Dentistry/bone loss


QUESTION: Hi Dr Finnk,

I was told yesterday during my dental cleaning visit that I have 10 (4mm pockets) I also have a few 5mm pockets. No 6mm's.

I was told I will lose my teeth due to grinding and having braces as a kid. I was diagnosed with "maintenance periodontitis." It is currently inactive.

6 months ago my pockets were a 1's, 2's, 3's. I had a few 4's.
Can bone loss occur that quickly in 6 months?
Additionally, I asked hygienist if I needed a deep cleaning? She said no since my periodontitis is inactive and I didn't have a lot of plaque build up nor bleeding.

I am confused. I brush, floss, and use Listerine twice a day and with no bleeding.

Why the rapid bone loss if my teeth have little plaque? I want to shrink my pockets.

ANSWER: Dear Todd,

Bone loss can occur in 6 months.  However, the measurements we make are of the loss of the gum attachment to the roots of your teeth.  Not necessarily bone, although it could include bone loss.

I don't know how one can say your periodontitis is inactive or active.  Generally it takes time to measure activity of periodontitis.  In other words, if your gums stay at 1,2 or 3, you're ok.  But if you go from this to 4,5 and 6, this indicates activity of gum disease.  Sometimes the difference in measurement numbers can be due to the use of a different periodontal probe, or the pressure used during measurement.

If your pockets exceed 4, the only way to shrink them is deep scaling and root planing.  Sometimes the additional use of a chlorhexidine rinse may help reduce the swelling and inflammation enough to avoid DSRP.

Although brushing, rinsing and flossing are important, sometimes no matter how well you clean, gum disease can still occur.  The object is to keep up the good work.  Sometimes no matter how well we wash our face, we might still get pimples.  It might take a special doctor to treat the pimples succesfully,  The same is true of gum disease.  Sometimes no matter how well we clean our teeth and gums, gum disease can still occur.  This is why we dentist must constantly be checking.

Good luck.  Let me know how it goes.

---------- FOLLOW-UP ----------

QUESTION: Doctor Finnk thanks for the response.

I think killing the germs is the most beneficial method to stop the bacteria from eroding away my bone. As you said "no matter how well you clean, gum disease can occur."

What about disinfection? I will add salt, baking soda, and chlorohexidine to the mix so I can kill the germs that erode the bone.

I don't buy the dental hygienists' argument that braces and grinding my teeth causes this disease.

Its germs.

Braces contribute to the disease by making it much more difficult to clean teeth and gums thoroughly.  Braces provide many more nooks and crannies, making cleaning more difficult.

Clenching/grinding contribute to bone loss due to the constant pressure on the supporting bone.  Imagine a post sticking up out of the ground, with much of it buried under the earth.  No start pushing back and forth on the post.  Can you imagine moving loosening the post over a period of time of just pushing back and forth on the post?  In the same way, clenching does this to your teeth, because the bone surrounding the roots begins to dissolve away from the pressure.

Keep up the good work at home, and listen to the hygienist.  She has your best interest at heart.


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


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.


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 ( 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 (, 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.

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)

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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

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