Dentistry/bone loss

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Question
Hi,

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 have moderate gum recession. I am in my mid 40's.
I am not worried about losing my teeth, as I am about the tremendous cost of keeping them. I have spent 50k on my teeth over my lifetime with veneers, crowns, fillings and still need more work. If I lose my teeth do to bone loss and have to get dentures --- then so be it. At least the dentures will look better than my real teeth. The problem is my veneers need to be replaced again due to gums pulling away from my teeth and staining around the veneers. Why replace them if I am losing my teeth? Makes no sense. Maybe my dentist is out to make a few bucks?

I was told I will lose my teeth due to grinding and having braces as a kid. I do wear a night guard every night. 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. Then I was told to replace the veneers. Again, why replace the veneers if I am going to lose my teeth?

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
Hi Todd,

Sorry for the delay on this answer.  I don't think things are as bad as you might think.  First of all you are most likely not loosing bone rapidly.  Periodontal pockets are not necessarily associated with bone loss.  First of all, pocket depth measurements are not accurate.  A two mm difference at 2 different probing times is common.  It depends on the clinician doing the probing, the amount of pressure difference used each time etc.  The only way to determine bone loss is by serial x rays over time.  Ask your hygienist to show you on x ray if there is bone loss over time.  Furthermore pockets can be getting deeper without bone being lost.  Your description and your hygienists assessment of "arrested", suggests your gums and bone are relativly healthy.

Regarding replacement of your veneers.  The problems you describe with the veneers is an esthetic problem.  That is, the appearance may trouble you.  But unless there is decay under or around the veneers, the teeth are not endangered by the recession or staining.  I just want you to know you don't have to replace the veneers now to save your teeth unless there is decay involved.

So in summary, it is highly unlikely that you re in danger of loosing teeth because of periodontal disease.  Next you should find out from your hygienist if new decay is present necessitating remaking of veneers.  I like this opinion to come from someone like a hygienist, who has no financial interest in the diagnosis.

If everything turns out to be OK, I would suggest you practice effective prevention to keep decay from starting around the veneers where the gums show recession..  This is accomplished by getting fluoride from tooth paste on those areas that show recession, twice a day..  If someone tells you that early decay is starting, it may be halted and reversed with an additional fluoride rinse such as ACT twice a day in addition to your toothbrush routine.  In other words, you are doing the right thing if you are using a fluridated tooth paste now.

I remain available for any further questions concerning this matter.  You should do whatever necessary to avoid dentures.  I hope the appearance doesn't influence you to loose your teeth.  Dentures will be a poor substitute. I certainly sympathize with you concerning the accumulated costs

Larry Burnett, DDS

Dentistry

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Larry Burnett DDS

Expertise

Preventative Dentistry. Conservative Periodontal Therapy

Experience

National lecturer on conservative treatment of periodontal diseases and elimination of tooth decay. Former adjunct professor of oral microbiology at a Leading school of dental hygiene. Former investigator for State Board of Dentistry. Retired from private dental practice.

Organizations
ADA

Publications
RDH Magazine. Numerous articles

Education/Credentials
Graduate of Medical College of VA School of Dentistry. 20 years teaching hygienists at NOVA

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