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Periodontics/RE: 50% bone loss


Hi Dr. Siegelman,

I want to ask for your opinion.

I am 47 years old, non-smoker, non-drinker, exercise and eat very healthy.
My teeth were strong and healthy up until 2012.
However, in 2014 my x-rays revealed 15% bone loss on my lower 4 front teeth. My dentist said I have perio-maintenance.
I used to have mild periodontitis but it stopped a few years ago with my excellent oral hygiene.
I get my teeth cleaned every 3 months and my gums are always pink and teeth are healthy. I have always brushed and flossed twice a day.

Yesterday, I went in for another x-ray and cleaning.
I now have 50% bone loss on my lower 4 front teeth. Its getting worse.
My dentist is concerned and does not recommend a deep cleaning because there is no tartar or plaque around my teeth.
The bone loss is centralized. My entire mouth has full bone density except for a specific area.

What else could be causing this bone loss? We have talked about a bone graft and gum graft, but he does not recommend it because the bone loss in that area would not anchor the teeth properly and the bones loss will progress again.
He says possibly getting a bridge if my lower front teeth fall out.

I am not sure how to stop bone loss if I am doing everything right. Should I take extra calcium and Vit D?
I eliminated dairy from my diet years ago. I wonder if this could be causing it. I also take Advair steroid and used prednisone for asthma. Could this cause bone loss?


Todd, without seeing the films and doing an examination I cannot give you a good answer.  I do not believe that your diet or lack of taking supplements is the culprit.  That being said, if you have lost 35% of the bone around your front teeth over the last 4 years that is a concern and you need to find out what is causing it or it will continue.  I would suggest seeing a periodontist and have that person figure out exactly what is going on.  I don't like your dentists plan of waiting for the teeth to fall out and then doing a bridge.

Good Luck
Dr. Siegelman


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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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