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Opg differences



Dec 7, 2020
Hey, I had an opg taken last June. Have had a number of dental issues since then and two teeth taken out. Dentist thinks pain is primarily tmjd/myofascial with elements of atypical facial pain thrown in just for good measure. Another opg was taken recently, but dentist didn't explain what he saw in it and quite frankly I was too scared to ask him. I'm now worrying that there has been quite extensive damage to my teeth since the previous x ray in June. Would any dentist be kind enough to have a look at the opgs and advise if there are any changes between the two? As aforementioned, I've had two teeth out since the first opg, but I'm worried about bone loss/cavities etc


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Don't seem to be any drastic changes. Bone loss takes years, you'd never notice a change in less than 9 months on an OPG.
Thank you so much for your reply @Gordon You honestly are such a lovely dentist. I wished you still practiced! I went to see maxfax consultant today as been having facial pain in the left side since last May. Long story short he feels the pain is not tmjd nor AFP (which previous dentist diagnosed) but rather the UL7 is the culprit. I've never really experienced pain from this tooth although the area behind it (where the UL8 was) is often sore. I've been to several dentists who feel the UL6 is causing issues due to the proximity of amalgam to nerve, but consultation says no. He didn't tap any teeth, just had a look at the newest opg and had quick look in mouth with mirror. I explained I mostly experience pain in the gum between the UL6 and UL5 and the 6 is often sore to press on. He states there was bone loss around the 7 and it wouldn't be a terrible idea to get it out (but to leave the UL6). I went home feeling extremely demoralised as just don't really know who to believe anymore. Obviously I'm not a medic but find it hard to believe that months of pain is caused by the UL7 when no other dentist has ever mentioned it. Any advice would be really welcome.
Needs a better radiograph really, OPGs are no good for serious diagnostic work, they just give a quick snapshot.
On the older film it shows a bit of a boney pocket between 6 and 7, but hard to be certain from an OPG.
Thanks @Gordon! What can be done in regards to the pocket? Maxfax dr seemed to think removing the 7 would help but its the 6 that causes pain on biting etc. Up until now I had believed the 7 was a fairly sound tooth.
You don't know for certain that there is a pocket because OPG :) Needs some more diagnosing first. At least somebody sticking a periodontal probe in there and a better x-ray.
@Gordon I took your very wise advice and got a better x ray. From this can you see evidence of perio endo lesion around the UL7? My dentist said he couldn't but it's always good to get a second opinion. I don't really have any pain around the UL7, however I have pain when pressing the UL6 and it's very sore to floss between the 6 and 5. Is there anything that might suggest what's causing the pain from the xray?


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There is a deep pocket between 6 and 7. Could do with some attention to clean it out. No sign of a perio-endo lesion though. Does the 6 respond to cold/hot?
Yes and no. Certain areas of the tooth respond (painfully) to the cold cotton wool whereas other areas don't. The tooth is sore to push on. One dentist has advised removal as he said it's essentially non functioning as the LL6 is gone. Another dentist advised to keep it. So I'm in a bit of a quandary. Would removal help with the peridontal pocket? Or is it a different treatment for pockets?
It could be food packing into the pocket that's causing the symptoms from the 6. It would be worth giving it a good clean out (by a dentist or hygienist, not DIY!) and then you irrigating out the pocket with some chlorhexidine and a syringe. Or trying a periochip. Removing the 6 would probably shorten the life expectancy of the 7 as well I expect.
Just googled periochips. That seems like a very sensible option. As always your advice is invaluable @Gordon . If the UL6 does end up getting extracted, do you think I would "miss it" so to speak or is the dentist correct in saying it's non functioning anyway? Oh goodness I wasn't aware that the lifespan of the UL7 could also be affected! Why is that? Thank you so much again for all your help. It really enables me to make a much more informed decision.
I can't tell how functional it is without seeing the lower arch. Probably not if the lower one is missing.
The 7 would suffer because there's a chance it would tip forward making the perio worse. On the other hand it would give much better access to clean it which would improve the prognosis :)
Thank you so much @Gordon for all your help and time in answering my (slightly neurotic questions!). You really are a star! ⭐