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Dentistry/Deep scaling and root planing

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Expert: - 11/14/2008


Question
I've been seeing a student dentist at the University of Southern California. She's quite clumsy with sharp instruments, and when she did the periodontal exam to test the depth of the pockets around my gums she caused me a lot of pain and made me bleed. When I complained she said it was just because my gums were sensitive and the bleeding was a symptom of disease. I finally got sick of the pain and insisted that another student finish the procedure. No more pain, no more bleeding. However, the depth of the pockets on some of the teeth are 4-6 mm.

The student dentist ordered four quads of deep scaling. I'm now wondering if this is really needed. My gums are very healthy. I have excellent dental hygeine (floss daily). While having two endodontists examine one of my teeth recently, both of them spontaneously complimented me on the excellent condition of the gums around that tooth (they didn't look at any of my other teeth though).

The student dentist who ordered the deep scaling said that it's necessary because when I was in my twenties I had terrible dental hygeine so I probably had periodental disease then, and that's what caused the deep pockets. I'm 63 now.

Since I don't much trust the diagnosis of someone who stabs my gums and makes them bleed, I'm having trouble accepting that this scaling and root planing is really necessary or whether it's more that the dental school likes to order deep scalings so that their students can practice.

Are somewhat deep pockets on otherwise tight, pink, healthy gums reason enough to do a deep scaling? Is this more of a pre-emptive thing than resolution of actual existing problems? I was told that it can help to make the pockets get shallower. Is that accurate?

In any case, does it make sense go ahead and let them do this deep scaling whether I need it or not? Is there any real reason NOT to, aside from it possibly being a waste of time and money?  

Answer
Dear Gail:  The fact that your gums were sensitive and bled during the examination of your gums, and that your pocket depths exceed 3 mm., tell me that you have at least a Stage 2, or possibly a Stage 3 Periodontitis.  That is gum disease at the middle of its progression.  You can help make the pocket become less deep, but usually the disease progresses without treatment.  Once your gum pocket depths exceed 3mm., there is usually progressive disease.  If you have measurements that exceed 5mm, you have loss of gum attachment that extends about halfway down your roots.  As a dentist, I take this very seriously.  Much more attachment loss, and your teeth will begin to become loose and unsavable without extensive treatment.  The problem with early detection of gum disease is that you do not feel anything until your teeth become painful or loose, or your gums begin to develop boils.  Plus, what you have is infection under your gums.  This infection can spread to other parts of your body.  Google "gum disease and health" and see what you find.  Right now, you may feel you're ok.  You're not.  Have the deep scaling.  It is a very conservative treatment that will likely heal your gum detachment, as well as reduce the amount of infection your body is constantly fighting.  dd

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Howard Finnk, D.D.S., P.A., CEO

Expertise

I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.

Experience

Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center (floridaimplantcenter.com). On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (nobhilldentalcenter.com), I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.

Organizations
American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)

Publications
"How To Save Money At The Dentist" Going to press soon.

Education/Credentials
Bachelor of Arts and Sciences in Psychology from Wayne State University Doctor of Dental Surgery from University of Detroit College of Dentistry Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida

Awards and Honors
Membership in The Vedder Honors Society

Past/Present Clients
HIPAA rules do not allow me to post this information.

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