Scaling and arrestin for 4mm pockets?

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Brandover in Bradenton, Florida

55 months ago

My name is Brandy and I work at North River Dental. Periodontal disease is very complicated with several factors. I have been a Dental Hygienist for several years. I recommend SRP in areas with 5 mm pockets and bleeding upon probing. No way shape or form can floss and tooth brush bristles reach straight down the side of a tooth 5 mm's. Periodontal disease is literally the loss of bone and supporting structure of a tooth! The evidence is all in the x-rays. If bone loss is not present than it may be gingivitis which is easily treated with a general cleaning and an oral rinse (Peridex, diluted Peroxide or even warm salt water rinses). I sometimes will ask the patient to come back in 6 weeks to re-evaluate the area(s). Ask how much bone loss you have. If they say none or crestal (less than 10%) get a second opinion. Also ask if the calculus is radiographic (seen in the x-rays); if it is radiographic than the probing may be 4 mm's but the probe is hitting the top of the calculus which is trapping the infection within the calculus and must be scaled off to prevent further bone loss. It is like having barnacles on a boat than need to be removed. If you try to polish a boat with barnacles you are wasting you time and energy. Like wise, if you are doing a prophy on an infected tooth you are wasting you time and money (or insurance benefits). Most people have $1,500 benefit per year why waste $89 of it on treatment that does not good. Actually, it could cause gingival abscesses (depending on the severity of periodontal disease). Because periodontal disease has NO pain people are less inclined to believe something is wrong until they are diagnosed with other health complications which are a direct link to the disease they are swollowing from their gums. If a patient has several 4 mm pockets in a single quadrant and subgingival tartar or bleeding than an SPR may be needed. Prior to the SRP treatment another full mouth probe should be completed.

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Brandover in Bradenton, Florida

55 months ago

My name is Brandy and I work at North River Dental in Ellenton, FL. Although I live in FL and our local school, SCF, does do follow up treatments and regular cleanings as I'm sure most in the U.S. do as well. Time heals all pain. Sorry to say but after the cleaning it could take up to 6 months to heal properly (none of which causes any more pain than you currently have; normally makes things better with fluoride treatments and oral rinses) and the rest of your life to maintain the periodontal pathogens that cause periodontal disease. These bacteria are opportunistic meaning that a seasonal cold with bacteria, foods that cause gum irritation (popcorn, pizza and hard bread), stress, hormone changes, grinding and dry mouth which are normally caused by medications all usually set the infection in motion. DO NOT be discouraged because 80% of all Americas have active periodontal disease at some point in their lives. Floss, floss, floss.

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autum in Nashua, New Hampshire

50 months ago

I have had numerous deep scaling done and have been on perio maintenance debridement. They do not use every time the special liquid for had the debridement done. Nothing really to kill the bacteria and my pockets are not better but worse, plus they always send me home without any special rinses but toothbrush and paste and crest products. Some how I'm feeling duped. Wished I had researched more.

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sdavisrdh in Huntington Beach, California

48 months ago

Has no one ever recommended a water pik to you? Brushing and flossing only get maybe 4mm into the pocket. The waterpik flushes bacterial biofilm away. If you have had numerous deep scaling and still need them every once in awhile, then your home care needs to be revamped. I have many patients who use a waterpik daily, with water only and not adding any rinses, and they are maintaining their gums beautifully and do not have any bleeding even during their cleanings! Try it, you will see.

autum in Nashua, New Hampshire said: I have had numerous deep scaling done and have been on perio maintenance debridement. They do not use every time the special liquid for had the debridement done. Nothing really to kill the bacteria and my pockets are not better but worse, plus they always send me home without any special rinses but toothbrush and paste and crest products. Some how I'm feeling duped. Wished I had researched more.

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Jack P. in White Plains, New York

48 months ago

Just a general comment. It would be helpful if the healthcare professionals replying to patients in this blog would identify themselves including, title, education and years of experience. Without this we do not know how to evaluate your advice and response. I note that one responder above noted that Listerine was the only mouthwash approved by the ADA. Well,I tend to be cynical and would like to know how that recommendation came about.

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FlossBoss in Oceanside, California

48 months ago

Jack P. in White Plains, New York said: Just a general comment. I note that one responder above noted that Listerine was the only mouthwash approved by the ADA. Well,I tend to be cynical and would like to know how that recommendation came about.

There are many many mouthwashes besides Listerine that have been approved by the ADA. Here is a list...Go to the source and do not always believe everything people say.

www.ada.org/ada/seal/shoppinglist.aspx

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Jack P. in White Plains, New York

48 months ago

I thank you for your response which goes to the first point in my comment which either did not go through or was deleted.

I will repeat it. Why aren't the credentials ( i.e. experience, education and background) of the professional responders shown? How does the patient know how to evalute the answer if he does not know the source?

With this in mind, I recomend that credentials be included in the professional replies.

I look forward to your response.

Thank you

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autum in Merrimack, New Hampshire

48 months ago

sdavisrdh in Huntington Beach, California said: Has no one ever recommended a water pik to you? Brushing and flossing only get maybe 4mm into the pocket. The waterpik flushes bacterial biofilm away. If you have had numerous deep scaling and still need them every once in awhile, then your home care needs to be revamped. I have many patients who use a waterpik daily, with water only and not adding any rinses, and they are maintaining their gums beautifully and do not have any bleeding even during their cleanings! Try it, you will see.

The practice never ever mentioned waterpik to me, or any special rinse. It was as if they're hoping my pockets would get worse so they can be extracted. The time when I came down with a really bad gum infection, they did not prescribe me any antibiotics or rinse. I have since that time done a lot of research and decided to buy a waterpik and be religious with my home care. I also ready about Judy Carroll's RPE and emdogain that have treated a lot of perio patients successfully reducing deep pockets from 15mm to a healthy depth. I am consider this and hope she opens a practice in my area soon. I have recently changed my dentist and the new one did a thorough job of evaluating my teeth and gum and my last treatment involved using Arrestin. We'll see how that goes in 3 months, but from what I'm reading here I should have it checked after a month.

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Slee in Orlando, Florida

48 months ago

I have several 6 depth pockets, 3 with bleeding. This is an improvement from 3 weeks ago when 15 were bleeding. Some of the depths improved too.

Now I'm told I need scaling and medicine put in them. Isn't 12 stopping bleeding in a few weeks a good sign of improvement?

Also, I told the dentist I have a super durable nightguard top/bottom but it's 8 years old and definitely has a lot of build up at this point. I wondered if that contributed to the pockets or inflamation. She kind of shrugged this off and said they needed to the scaling/medicine first to see how that went, before thinking about the nightguard.

Does that seem a bit fishy to anyone? If build up and deposits on teeth cause infection/inflamation, then wouldn't they do so on something that they are pressed into all night long? Yes I clean the thing often, but after 8 yrs there's plenty that just doesn't come off.

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Iluvteeth in San Jose, California

48 months ago

You should take your nightguard to dentist, some of the build up may come off if they clean it.
And 6mm pockets you most def need scaling and root planing. Inflammation is caused by an inflammatory response by the body to BACTERIA, periodontal pathogens. The calculus does cause some inflammation but more importantly it causes retention and proliferation of the colony of bacteria.
Why do people question there perio disease? It is an infection, a disease if you had an infection on your arm you would most certainly take care of it.

Slee in Orlando, Florida said: I have several 6 depth pockets, 3 with bleeding. This is an improvement from 3 weeks ago when 15 were bleeding. Some of the depths improved too.

Now I'm told I need scaling and medicine put in them. Isn't 12 stopping bleeding in a few weeks a good sign of improvement?

Also, I told the dentist I have a super durable nightguard top/bottom but it's 8 years old and definitely has a lot of build up at this point. I wondered if that contributed to the pockets or inflamation. She kind of shrugged this off and said they needed to the scaling/medicine first to see how that went, before thinking about the nightguard.

Does that seem a bit fishy to anyone? If build up and deposits on teeth cause infection/inflamation, then wouldn't they do so on something that they are pressed into all night long? Yes I clean the thing often, but after 8 yrs there's plenty that just doesn't come off.

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Slee in Orlando, Florida

48 months ago

They don't want to clean it until after the scaling and appliction of something in the pockets. So every night I am putting something with old crud and possibly bacteria back on my teeth and gums.

I apparently recovered some with just upping the home care, but they want to charge me for something before taking care of something that could be creating or aggravating the problem in the first place.

So you bet I question it, just like I would if a doc wanted to suture that arm up with a piece of wood still sticking in it.

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autum in Manchester, New Hampshire

48 months ago

I switched dentist and the new one did a thorough job at evaluating me, but I'm thinking they're only doing it to impress me so I'll stay right. Anyway since they have all of my xrays and known depth of my gum they could have just simply poked my gum deep enough to confirm that the infected tooth is the depth I left my other dentist with. Wow no change although I am more religious now with my dental care. I'm even adding waterpik to my flossing and routine as well as supplements. I am hearing better numbers though on my other teeth.

I had an area treated with Arestin and though I was not suppose to floss it for 10 days I was beginning to feel itchy in the area. Could this be normal? I floss 3 days early than I'm told because of the fear of another infection. Does arestin mean to stop me from doing my job, so that the infection gets worse? I was feeling fine before the SandR. They should have left me alone.

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Cora in Tucson, Arizona

47 months ago

Matthew in Brighton, Massachusetts said: I work as an RDH and I am not a firm believer in Arestin. Periodontal disease is a chronic disease that is very difficult to treat. You CAN NOT cure periodontal disease, once you have it you have it for life. I am not even really a firm believer in quadrant scaling unless it's 5-6mm pocketing or less. Good luck trying to instrument to the base of a 7mm or > pocket and remove all of the subgingival calculus (can possibly be done by experienced hygienist, but I would say there are few out there). I am a FIRM believer that once a patient has periodontal disease they should be under the CONSISTENT and FREQUENT care of a periodontist...not a general dentist who thinks they know what they are doing. Periodontal disease is with you for life, so investing $1000 at one visit is not going to cure your disease. I see patients that would probably do fine for their whole life with 4-5mm pockets as long as they stay on a routine cleaning schedule (4-6 months). GENETICS plays a HUGE role in periodontal disease. Yes, brushing and flossing help significantly...but I see patients on a daily basis that haven't flossed a day in their life and DO NOT show any signs of periodontal disease (generalized mild to moderate gingivits). I also see patients that floss 2x daily and still cannot reduce the 4,5, and 6 mm pockets. Many factors come into play with periodontal disease....hygiene, genetics, TOOTH POSITIONING, composition of minerals in your saliva (which may allow you to build calculus/tartar quicker). They only perio procedure I would invest time or money in after 5mm is flaps. You cannot be sure the root surfaces is completely debrided unless you see it. That or a subgingival cam/microscope.

I wish I live in your area. Keep up your honesty. You will be rewarded in some ways for that. God Bless you.

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Yet another RDH in Ottawa, Ontario

47 months ago

Hello Matthew:
I couldn't agree more with your comments. I've encountered the same situations and I've had the exact same thoughts. I've worked both in perio and in general offices and honestly, the only way with regards to perio is to treat it aggessively with antibiotics, antifungals, scaling and root planing, and flap surgery. And then you cross your fingers... It's not a cure; it's just therapy. You hope for the best, but tooth loss, for many, is inevitable. That's not to say that you don't try to maintain what you can, but sadly, once the disease process has been initiated, one may be out of luck.

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Alex Bauman in Schaumburg, Illinois

47 months ago

I have a history of perio disease. My numbers had been improving with a 9-week cycle of cleanings (no 4s, no bleeding). My last cycle pushed to 13 weeks because my dentist canceled my appointment. It took me a few weeks to get a chance to get rescheduled. My numbers at the rescheduled exam included two 5s and eight to ten 4s with bleeding in a few spots. The hygienist recommended a deep cleaning. My insurance is maxed for the year, so they quoted me their full price of $1200. That seems outrageous to me. Am I being taken? The hygienist suggested I could wait until January to get the procedure done so my insurance would help pay for it. I questioned waiting two more months to get me teeth cleaned. She said that my teeth "might" get worse. She didn't seem to care when I did it as long as I agreed to the procedure.

I also wonder about the methods used to get my numbers done. This hygienist pushed the instrument into my gum until it was painful. Was she adding a number to the depth by being aggressive in the exam? I have had other hygienists in the same office check my numbers without causing me pain.

I would like to know if their price is too high and if I should seek a regular cleaning first to see if my numbers bounce back.

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exp in Exeter, New Hampshire

47 months ago

Alex Bauman in Schaumburg, Illinois said: I have a history of perio disease. My numbers had been improving with a 9-week cycle of cleanings (no 4s, no bleeding). My last cycle pushed to 13 weeks because my dentist canceled my appointment. It took me a few weeks to get a chance to get rescheduled. My numbers at the rescheduled exam included two 5s and eight to ten 4s with bleeding in a few spots. The hygienist recommended a deep cleaning. My insurance is maxed for the year, so they quoted me their full price of $1200. That seems outrageous to me. Am I being taken? The hygienist suggested I could wait until January to get the procedure done so my insurance would help pay for it. I questioned waiting two more months to get me teeth cleaned. She said that my teeth "might" get worse. She didn't seem to care when I did it as long as I agreed to the procedure.

I also wonder about the methods used to get my numbers done. This hygienist pushed the instrument into my gum until it was painful. Was she adding a number to the depth by being aggressive in the exam? I have had other hygienists in the same office check my numbers without causing me pain.

I would like to know if their price is too high and if I should seek a regular cleaning first to see if my numbers bounce back.

Hi, Check Periodontists and other General Dentists...to see if you can get quotes on quadrant scaling(s). Does this include Arestin placement? Some offices do this...some don't. As far as it helping the perio process it's 50/50 as to it's aide in perio disease. Call around , I'd like to see what you find out too.

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Iluvteeth in Patterson, California

47 months ago

If you are truely concerned about whether your perio is being adequetly diagnosed and treated/maintained you should see a periodontist.
With that being said 1200 is a normal price for full mouth sc/rp depending on your area but regardless of the area it Is not outrageous . I have never heard of an office including Arrestin In that amount of a fee because
Arrestin is $35-50+ site. I'm not going to tell you what the office pays for it but I will say it's not cheap. And it is only indicated for 5mm+ and bleeding. And even then most hygienists are not sold on whether it works because it is so inconsistent.
Wha is your homecare like? Be honest, do you bx for 2+min 2x day very thoroughly and floss at least 1x day. These are the minimum things you should be doing. Have you ever had perio surgery?
Do you have a lot of plaque/tartar In between these 9-13wks cleanings? If you do then something Is lacking in the technique of your homecare because your should be able to keep your plaque accumulation to very light in 9-13 weeks.
Also just so you know that deep cleanings full quadrant is only indicated if you have MORE than 3 teeth In each quadrant with 4mm or higher probings (4mm is what I consider yellow light I don't recommend deep
cleaning for 4mm). If you have 3teeth or less it is billed as a different proceudre that costs less
And yes there can be a 1mm discrepancy different between different clinicians. Why because it's 1mm, have you ever looked with what we measure with 1mm is small and most offices use perio probes with 3mm increments.
All in all if your unsure go see a periodontist. Take charge of your health.

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Alex Bauman in Schaumburg, Illinois

47 months ago

I have religiously cared for my teeth for the past ten years or so after not flossing when I was younger. I brush thoroughly at least three times a day and never miss flossing before bed. I sometimes add a flossing earlier in the day too.

I will call a few places to gauge the cost of the care for my area to see if my dentist is out of line.

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Alex Bauman in Schaumburg, Illinois

47 months ago

I should add that I never have much plaque build up. My hygienists' comments about my plaque build up have always been about how little plaque I have. My understanding is that my plaque build up is considerably less than normal.

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maria from vienna virginia in Washington, District of Columbia

47 months ago

can someone send me template of letters to insurance to cover scaling and root planning.

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maria from vienna virginia in Washington, District of Columbia

47 months ago

can someone send me template of letters to insurance to cover scaling and root planning.

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Jack P. in White Plains, New York

47 months ago

Since you chose to ignore my request to show the credentials and eduction of the healthcare professionals responding to individuals, please unsubscribe me from your blog.

Thank you

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exp in Exeter, New Hampshire

47 months ago

Jack....if you want to unsubscribe....just don't come to this page.

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Jack P. in White Plains, New York

47 months ago

I'm not coming to your page. I'm receiving e-mails. Please unsubscribe.

Thank you

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exp in Exeter, New Hampshire

47 months ago

Jack, Maybe , you need to find a phone number on the mainpage for Indeed, speak to an actual person....and or find an e-mail...GL. P.S. Are you a patient or Dentist? I would say that the majority of us are REAL RDH's and then there are a few instigators. GL on the above or....just keep deleting the material until you contact Indeed directly.

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greeneyedprincess in Erin, Tennessee

46 months ago

Ok I am 25 and I went to the dentist and they told me I had slighty peridontal disease. I am terrified of loosing my teeth. It's my fault becuase I was not the greatest at taking care of them. They want to schedul a deep cleaning. They had measured my gums. Nothing was over a 3 but I had alot of 3's. Also, i have bad decay and im scared that when they go to do my deep cleaning on bottom where they decay is that my teeth will start breaking... Anybody with same issues please help me. If i push up on bottom gums u can see what appears to be plaque come or squish up. he said I needed a bridge but not sure where. if he thought my teeth were that bad would he schedule to do a deep cleaning. So evidently they must be salvageable right. my bottom 6 are the worst. even turning blue on back of teeth and u can see the plaque build up.

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ferby8 in Newark, Delaware

46 months ago

If you have several 4-5mm pockets in localized areas and are a grinder, it is most likely a mechanics issue.

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ferby8 in Newark, Delaware

46 months ago

maria from vienna virginia in Washington, District of Columbia said: can someone send me template of letters to insurance to cover scaling and root planning.

Letters?

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green eyes in Anaheim, California

45 months ago

ana2lili in Kennewick, Washington said: Hi, I am going to agree with you, i am a hygienist and find that if the hygienist that finds all of this stuff is working on a commission type of job, alot of unnecessary stuff is diagnosed. If your pockets are not bleeding, it is an indication of it being stable and more frequent recare appts are warranted, if they are bleeding it means unstable pockets and further treatment may be needed.

I went to a regular check with my dentist because i finally have insurance. It had been maybe like 3 years or so that i havent been to the dentist. They told me i have 9 pockets of i think 6mm or 7mm and 5 cavaties my gums bleed when i floss or brush my teeth and gets swollens and my breath stinks even as soon as im done brushing them also and i also get cold sores. I also noticed my jaw on my right side snaps when i open my mouth. They told me i need a deep cleaning and remove the cavities and that i need arestin and some other thing so i wont bleed alot when they do my cleaning i guess like a numbness. The arestin charge would be $75 per pocket which comes to a total of $600 and cavities are covered in silver unless i want them white then i pay that myself and for the cleaning is $100 for all the mouth and $120 for that thing to control the bleeding. I dont know if they are just trying to get my money what should i do should i go to another dentist?

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John in Highland Park, Illinois

45 months ago

So listen to this.

I go into the dentist offcie today to have my cleaning. I was cornered by the dentist and hyginist about some dire problems with my gums. Seems my teeth are going to fall out. A majority of my teeth were at 4mm and I did have a couple 5's and even one 6.

The Doc told me that it would be cheaper to remove my wisdom teeth and give Arestin at 74.00 per site. 57 times over. My total bill 4,552. After the Doc apoligized for not catching this on the last visit he knocked a generous 455 bucks off. After insurance I am only out of pocket 2,279 but the good news is I can finance this at 15% APR.

What a joke, glad I did my research. Is it ok for me to go in there and yell at them for making me feel like I was about to lose all my teeth!

so upset

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exp in Exeter, New Hampshire

45 months ago

John in Highland Park, Illinois said: So listen to this.

I go into the dentist offcie today to have my cleaning. I was cornered by the dentist and hyginist about some dire problems with my gums. Seems my teeth are going to fall out. A majority of my teeth were at 4mm and I did have a couple 5's and even one 6.

The Doc told me that it would be cheaper to remove my wisdom teeth and give Arestin at 74.00 per site. 57 times over. My total bill 4,552. After the Doc apoligized for not catching this on the last visit he knocked a generous 455 bucks off. After insurance I am only out of pocket 2,279 but the good news is I can finance this at 15% APR.

What a joke, glad I did my research. Is it ok for me to go in there and yell at them for making me feel like I was about to lose all my teeth!

so upset

Get a second opinion....Arestin is on the border for alot of RDH's as working or not.....second opinion. Do you live near a DH clinic/school or Dental school? Go there and see what they find, have them chart your perio, etc, get copies, etc. VET

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monikanon in Montril, Alberta

44 months ago

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44 months ago

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trouble in Ottawa, Ontario

44 months ago

Hi everyone,

I could really use some opinions right now.

I recently had a dental appointment for a routine cleaning and check up. I go twice a year, and have been going since I was a child.

This appointment has left me with some disturbing results. My dental hygienist had found a 9mm pocket in the top, right molar area. My dentist then suggested that I go to a periodontist for a consultation. At the consultation, the periodontist not only observed this 9mm pocked, but also mentioned that I have a 14mm pocked in the top, left molar area. I am not an expert in the dental field, but going to a dentist but since I have been going to a dentist every 6 months since I was a child, shouldn't my dentist have picked up on this issue, before it reached both the 9mm and 14mm mark?

The periodontist recommends surgery a.s.a.p., and I don't see any other option at this point. What should I do?

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trouble in Ottawa, Ontario

44 months ago

Hi everyone,

I could really use some opinions right now.

I recently had a dental appointment for a routine cleaning and check up. I go twice a year, and have been going since I was a child.

This appointment has left me with some disturbing results. My dental hygienist had found a 9mm pocket in the top, right molar area. My dentist then suggested that I go to a periodontist for a consultation. At the consultation, the periodontist not only observed this 9mm pocked, but also mentioned that I have a 14mm pocked in the top, left molar area. I am not an expert in the dental field, but going to a dentist but since I have been going to a dentist every 6 months since I was a child, shouldn't my dentist have picked up on this issue, before it reached both the 9mm and 14mm mark?

The periodontist recommends surgery a.s.a.p., and I don't see any other option at this point. What should I do?

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Pam Holloway in Bellingham, Washington

44 months ago

smile in Calgary, Alberta said: I have alot of patients using the prohealth & have never seen the staining. Prohealth's sustainsibility is is up to 75% after 8 hrs whereas listerine only lasts 30 min. One of the selling points of using prohealth over chlorohexidine is the non-staining property. Also long term use of an alcohol based rinse causes tissue changes. This is the same affect as alcohol on a liver. Alcohol based rinses are being researched for potential cancer-causing agents with long term use. It's easy to research this yourself. Alcohol rinses contain more alcohol than "drinking" alcohol. I would rather my patients deal with stain (although, as stated, I've never seen this) than cancer.

My husband got tonsil cancer shortly after using alcohol mouthwash, does not smoke or drink, I really think it had something to do with the mouthwash, and normally he did not use mouthwash, but I gave it to him to use because I decided to use non alcohol mouthwash and did not want to throw it away.

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Pam Holloway in Bellingham, Washington

44 months ago

trouble in Ottawa, Ontario said: Hi everyone,

I could really use some opinions right now.

I recently had a dental appointment for a routine cleaning and check up. I go twice a year, and have been going since I was a child.

This appointment has left me with some disturbing results. My dental hygienist had found a 9mm pocket in the top, right molar area. My dentist then suggested that I go to a periodontist for a consultation. At the consultation, the periodontist not only observed this 9mm pocked, but also mentioned that I have a 14mm pocked in the top, left molar area. I am not an expert in the dental field, but going to a dentist but since I have been going to a dentist every 6 months since I was a child, shouldn't my dentist have picked up on this issue, before it reached both the 9mm and 14mm mark?

The periodontist recommends surgery a.s.a.p., and I don't see any other option at this point. What should I do?

I am not an expert but I heard that there is something that some periodontists do and that is laser to gums, it is painless but costly and few do it, maybe look for a dentists who does it, let me know how it goes, since I may have to get my gums fixed someday, as I have some painful gums and they won't heal up. God Bless/ In Christ I will say a prayer.

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Iluvteeth in San Francisco, California

44 months ago

In a nutshell, no you didn't get that 9mm or 14mm pocket overnight it doesn't work like that. So yes you should have been referred sooner to a periodontist. You don't have any other options besides surgery. You might want to reconsider having your cleanings at that office as maybe you need your perio monitored better.

trouble in Ottawa, Ontario said: Hi everyone,

I could really use some opinions right now.

I recently had a dental appointment for a routine cleaning and check up. I go twice a year, and have been going since I was a child.

This appointment has left me with some disturbing results. My dental hygienist had found a 9mm pocket in the top, right molar area. My dentist then suggested that I go to a periodontist for a consultation. At the consultation, the periodontist not only observed this 9mm pocked, but also mentioned that I have a 14mm pocked in the top, left molar area. I am not an expert in the dental field, but going to a dentist but since I have been going to a dentist every 6 months since I was a child, shouldn't my dentist have picked up on this issue, before it reached both the 9mm and 14mm mark?

The periodontist recommends surgery a.s.a.p., and I don't see any other option at this point. What should I do?

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Iluvteeth in San Francisco, California

44 months ago

Pam Holloway in Bellingham, Washington said: I am not an expert but I heard that there is something that some periodontists do and that is laser to gums, it is painless but costly and few do it, maybe look for a dentists who does it, let me know how it goes, since I may have to get my gums fixed someday, as I have some painful gums and they won't heal up. God Bless/ In Christ I will say a prayer.

Ok so do your research please people, your not a dental professional. Laser assisted periodontal therapy does not have enough research behind it that the ADA is uncertain as well as the studies that have been done have not proved that lasers help periodontal treatment.
www.ada.org/1860.aspx
The common procedures are the bacterial decontamination and the curettage, so read those areas.
The staples of periodontal therapy is STILL thorough root planing and periodontal surgery.

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Iluvteeth in San Francisco, California

44 months ago

Pam Holloway in Bellingham, Washington said: My husband got tonsil cancer shortly after using alcohol mouthwash, does not smoke or drink, I really think it had something to do with the mouthwash, and normally he did not use mouthwash, but I gave it to him to use because I decided to use non alcohol mouthwash and did not want to throw it away.

Excuse me, are you a doctor? Geez because you sure sound like you know it all. Get a clue, alcohol mouthwash did not give your husband cancer! When we are talking about tissue changes from alcohol mouthwash this is over many years and chronic consistent use. It is not proven to even be linked to cancer. Health is not black and white, just because he didn't smoke or drink does not mean that he has 0% chance of ever getting cancer. A bigger contributed to newer cases of oral cancer especially those involving the throat is HPV and men can have that virus and never know it as well as women.

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trouble in Ottawa, Ontario

44 months ago

Hi,

Thank you for your comments.

I don't have a dental plan, and my feeling were the same with regards to the dentist being able to diagnose periodontitis before it reached the point it is currently at. I am now stuck with a bill costing upwards of $3000 for something that may have been resolved before it hit this stage.

At this point, would you suggest taking legal action? I'm quite distraught with the fact that I have to pay such a large bill that doesn't even secure that I keep my tooth (14mm pocket). Not to mention how my teeth are going to look with a lowered gum line.

What are your thoughts?

Thanks again for all your responses.

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Iluvteeth in Manteca, California

44 months ago

trouble in Ottawa, Ontario said: Hi,

Thank you for your comments.

I don't have a dental plan, and my feeling were the same with regards to the dentist being able to diagnose periodontitis before it reached the point it is currently at. I am now stuck with a bill costing upwards of $3000 for something that may have been resolved before it hit this stage.

At this point, would you suggest taking legal action? I'm quite distraught with the fact that I have to pay such a large bill that doesn't even secure that I keep my tooth (14mm pocket). Not to mention how my teeth are going to look with a lowered gum line.

What are your thoughts?

Thanks again for all your responses.

What will you gain from taking legal action? Maybe your treatment payed for but you will have to go thru court meetings and court bills.
Do you even know what your pocket depths were the last time they were recorded and when that was? Did you even ask? Do you know if the tooth is mobile or not?
There are 6 pocket readings to each tooth so do you know the measurements at the other sites?
Did you ask the periodontist if he expects a good prognosis after the surgery or if the tooth/teeth are likely hopeless? These are all things you need to answer. For 3000 you might consider an implant if the tooth's prognosis is guarded.

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Susan in Brooklyn, New York

44 months ago

My dental Hygenist cleaned me 4 times a year. The dentist did come I twice a year.. I don't know my numbers or anything. I had a rough cleaning and now all my teeth are aching and shifting. They have cracks in them and seem transparent. Food no longer tastes good. I have swollen cheeks. Saw a new dentist and he did not check for numbers and he did 4000 with of work. Now I am in worse shape. From someone with beautiful teeth and smile to a hideous monster. Pain in nose and hard cactus keeps forming on bottom teeth. Air even hurts the teeth. Saw another dentist and she says I have a cavitation. Work to be done is 15000. No guarantee if I will be pain free. My neck is now swollen and redness face and neck. Where can I go. I am losing my hair and had the hair test done and I am overloaded with mercury aluminum and tin. Please help. 08723 is my zip code.

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FlossBoss in Oceanside, California

44 months ago

trouble in Ottawa, Ontario said:
I am now stuck with a bill costing upwards of $3000 for something that may have been resolved before it hit this stage......At this point, would you suggest taking legal action?

I agree that a 14mm perio (not endo) pocket likely means that an extraction and an implant might be the better way to go. I would also suggest that you consult a dental malpractice attorney for advice. If your claim has merit, you might get all your legal costs as well as money for emotional pain, covered in a judgement as well as the cost of replacing the tooth and controlling your periodontal disease on your remaining teeth. Bring any documentation (billing statements) to your first meeting with the attorney as well as all your questions that you need answered. You may need to prove that you have had your teeth cleaned on a regular basis for all those years. Your attorney will get all your records and x-rays from your dentist who did not diagnose and treat your disease. Note to hygienists: DOCUMENT diagnosis, treatment options and patient compliance every time, not just at initial appointment.....

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trouble in Ottawa, Ontario

43 months ago

Thank you for your responses. They are helping me in my decision making. I really appreciate it.

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Jwel in Denver, Colorado

43 months ago

chris in Moreno Valley, California said: I recently went for my regular 6mo cleaning. I am new to the area I am a new patient to this practice. They were running a "special" for new patients, x-rays, exam and cleaning for $49.00, excluding any perio issues. My hygienist found 7 4mm and two 5mm pockets, all non-bleeding. (All were 1-3 at my last visit). She wants to do a scaling and place Arrestin in all of the pockets. Does this seem excessive? My husband had a few 5mm pockets , which were bleeding, they were reducedd to 3mm with a regular cleaning and rinsing with Chlorhexidine. I will do what I need to in order to maintain good oral health, as I am a monster grinder and worry about developing periodontal disease. I have had moderate pocketing (4mm)in the past, which my Dentist said was do do the bruxism. After having my teeth cleaned and a night guard made, they returned to normal (1-3). I can't help but to feel that at $125 per quadrant, and $50.00 per Arrestin, that this treatment may be more about money. I would appreciate any feedback. Thanks!

I would like to ask what would make a periodontist suggest scaling and root planning with every full exam that walked in the office and then with your return of the exam suggesting an fos?! Does this make me sound cray or are these responsible concerns? I think that he is double dipping if you know what I mean and it does not sit right with me!!

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Jwel in Denver, Colorado

43 months ago

Matthew in Brighton, Massachusetts said: I work as an RDH and I am not a firm believer in Arestin. Periodontal disease is a chronic disease that is very difficult to treat. You CAN NOT cure periodontal disease, once you have it you have it for life. I am not even really a firm believer in quadrant scaling unless it's 5-6mm pocketing or less. Good luck trying to instrument to the base of a 7mm or > pocket and remove all of the subgingival calculus (can possibly be done by experienced hygienist, but I would say there are few out there). I am a FIRM believer that once a patient has periodontal disease they should be under the CONSISTENT and FREQUENT care of a periodontist...not a general dentist who thinks they know what they are doing. Periodontal disease is with you for life, so investing $1000 at one visit is not going to cure your disease. I see patients that would probably do fine for their whole life with 4-5mm pockets as long as they stay on a routine cleaning schedule (4-6 months). GENETICS plays a HUGE role in periodontal disease. Yes, brushing and flossing help significantly...but I see patients on a daily basis that haven't flossed a day in their life and DO NOT show any signs of periodontal disease (generalized mild to moderate gingivits). I also see patients that floss 2x daily and still cannot reduce the 4,5, and 6 mm pockets. Many factors come into play with periodontal disease....hygiene, genetics, TOOTH POSITIONING, composition of minerals in your saliva (which may allow you to build calculus/tartar quicker). They only perio procedure I would invest time or money in after 5mm is flaps. You cannot be sure the root surfaces is completely debrided unless you see it. That or a subgingival cam/microscope.

I would like to ask what would make a periodontist suggest scaling and root planning with every full exam that walked through the office door and then with their return of the exam suggesting an fos and bone grafts?! Does this make me sou

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1spclnurse in Valley Stream, New York

42 months ago

So I have approx 44 5mm pockets..hygenist is pushing Arestin between scalings..after reading this thread I'm a bit apprehensive..my copay $100.00 for the medicine and $240 for processing the med. Should I hold off on the Arestin and just complete the rest of the scaling? Nothing impressive on the web about Arestin

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josephl in Walnut Creek, California

42 months ago

Don't do it. People who are pushing for Aresting is a money making deal. For example, I took my wife to this new dentist for a dental cleaning. As soon as she sat in dentist chair they told her she not only needed deep cleaning but also Aresting (by the way, in front of her chair in the wall there wa a huge sign, guess what: Aresting). The charge would in the $1,000s. I told the dentist make the appoinment and I will call you. That never happened. I took wife to another honest dentist, and she did the X-rays and cleaning, no problem, except she would eventually need a filling.
Please don't listen to those fakers
Joseph

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Iluvteeth in Manteca, California

42 months ago

Joseph, why did she need deep cleaning? How do you know this other dentist was not misdiagnosing or didnt take perio as seriously as it should be taken? Just because another dentist did a regular cleaning does not mean Oh! The other office must have been trying to pull one over on me.

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