Different dentists say vastly different things??

[Toothanxiety]

So I went to my NHS dentist a month ago early December and second time early January.
She is very rushed, time slots are short I'm guessing there's a lot of backlog and waiting lists made worse from the pandemic, I don't know

The first time she cleared off the tartar, did my X ray and said my bones were normal for my age (22) and that I had some inflammation in my gums/ gum disease
The second time she did another X ray (I'm not sure why, it was only a few weeks apart??) and told me I had irreversible bone loss in my bottom front teeth. I cried a lot and had a lot of sleepless nights over this. I don't get why she didn't say this before?

So I paid for a private dentist ( I'm surprised it's quite affordable, I was expecting some ridiculous prices) and he did everything as I was a new patient. X rays and all.
He said my bone levels were good and that I have mild gingivitis and not periodontitis. He explained very calmly that I would have had to have deep gum pockets and bone loss on the X ray for it to be periodontitis (I'm paraphrasing what I remember, I'm not an expert) but when he put the tool in my gum it was 1s and 2s
He actually frowned a little when I said to him that my NHS dentist says I have irreversible bone loss that I'll have to manage forever.

My gums have actually stopped bleeding as much as they used to, they still do but no longer everywhere, just in one specific area around my permanent retainer.
I have another cleaning session in March too, they will help me with tips on how to clean around that area better.
Overall it was a much better experience, I'm glad I went private

But my question is...why would dentists differ on this? Are X rays not straightforward? Is determining bone loss not an exact science/ an estimation? Or if I do have bone loss is it so mild that one dentist just doesn't see it at all? It's very strange and I'm starting to lose confidence in dentistry a little bit.

 

[NervousUSA]

Though this is a different condition, I wanted to share my experience of vastly different opinions in case it is of use to you, in my case, opinions and prognosis on a bite problem I have. Ranging from it will shortly destroy all my front teeth, to that it is having no harmful effect on me at all, to "I can't predict this". I have been told I need totally different treatments too, veneers, orthodontics, or nothing at all. I have talked to my dentist and hygienist about the differing opinions, and they both said that this is because of different people having "different philosophies". Though a different doctor who told me explicitly my bite wasn't hurting me implied people who said otherwise were money greedy, though he also mentioned "different philosophies". The conclusion I have drawn is that there are some dental situations that aren't an exact science, can't be fully understood, and can't be fully predicted, so dentists follow a personal philosophy in how to treat them. I don't know if this applies to bone loss or seeing bone loss on x-rays, but it is definitely the case sometimes. I hope you can get some light shed on your situation, and get some clarity in your case.

 

[Gordon]

But my question is...why would dentists differ on this? Are X rays not straightforward? Is determining bone loss not an exact science/ an estimation? Or if I do have bone loss is it so mild that one dentist just doesn't see it at all? It's very strange and I'm starting to lose confidence in dentistry a little bit.

It's not an exact science I'm afraid, as soon as you start involving squishy lumps of fleshy matter things get difficult
As you're a 22 year old any more than minimal bone loss would be a big surprise to me, as I keep saying here, it's a slow gradual process and takes decades to really get going.

Reading bone levels off x-rays accurately is a slow process, involving lots of poking and prodding and chances are the first dentist was too rushed and was a bit over pessimistic about things. I don't know for sure I've never examined you.

To be brutally honest, I'd rather they were a bit pessimistic and got the patient motivated to do something about it than cheerily saying all was fine and things deteriorate further down the line.