Gum problems

Factual Questions
1

Hi. I am an idiot and hadn’t (until this morning) been to the dentist in about 3 years. During this time (or at least for the first year or so) I spent a lot of time smoking and eating/drinking sugary stuff (you can probably see where this is going already). Recently I noticed I have quite a lot of calculus build up on the backs of some of my teeth so I decided it was time to go to the dentist and see how much damage I have done.

I went this morning and he said I need deep cleaning and x-rays to make sure there is no bone decay (although he said it is not likely there is bone decay). This appointment was supposed to set my mind at ease but has just made me more panicky that I have caused irreversible damage to my gums by being a fool. The main problem is I could not get an appointment for deep cleaning right away, and have to wait a month to get it done. On the form that you take back to the receptionist he had originally ticked ‘emergency treatment’ but had then scribbled it out. I am worried that by waiting an extra month the potential for bone decay is likely to increase and if I haven’t got some already then this time period may be detrimental.

In terms of hygiene, I brush my teeth regularly but have not started flossing until recently. Occasionally when I floss some blood pools up between one or two teeth but not a too alarming amount. I am now going to be zealous about dental hygiene but feel as though waiting a month may be stupid, and perhaps I should check regularly to see if they have had any cancellations. I assume I do have periodontal disease to some extent, especially as deep cleaning has been advised, but how quickly does it progress? To be honest, I’ve no idea how long my gums have been this bad and obviously the dentist is a trained professional who knows what he is doing but I’m still worried. I’m not even 21 yet and having bone decay would be a real downer. Anyway, will waiting 4 weeks make much difference or can I relax and ‘look forward’ to a procedure which should help reduce the damage I have already done?

2

Can’t work how to edit but should have read forum guidelines, silly me. Never mind!

3

I don’t know about you, but I’ve been in a similar situation and it’s curious how I have this ‘serious’ situation, that requires quarterly treatment, very little of which is paid for by my insurance.

Teeth cleaning twice a year? Covered.

Checking on the status of this Evil Awful Consumptive thing that should be managed, but will have me going to the dentist four times a year for the rest of my life? Not Covered.

4

Luckily I am in the UK, which means that I have to pay about £50 for this check-up and treatment. Does this mean I am going to have to have this done every few months for the rest of my life now?

5

No clue (I’m not a dentist)

6

Fair enough. It does seem odd that insurance would not cover that… ‘Good’ old David Cameron is trying to privatise the NHS so one day I may be in the same position as you.

7

IANAD, but I wouldn’t worry too much. Any damage done is already done and I wouldn’t think that another month is going to make that much of a difference. The dentist is a professional and while I am sure that he would like to get you in right away he would have had it been a priority matter. Of course I will refrain from my usual comment about government run health care and not being able to get treatment because of a waiting list. I would assume that if the month wait time was a serious issue, the dentist would have fit you in somehow, even if that meant bumping someone ahead of you. I assume medical professionals in the UK can be sued, so if it was going to hurt you I wouldn’t think he would risk getting sued by delaying treatment.

On a personal note, take care of your teeth. I am only 44, but have lost three back teeth. I needed root canals that at the time I couldn’t afford. Now it looks as though I will need partials to replace them. It could have been avoided had I been more responsible with yeaely checkups.

8

I am a dentist. One month probably wont make any difference. Call the dentist for a Peridex prescription(antibacterial mouthwash) it works great. It kills the bacteria that trigger the inflamitory response that causes bone loss. The physical tarter buildup just makes it harder to keep the teeth and gums clean of bacteria but doesn’t really do any damage. They should do a full mouth probing, measuring the pocket depth in the gums. Listen to the numbers they call out. Lower is better. 3 is normal 4or 5 may be due to some inflamation. 6 and up often means some bone loss, of course this is all just generalities since I haven’t seen you but I’ve been doing it longer than you have been alive and I dought you have a major proplem.

9

Thanks for the reply. Don’t worry, from now on I shall be cleaning my teeth properly. I don’t need telling twice!

Thanks for the information. I have some mouthwash with whatever ingredient (Chlorhexidine I think) is in Corsodyl (I got the store brand version as its much cheaper), will this do the same job?

They did probe a little (it was just a quick check up as I originally went in for jaw pain as well) and there was nothing higher than 3. So that seems like slightly better news than I thought.

10

go easy, don’t go nuts in a panic. 4 weeks is not too long.

floss daily though do it gently. flossing hard because you want to clean better will only cause problems for your unhealthy gums and not clean better.

a rotary electric brush tends to clean through without being too aggressive to teeth and gums, guide the brush and let it do the work, you don’t scrub.

your gums are sore, hard flossing and brushing will only hurt them. having four weeks is also maybe good. if you floss gently for 4 weeks your gums will get less sore every day so the cleaning the dentist wants to do will be easier then.

11

Yes Peridex is a brand, chlorhexidine gluconate 0.12% is the generic name. Sometimes however an over the counter product will be a lesser strength v. a prescription. Probably fine for now.

12

Thanks, will bear that in mind.

Yeah I think maybe I may have flossed a little too vigorously earlier. I just wish I wasn’t prone to such ridiculous levels of panic over such small things.

13

I am not a dentist, just someone who wound up with periodontal problems in my 20’s, like you, so take this as the voice of experience. Of course, there are probably some differences between you and mean, I am not a dental professional, but I think I can offer some encouragement here.

I went 7 years without seeing a dentist. Like you, I had calculus build up. In fact, sometimes I would actually be able to flake a bit off with a fingernail. My gums wound bleed when I brushed (which I did twice a day). They started to recede.

Finally, I got dental insurance/money and went to get my teeth cleaned up.

I got the initial cleaning done, but it hurt like **** and I required painkillers afterward. My gums were definitely inflamed. I got my “pockets” inspected and it was determined deep cleaning was needed. This was not a lot of fun, and after the first time the dentist did offer some medication both to calm me down (dental pain is NOT something I handle particularly well) and to relieve pain. I’d advise getting it over with, but as others have said, while it’s important it’s not an emergency in the same sense as an abscess would be. I also had antibiotic mouthwash for awhile.

Afterwards it did take awhile for my gums and teeth to lose their oversensitivity, but it did happen. I started brushing three times a day and flossing more. I still don’t floss as much as I should, but apparently it’s enough to make a difference. I go every six moths without fail for routine cleaning. I have not required another deep cleaning since the first one, probably since I improved my dental hygiene after the first “lesson”.

After about 2 years I found that my routine cleanings were just that - routine. Non-painful and even pretty quick since for the most part I didn’t have all that build up and staining to get rid of, and nothing was sensitive and inflamed anymore.

It is now 25 years later and my “gum disease” is in remission, if not actually cured. No inflammation. Pockets are what they should be. Where my gums receded they have remained that way, but it has not progressed further. Absolutely no sign of bone loss. I still have all my teeth. No further cavities. No shifting of teeth. No more bleeding gums (well, OK, during my recent brush with poverty I went 9 months without a cleaning and started seeing pink in the sink again - you really do need to go every 6 months. I made an appointment and negotiated a payment plan with a dentist to get it done.)

So my message to you is DON’T PANIC. Get the cleaning done. Then go forth and sin no more - regular cleanings, brush better (which isn’t the same as “more often” - ask to have your brushing technique evaluated for effectiveness), learn to love flossing. I went a lot longer than you did neglecting my teeth but found the problem to be correctable.

The only thing I haven’t done is “invest” in a powered tooth brush. It’s because I know I won’t use one. Not to mention that my employment in recent years I haven’t always had access to bathrooms with flush toilets at work, much less a power outlet for a toothbrush for the post-lunch brushing (construction work is so much fun). With the old fashioned kind I can at least brush with some bottled water whether I have access to power or not. My dentist says it’s more important I brush regularly than what sort of brush I use, and the hygienist approves of my technique. If the fancy plug-in brush makes it easier for you, or more likely to brush, or whatever go ahead and get one but the old style hand powered ones will work too if properly used. Unused, it doesn’t matter how good the brush is.

So calm down, get the cleaning down, improve whatever needs improving, and don’t put off your next visit so long.

14

keep a manual one in your lunch bucket for at work. you can use a powered one at home.

lots of powered ones have rechargeable batteries inside so they aren’t plugged in while in use. there are also powered ones that use disposable batteries that you could use at work.

15

Thanks for the words of encouragement, sounds like it’s been a rocky road for you and your teeth. This has been a wake up call, not just in terms of dental hygiene but in terms of consequences of not being sensible. I always used to say when something like this came up, “Ah, I’ll leave it for future me to deal with” which at the time seemed fine, but now ‘future’ me has appeared and pointed out that ‘past’ me was an idiot. At this stage I don’t really mind if it is painful (although no doubt post deep-cleaning I will be cursing myself some more) just as long as it fixes/helps with the problem. Originally they wanted to schedule it for just before my final year university exams started, but I decided this was a very bad idea and changed it to the day after my last one. What a celebration that’s going to be!

16

Yeah, except I’m weird about preferring non-powered tools. I mean, the industrial sewing machine I use at work (no longer in construction) is treadle powered, not electrical. We have an electric can opener for my spouse but I still use the handcrank. It’s a personal quirk.

Rather than have two separate technologies I just stick with what I’m comfortable with. Which was my point, on a certain level. Which tool you use is not so important as that you use the tool to do the job. Brushing properly is more important than what, exactly, you use to brush with.

If the choice is between purchasing a fancy toothbrush and being able to afford my next dental appointment I’ll choose the dental appointment - and really, for about four years my budget really has been that tight. Two people living on less than $12,000 a year have to be VERY careful about how they spend their money.

17

Not so much - the clean up and healing to the point of no more bleeding, sensitivity, and the routine cleanings being quick and easy took about 2 years start to finish. Since then it’s been a steady state of “no problems”.

Just learn from this and do better maintenance going forward.

18

In the U.S. it’s easy to find so-called travel toothbrushes with built-in batteries. You use them until them run out. They’re quite cheap.

The only real advantage to powered toothbrushes is that most people don’t have a good idea of what good technique is and don’t ensure that they do enough strokes of each tooth. As Broomstick correctly says, if you’re careful and watchful then the type of toothbrush doesn’t matter and a manual toothbrush is certainly cheaper than even a cheap disposable electric. But most people are also lazy and hurried and neglecting. Somebody else’s personal quirk is not a good guideline for you. I use an electric toothbrush and I think it makes a difference. My gums bleed less or not at all at cleanings since I started using them.

19

powered brushes do give more strokes which is good. they also promote being gentle, they stall if used with the same force as people use with a manual brush. rotary head powered brushes are small and allow getting behind rear teeth (a real problem area) which is difficult with manual brushes and reciprocating power brushes.

you can if you are careful, thorough and gentle brush ok with a manual, though maybe not as well behind rear teeth.

manual toothbrushes need frequent replacement. i think rotary powered ones last for fairly long. also to be factored in the cost is better health of teeth and gums. the powered brush tend to be very helpful to the gums (less chance of damage and good stimulation done in just the desired brushing, not separately).

20

Definitely. In my case this is complicated further by still possessing all four wisdom teeth, but according to my hygienist I am getting all the way back there in a proper manner. If my teeth were more crowded in a smaller jaw things might be different.

I do ask the hygienist if I’m missing any part of my mouth, if I’m doing a good job, etc. Since they’re the ones who actually clean the gunge off your teeth they’re the ones to ask. I’ve yet to meet one who won’t be honest with me! Most of them have no trouble describing which areas you need to brush better.