Category Archives: Gum Disease

Suffering from advance gum infection and bone loss

I am suffering from advanced gum disease and bone loss around many of my teeth. My teeth are shifting and my gums bleed when I brush my teeth. What are my treatment options?

Thanks, Tim

Dear Tim,

It sounds like you are in the progressive stages of periodontal disease most commonly known as gum disease. Periodontal disease occurs usually from poor oral hygiene habits as well as not going to the dentist for your dental cleanings every six months however can also be hereditary. Treatment options can vary depending on the severity of the disease. The first thing you will need to do is go to the dentist for an evaluation to see if your gum disease can be treated and kept under control. If it can be controlled scaling and root planing will be preformed first. This procedure entails your teeth to be thoroughly cleaned above and below the gum line with a local anesthetic to remove all the tarter and bacteria from your teeth and root surfaces which controls the progression of the disease.

After you have healed from this treatment your dentist will evaluate your teeth to see if and where bone grafting is needed to stabilize your teeth. If your bone loss is severe around some of your teeth and mobility is noticeable you may have to have them extracted to prevent the disease from spreading to the next tooth. If teeth need to be extracted and the bone levels are stabilized you may be a candidate for dental implants or dental bridges to fill in where you had teeth extracted. We advise you to visit a dentist soon for a consultation because periodontal disease not only affects our teeth it also affects are general health and relationship with heart disease and diabetes.

This post is sponsored by Cleveland Implant Dentist Hylan Dental Care

Why do periodontal probing depths not change after dental scaling?

I had periodontal scaling done three months ago due to gum disease and went in for my periodontal maintenance appointment last week. The dental hygienist measured my pockets and I still had several areas where the probing depths did not change. What would be the reason for this?

Thanks, Joyce

Dear Joyce,

Probing depths should decrease over time ranging from 1 to 3mm in reduction after treatment, however not always the case. The clinical attachment loss that has occurred does not change once the disease is under control however you may gain some clinical attachment but it is usually minimal without surgery.

Let’s say for example you had an 8mm pocket before your treatment and after your dental scaling the pocket remained the same. Even if you have immaculate oral hygiene habits, flossing an 8mm pocket is almost impossible. Floss can usually reach a 4mm pocket but not greater, this is why it is vital to go in for your periodontal maintenance appointments every 3 or 4 months so your dental hygienist can maintain those deeper areas and clean them out to prevent further bone from dying around the tooth. By doing this those deeper area’s can see a reduction in tissue inflammation which overtime decreases your pocket measurement. Sometimes when pocket measurements don’t change it is an indicator that the pocket is not healing properly especially when bleeding upon probing occurs and may need more attention or possibly a sign that some type of periodontal surgery is recommended.

Do not get discouraged, maintain excellent oral hygiene habits, and see your dental hygienist for your cleanings as recommended. If you are not satisfied overtime with your measurements ask your dentist or dental hygienist what options are available for you to get the disease under control.

This post is sponsored by Cleveland Implant Dentist Hylan Dental Care

Dentist won’t clean her teeth without surgery

My wife has large pockets and has been told she needs surgery BEFORE our dentist will clean her teeth. She isn’t willing to do the surgery for various reasons. It’s frustrating because we’re being forced into unwanted surgey simply because she wants/needs her teeth cleaned. Any idea’s you can offer to help this situation would be appreciated. Thanks-
– Roger from California

Dear Roger,
I don’t know the specifics of your case, but I have some insight that may be helpful.

You say your wife has large pockets. This means that she has serious gum disease and is headed toward losing her teeth.

Your dentist feels she needs gum surgery. Since I don’t know any more about her case, I don’t know if that is true or not. But to not agree to that recommended treatment could have serious consequences for your wife. I can fully understand why her dentist might say that without that surgery, there’s no point in cleaning her teeth.

When you have deep pockets, cleaning your teeth is not a simple task at all. It often requires multiple appointments. The pockets have to be cleaned to the very bottom. You usually need novocain, and in some cases there may be surgery required simply to get access to the deepest part of the pockets.

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A yellow build-up on my teeth

Dr. Hylan,

My lower teeth have a yellow build-up on them, and when I try to remove it, it seems as though I don’t have any tooth left. What is that and what can I do?

Wanda in Georgia

It sounds like it just must be quite a while since you’ve had your teeth cleaned.

The yellow build-up is called calculus or tartar. What happens is that your saliva has minerals in it, and those minerals very gradually build up on your teeth as a substance called calculus. When that build-up is visible, it is called tartar.

The build-up occurs so gradually that people often get used to it, and when it is cleaned off it feels strange, like there are large gaps between their teeth or part of each tooth is gone. But it needs to be all cleaned off.

Calculus is very damaging to the health of the gums. It leads to gum disease, and over a period of years it causes the gums to pull away from the teeth. The teeth become loose and will eventually fall out. When the teeth are loose, it is usually too late to save them. The best practice is to have your teeth cleaned every six months. If you are particularly susceptible to gum disease, it may even be recommended to have them cleaned more often.

For more information, read our dental hygiene page where we explain how we check for gum disease each time you have your teeth cleaned in our office.