I am done with that.

My gums? Holy crap. They are pink! They actually look healthy. And as promised there was little to no gum recession. The shrinkage is from the lack of inflammation.

My overall impressions so far .....

LANAP is well worth the drama of the procedure. I did not find it as easy as advertised. I really did need an extra day to recover and my mouth was/is still tender. The part I hated the most was the occlusal adjustments. The idea of grinding on my crowns freaked me out. But you absolutely have to follow the protocol with liquid food, no brushing, no flossing, antibiotics, preloading with ibuprofen and those adjustments are absolutely necessary. Most of all you need PATIENCE. Patience with the food restrictions and the lack of oral hygiene and the realistic time frame for healing. Yes, the gums respond pretty damn quickly once the bacteria have been (literally) vaporized. But this is a long haul process. Deep healing takes months and the whole process needs a year before results can be measured.

The amount of chair time is long. Two procedures about 2 hours each. And there are post-ops check ups, and 3 month recalls for cleaning. It is a big investment in time and money.

I have googled a lot about LANAP and I would caution anyone who wants to commit to the process to really screen the practitioner. There is a LANAP Protocol that has to be followed by the dentist to the letter for successful outcome. The laser that is used is also specific. Not all lasers are equal. I have seen some dentists advertising LANAP and their Post-Op instructions are not following the protocol. From what I have been told by my doctor the outcome is predicated on both dentist and patient compliance to a strict set of rules.

Do I have dental fatique? YOU BET.

 

[blackhound]

This past Tuesday I had my post-op visit and everything is healing well and looking as it should!

I can FINALLY brush all of my teeth and start to carefully introduce actual, chewable food. Carefully being the operative word.

October 1st I have my first post-op scaling. They will carefully clean above the gum line, polish away the gruesome chlorhexidine stains, and repolish the restorations that were scuffed up from the occlusal adjustments. I will also have my existing NTI mouthguard checked to make sure it is doing what needs to be done.

As I said in a previous post, LANAP is a commitment but so far the results are pretty amazing. My mouth is clean, pink, and getting healthier by the day.

YAY ME!

 

[carole]

Congratulations

 

[blackhound]

Yesterday was my final perio appointment until January. WHEW!

The hygenist did a supragingival cleaning and polished up my teeth. All is progressing as it should!

I still have to see my regular dentist to have my restorations repolished. The occlusal adjustments on the molars (both sides) wiped out patches of the glazing on the CEREC crowns and inlays/onlays and those have to get slicked back up. I think I am going to wait until January when my dental insurance resets because I used it all up with the perio work.

I'm still not eating anything that requires vigorous chewing. Last night I tried to eat a chicken cutlet and it was a little dicey. Some of it is fear (imagine that ) that I'll do some damage. Some of it is caution because while I can now carefully floss the right side of my mouth I can't floss the left side of my mouth until October 21. And if I get something caught in my teeth on the left side I'm afraid I'll do some damage to the healing tissue.

Interestingly I have no desire to eat meat. I was never much of a meat eater to begin with. Mostly chicken and turkey and an occasional hamburger. I don't eat seafood because of allergies. But since August meat hasn't been on the menu because it would be too difficult to chew and have too much risk of being caught in my teeth. Now? I could care less. Last night I ate a whole bowl of cauliflower in garlic sauce and loved every bite. The few bites of the chicken really didn't seem worth the trouble.

The one thing I wish I could load back into my diet RIGHT NOW are whole grains. They have to wait. Too many small bits with things like quinoa and couscous, crusty bread has too many sharp bits, and chewy bread is well ..... too chewy.

This? Is a marathon. Oy.

BH

 

[carole]

WhoooooooooooooooooooHoooooooooooooooooooooooo well done.

I know what you mean about the food thing, I live like that most of the time. I also am worried (in my head) about meat getting stuck in between my teeth. I love cauliflower and often have it instead of mash potato, I love bread sauce on it.

All the best in the healing and Good luck for January. I also return in Jan

 

[blackhound]

Getting close to 3 months since I started the LANAP treatment. I can now floss my teeth without reservation. I can definitely see a change in my gums. They have a different color and texture.

There are several teeth on the bottom that are slow healers. The perio said that he is not concerned as those were the teeth that had seriously deep pockets. Apparently one of them had pus at the bottom. But none of the really bad teeth are painful or bleeding when I brush or floss and they are pink at the gum line so something good is happening. I was told that surface healing takes about 6 weeks and deep healing will take 6 to 9 months. Clearly patience is required.

I am starting to eat more normally. Last week I actually had a grilled cheese sandwich which was a BIG DEAL not because of the cheese but because the bread was toasted and therefore 'crusty' and I haven't been able to handle that until now. I am still not eating hard foods because I want to give my gums the best chance of healing and I find I don't really miss much except for artisan style bread.

I have also lost my taste for anything sweet with the exception of ice cream. Cakes, and particularly candy hold no interest. The idea of eating a candy bar is actually sort of revolting. Amazing how your taste for things can change when you avoid them for a longish period of time.

 

[blackhound]

Yesterday I had my 6 month checkup post-LANAP and my quarterly cleaning at the periodontist. Until the one year mark all the cleanings are carefully done around the neck of the tooth. No probing or digging so as not to disturb the healing process.

For the first time in DECADES my gums are healthy. The perio is very pleased with the progress. The tissue is tight and pink and there was no bleeding on the cleaning. The 3 teeth that had slight mobility before the treatment are now rock solid.



After several years of being on a 3 month cleaning schedule, rooth planing and scaling, Arestin placement and aggressive home care my perio situation was not improving. I know I sound like a commercial for LANAP, but seriously, if you have perio disease it is worth the money and the hassle to keep your teeth. I have not lost one tooth and I had 2 teeth with 11mm pockets. One of them even had pus in the pocket.

My next cleaning and reassessment is in April.

 

[blackhound]

I had my one year post LANAP check up. This was the big one. After the LANAP procedure you have to wait approximately one year before the pockets can be rechecked. This is to prevent any disruption of the healing process.

Well ….. OMG WHAT A SUCCESS!

I had zero bleeding on probing and the pocket reduction was absolutely unbelievable. The double digit pockets are all in small single numbers -- 2mm and 3mm with one 4mm. I had one pocket pre-LANAP that was 11mm with pus. That pocket is now ….. (drumroll) ... 2mm. The amount of bone, cementum, and ligament that has regrown in my mouth is nothing short of amazing. Yes, BONE. The Periolase has a stimulative effect and bone regrowth is a result.

The really best part of the visit was seeing the chart pre-LANAP vs post-LANAP. The number of bleeding teeth on probing I had before the Periolase was appalling. And now there is zero. I haven't had any blood from flossing or brushing since I went post-op a year ago. The rear molars that were always cold sensitive no longer have that problem because my gums are now tightly attached to my teeth and the pockets have closed down to a maintainable level. And no negative cosmetic effect with regards to gum recession.

I still go every three months for cleanings because once a perio patient, always a perio patient, but that's just fine because …. YAY LANAP.

Worth every penny. Worth all the annoyances of the post-op regimen and the limited diet. Worth it.

 

[blackhound]

Just when you think it is safe to go into the water .....

Tonite while I was flossing I pulled out the floss and a piece of tooth came with it.

Good old #18. One of the four teeth in my mouth that still have old silver fillings. I can't say I'm surprised but I ain't happy. Fortunately it wasn't a massive break. It would appear to be one of the cusps that butts up against #19. So ..... here we go again.

Calling the dentist tomorrow and jumping on this as soon as he has an opening. This will be a new dentist. I had to change dentists because I really didn't like what was going on with the administrative side of the practice. Mixed feelings on leaving because I really liked the dentist and his medical staff. But things were not good with the billing and administrative part of the practice and I'm just going to leave it at that.

The husband has already been to the new dentist and he likes him just fine, but then he is not phobic. The good news is that this dentist comes highly recommended on this forum so he works well with the phobic. I'm sure he's dealt with people even more freaked out than me and the one good thing I have going for me this round is that my mouth is actually healthy. So here's hoping .....

 

[blackhound]

Called today and I have an appointment tomorrow at 12:30 pm. And ...... NERVOUS. God Almighty. I've had so many appointments and so much work done since the summer of 2012 that you would think I'd be better with this by now. Apparently not.

Strangely? I am less nervous about periodontal work than I am about dental work. Possibly because it deals with tissue and bone and seems more like a medical procedure than a dental one? I don't know. But once again, a busted tooth and the prospect of NEEDLES in my lower jaw. Just ....... UGH.

 

[blackhound]

Another broken tooth. #13. The seriously galling part of this is that I have an appointment in a few weeks to have this tooth crowned because it has an old silver filling. But it just couldn't wait.

The lingual cusp broke off. Seems to be above the gum line. *fingers crossed* So either it can be repaired or it can't. If not then I'm going to have to go through the implant process. I am seriously. sick. of. my. teeth.

I have 2 teeth left with old amalgams and I am going to have them drilled out and possibly crowned because I am so sick of the fractured cusp routine.

 

[blackhound]

The verdict on #13 -- REPAIRABLE!

It needed a hefty buildup due to decay under the old amalgam and a broken cusp, but there was no other fracture and the root wasn't affected. I'm now sporting a temporary crown which makes me VERY HAPPY as I was fearing the worst. As usual.



I have 2 teeth that still have silver fillings. Making appointments to have them drilled out. One is a back molar with a huge amalgam and the very last thing I want to deal with is another broken tooth. One thing I have definitely learned from all this dental/periodontal trauma is that putting off care is a DISASTER.

 

[blackhound]

Grousing to the internet doesn't correct the problem but it makes me feel better, SO ....

Had a crown put on a few weeks ago. The crown margin on the back of the tooth isn't right. It's not flush to the tooth. I can literally stick the tip of my nail into the space and my dental floss catches in that space. I don't know if it is just a bulky margin or an open margin.

Went back to the dentist to address the problem and his solution is that I should make sure I floss carefully around that edge/ledge. Didn't even try to reshape. Don't even know if it is possible. Maybe the fault was with the impression or with the lab or with the tooth preparation. I don't care. I want it fixed. My repeated insistence that the crown isn't right was brushed off.

I have 5 crowns and none of them fit like this. (This is the first crown done by this dentist.)

Got into the beginning of an argument but needless to say I'm done with him. And out the cost of the crown. But I still have to solve the problem so now I am looking at finding a new dentist that can deal with either fixing this crown or making a new one that fits properly.

NOT HAPPY.

 

[shamed shane]

I'm so sorry to hear about your new crown. I hope that you've found a dentist that can help you get it all sorted out.

I do want to say that your journey has been an inspiration to me. I start my dental journey on Tuesday. You've provided me with the motivation and courage I need to move forward. And I want to thank you for that.