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Sudden Deep Periodontal Pocket and Potential Wisdom Teeth Removal

  • Thread starter Thread starter AnxiousWretch
  • Start date Start date
Would you please remind me what the actual treatment plan is that your periodontist is proposing? I'm a bit lost!

Immediately, I'm worried about the local anesthetic and the injections. I assume that there will be at least two per appointment, but I don't know how many there should be exactly, where, nor how much discomfort should be reasonably expected? It might be laughable, but it is a very real fear of mine.
Are we just talking about root planing a single pocket area here or something else?
A single pocket, probably half a cartridge of local in one injection. I wouldn't expect you to feel much of anything in that location, other than the numbness setting in.

After that, the other worry is about recovery. I've never really had a dental procedure with a recovery phase after it, but it sounds like SRPs are a procedure that involves it.
For SRP in one area? You might have a slight issue with sensitivity for 2-3 days afterwards. Not much else.
 
Would you please remind me what the actual treatment plan is that your periodontist is proposing? I'm a bit lost!
Sorry! It's been a hot minute, and I sometimes forget that my obsessions aren't as given as I assume.

The title is a little bit misleading now, but that severely deep pocket that the dentist found didn't manifest with the periodontist, who instead found moderately deep pockets all around. They wanted to do SRPs on all four quandrants split over two appointments about a week out from each other. Follow-up in three months, and depending on results, either ship me back to the referring dentist or keep me longer.

They didn't mention anything about periodontal maintanence, and the hygienist suggested that I can probably return to normal six month cleanings with my dentist if everything goes well, but Dr. Google's MD team seem to suggest that constant 3-4 month maintanence is required after an SRP—which was my other concern beyond injections and post-treatment recovery.
 
Righto, thanks for clearing it up.
SRP recovery isn't a big deal, typically there can be some sensitivity to cold/sweet things for a few days, if it persists then some desensitising toothpaste will sort it. Local anaesthetic isn't always required but it doesn't need a block injection normally, just a bit infiltrated to the area will do the trick.

Maintenance phase would be regular review and further scaling as required. Root planing regularly shouldn't be a thing.
 
I've just read your thanks to me and that's lovely to hear.
The one thing I know about being dentally challenged is how obsessive you become about every part of your mouth and any little changes that occur.
I've been under a periodontist for 23 years and it's been the best thing to ever happen for my mouth. I have an excellent relationship with the whole practice including the hygienist who I see every four months.
Yes it's expensive....( I live in the UK ) and it's private not NHS but honestly it's really worth it for peace of mind.
I really wish you luck going forward , keeping my fingers 🤞 crossed for you.
 
SRP recovery isn't a big deal, typically there can be some sensitivity to cold/sweet things for a few days, if it persists then some desensitising toothpaste will sort it. Local anaesthetic isn't always required but it doesn't need a block injection normally, just a bit infiltrated to the area will do the trick.
That's a bit of a relief. Well, it still doesn't sound like a great time, but I'll take dietary restrictions for a few days over the aches and pains I initially expected.

Unfortunately, it sounds like local anaesthetic is on the table, since I had asked the periodontist whether a deep cleaning was possible without, and received a particularly dismissive response. The needle fear is pretty bad, but it's somewhat assuring to know that it shouldn't normally involve a nerve block.

Maintenance phase would be regular review and further scaling as required. Root planing regularly shouldn't be a thing.
"As required" and "regularly shouldn't be a thing" are definitely quite reassuring things to hear!

I suppose, out of clarification and curiosity, is there an 'after the maintanence phase', where somebody would be shifted back to normal six-month interval cleanings provided good outcomes—or is the maintanence phase typically an indefinite situation, where patients have to be under more frequent discretion regardless?
 
AnxiousWrench,
I remember my first scaling and root planning and I was so scared out of my mind, I actually called to cancel that morning and my dental office talked me into coming in. They knew my anxiety level and were really good. I did have to have the anesthetic but first they used the topical so couldn't even feel the other . And my dental office let me hold the suction thing so I wouldn't worry about any of the anesthetic dripping.. and I just felt a lot more in control in general. She talked me through every step and at the end I felt just had a nice visit with an old time friend. and it was a little sore for a few days meaning like maybe 3 out of 10 on a pain scale but a few Tylenol I was good. and my mouth actually felt really clean and good after I hope all goes well and they are gentle and caring throughout. Let us know how it goes! I only needed one SRP after that went back to usual cleanings just fine.
 
I suppose, out of clarification and curiosity, is there an 'after the maintanence phase', where somebody would be shifted back to normal six-month interval cleanings provided good outcomes

Maintenance phase is kind of forever, but normally just involves a bit of scaling as and when required, along with monitoring that the patient's plaque control is up to scratch, as well as reinforcing the whole oral hygiene message. Research has shown that if the reinforcement is repeated regularly the results are much better. Funny that!
 
The idea of 'forever' is a still little bit daunting, but when you put it that way, it sounds more like routine cleanings with a few extra cavaets—not great, but not terrible.

Admittedly, I might be jumping the gun a little bit; maintanence not being explicitly mentioned, as much as something read about, but it's reassuring to hear specifics from a dentist themselves rather than vague fear-mongering from Dr Google & Associates. Thank you, Gordon.

Thanks feelingbetter, Tolkiensta, and krlovesherkids, too. It's a little comforting to know other people's experiences with this sort of thing, and I'll let you know how it goes in about a week or so. I'm hoping my experiences will be similar to the latter—though, perhaps not so much the pain—but we'll see! Still not too eager, still filled with anxiety, but I'd like to think I'm better now than I was before.
 
Following up immediately after the appointment—not great, not terrible.

Periodontist and dental hygienist were out, so I ended up with a third, new hygienist who I had to acclimatize to. Thankfully, there was a lot of time to do that, since the office called about my anxiety—apparently promptly noted in their records—and asked if it was easier to schedule me for one, four hour session on the 15th rather than two, two hour sessions between the 8th and 15th. After getting my whole mouth numbed, I can kind of see why they'd normally suggest splitting it into two sessions, but outside of that, things were pretty unremarkable.

The hygienist was very courteous, constantly asking me if I was okay, and reassuring me that things weren't all that bad, even when I mentioned that all that really bothered me were the needles—which again; not great, not terrible. Topical and good technique does wonders, and while I could kind of feel some of the injections, it was like, 0-1 on a ten point scale with maybe a 2 at the worst—and this was over the whole mouth, so the fact I only felt maybe one or two minor 'tensions' at best was pretty good. I wouldn't want to go through it again, mind, but it's not something that I would lose too much sleep over at the moment.

Actual SRP was as Gordon put it; lots of water, funny noises, and odd tastes. It's not a joyous experience, but local anesthetic does really reduce most of the experience to the tedium of sitting in a chair for a few hours—and even that goes faster than you'd think. After that, some classroom instruction on how to brush, floss, etc., and that was it for the office. Aftercare in my case is about eight days of antibiotics, no alcohol for twelve days, and to stay away from seeds, nuts, crisps, etc. for twenty. There's a little residual soreness as the anesthetic is wearing off, but it's mostly a dull feeling—like the day after streneous exercise where it sucks, but you can lay around and live with it—and that's before any of the OTC painkillers they recommend.

Slightly confused at office practices, since they booked my follow-up appointment in January—five months away—which as I understand, isn't common practice for this sort of thing, but eh, if it works? They said that they'd give a follow-up call on Monday to see how I'm doing, and I figure if there's a clerical error, they'll correct it at that time. Unfortunately, the periodontist rarely talks and the hygienists say conflicting statements, but this hygeniest was kindly enough to go over my x-rays and charts—a seven at worst, fives median, plentiful bone with relatively little loss—so generally an optimistic prognosis. Still don't know what the initial twelve that got me referred was about, and while they insistantly suggest wisdom teeth removal, it's more in a general caution of future issues rather than current ones—which I will defer to future me, since I am determined to keep them if they're not actively causing issues.

Anyway, to summarize—not great, not terrible! The thread has definitely shifted in theme, and I'll probably only follow-up if there's any radical change in situation, but as the hygienist said—no news is good news! Thank you everyone for letting me vent, and working through this with me! It's helped alleviate many, many sleepless nights and runaway thoughts. Words cannot nearly express my immense gratitude! 😄
 
Thanks for the update. I hope things continue to go well for you, I'm sure you'll be fine.
 
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