Diagnosed with advanced periodontitis out of the blue

[BrusherFlosser]

Hello, I've enjoyed reading lots of the messages on here and thought I needed to add my own. I'm a 37-year-old male, and was diagnosed with advanced periodontitis about 8 hours ago and naturally haven't stopped thinking about it.

This all started with some sudden tooth sensitivity. One tooth on my left side, sensitive to cold. I don't see dentists often like I (now) know that I should - I always hoped brushing/flossing/mouthwash at home would suffice. So when I made an appointment to have this one tooth looked at, the dentist told me I had some receding gums and might need a graft, so I made an appointment with a periodontist.

Once I knew what to look for, I noticed recession on several of my teeth. I hadn't noticed before because it seemed to happen so gradually. I was fully expecting to need a gum graft and had largely braced myself for it. When the perio did the probes, I mostly heard him call out 2s and 3s, a few 4s, I think there was one 5 and one 6, but I don't think my gums were bleeding.

What happened next though truly shocked me. He said I had about 33% bone loss. I don't know if that's all throughout my jaw or just in the worst areas, but I was floored. And he said I'd need a gum graft and some kind of bone injection for every single one of my teeth. The dentist, who also took X-rays, didn't mention a word about bone loss.

I believe the perio, but I still want a second opinion. I'm nervous about letting the situation deteriorate even further, though. He seems knowledgeable but I didn't get to ask as many questions as I wanted to. Are there any non-surgical options at this point? I know that gums and bones can't grow back on their own, but if I could simply halt the progression where it is now, would there be a non-surgical way to do it? This is now looking like it's going to dominate at least a year of my life, with six separate surgeries and lengthy, painful recoveries for each - which is nothing, of course, compared to losing all my teeth, but I'm perplexed that the situation could be so severe when my only glaring symptom was one cold-sensitive tooth.

The perio wants to do the gum graft with a combination of Alloderm and my own tissue - that's another thing I'd like clarity on, as the tissue removal seems to give people the worst side effects/most painful recoveries. Some of the horror stories sound unbearable. If we're already using Alloderm, why not use all Alloderm? Should something else less-invasive be attempted first, and follow up with X-rays to be sure the bone isn't deteriorating further? How long can the other 67% of my bone last with proper, more diligent intervention from here on?

Thanks for any guidance or wisdom anyone has to offer. I know my situation probably isn't unique or uncommon, and I ought to feel grateful I caught it while there's still some hope of salvaging things, but I had never heard of such a thing happening before today and I'm extremely depressed by it all. Dental treatments are not my favorite thing and I've had some pretty bad experiences with an extraction (long ago, due to crowding) and braces, so I'm very reluctant to have this extremely invasive surgery with its long, painful recovery times.

 

[Gordon]

Really hard to comment without examining you. A few general comments if it's any help.
1) 37 is quite young for that degree of bone loss. Which would suggest that your disease is more aggressive than normal and so a more surgical approach might be better
2) If you smoke, stop now (vapes as well) otherwise you're wasting your money.
3) Deep pockets (>3-4mm) are usually not possible for patients to maintain, in somebody as young as you (see 1), then eliminating them as far as possible would make sense.

HTH a bit.

 

[letsconnect]

@BrusherFlosser so sorry to hear about what happened, that must have come as a huge shock .

Personally, I would ALWAYS get a second opinion when it comes to any extensive medical procedures. While the proposed course of action may well turn out to be correct, I've had too many experiences where a second opinion would have made a huge difference. So I think your idea of getting another expert's advice is very sensible. Please let us know how you get on!

 

[anonfemale]

@letsconnect @Gordon I thought it took decades to get meaningful bone loss and gum disease?. I was diagnosed with 20 to 30 percent bone loss and gum disease in May so does that mean I am close to the severe stage as it is near 33 percent?.


@BrusherFlosser I am so sorry you are going through this too. I understand how you feel. I am 40 years old. I think Gordon and Let's Connect have given you great advice. I only started flossing with a waterpik two years ago and started flossing with interdental brushes as well as the waterpik this year. No one had recommended flossing to me and my diet wasnt as good when I was younger so that might have caused my bone loss. My diet is better now. I hope mine is under control now and can be stopped from progressing and I hope yours will be too.

 

[letsconnect]

I thought it took decades to get meaningful bone loss and gum disease?. I was diagnosed with 20 to 30 percent bone loss and gum disease in May so does that mean I am close to the severe stage as it is near 33 percent?.

The rate of progression can vary. Usually gum disease progresses very slowly (as in your case - looking back at your posts, you were diagnosed with it back in 2014/2015 when it was "moderate", which seems similar to what it is now). "Moderate" is usually up to 33% bone loss so 33% is right at the cusp. Not that I know how you could accurately tell the difference between 32% and 34% - presumably there must be a bit of guess work involved, and I'm sure other factors are taken into account as well!

Some people have a form of gum disease that progresses more rapidly. This is not nearly as common, but it does exist. When this happens, there's often a strong genetic component involved.