When I went to the periodontist and had a deep cleaning done, I had only 3s and a couple of 4s. I had the deep cleaning and now am on a 3 month cleaning schedule rotating between the periodontist and the regular dentist.
I'm glad I did it honestly. I look at it like preventive maintenance that certainly kept it from progressing and will hopefully keep me from having to have anything worse done like gum surgery. My periodontist visits are just like my visits to the regular doc and they send notes back and forth on the in-between visits. It's worked really well for me. Like other health issues, I'd rather catch it early.
I have to tell you, we can argue about causation, but there is a strong relationship between gingivitis (periodontits) and heart disease. I think most argue that it is related to systemic inflammation.
There is a difference between gingivitis and periodontitis. Gingivitis is an inflammation of gum tissue in response to certain bacteria. Periodontitis is the progression of bacterial destruction to the bone which results in bony-walled defects that must be repaired through surgical flap procedures, debridement and replacement of osseous structures with synthetic bone. While bone cannot be repaired once it is lost, there is the ability to regenerate some attachment. This can only be done surgically.
I have been in practice for 26 years and actually do a lot of periodontal procedures in my practice. I have a very good understanding of the whole process. I have also run a dental business for 26 years and I have a good understanding of that as well. In my opinion of Joe's circumstances, limited as that may be without actually seeing him myself, I still stand by my original statement. Root planing removes deep tartar. If he was being seen on a regular basis I am not sure why this tartar was not debrided earlier by his dental team. In any event, I am sure he could get a thorough cleaning (one that will sufficiently clean 4 mm pockets) without having to be injected per quadrant and needing to return on four separate occasions. True root planing should be done by quadrant, with anesthesia and take at least 45 minutes per quadrant.
Thanks for the clarification. Sadly, I know the difference between gingivitis and periodontitis, I have periodontitis. While we can say call them different names, I consider them the same condition along a continuum.
But as I learned more about gingivitis, I also learned of the strong connection between the inflammation in your mouth and other conditions like heart disease. I think there is still a lot we don't know, but I think we would both encourage Joe to work to clear up his gingivitis, not only because of the risks to his dental health but because this condition may in fact present real and serious risks to his overall heart health.
I so appreciate everyone's interest and concern about their oral health. I try every day to impart this knowledge to my patients. Some are accepting and others not so much. Brian you are correct that inflammation in the mouth is the same as inflammation anywhere in the body. It activates the immune response which in turn can trigger a whole host of other problems.
That said, and possibly because I am old school and may give away a lot of free dentistry, when I clean teeth (and I do about 70% of my own cleanings) I always scale to the depth of each pocket of each and every tooth. It's just that I don't charge my patients for root planing. The only time I schedule root planing is when a new patient comes in with a gross amount of tartar and I know there is no way on earth I can properly clean in one visit.
Interesting to note that when I do surgical procedures (and I do quite a lot of perio surgery) I always find a lot of tartar remaining on the roots below...even on those who are root planed. I do believe for those who suffer from periodontitis that surgical reduction of pockets is the only way
Mine was done in two sessions of 2 hours each also under local anesthesia. Honestly the worst part for me was keeping my mouth open that long; maybe because my pockets were less advanced I really did not have alot of pain. Some soreness after but nothing to the point of affecting my normal activities.
To me, it was just sort of like an "advanced" regular dentist visit. I was really apprehensive about it beforehand but it was not nearly as bad as I imagined it would be.
Now the thought of the gum surgeries, etc. scare me to death so that's one reason why I went ahead with it to avoid something worse.
I find the hygenists at my periodontist have a much better "touch" than at my regular dentist. I don't know if that's just coincidence or if they have additional training of some sort.
Well, I suppose it's not something I'll worry about. My resting heart rate is 48. I can jump on a bicycle and ride over a 10,000' mountain pass. Any day of the week. The only thing systematically inflamed is my aching quads after a 6 hour bike race. :)
I know I'm a little late to the conversation but I'm kind of in the same boat. have type 1 diabetes and my gums are in not great shape. Had part of a deep cleaning done and heard lots of 5's and 6's. The dentist told me there was a possibility of needing to get a gum graft. A family member was told they also need one and got a price estimate of around $10,000 for the procedure. I contacted my health insurance and they told me that if I can get my doctor to provide something to show medical necessity my health insurance would cover it. My Endocrinologist says we could certainly make a case for the medical necessity of the gum grafting with regard to potential adverse effects of untreated gum disease on diabetes control. There is quite a bit of literature on the topic that would support this. Maybe the same can be said for your deep cleaning requirement. Can't hurt just to ask your health insurance company & your specialist or PCP.
