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Uncertainty after Periodontist Appt

V

v0latile

Junior member
Joined
Aug 3, 2019
Messages
6
Location
USA
I posted back in 2019 thinking I was mostly out of the woods but unfortunately somehow despite my best efforts, things took a turn for the worse:cry:

I have a spot between my back two teeth (top row) which has been bleeding on and off for several years. I've had a filling there and have an onlay on one of the teeth. I've mentioned this bleeding spot a lot and have always just been told to keep it clean, and floss. In 2019, my dentist had told me that the pocket depth in that area was between 3-4mm and that it wasn't deep enough to warrant a deep cleaning. At a later appointment (I think in 2020?) she mentioned that there's a chance I may need gum graft surgery (?) but didn't fully explain why. She wasn't pushy about it and the advice was to keep that spot clean, floss often, etc. She did not tell me that anything had worsened in that area at our usual checkup. I dismissed this initially because it sounded like she was prescribing surgery for something that wasn't a huge issue yet.

Fast forward to 2021. In April of this year, I saw a new dentist. I had xrays done as usual and once again pointed out the spot that bleeds on and off. My dentist took a look at the xrays and said that I have bone loss in that area, likely due to food impaction in that gum. I'm not sure what made her think it was food related...she didn't have a reason for it but told me I may want to see a specialist. I was shocked. Either the bone loss progressed quickly or no one had pointed it out on my previous x-rays!

I waited for months for a periodontist consult. Today I finally had the appointment and I was told that the pockets near that tooth were 4mm and 5 mm, that I would need gum flap surgery to prevent further bone loss from occurring. I was gutted. It really felt like my worst paranoia realized and it felt unfair because I've been so diligent about my oral health ?
He said that it's a tricky situation to resolve and the cause was that likely my filling was placed too low in my tooth close to the bone, normally more space is left for the gum. I think he also mentioned that they would shape my tooth after the gum surgery, but I am a little unclear as to what that entails and why. He mentioned if the idea of surgery freaks me out too much, I could technically try to go for a deep cleaning, but supposedly that won't resolve the issue fully (is this because bone loss has already occurred?) it would just be a temporary solution.

I would like to seek a 2nd opinion, but I also don't wait to wait many months while the situation worsens.

Needless to say, I'm devastated. I'm 32 years old and have had regular cleanings, gotten work I've needed done, brushed, flossed, etc. I know it's not the end of the world, but it feels sudden, unfair, life-altering.

I'm wondering if anyone has had similar experiences or could tell me:

-How likely is it that gum flap surgery will fix this? He said nothing is guaranteed 100%, but if the issue has to do with the placement of the filling, then won't the issue still be there unless something changes with the filling placement?

-How could bone loss progress so quickly? How could gum pockets deepen so quickly if I was cleaning them regularly? It seems really quick that I bypassed the deep-cleaning stage and now need surgery.

-Is the bone loss likely to spread to other teeth? There's a gum on the other side of my mouth which has started bleeding a bit more frequently regularly and I'm terrified that at my next cleaning I may get awful news that my Periodontal disease has spread :(

Thank you for reading & for the support.
 
1) They'll reshape and polish the filling when they have access to it from the gum flap. So yes.

2) The evidence is that one can only effectively clean pockets to a depth of around 3mm, so no matter how hard you tried at home it wouldn't help in this particular area.

3) No
 
I really feel for you. I am older than you but am facing the same situation. I have had trouble with my gums for several years, held in check by 3 monthly hygienist appointments. A couple of weeks ago, I realised that my 6LL was not feeling 'right', I was getting twinges in it and I was feeling pressure on biting. Made an assessment appointment with my dentist who said she was pretty sure it was not the tooth/teeth, but that my gums had deteriorated - this was after the tapping, cold and biting tests. She referred me to a specialist periodontist who luckily had a cancellation for this coming Tuesday. I am very, very anxious about this and dread what she might say. I too have followed every single instruction regarding flossing, cleaning, salt water rinsing, etc. I have ever had - it just seems so unfair. Apparently, you can just be unlucky and despite doing all you can to maintain gum health, if you are genetically disposed towards perio, you can get it anyway! Any treatment is not likely to happen until February 2022 at least! I can put up with that but cannot put up with the discomfort and feeling of swelling and a 'full mouth' for 6 months. Do let us know what you decide to do and how any treatment goes. It really is (a rude word!).
 
1) They'll reshape and polish the filling when they have access to it from the gum flap. So yes.

2) The evidence is that one can only effectively clean pockets to a depth of around 3mm, so no matter how hard you tried at home it wouldn't help in this particular area.

3) No
Thanks for the replies, Gordon. If you can only clean up to a depth of 3mm, why didn't the dentist suggest a deep cleaning in the first place? Are those normally suggested if you measure anything over 3mm? I'm thinking maybe this could have been avoided if she sent me over for that instead.
 
If you're measuring more than 3mm then it's always worth considering further action, but periodontal pocket measuring is not a precise science, try measuring to a mm or so in ideal circumstances :)
Most dentists will wait till they're certain that there's a deeper pocket before jumping in with further treatment.
 
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