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Periodontitis - 90% bone loss (Page 1)

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Hi, I am 36 yrs old. I recently discovered some loose teeth in my mouth, which had me running to the dentist. After full mouth x-rays it was discovered that I have extremely advanced periodontitis with 90% bone loss. Ugh. On visiting a periodontist he measured pocket depths of 7-8 mm all throughout my mouth. Ugh again. He recommended scaling & root planing. When I asked him what the likelihood of this procedure was to stop the progression of the bone loss, he said: slim to none. We went onto discuss flap surgery.

This perio wanted to do the SRP right then and there, and wanted me to pay up front for it, "incase insurance doesn't cover it." Yeah so tomorrow I am seeking a second opinion. I happen to know already that my dental insurance will not cover me for anything, because when I joined the plan I was what they call a "Late Entrant", and so my coverage is delayed for 2 years. The good part of this is that the company I work for may pay for part of my treatment because it is their fault I was signed up late. I am also looking into financing for the whole deal. I hear it's ridiculously expensive!!

I am willing to do anything to save my teeth. There are several very loose ones in there and I only hope they don't fall out during surgery. I have started brushing, flossing, stimudenting and rinsing with Listerine after every meal (3 times a day). At first the prospect of surgery scared me too much, but now the prospect of having no teeth scares me more.

My main question for the periodontist tomorrow is going to be whether we can just skip the scaling & root planing and go straight for the flap surgery. With pocket depths of 7-8mm I really don't think this infection is going to slow down unless arrested right at the bone.

I am also going to ask him about the possibility of using minocycline microspheres in conjunction with the flap surgery.

I am glad I found this board, no one in my life wants to hear me drone on about my teeth. Both dr's I have seen so far say that this has to be genetic in my case; though I wouldn't know because I am adopted. They said I am really young to have it this bad and if I don't do something fast, I won't have any teeth left, or any bone for a denture to hold onto.

I have been a smoker for the past 23 yrs also, so I imagine that cannot have helped any. I am willing to quit smoking after the surgery. I am willing to go to absolutely any lengths to save my teeth. I like chewing and talking. Thanks for reading this if you made it this far!

I have a great smile, but bone...not so much. Very Happy
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First Helper diablotopaz
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replied February 4th, 2008
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before any periodontal surgery you have to had a very low percent of plaque and no calculus inside those pockets because those bacterias could infect the healing processes and could be worse ,thats why root planning and curreteage is made for to clean inside your gums and control the inflamation . it would be good to use tetracycline and peridex or perioguard too . do the surgery its the best option to save your teeth maybe not all of them but maybe there are ones with better prognosis than others.
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replied February 5th, 2008
I saw another dentist today who told me he does not recommend the flap surgery because my bone loss is so advanced and flap surgery would cause more bone loss. He said that not every area in my mouth has as severe bone loss as many others. My 2 rear molars are pretty well rooted in bone, while everything forward of them is not.

He recommended the scaling and root planing, and when 2 or more of my teeth fall out during that procedure, which he assured me they will, to replace them with bonded bridges. To the cool tune of $1200 a bridge.

My question becomes this: if I do get the scaling & root planing and 2 or more of my teeth do fall out and say I do get them replaced by bridges...all the while the bone in my mouth is melting away under the periodontal disease.

At what point will I have waited too long to act and there is now no longer any bone for a denture to hold onto? The first periodontist I saw made this point. Only now is it just sinking in. Dentures hold onto the bone in your mouth, right? Well my jaw bone is melting away, most especially in my lower front. The guy today said he thinks plaque & tartar must be the only things holding my front lower teeth in. You can clearly see on the x-ray the lack of any BONE around the bottoms of those teeth.

I think I may call the original periodontist again and get his perspective some more. I just don't see sinking $1200 bucks a pop into replacements if I am going to ruin any future chances of a denture by taking these temporary measures.

I also have an appointment with yet another periodontist on February 25th. I realize I am not going to find a dr. to tell me my teeth won't fall out: because they will. I just want to take the most effective action I can to ensure my ability to eat and talk well into my old age. I don't have a spare $3000 laying around, and if I spend the money I want it to be money well spent, not on a losing battle that obviates more spending.
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replied August 7th, 2011
I would love to hear how you have been going. My situation sounds similar to yours...8mm pockets @ 30 yrs of age.
I start scaling of the gum line in the next couple of weeks.
Amy
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replied February 6th, 2008
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its difficult to know what is best to you without looking the radiographs but you have to ask your dentist if the teeth that would support the bridge are hard(no mobility ) and have no deep pockets, if they have good prognosis the bridge is a good option . look if there is a perio -prosthesis specialist in your area that can help you
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replied February 7th, 2008
All of my teeth have deep pockets measuring 7-8 mm. Almost all of them have some degree of looseness also. All of the teeth around the ones they are almost certain will fall out during SRP are also loose.

I did call the original periodontist I saw and asked about having them all removed, but he didn't recommend that either.

It seems these dentists really want me to hold onto my original teeth, but my teeth do not share their idea!!

I don't want to sink thousands of dollars I do not have into a losing venture. I wish I could just find a dentist who will pull all my teeth and give me dentures right now!! Before all my jawbone is gone and a denture won't stay in.
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replied February 7th, 2008
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for us ,dentist, in this modern times with all new technique in bone replacement theraphy it is very difficult to find a dentist that extract teeth without reasons , teeth are very important for our speech , digestive process and taste and appeareance having a complete denture is not a pleasant experience firt of all you can not have the same perception of taste, hot and cold because a lot part of your mouth will be covered by acrilic, second you can not eat hard things as you do with your natural teeth (its dificult for complete denture patients to bite an apple be) you have to learn how with your tounge and muscle maintain the dentures in place, you will have a feeling like is your mouth is entirely full with something hard and dont thing you will not loose bone ,you with loose more bone because if no teeth are present bone reabsorb faster. dentists study more than 6 years to cure disease and replace function of patients mouth if your dentist is telling you that you can preserve your teeth with ambulatory surgery do it , is the best you could do to preserve it and if periodontal disease is controlled bone loss stop
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replied February 7th, 2008
A very good friend of mine has full dentures since she's 24 yrs old. She is 48. She can bite an apple and eat corn on the cob and you'd never guess she has dentures. They fit her so well that she doesn't even have to use that glue junk.

Anyway, I won't be needing dentures.

And prdent, whoever you are, to suggest surgery without knowing a thing about my situation, is reckless and unethical.

I saw my 3rd and final periodontist today. He says I definitely DO NOT need surgery. He focused on something that NONE of the other periodontist focused on. The fact that I clench my teeth when I sleep. I have what he called Occlusive Periodontitis. I told all the other "doctors" this but none of them addressed it in their "treatment" (banking) plan.

This Doctor says I need a course of deep gum treatment, including subgingival antibiotics, 4 quadrant root scaling & planing and a bunch of other follow up care. He said I MAY possibly lose 4 teeth but even that is unlikely. He said it is not really as bad as the other idiots made it out to be. AND the best part is that this whole phase of the treatment will be about $2200 bucks. Not the eventual $8000 for flap surgery the other two steered me towards.

So as I suspected, the other "doctors" were trying to sell me UNECESSARY SURGERY just to line their pockets.

The sad fact is, that those other doctors are probably just not intelligent enough or motivated enough to keep up in their field. They tell people they need surgery, they use fear to sell unecessary medical treatment, and people jump for it. I wonder how many completely unecessary flap surgeries that other perio I saw does every year.

Enough to buy him that Porsche Carrera parked in the lot.

So if anyone out there reading this has gotten an opinion from a dentist or periodontist, SEEK ANOTHER ONE.

Keep seeking until what that doctor says strikes a chord in you that RINGS TRUE.

I had researched subgingival antibiotics and each dr I mentioned them to seemed alarmed that I knew about them. I flat out asked one of them if he never used subgingival antibiotics, or if they were just too cheap a solution for him to offer? The one guy answered that they don't work. And that if I didn't go with his idea, I'd be back in his office in a few years begging for implants.

The perio I went to today SPECIALIZES in implants - but never mentioned implants to me even once. He gave me hope, and a plan of action, and a reasonable price tag. Quite the opposite of what the others did, which was fill me with MORE fear.

Fear is a great tool of manipulation. It's a good thing I am past that stage of my life.
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replied February 11th, 2008
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first of all let me tell you that there are a lot of different schools approve by the ADA that have differents theories of how to address periodontal problems and all theories are scientifically and clinically proved.
there are some dentist that address the periodontal problem by bone augmentation and remodel surgery,pocket elimination surgery and other minor surgicals technique and other dentist uses other methods
the majority of them uses is the root planning and curreteage technique for cleaning deep pockets. so the thing is there are not bad dentists and good dentists ,they're just using different methods to reach the same result(periodontal stabilization).
I personally prefer surgery phase because I have seen better results with it . and sorry if I offend you ,the thing is that I was trying to convince you that if there exist posibilities to retain your tooth dont think in the idea of getting them all extracted because maybe your friend could bite an apple but believe me there are many patients that cant,and its not the same to have plastic teeth than to have the teeth that God gave you
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replied March 20th, 2008
omg exact same story
my teeth are perfect but losing them to peridontal disease.i have been advised to have all my teeth pulled.i know i have 2 very loose teeth,but the dentist said in the next year i will lose them all.guys please keep me informed of your treatments i really dont want dentures.i also told them i grind my teeth and always have them clenched due to stress can,t relax
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replied March 15th, 2009
to greatsmile
hey i am 24 years old and am having the exact same problem as you right now. I have perfect teeth, all white and straight but have 7mm-8mm bone loss. I have been going to see different periodontists ever since my front tooth has gotten loose. I am extremely nervous. I went to see one just a few days ago and he said or a 24 year old girl I have a 60 year old lady's teeth. He was so surprised to see my teeth and he was so negative about them. Ever since I met that periodontist I have been extremel depressed and I do not know what the right treatment is for me. The periodontist said that my condition is so bad that I cannot even get implants. I would like to know how are your teeth now and what treatment are you on right now?

I am really anxious and hope to hear from you soon.
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replied November 3rd, 2012
Hi Cyma. I'm in your situation at the moment (I'm 23 years and have periodontal disease, most of mine are around 5mm but I have one 8mm on my front tooth). How have you gone with your teeth since this post? Thanks
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replied October 1st, 2013
I am 26 and have the same problem. I was lucky enough to find a periodontist( my second opinion) that believed with deep cleanings every 3 months that we would be able to save my teeth. I am still depressed and constantly worried though.
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replied October 1st, 2013
I am 26 and have the same problem. I was lucky enough to find a periodontist( my second opinion) that believed with deep cleanings every 3 months that we would be able to save my teeth. I am still depressed and constantly worried though.
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replied March 28th, 2009
just some more ...
Less than 4 years ago, I noticed that my frontal tooth slid down and outward just a tiny bit so I went to an orthodontist to see if I could get invisalign. This orthodontist sent me to a dentist to check on my gums and bones. To my horror I, too, learned that I had 7mm pockets and advanced bone loss and could lose 7 teeth. The dentist referred me to a periodontist and there I was recommended to have flap surgery on both jaws. Despite that I was advised to pull out two of the teeth, I refused as I wanted to keep all mine for a while after the surgery.
The surgery cost around $4500. My insurance only covered $1500 and I paid the rest $3000 out of pocket.
My frontal tooth that has so much bone loss has been quite stable ever since but it is 1mm longer than the adjacent and worse, rotated a bit outward as well.
One of my molars continued to have trouble with a 7mm pocket so eventually, I opted to have it removed and place an implant there.
Now all my teeth are 2-3mm pockets (which is supposedly healthy) and a crown has been put on top of the implant. I could chew hard stuff and don't feel anything foreign in my mouth at all.
Who would've thought teeth could cost tens of thousands of dollars?
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replied April 3rd, 2009
loose frontal teeth
omg me 2 thought i was alone with this situation.i am 34 years old and have 2 loose teeth at the front,one sticks out wich makes me have a large overbite.its makin me feel down in myself.so i went to see my dentist and he said that if i had chronic periodontal treatment it may not work on the top teeth leaving me still having moderate periodontitis.so i asked if i had them pulled would that work.he said yes.i thought great atleast it will cure my issues.but now i have other issues and im terrified of having dentures.i do want lovely straight white teeth,but also want to still taste food and the tempretures.to makee things worse im terrified of the dentist.i just dont know what to do.
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replied April 12th, 2009
to jodi1974
did you have surgery on those teeth? mine has very little bone left (i saw the x-ray) but the sliding seems having stopped and yes, i am also very conscious about it. i have been debating to pull it out and put in an implant or consult different orthodontists to see if it's possible to push it back in as the pocket now is just around 3mm.
do you have implant as an option? it's very expensive but the result is excellent.
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replied April 22nd, 2009
i am only 20 and i have severe periodontal disease.
i don't have the wealthiest family and i just made it worse being really stupid these last 6 months. not looking after myself equals more money problems.
50 grand for implants..it's probably cheaper to die.
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replied February 14th, 2010
Hi there,

I too have widespread periodontitis. I got the gum recession and bone loss from orthdontic treatment done 10 years ago. I have widespread
gum recession and bone loss (5 to 6mm pockets, although
my periodontist is putting me on extensive SRP to reduce
pocket depth and to "seal up" the gums to keep bacteria out).

Don't give up. I'm not a dentist but I've done lots of reading and research on the net. There are new techniques out there that can regenerate gums and even the bone (although the results are still somewhat limited, but they're getting better). The important thing is to rebuild alveolar bone so that the teeth has more support. And then gum tissue can be grafted or even regenerated to some extent to keep the bacteria out.

Try googling guided tissue regeneration or "bone augmentation" and you'll find different techniques available.


Best to keep your natural teeth if you can. Good luck.

Peter (in Canada)
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replied April 22nd, 2010
loose teeth and bone loss..specialist info help
gosh I am so glad for this board. I am 36 and my two font lower teeth areloose and have sever one loss..the gums have been pulled down due to about 80% bone loss. My regular dentist suggest removeing all FOUR front teeth and hooking the bridge onto the canine teeth..

I have been severely depressed about this and anxious. I dont even know who is a good specialist to go to for a second opinion and I have been unemployed for almost a year. The thought of these teeth falling out and me walking around toothless is driving me crazy but i know the longer i wait the worse it will be. My dentist said they will both fall out within the year.

I cant do an implant b.c there isnt any bone to support. I am thinking about getting that wire that holds the teeth together just until i get a job and some insurance.

I also have TMJ,,this on top of having braces in high school apparently may have contributed to this problem b/c it isnt due to poor hygiene according to my hygienist.

Would be good to hear how great smile went with her treatment.

Does anyone know how to find a specialist in their area with a great track record?
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replied May 14th, 2010
Alternatives to yanking out all my teeth?
I went to the dentist today for the first time in a few years. I've had about three teeth fall out in the past year and I knew I had a problem. With diabetes and being a smoker, but I was shocked to tears when he told me that I had to have all of my teeth removed and dentures put in. I'm 36.

He's not a periodontist, he's a general and cosmetic dentist and while I see the lack of bone in my x rays, and feel almost defeated, I've decided that I must seek out the advice of specialists. He made a point of saying that he could not grow bone for me. But after a lot of research it seems that some people can, with bone grafting and oral surgery and serious work I'm hoping to keep my teeth.

I've requested consultations with two periodontists here in San Diego.

I'd rather spend the $17,000 that it will cost to extract my teeth and get immediate dentures on doing everything else I can to save what I've got. I'm also going to quit smoking. This is ridiculous.

Has anyone else been told to remove all of there teeth and found a successful alternative? I'd really like to hear your stories if you have.
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replied October 1st, 2013
Im 26 and am diabetic also. They told me that my blood sugars had a lot to do with my bone loss being that I for awhile did not have them where they needed to be.

Hope you got some good news!!
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replied January 4th, 2011
I discovered lose teeth about 5 years ago. It was a time when I was struggling to pay the bills and after the dentist charged me a fortune for a 4 hour scale and clean, I got into debt and could not afford going back.

Now I have one of my front teeth at the top that's slid out almost completely. I am just waiting for it to come out. I cover my mouth when I speak and try not to smile. I had a 6yo tell me the other day that I look like Nanny McPhee.

I did see a dentist a few months ago who told me that I would lose some teeth but not all and that I may be able have bridges and advised me to see a periodontist. I am just hesitant because I cannot afford to stay away from work right now and any cleaning will make this - and possibly others - tooth fall out and I don't want to go to work with a missing front tooth.

Also, I have some savings now, but I still cannot afford to spend thousands.
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replied March 25th, 2011
Well guys, I am in the process of doing the cleaning of my tooth and getting ready for bone implant. Whatever that is cos, the dent says once the gums are clean he will start the sugery but no gurantees that it will work. I am already 63 years old, I've got 3 implants (now shakey)and a crown. Just worried.
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replied March 30th, 2011
I am under treatment for periodontitis, I see my specialist once a month and the bill is for debridement, meaning scaling and all the cleaning of the gum area. Smoking is on of the cause. I tell you even my implants are wobbly. i am so afraid. The treatment is lo painful with at least 7 anesthetic jabs around your mouth. When the effect kicks in you feel like your mouth is swollen shut. I was told that it will have to take at least 2 month to get everything clean and then the bone transplant can start. No promises that it will work. The cleaning of the tooth one by one day using small periodontal brush day and night is also tedious
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replied March 28th, 2011
Hello,
I was Told by 2 dentists I would have to have all of my teeth taken out early last week. I am 30yrs old and have Extensive advanced periodontal bone loss, discovered on an OPG (x-ray).

However I was not going to just go and have all of my healthy teeth out before I did some Research my self. After many long hours in front of the computer I came to the conclusion i needed to see a PERIODONTIST! And very glad i did. DR Mynaz Syaed from Elite Perio gave me a very high chance of saving my teeth. OMG There is another option to extraction for me. WOW.

I am shocked that neither of the 2 dentists i seen had mentioned that there was such a specialist avaliable and that i should see a PERIONONTIST before they go ahead and extract all of my Teeth, and informed me that if i was to have implants it would cost me in the vicinity of $40,000, As compared to the alternate option of a PERIODONTIST which will now end up being around $3,000 AND I SHOULD BE ABLE TO KEEP THE MAJORITY OF MY OWN TEETH. Much better.

I URGE EVERYONE WHO HAS OR EVEN THINKS THEY MIGHT HAVE PERIODONTITIS OR BONE LOSS TO SEE THE CORRECT PROFESSIONAL A PERIODONTIST BEFORE YOU HAVE IRREVERSABLE THINGS DONE LIKE TOOTH EXTRACTIONS UN NESSICARILY !!!
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