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Periodontics/Periodontal pocket


QUESTION: Hi, I never miss a dental check up and always alert my dentist of pant problems I have.  I recently cracked an existing molar filling and my dentist said I would need a crown.  He tried to numb the tooth with 10 shots and it wouldn't work.  He told me to come back as this sometimes happens with a bottom tooth.  I came back and was given 8 more shots that failed to numb the tooth.  He told me to come back in a few weeks when I was due for my check up.  I came back and the hygienist to.d me that everything was fine even though i complained about bleeding in an upper molar.  She also took bitewing xrays. She told me not to be so aggressive flossing.  I floss after vey meal.  The dentist then tried again to numb the tooth 10 more times.  At this point I was feeling like Dustin Hoffman in Marathon Man but I trusted him.  He finally gave up and referred me to a sedation dentist.  I went to the sedation dentist and she looked at the tooth and said I had a pocket.  She measured it at 8 mm!  She referred me to a periodontist who deep cleaned and gave me an antibiotic.  He also told me my other three molars had pockets 5-6.  My other teeth were fine.  I go back in a few weeks and he said I will probably need flap surgery.  I have never had a tooth pulled or root canal and the thought of this makes me want to run.  Is laser surgery as effective?  I am vey upset?  Thank you, Lynn

ANSWER: Lynn, it is hard to know if laser surgery will be effective in your case.  I have not had an opportunity to examine you or look at your radiographs so I don't know what your diagnosis is.  If you had digital radiographs you could e mail me that would help.  There are many times when non surgical treatment can resolve the problems, but again, I have not examined you.  I am located in York, Pa.  Again, if I could see your radiographs I could give you a lot more guidance.

Bryan Siegelman

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QUESTION: Thank you for your prompt response.  I realize the 8mm might have to be pulled.  I was  concerned about the other molars.  Also how long does it usually take for a tooth to get to 8mm?  I have never missed an appt.  are radiographs X-rays?  I am going to my dentist today to pick up my records as I am switching dentist.  I live in Langhorne, Pa.   What are the reasons why laser therapy would not be appropriate?  Is it depth of pocket?  When I questioned my present dentist why he didn't notice that the was a problem with his tooth his reply was that there was no bleeding and the gum tissue looked healthy.  I realize I am peppering you with a lot of questions it is just that I am trying to make  an informed decision and to be honest I don't know who to trust after this mess.  Thank you.

Lynn, if you live in Langhorne, Pa there is a periodontist there named Dr. Paul Rosen.  I would trust him with my life.  I would go to him for a second opinion, unless he is the periodontist you are seeing.  I would bring him the films and have him take a look.  You can google him to find his number.

Good Luck
Dr. Siegleman


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Bryan M. Siegelman, DDS


I can answer any question relating to the diagnosis and treatment of periodontal disease. I can also answer questions relating to the placement and restoration of dental implants.


I have been practicing Perioodontics for the past 20 years. I limit my practice to periodontics and implant dentistry. I am a diplomate of the American Academy of Periodontology. I am in private practice in Pennsylvania and am on staff at the local hospital in my home town. My practice website is

American Academy of Periodontology, Academy of Osseointegration, American Dental Association, American College of Dentists, Pennsylvania Dental Association

I have a BS from Muhlenberg College, I did a general practice residency at St. Joeseph's Hospital and Medical Center in Paterson, NJ. I received my DDS degree and specialty certificate from the University of Maryland Dental School.

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