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Deep Cleaning & Dental Hygienists

A

Amoreyna

Well-known member
Joined
Nov 5, 2011
Messages
162
Location
The Rainy Pacific NW
The only bad part of my appointment today was that I had a different hygienist since mine was out sick. She did my gum measurement. I has 3-4 mm pockets, although my front teeth on the bottom which for some reason are doing excellent and need nothing had 1-2 mm pockets. A lot of my other teeth had 2 mm pockets as well. Way back in my mouth, near the molars that need the large fillings soon, I had a couple 5mm pockets and one 6mm pocket.

I have no signs of gum disease. I don't bleed while brushing or eating anything. My gums are healthy and pink. The thought behind why I have those 5-6 mm pockets is due to the decay of teeth that is effecting my gums.

So this hygienist wants to deep clean. Okay, I can see maybe doing the 5 mm ones. But no, she wants to deep clean my entire mouth in 2 2 hour sessions!

All I could say was - WTH? My grandmother, who goes with me for support has struggled all her life with her gums. She's had many deep cleanings and pockets. She was shocked that this hygienist wanted to deep clean my entire mouth.

On top of that, my dentist believes that with my use of the special mouthwash and treating my teeth will benefit my gums. The hygienist wants to deep clean before any dental work, which makes no sense to me. If the decay is having a serious effect on my gums, wouldn't you fix the source of the problem and then deep clean if necessary?

I am so glad that my dentist does not see the deep cleaning as being necessary. I'm even happier that this woman is not my regular hygienist. She seemed overly focused on trying to find a reason to deep clean. It makes me so upset. If my dentist doesn't see a need right now, especially for a full mouth clean, why would she try to push it on me? She even talked about how I had all this bone loss without looking at my x-rays while my dentist said I didn't have bone loss after the full panel was taken!

I don't know what to do. I'd hate to complain about her, since she belong's to the practice I really like. She tries to appear all nice but it ends up feeling like she's judging you. When the did the acidity test in my mouth, she talked about how high it was and how I had periodontal disease without even looking in my mouth. :mad: It felt like, if I didn't agree to what she suggested then I was a bad person that didn't care about my teeth.

Sorry all, had to vent. My dentist believes in watchful waiting and if the pockets don't improve in the back after treating the teeth, he recommends just deep cleaning those. I'd just hate for someone else to have that kind of experience with that hygienist and to not go back to either the office or a dentist in general.
 
You are obviously a dentally smart person, so this might be a silly ?....do you use a water pik? I also had some bad pocket #'s last year. All credit for them ALL being 1's and 2's now is to my water pik (with kudos to my sonic toothbrush), after an initial deep clean.
A deep clean can be an awesome thing, if your finances allow. I'm 50+yrs. old so it made sense for me. If you're in your 20's-30's, maybe not.
I have one back molar that will probably never be better than a 2. Well spaced molars that trap every G-D thing I eat. My water pik keeps it all healthy (last year it was a 4).
And yes, I question your "stand-in" hygientist...time to out-think and out perform her!?
 
I'm cleaning phobic, remeber but I also know you can't clean pockets yourself over a 4, the calculus deep in the pocket needs deep cleaned out. I don't think it matters how old you are, they are what they are and no amount of rinses or gadgets is going to change that until what's down there is out.........

I've never heard of pockets being caused by decay, and if you have pockets that deep you have bone loss, otherwise the probe wouldn't go down so far....it would hit bone at the height it is supposed to be- make sense? You can't expect to have a regular cleaning with pockets in the danger zone...sounds like you have localized periodontitis- so just agree to have those quadrants deep cleaned. Whatever caused the pockets still needs addressed, maybe when you are all numbed up for filling- they can do a deep clean at the same time.

So maybe she tried to upsale a little.....

Just like mgh, I had mine done as well - SRP and then a periodontal maintenance visit and last time, despite seeing a periodontist- got billed for just a regular prophy visit....I use the sonicare and waterpik too. But my only teeth with the 5's- molars- they are gone- periodonatlly failed, furcated....implants now.

My dentists started with a clean mouth as well, which makes sense to me, before doing any restoration- even on my 1 and 2's in front- got under the gumline just that far and nade sure there was no subgingival calculus - even though they were normal, I could feel "bumps" when I flossed so I knew I had some calculus under there. far better to be numbed up for a deep clean to me......

So what i read out of all of this is you don't trust this hygienist- ask the practice to call you and reschedule next time if yours is out. I also can't imagine the dentist and she would not agree on a treatment plan- they don't work independently- unless he's playing good cop, bad cop games.



rp
 
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What RP said...
She says it so much better (I still don't have all of those technical words down).
 
I'm just surprised about everything she said. There's only three teeth with the measurements that would need deep cleaning. I only had 2 5mm and one 6 mm, with the latter being a wisdom tooth that's coming out. The teeth next to these ones were 3 -2 mm pockets -so honestly it's seems very strange to have localized periodontal disease on just two teeth that also need very large fillings before the cavity reaches the nerves.

The other thing is she really dug in that pick. I could tell the difference when she was just measuring compared to her digging around to make me bleed. She was digging around on my teeth that had 1 mm pockets to the point of bleeding and pain.

You're right, I don't trust her and honestly I don't trust her measurements. I can see having the teeth with the 5mm pockets deep cleaned but I'm not all for deep cleaning teeth that don't need it. She wants to deep clean my entire mouth, including my front teeth that are perfectly fine. I do not want teeth to be deep cleaned that do not need it, period. My bottom front teeth are as perfect as they can be, no carries, no gum issues, no issues period. Why in the world would these need this treatment?

Right now, the focus on my teeth that need the large fillings so that I won't have to undergo RC and crowns on them. The other thing is that she is new to this office. I've also been told in the past that I needed a deep cleaning only to have another dental office tell me nope, you don't have any need for it and been perfectly fine. I'd be willing to undergo it on these two teeth after they are taken care of cavity wise and the other issues are fixed if there are still problems. I'm just not willing to disturb teeth that are perfectly healthy with something unnecessary.
 
It's ok amoreyna vent until ur hearts content :) and yea she didn't seem very nice and like she was rushing it and that's not right it should be about moving at ur time and speed that's important but none the less congrats on how far you have come:XXLhug:
 
There's only three teeth with the measurements that would need deep cleaning. I only had 2 5mm and one 6 mm, with the latter being a wisdom tooth that's coming out. The teeth next to these ones were 3 -2 mm pockets -so honestly it's seems very strange to have localized periodontal disease on just two teeth that also need very large fillings before the cavity reaches the nerves.

Why would that be strange? Makes perfect sense to me. If you are having trouble keeping them cleaned compared to your other teeth- they develop cavities and periodontitist (inflamed gum pockets) around the tooth. I gagged terribly trying to clean my molars- so I lost them.
 
Sorry all, had to vent. My dentist believes in watchful waiting and if the pockets don't improve in the back after treating the teeth, he recommends just deep cleaning those. I'd just hate for someone else to have that kind of experience with that hygienist and to not go back to either the office or a dentist in general.

Why is the hygienist suggesting a deep cleaning against the dentist's wishes? Surely she has to work under his authority? Or are you saying he overruled her but it was her whole attitude which annoyed you?

If she is not your regular hygienist, I would let it go but tell them you do not wish to see her again and to mark your records accordingly.
 
Why is the hygienist suggesting a deep cleaning against the dentist's wishes? Surely she has to work under his authority? Or are you saying he overruled her but it was her whole attitude which annoyed you?

If she is not your regular hygienist, I would let it go but tell them you do not wish to see her again and to mark your records accordingly.

He overruled her and it was her attitude both before and after that.

I need to have them make a note on my records. She is new to the office and it sounded like she was new to doing gum measurements on actual patients. Perhaps the way she works with patients will be better in the future, I just really don't want to be her practice patient.
 
I kinda had the same problem if you read my other thread. 6 months ago the hygienists was saying I might need a deep cleaning. But they both decided to watch it and it improved next visit just from using waterpik..
 
Why would that be strange? Makes perfect sense to me. If you are having trouble keeping them cleaned compared to your other teeth- they develop cavities and periodontitist (inflamed gum pockets) around the tooth. I gagged terribly trying to clean my molars- so I lost them.

Actually, I have multiple issues. I suffer from dry mouth from medications. Along with that I have enamel issues (fortunately not severe, thank God), which is what I mean when I refer to soft teeth. Every dentist that has every looked in my mouth immediately knows what I have. My teeth sadly will never look like 'normal' teeth unless I have them crowned. When I was young and my adult teeth started coming in, my dentist then thought fluoride was the cure all treatment. With the amount of fluoride treatments I received plus all the fluoride pills, I'm probably lucky I didn't get too much, lol. Whether or not I received appropriate treatment from the dentists I've seen as an adult is another story.

If you add into the mix that I was lacking regular cleanings for a couple of years because of phobia on my part, then yeah, things can go down hill pretty fast for me.

My mouth is already full of tiny/small fillings. I am already more prone to certain things, and it is my fault for not getting regular cleanings and checkups. Then it would have been noticed much sooner that one tooth had a large cavity and the other had lost it's filling and the cavity was progressing. It is actually incredibly frustrating that no matter how immaculate my home care is, I have at least one small cavity once a year. I rarely drink soda, and brush after eating, floss once a day, use a mouthwash and watch my sugar intake. I can't help but think that if my teeth were treated differently when I became an adult instead of just filling all the small little nodes of decay, then I would be in a much better spot right now.

At the same time, I have big issues with having every tooth being subject to deep cleaning. Some of my front teeth that are fine already have sensitivity issues, I don't need to chance them getting worse. While my teeth may never be like others, or white for that matter, I am protective of them and dislike exposing them to any treatment that is not necessary.

While I don't object to deep cleaning the two teeth, I do have issues with doing it before the cavity is filled. If bacteria in the cavity is causing problems in my gums, then it makes sense to not deep clean before it is filled. You treat the primary problem before tackling the second. If they are right, then deep cleaning these teeth with the cavity still present will only allow more bacteria into the gum immediately afterwards. Hence pointless lost money.

Make more sense on where I'm coming from? The hygienist's whole deal was that the bacteria being generated from the cavities I currently have is causing my gum issues. If that's the case then the primary cause should be treated - the cavities - then the secondary problem is treated successfully.
 
I kinda had the same problem if you read my other thread. 6 months ago the hygienists was saying I might need a deep cleaning. But they both decided to watch it and it improved next visit just from using waterpik..

I am getting a waterpik. You were probably in a better place then I am, if I remember correctly, and didn't really need the deep cleaning to begin with. I believe one of the dentist here even said that a 4mm pocket didn't warrant it. I am glad that it improved for you :)
 
If bacteria in the cavity is causing problems in my gums, then it makes sense to not deep clean before it is filled. You treat the primary problem before tackling the second. If they are right, then deep cleaning these teeth with the cavity still present will only allow more bacteria into the gum immediately afterwards. Hence pointless lost money.

The primary cause is plaque- it is giving you cavities and causing gum diease- you can have either independently...the decay is not causing the gum pockets. I don't think it works that way- while both are caused by plaque, cavities form when acid from the bacteria reacts to fermentable carbohydrates(sugars) and attacks the teeth. Pockets form when the plaque is not removed (no professional teeth cleaning for awhile) and hardens into calculus or tartar under the gumline causing inflammation and eventually destroying bone as the pocketing gets deeper and deeper. I think you are stuck in a chicken/egg approach but either way I think what she is suggesting by the cleaning is to disturb the biofilm which develops into plaque causing both the cavities and gum disease. The bacteria is in your entire mouth not just hanging around a couple molars. How deep she needs to clean depends on how deep the pockets are- I think it's just a term for saying above and below the gumline, not just a quick prophy around the edges.....deep cleaning doesn't damage your teeth- there is literature out there though that says root planing shouldn't be done anymore....so clarify what exactly she is talking about. I would ask the hygienist you trust or honestly get a sceond opinion from a periodontist- that would be your best bet!

My oral surgeon summed it best when I talked about all of my mouth issues and being born with "bad teeth" - he said you don't have bad teeth, they were fine- you were born with bad bacteria... when I was young (starting at age 5) through my 40's I had lots of cavities, now that I am just a little bit older I have gum disease....hence the life-long battle title to my journal.



rp
 
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I know RP - that's what I always thought concerning how pockets are formed. I actually didn't start having cavities until my late teens - outside of my tooth that decided to come in sideways. It may be just because of all the fluoride treatments I received (and like I said, it was a lot of fluoride that went over the course of several years). I don't believe the whole thing that's being presented now that you can get 'bad bacteria' from your mother from certain activities (eating off the same spoon for instance) and if you're mother has a lot of cavities then you will too. A lot of it seems to be genetics to be honest.

I wish I could blame bacteria but I think you and I are in different situations. I actually don't think of my teeth being bad, I just know they are more fragile then most and skipping dental cleanings is only a determent to me. This hasn't been a mystery to me or my dentists from the time I was a little girl till now - it is an obvious problem.

Honestly, if I went through with a deep cleaning of my entire mouth I would go somewhere else for it. She wants to do scaling AND root planing on me. I think it's about $$$ to be honest, especially when it feels like she is intentionally trying to make me bleed.

And yes, that bacteria is all over your mouth. The problem is that only two of my teeth are really effected by it. And that bacteria will still be there after a deep cleaning. To argue that since that bacteria is everywhere means that all teeth, even the healthy ones, need deep cleaning is a rather faulty argument. The point of the scaling is to disrupt the tartar under the gum line to help restore the gums to health and to hope they attach to the tooth better. There is no reason to disturb healthy teeth and gums with this procedure since they are not having this problem or to this extent. It's simply overkill.

The really ironic thing is that I have very little tartar build up on my teeth. If I had to have the deep cleaning done I would go to a periodontist to make sure it was necessary and to have someone who deals with gums all day do the procedure.
 
The really ironic thing is that I have very little tartar build up on my teeth. If I had to have the deep cleaning done I would go to a periodontist to make sure it was necessary and to have someone who deals with gums all day do the procedure.

I have virtually zero tartar as well. Gums can recede for all sorts of reasons as well as plaque turning into tartar. I think you should see a reputable perio before thinking of getting a deep clean too.

It's a shame that a dentist you trust is employing a hygienist you don't. Hygienists sigh....when they are bad, they are really really bad...
 
I have virtually zero tartar as well. Gums can recede for all sorts of reasons as well as plaque turning into tartar. I think you should see a reputable perio before thinking of getting a deep clean too.

It's a shame that a dentist you trust is employing a hygienist you don't. Hygienists sigh....when they are bad, they are really really bad...


I know - I have this laid back, gentle dentist and then a hygienist who actively tries to make me bleed to make a point. I've gone through this before - I had a hygienist years ago that insisted that I had to have deep cleaning on my bottom front teeth or I'd lose them in short order. You know, the ones with the perfect gum scores and no issues right now. I told her no, and asked for a different hygienist.

My whole family told me to go to a perio before I did anything, if my gums where still having issues by those two molars in the near future, lol.

I can get a different hygienist, I just hate the thought of another phobic patient getting her and then not returning for treatment. Fortunately my dentist is trustworthy and very gentle. His main goal is to get the two deep cavities filled asap, the rest of my mouth is stable and we can progress at my own pace. He doesn't push things on to me, and showed me the teeth that needed work right away from my x-rays.

I guess that's my question now: What do you do when you have a gentle compassionate dentist who doesn't judge you at all and puts phobics at east, but has a hygienist that would drive phobic patients out the door? I don't want to get her fired or anything like that, but at times she seemed unethical, like claiming 3mm pockets where abnormal and needed to be cleaned right away...
 
Tell her you know better and send your dentist an email............she works under his direction. He is the CEO of his dental practice.

One of two things is happening- as much as you love him, the push toward profitable hygiene departments in dental practices is a big business strategy............they pay them a lot of money and dentists expect them to earn their keep- maybe he backs off as soon as the patient goes whoa........or she is a typical holier than though, lecturing, anything for the sake of getting that last scrap of calculus off, the dentist is unethical cause he doesn't supoort me in making the patients do what is best for them even if it hurts, aggressive hygienist philosophy................

Now with that being said....be really careful wtih those 6 pockets- that's enough to need flap surgery, I don't want to see you end up like me, losing all of your molars ........

rp
 
RP - I know you and I have different points of view, and I do appreciate your input, especially since the claims being made by the hygienist where strange at times. :XXLhug:

You and I suffer from different problems, but the bacteria that both of us seem to have may be causing me further problems. It's been a debate of my dentists as to why my teeth are the way they are. Some think that it is because I had multiple instances of very high fevers when I was a child (I have a white strip on my teeth that they use to support this). Other's think it's genetic due to my mother having similar but slightly more mild issues as I do, along with her brothers having various levels of the same problem. My grandmother on that side of the family lost all her teeth fairly early (around 30) due to more severe enamel problems, and got dentures, after going through a lot of effort to save them. Which is a shame because she never showed her teeth when she smiled, even when she was young.

While we may have different problems, there is something we can share - a mouth full of fillings, well at least until you had your work done on your teeth anyways. And btw - a cavity at 5? Wow. My dental experiences revolved around yanking out baby teeth that refused to come out, not cavities. That and those awful fluoride trays, ugh. :sick:
 
Tell her you know better and send your dentist an email............she works under his direction. He is the CEO of his dental practice.

One of two things is happening- as much as you love him, the push toward profitable hygiene departments in dental practices is a big business strategy............they pay them a lot of money and dentists expect them to earn their keep- maybe he backs off as soon as the patient goes whoa........or she is a typical holier than though, lecturing, anything for the sake of getting that last scrap of calculus off, the dentist is unethical cause he doesn't supoort me in making the patients do what is best for them even if it hurts, aggressive hygienist philosophy................

Now with that being said....be really careful wtih those 6 pockets- that's enough to need flap surgery, I don't want to see you end up like me, losing all of your molars ........

rp

lol - you posted while I was typing.

The 6 on my wisdom tooth does worry me a little. There's only one 6mm ironically, the rest of my wizzies are fine. That tooth is coming out soon, and fortunately extractions seems uncomplicated on it. (my Wizzies liked to slide in and out of my gums when the came in, it was noticed by a military dentist that they were causing decay on the top, but told me to wait until they either fully erupted and/or bothered me to take them out, since that's much easier). What happens after with my gums back there remains to be seen, which is why I should probably see a perio after that one is out to make sure there aren't going to be problems. Well that and to make sure the measurements are accurate to begin with.

I think it's just this one hygienist. The (I think) hygienist entering the numbers seemed really uncomfortable with what the other hygienist was suggesting. And seeing that my family members have been going to this office for over a decade and have never been treated like this, I think it's just her since she's new.

She seems to be the holier then thou. Her efforts to be 'nice' made her sound like a condescending [something I probably cannot type but rhymes with Mitch] and did seem upset when the other hygienist was more then happy to start me on the mouthwash and made sure I got my fillings that I really need scheduled before any deep cleaning. She's the complete opposite of everyone else I've met in the office - maybe she worked somewhere that had hygienist working on commission or something. No idea, but she's not really a match to everyone else.
 
I know you and I have different points of view, You and I suffer from different problems
Unfortunately the disease process of decay and gum disease is the same in every human body and it's universal.........science - not my opinion. Why it occurs may vary slightly.

And btw - a cavity at 5?
Don't think I'm that unusual. especially from the non-flourid generation. A Prevalence study by the NIH that was published in March 2011 said 42% of 2-11 yr olds had tooth decay with 23% untreated - this is in the flouride years in the US. MY kids were all lucky- only one had a small cavity and he promptly got sealants, he's almost 30 still no cavities.

I think it's just this one hygienist. The (I think) hygienist entering the numbers seemed really uncomfortable with what the other hygienist was suggesting. And seeing that my family members have been going to this office for over a decade and have never been treated like this, I think it's just her since she's new.
Usually a dental/hygiene assistant enters the numbers- unusual to have two hygienists working together unless they had a cancellation. Sounds like you need time to develop trust with her or sometimes we have a personality clash with caregivers- human like everyone else, not a good fit, so ask for the other, also maybe an element of shoot the messenger...displaced anger over the situation (I was way guilty of this with an assistant I told to mind her own business and get out of the middle between me and the dentist) so I understand it.

Forget what she said, as I said before get a second opinion, ask the dentist to do it himself after you have stepped up your home care. The periodx in a waterpik can clean down to a depth of 4mm -should really help you.

rp
 

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