Question:
I recently moved, and went to a new dentist today. He diagnosed me
with the early stages of periodontal disease and wants to schedule a
scaling for all four quadrants. According to what he showed me and
the chart he recorded, I have many 5mm pockets (around 2/3 of my
teeth), with the rest 4mm and 3mm. He took these measurements in a
matter of 2-3 minutes by poking his tool into my gum in various
places. I also had full X-rays taken, but he told me after looking at
those (but before actually performing an examination) that he didn't
see any problems.
The dentist has been practicing for some time, so I consider it
unlikely that he misdiagnosed me. However, I'm only 22 and my
understanding is that it is pretty unusual to have periodontal disease
at this age. It had been about 8 months since my last checkup, and
I've never gone more than 8 months between visits. I have no family
history of this, although both myself and my (younger) siblings have
been told that we have an above-average plaque buildup.
My home care consists of brushing once per day, flossing approximately
every other day (although I didn't start until about two years ago),
and using antiseptic mouthwash almost every day (although I didn't
start that until about one year ago). The dentist tells me that there
is not a problem with bone loss, but that there likely will be in the
future without the scaling.
Essentially, my question is how common this situation is and if it
would be wise for me to seek a second opinion. I'll happily have the
scaling done and consider myself lucky to have the problem caught so
early, but since this was my first visit to this dentist I can't help
but be skeptical. Are there any risks of complications if the scaling
is done unnecessarily?
Answer:
It is a little unusual for a person of your age to have periodontal disease.
However I don't have you in my chair.
Ask your doctor if you could wait six months, to have the hyg clean your teeth
now and see how it goes. He'll balk, I'm sure. Dental people don't like to
leave infections.
Regarding home care, you must start on a waterpik. The home care you
described, is inadequate for pocket readings over 3mm.
I only say this because I recently read a report somewhere, in a dental
journal, that more diagnosis occurs on new patients than any other group.
Because there is now history to reflect on. This can be good or bad.
Disregard everything if you use tobacco products, drink over a 6pk a day of
beer or other liquor, or have diabetes, heart trouble or heart trouble in your
family, or any other YES on a health history.
Many 5 mm pockets in a 22 yr old is kind of unusual. It sounds like you
build up a lot of calculus (tartar). This build-up really irritates the
gums, causes inflammation, which in turn can cause the deep readings.
(Plaque is different, it is the soft stuff that you can brush and floss off.
Old plaque that has mineralized into a hard substance is calculus)
There are some people who cannot wait 8 months between scalings just because
they grow so much calculus. Or, perhaps for the last few years, you have
had cleanings above the gums, but none below. And thus, the calculus was
building up under there. I'm just guessing.
Anyway, it sounds like quadrant scaling would be a good idea. With smooth
roots and teeth, and flossing every other day, hopefully your pockets will
all heal up.
For other good information, please see connections with Ehlers-Danlos
Syndrome, and other rheumatoid arthritic connections ......
After all, the periodontal ligament, like other ligaments is nothing
more than collagen!
I needed some electrical outlets placed. My electrician (a new one)
told me I needed my entire circuit board replaced first.
My policy:
1. Get a second opinion first about overutilization.
2. Make sure the proposed treatment (improvement) is up to
professional standards and the fee (price) is fair ......
