Is my hygienist being straight with me?

Factual Questions
1

I went and got my teeth cleaned today.

Here’s the background story: Last year I decided that I wasn’t taking care of my teeth very well and resolved to do better. I made an appointment with the dentist.

My gums were not in great shape since I almost never flossed and the hygienist gave me the mini lecture about gum disease etc. etc. (she couldn’t say enzyme and instead kept saying emzyne which I thought was hilarious but I digress) I had a cleaning and later a root scaling and was put on low-level antibiotics and a special rinse to help combat my gum disease. At that time I had one area where the pocket under my gum was an “8”. (anything above a 3 is bad I’m told)

Next time I see her, 3 months later, that particular pocket is down to a 7 (All of my other numbers had improved dramatically, only that stubborn bastard hadn’t changed all that much) She jammed some medication up there and referred me to a periodontist.

I never went. That was April 2005.

Fast forward to today. She doing the probe thing and calling out the numbers to the assistant who’s dutifully logging the numbers on the computer. She gets to the area where the big pocket was and calls out “3, 2, 3” and I think great. I didn’t need to go to the periodontist after all. Regular brushing and flossing has fixed my problem.

But no, she finished probing the rest of my mouth and goes back to that spot.

She jams the probe in deeper and decides that it’s not a 3 like she originally said it’s a 6 and I’m thinking, sure, because you just made it a 6. She calls the dentist over and he advises that since it’s improved we should just keep an eye on it.

She starts the cleaning and starts digging and digging and digging in that area where the pocket is. It hurt quite a bit (she claimed that she was giving me a litle extra root scaling in that area because it’s a problem and said she should be charging me extra but wouldn’t, right, I like to pay for my pain). She finishes torturing my mouth and goes back to that spot with the probe. Now that she’s reamed it out a little the pocket is up to a 7. She advises that I should see the periodontist after all and gives me a copy of the referral she gave me last year.

So what gives? Was my problem area an acceptable 3 until she jammed her instruments up there and made a deeper pocket or am I ignorant as to the ways of dental hygiene?

I’m going to make an appointment with the periodontist as soon as my mouth stops hurting but I’d love to hear what others think about it. My sister just had about $4000 worth of gum surgery done and I really hate to think of it.

Any advice, thoughts or opinions would be most welcome.Thanks.

2

Is this a dentist you’ve had for years, and whose opinion/diagnosis you trust, or is he/she new?

I still have all of my wisdom teeth and I was once told by a new dentist that they definitely needed to come out, and I was handed the card of a <insert type of dentist that extracts wisdom teeth> that they recommended. I was not sure about this, so I went back to my life long dentist in my home town for a second opinion. He told me someone was just trying to make their friends some money- that my wisdom teeth were fine. I have never since made any medical/dental decision without a second opinion.

My advice is that you should do the same: get a second opinion.

(for what it’s worth, nobody’s ever gone digging around like that in my mouth, but I guess everybody has their “specialty”…)

3

IME, going to the periodontist made me believe that they are basically shysters. I paid $3K for gum graft surgery that really didn’t do a darn thing. My pockets are still deep like they were.

YMMV, of course.

4

I think a second opinion is a good idea. I’ll have to get out my list of dentists and see who else is out there.

5

I’m with ya, brother/sister, I don’t trust any of 'em. Good luck!

p.s. another wee bit of advice: I’d say don’t give 'em too much info at first, it seems like there are a lot of opportunists out there that try to use what you tell them to drum up a big, fixable (read: $$$) problem. Kind of that whole “My brakes have been squeaking for 6 months”/“Ooo- that’s bad, 6 months means you need new rotors, discs, AND drums for our low, low price of $$$” scenario.

6

A second opinion never hurts. That said - Pocket reduction of 5mm (from 8 to 3) would have warranted a second look, as it would be highly unusual. The first reading (3) may have been caused by the probe hitting a chunk of calculus. Further cleaning may have removed enough calculus to account for the subsequent jump from 6 to 7.

7

My wife the dentist says this… the dentist and/or hygienist are probably playing it straight. On healthy tissue, you get up to a 3mm reading. Pockets won’t normally form without a fissure to the surface, so the dentist doesn’t have to use a lot of force and the reading is regarded as accurate. However of a tooth that’s already had a pocket formed, it’s possible that the tissue can start to heal and re-adhere to the tooth above the pocket, closing the fissure. The pocket is still there, though, and that’s bad. Normal force is called for, but she probably looked at your chart and remembered the previous pocket, which in this case (1) called for more force; (2) opened a healing wound and would hurt as you described; and (3) needed to be done to see what degree, if any, healing of the pocket had occurred.

She goes on to say that you need to have a special cleaning in the pocket, and that may be why the general practitioner doesn’t want to do it. Also to see what’s really going on, radiographs are called for, and it may be that the GP doesn’t want to risk it.

FWIW, this is reported to my wife and back to me. She’s not your dentist; you’re not her patient. And so on.

8

That’s exactly what she said, that the jump from 6 to 7 was because she removed some calculus.

Thanks Balthisar that explains what happened exactly.

I guess the good news is that all of my other areas that had pockets that were 4s and 5s (and I think there was one other 6) have healed to 1, 2 or 3 so it’s just this one area that’s having an issue. Flossing is my friend :slight_smile:

Thanks to all of you for your help. I feel a little better about everything. I just had visions of the recommenced periodontist being her brother/cousin/uncle who needed some extra cash after the holidays. I have no idea when I became so suspicious, I never used to be like that.

We’ll see what he recommends and then I’ll get that second opinion.