Expert: Jeff Dalin DDS - 9/5/2005

Question
Hi Jeff:


In your opinion, do 6MM pockets necessitate root planing and antibiotic treatment?
My dentist tells me he won't let me do a normal inexpensive cleaning since he would be
liable if my gingivitis  worsened  in e future.   Planning and antibiotics costs $580 which I don't have, being a 53 year old single parent, who is below the povery line.  I don't think he used a probe, but instead
went off the x-rays ( which he showed me)  

I suspect that he is diagnosing based on fear of being sued.  He told me as much, stating that he could loose his license and would be liable if
he let me just get a basic cleaning.

My last dentist in another town had me on a 3month cleaning regimen which I had adherred
to.  But the planning was never recomended.

Many thanks in advance!

Rob  

Answer
Rob,
First off, I apologize for the delay in answering this question. I have had some email problems which just got fixed. Now to answer your question.

To diagnose gum issues, you must use a probe. You cannot go by xrays alone. You need to look at both items. Now if it is truly a 6 mm pocket, you might have to consider root planing. But you are the boss here. Tell the dentist that you will sign something on your chart stating that you were told about gum problems and understand his recommendations but really want to do 3 month cleanings alone for now. Many patients are able to maintain these pockets if they perform good hygiene at home and come in religiously every 3 months. One way to check this is to try 3 month cleanings for 3-4 times and then remeasure the pockets. Often they will shrink. The key here is that things do not get worse.

So if this dentist is not listening to your wishes, consider a second opinion from a different dentist. If everyone tells you the same thing, then maybe you will have to try the root planing.

Good luck,

Jeff Dalin, DDS