Question:
I would like to ask a question about my dentist.
Recently, my wife went in for a checkup and he stated
that she needed a root planing. He teeth were pretty
bad so we went ahead with it.
I also visited him and he also stated that I need a the
same thing. Now, I am not going to say that my teeth are
perfect but, I never had a cavity yet, my gums are just a
little puffy and red, and I dont think I need it. I am
a 25 yr. old male with almost perfect teeth(just need an
orthodontist to fix the small gap between my two front upper
teeth.)
Just about 2 weeks ago, I went on vacation and visited my old
dentist and he stated that this other dentist is stupid and wrong!
He also stated that almost 80% of the population walks around with
gingivitis and almost everyone has some sort of a small case of
gum disease. He cleaned my teeth and stated that my teeth are
fine and that not to beleive the other dentist.
Who should I beleive?
My old dentist also stated that I have alot of calcium in my
saliva and that is why I get an unusual amount of calcium deposit
on the back side of my front bottom jaw teeth....
Can anyone give me some info and help?!
Answer:
This is most likely two differing opinions of how to treat patients.
One is more conservative,
"Don't fix it if it ain't broke."
and another being more agressive.
Most dental problems are chronic in nature, so each dentist COULD be
correct. One is intervening to prevent future problems, the other
relies more on the natural healing process and YOU!
If this guy has periodontal pockets 4mm deep or more, he needs root
planing. Otherwise, he needs a good cleaning.
I really wish people would get away from the numbers game. A 4mm pocket
has nothing to do with whether or not root planing is necessary.
Whether or not attachment loss is present is what would determine if
root planing is necessary. A 4mm pocket can be present without any
attachment loss (pseudopocket) and root planing would not be indicated
(there is no root surface to plane). You can also have situations where
root planing is indicated in "pockets" of 3mm or less, if attachment
loss is present (ie, recession present with exposed root surface).
"too much calcium in your saliva" is a pretty simple way of putting it but
not a totally bad one. Many factors decide how much calculus are deposited
on your teeth, including your saliva's pH.
But the most important one is the thouroughness of your dental hygiene,
including daily flossing.
If any of the two dentist has explained this to you and offered to help you
in mastering your flossing technique, choose that one...
N.B. If you have periodontal disease truely recquiring root planing, no
"natural healing process" (as the other guy talked about) will save your
teeth in the long run.
What follows below is very good advice. You know, home care. What you
contribute to your own dental health is really quite valuable. A high
school friend brushed his teeth 20 or more times a day. He had
wonderful teeth and gums. I encourage patients to follow these good
examples.
I am asked and tell patients that I'm not sure why some people have
heavy calculus (tartar). This of course, is the calcium deposits which
you refer to. It might be dietary, genetic or who knows what? I'm open
to suggestions as to etiology.
There was a dental clinic/office that went out of business in
Massachusetts because everyone who became a patient was told that they
needed 4 quadrants of scaling and root planing.
