Pyorrhea, Periodontitis

Pyorrhea, Periodontitis

Hello,

I have a question about Pyorrhea: Recently, I experienced this, on
the outer portion of the gum, Lower Right Quadrant.

I went to a periodontist, they are suggesting to remove the tooth and
the wisdom tooth behind it (47-48 respectively) The pocket is
nearing 11mm (I think it is less than that) I am told there is lots of
bone loss in this area, though on the X-Ray, does not look so bad,
there is bone still there

i.e.

|...| (... = Regular bone level)
--- (Present bone level)

A bit reluctant about the removal, would prefer to keep the teeth (at
least the wisdom one behind the problematic area, which is not loose,
but teeth apparently migrate into empty spaces, so that's an issue)

1. Any advice on preserving the teeth? Could a deeper, perio cleaning
help?

2. Anything I should know about the removal process?

3. What happens after removal? Does the Periodontitis still persist?
Does bone loss still continue, even after removal?

4. Is it possible for the gums to heal, after a Periodontist cleans
it, making the tooth stronger?

Re: Pyorrhea, Periodontitis


<bruce1vain@gmail,com > wrote in message
news:642e82c7-c9ef-4c70-bfd8-aa5b45723196@f63g2000hsf.googlegroups,com ...
> Hello,
>
> I have a question about Pyorrhea: Recently, I experienced this, on
> the outer portion of the gum, Lower Right Quadrant.
>
> I went to a periodontist, they are suggesting to remove the tooth and
> the wisdom tooth behind it (47-48 respectively) The pocket is
> nearing 11mm (I think it is less than that) I am told there is lots of
> bone loss in this area, though on the X-Ray, does not look so bad,
> there is bone still there
>
> i.e.
>
> |...| (... = Regular bone level)
> --- (Present bone level)
>
> A bit reluctant about the removal, would prefer to keep the teeth (at
> least the wisdom one behind the problematic area, which is not loose,
> but teeth apparently migrate into empty spaces, so that's an issue)
>
> 1. Any advice on preserving the teeth? Could a deeper, perio cleaning
> help?
>
> 2. Anything I should know about the removal process?
>
> 3. What happens after removal? Does the Periodontitis still persist?
> Does bone loss still continue, even after removal?
>
> 4. Is it possible for the gums to heal, after a Periodontist cleans
> it, making the tooth stronger?
>
I too had some deep pockets ( 12 mm ) and my Periodontist has
been able to reduce them to 2 mm through deep cleaning. Four teeth
were considered very periodontically unsound, present age 58yrs.
He originally wanted to do extractions and implants where the bone
was sufficient. However he went along with my preference for giving
deep cleaning a go. For this to have a chance you have to be
rigorous in your own daily cleaning and flossing. Two years on
and I still have all of my teeth except for 2 that were lost 20
years ago. The doc seems pleased but I have been warned that
things could turn for the worse, especially with any let up in
oral hygine. Tell your Perio you want to keep your teeth unless
he can mount a very solid counter argument!
Oh, and he did say that removal of teeth stops the disease in
its tracks.
Good Luck. Mick.

Re: Pyorrhea, Periodontitis

Hi Mick,

Thanks a lot for the info. Did you have a root canal as well?

And, as for the following:

>Probably already 'bought' it.
>;-(
>D

I don't think so, and I do not find any humour in this.

On Apr 7, 6:03 am, "Michael" <mikh...@bigpond,com > wrote:
> <bruce1v...@gmail,com > wrote in message
>
> news:642e82c7-c9ef-4c70-bfd8-aa5b45723196@f63g2000hsf.googlegroups,com ...
>
> > Hello,
>
> > I have a question about Pyorrhea: Recently, I experienced this, on
> > the outer portion of the gum, Lower Right Quadrant.
>
> > I went to a periodontist, they are suggesting to remove the tooth and
> > the wisdom tooth behind it (47-48 respectively) The pocket is
> > nearing 11mm (I think it is less than that) I am told there is lots of
> > bone loss in this area, though on the X-Ray, does not look so bad,
> > there is bone still there
>
> > i.e.
>
> > |...| (... = Regular bone level)
> > --- (Present bone level)
>
> > A bit reluctant about the removal, would prefer to keep the teeth (at
> > least the wisdom one behind the problematic area, which is not loose,
> > but teeth apparently migrate into empty spaces, so that's an issue)
>
> > 1. Any advice on preserving the teeth? Could a deeper, perio cleaning
> > help?
>
> > 2. Anything I should know about the removal process?
>
> > 3. What happens after removal? Does the Periodontitis still persist?
> > Does bone loss still continue, even after removal?
>
> > 4. Is it possible for the gums to heal, after a Periodontist cleans
> > it, making the tooth stronger?
>
> I too had some deep pockets ( 12 mm ) and my Periodontist has
> been able to reduce them to 2 mm through deep cleaning. Four teeth
> were considered very periodontically unsound, present age 58yrs.
> He originally wanted to do extractions and implants where the bone
> was sufficient. However he went along with my preference for giving
> deep cleaning a go. For this to have a chance you have to be
> rigorous in your own daily cleaning and flossing. Two years on
> and I still have all of my teeth except for 2 that were lost 20
> years ago. The doc seems pleased but I have been warned that
> things could turn for the worse, especially with any let up in
> oral hygine. Tell your Perio you want to keep your teeth unless
> he can mount a very solid counter argument!
> Oh, and he did say that removal of teeth stops the disease in
> its tracks.
> Good Luck. Mick.

Re: Pyorrhea, Periodontitis


<bruce1vain@gmail,com > wrote in message
news:03c22544-52bb-408c-9cb6-fbbd72dab27f@x41g2000hsb.googlegroups,com ...
> Hi Mick,
>
> Thanks a lot for the info. Did you have a root canal as well?
>
> And, as for the following:
>
>>Probably already 'bought' it.
>>;-(
>>D
>
> I don't think so, and I do not find any humour in this.
>
> On Apr 7, 6:03 am, "Michael" <mikh...@bigpond,com > wrote:
>> <bruce1v...@gmail,com > wrote in message
>>
>> news:642e82c7-c9ef-4c70-bfd8-aa5b45723196@f63g2000hsf.googlegroups,com ...
>>
>> > Hello,
>>
>> > I have a question about Pyorrhea: Recently, I experienced this, on
>> > the outer portion of the gum, Lower Right Quadrant.
>>
>> > I went to a periodontist, they are suggesting to remove the tooth and
>> > the wisdom tooth behind it (47-48 respectively) The pocket is
>> > nearing 11mm (I think it is less than that) I am told there is lots of
>> > bone loss in this area, though on the X-Ray, does not look so bad,
>> > there is bone still there
>>
>> > i.e.
>>
>> > |...| (... = Regular bone level)
>> > --- (Present bone level)
>>
>> > A bit reluctant about the removal, would prefer to keep the teeth (at
>> > least the wisdom one behind the problematic area, which is not loose,
>> > but teeth apparently migrate into empty spaces, so that's an issue)
>>
>> > 1. Any advice on preserving the teeth? Could a deeper, perio cleaning
>> > help?
>>
>> > 2. Anything I should know about the removal process?
>>
>> > 3. What happens after removal? Does the Periodontitis still persist?
>> > Does bone loss still continue, even after removal?
>>
>> > 4. Is it possible for the gums to heal, after a Periodontist cleans
>> > it, making the tooth stronger?
>>
>> I too had some deep pockets ( 12 mm ) and my Periodontist has
>> been able to reduce them to 2 mm through deep cleaning. Four teeth
>> were considered very periodontically unsound, present age 58yrs.
>> He originally wanted to do extractions and implants where the bone
>> was sufficient. However he went along with my preference for giving
>> deep cleaning a go. For this to have a chance you have to be
>> rigorous in your own daily cleaning and flossing. Two years on
>> and I still have all of my teeth except for 2 that were lost 20
>> years ago. The doc seems pleased but I have been warned that
>> things could turn for the worse, especially with any let up in
>> oral hygine. Tell your Perio you want to keep your teeth unless
>> he can mount a very solid counter argument!
>> Oh, and he did say that removal of teeth stops the disease in
>> its tracks.
>> Good Luck. Mick.
>

No root canals. But 6 fillings, scaling, root planing and gum curatage
were performed by a dentist before he sent me off to the Perio for
further assessment. Took about 6 hours ( in 4 sessions ) in the
chair with the dentist and 40 minutes ( 2 sessions ) with the Perio
doing the deep pocket cleaning.
I'll let you guess which guy cost the most!
Cheers Mick.

Re: Pyorrhea, Periodontitis



>>Probably already 'bought' it.
>>;-(
>>D
>
>
> I don't think so, and I do not find any humour in this.


OK dude. Just let me know in a couple of years that you
still have this tooth and that it only cost ???

Bet it's gone and you lost a bundle (if you can find anyone
to take your money to try and keep it).

Best wishes,
Steve

Re: Pyorrhea, Periodontitis



If you notice the emoticon, it is with a frown. Sometimes
people need someone to shake them into reality. 11 mm pockets
are just not normally treatable with any long term success.

A possible exception is if this is a lesion that began with
endodontic problems in the tooth and there is no other significant
perio disease in the rest of your mouth (and you aren't a smoker).

All we have to go on is the words on the screen. A real life
exam is needed for any concrete statements.

11 mm pockets just do not create much optimism.

D

bruce1vain@gmail,com wrote:

> And, as for the following:
>
>
>>Probably already 'bought' it.
>>;-(
>>D
>
>
> I don't think so, and I do not find any humour in this.

Re: Pyorrhea, Periodontitis


> 11 mm pockets just do not create much optimism.

Unless you were *hoping* for a bridge or implant.

<grin>

Re: Pyorrhea, Periodontitis



Had a fellow in this morning who had a couple of 5's. The
rest were 7-9 <OUCH>. 50% bone loss throughout. Off to
the periodontist, but likely headed for plastic in the long
run.

D

Amatus Cremona wrote:

>>11 mm pockets just do not create much optimism.
>
>
> Unless you were *hoping* for a bridge or implant.
>
> <grin>
>
>

Re: Pyorrhea, Periodontitis

On Apr 9, 9:53 am, Dartos <tuthjoc...@myturbonet,com > wrote:
> If you notice the emoticon, it is with a frown. Sometimes
> people need someone to shake them into reality. 11 mm pockets
> are just not normally treatable with any long term success.
>
> A possible exception is if this is a lesion that began with
> endodontic problems in the tooth and there is no other significant
> perio disease in the rest of your mouth (and you aren't a smoker).
>
> All we have to go on is the words on the screen. A real life
> exam is needed for any concrete statements.
>
> 11 mm pockets just do not create much optimism.
>
> D
>

Thanks for the info. I don't smoke, though Periodontitis is a
problem in other regions, and this is for a young person The tooth
question, which has the problem, began with a tiny cavity. Had that
filled (the dentist I visited used some new age material, did not
bother to do a traditional filling because it was so small) 7 months
later, this started, with a swollen gum, then the Pyorrhea (which was
never a problem before)

My dentist and the perio have both suggested that Periodontitis is the
problem. Ideally, I would have preferred to keep the tooth, get the
area cleaned properly, as in a perio deep cleaning. (My dentist has
suggested that I could keep it for a year or two this way) Though
there is some pain, and some looseness when pressed hard, it still
feels quite strong. On the X-Ray, it *looked* to me like a 4mm loss,
but not more than that (Will have to check this again)

If not, what are the after effects of a removal? For example, I have
heard that bite problems can occur, or that other teeth, can become
loose because of a missing tooth, a whole range of issues.

P.S. Any tips on what I should look for in a good Periodontist?

Re: Pyorrhea, Periodontitis



On the X-Ray, it *looked* to me like a 4mm loss,
> but not more than that (Will have to check this again)

X-rays are two dimensional representations. Pocket location may
prevent a true indication of total bone loss on film. That's
why probing and measuring pockets is essential to help diagnose
the problems.

It is also possible to have a 'walled defect'. IOW's the whole of
the bone around the root has not resorbed, but there is space between
the root and the bone. There is more hope of gaining new attachment
under this condition.

> If not, what are the after effects of a removal? For example, I have
> heard that bite problems can occur, or that other teeth, can become
> loose because of a missing tooth, a whole range of issues.

Depends on which tooth, the condition of the remaining teeth, occlusion,
parafunctional habits, etc. (IOW's can't say from here <G>)

> P.S. Any tips on what I should look for in a good Periodontist?

A referal from your present dentist?

D

Re: Pyorrhea, Periodontitis

Get a second opinion in real life

--
/

Amatus

/
<bruce1vain@gmail,com > wrote in message
news:642e82c7-c9ef-4c70-bfd8-aa5b45723196@f63g2000hsf.googlegroups,com ...
> Hello,
>
> I have a question about Pyorrhea: Recently, I experienced this, on
> the outer portion of the gum, Lower Right Quadrant.
>
> I went to a periodontist, they are suggesting to remove the tooth and
> the wisdom tooth behind it (47-48 respectively) The pocket is
> nearing 11mm (I think it is less than that) I am told there is lots of
> bone loss in this area, though on the X-Ray, does not look so bad,
> there is bone still there
>
> i.e.
>
> |...| (... = Regular bone level)
> --- (Present bone level)
>
> A bit reluctant about the removal, would prefer to keep the teeth (at
> least the wisdom one behind the problematic area, which is not loose,
> but teeth apparently migrate into empty spaces, so that's an issue)
>
> 1. Any advice on preserving the teeth? Could a deeper, perio cleaning
> help?
>
> 2. Anything I should know about the removal process?
>
> 3. What happens after removal? Does the Periodontitis still persist?
> Does bone loss still continue, even after removal?
>
> 4. Is it possible for the gums to heal, after a Periodontist cleans
> it, making the tooth stronger?
>

Re: Pyorrhea, Periodontitis

bruce1vain@gmail,com wrote:
> Hello,
>
> I have a question about Pyorrhea: Recently, I experienced this, on
> the outer portion of the gum, Lower Right Quadrant.
>
> I went to a periodontist, they are suggesting to remove the tooth and
> the wisdom tooth behind it (47-48 respectively) The pocket is
> nearing 11mm (I think it is less than that) I am told there is lots of
> bone loss in this area, though on the X-Ray, does not look so bad,
> there is bone still there
>
> i.e.
>
> |...| (... = Regular bone level)
> --- (Present bone level)
>
> A bit reluctant about the removal, would prefer to keep the teeth (at
> least the wisdom one behind the problematic area, which is not loose,
> but teeth apparently migrate into empty spaces, so that's an issue)
>
> 1. Any advice on preserving the teeth? Could a deeper, perio cleaning
> help?
>

Agree with AC. Get a second opinion.


> 2. Anything I should know about the removal process?


Most of these are pretty routine extractions.

>
> 3. What happens after removal? Does the Periodontitis still persist?
> Does bone loss still continue, even after removal?


By definition, the periodontal process will no longer be present after
healing at THAT site. However, if you've got periodontal disease of
this severity, you likely have it in other areas of your mouth.
Even after extraction, there is some continued bone loss. This is
unrelated to the periodontal disease previously in this area.


>
> 4. Is it possible for the gums to heal, after a Periodontist cleans
> it, making the tooth stronger?
>


With anywhere near 11 mm pockets, I wouldn't bet the farm.

Steve


--
Mark & Steven Bornfeld DDS
http :// www .dentaltwins,com
Brooklyn, NY
718-258-5001

Re: Pyorrhea, Periodontitis



Probably already 'bought' it.

;-(
D

> With anywhere near 11 mm pockets, I wouldn't bet the farm.
>
> Steve
>
>