Periodontal rip-off?

Has anybody else out there noticed that dentists seem to be recommending scaling and planing as a routine procedure now?

My dentist recommended it a few months back. After I had it done, my dentist recommended that I endure the very same procedure again in another six months to a year, even though I have no cavities, no fillings, and no evidence of gum disease. I’m planning not to follow her advice. It seems to me that one scaling and planing should be enough.

I mentioned it to my brother. He said his dentist also recommended this painful procedure recently. Since then, several other people I know have told me that their dentists recommended the same thing.

Why has scaling and planing aparently become a routine procedure? Is it really necessary for everyone? Or is this just one way for dentists to make an extra buck?

I don’t even know what scaling and planing are, in respect to teeth; but all contact I’ve had with dental hygienists and periodontists establishes that they live to hoodwink and enroll people in their gum monkey-business. They’re always harping on gum disease, with claims that the whole world is rotting away from gum disease. There must be a number of people that have that problem, as many people have other selective problems, but I’ve actually never even heard a single person complain about their gum disease, no relative did I ever know of who had it, and I don’t have that problem, although I’ve needed to have a lot of work done on my teeth.

Two years ago, I managed to get pushed up against one periodontist, as a consultant, when I was seeing two other dentists, one bringing in the second, who brought in the periodontist. Dentistry is apparently trying to upgrade itself by specializing more and more, with each dentist pulling into every act a collection of his expensive, varied-specialty colleagues. This periodontist, here in Bezerkeley, gave me the most ignorant and unobservant line of pseudo-health-science bull I’ve heard in a long time. But it was clear that he could easily pull this off on his pack of Birkenstock-shod clients.

Then, just the other day, this same DDS -> DDS -> DDS stuff was pulled on me, where the middle DDS is not only the implant surgeon I wanted, but also a periodontist.

DON’T BUY THEIR WHOLE BILL OF GOODS, only that portion you need.


My sister, who lives in another state, recently underwent this painful procedure. I mentioned it with some surprise to my hygienist, and she said that, given my twice daily routine of not only brushing and flossing, but also using a waterpik with warm water, baking soda and hydrogen peroxide, I’d never have to undergo the procedure.

When I repeated these words to my sister, suggesting she follow the same dental hygiene, she repeated it to her dentist (the expensive/painful, scaling/planing advocate). He told her that, while he couldn’t go into details, I was killing helpful bacteria and words to the effect that my mouth would some day apparently fall off. Anyone else care to comment about this?

“There will always be somebody who’s never read a book who’ll know twice what you know.” - D.Duchovny

The existence of periodontal disease can be easily determined by the layman (caution: gross-out ahead) by smelling his or her dental floss after use. Smell bad? You have at least the beginnings of it. (And probably halitosis, to boot).

The clinical procedures for detecting the progression of the disease are generally full-mouth X rays and determinging the depths of infection pockets below the gumline around each tooth by inserting a graduated probe.

Bacteria that live below the gumline and cause that characteristic smell are anaerobic and cannot be dislodged or killed by conventional brushing, flossing or mouthwashes. If these pockets of infection get bad enough and deep enough, they eventually begin to destroy the underlying bone - the bone that holds your teeth in. Any amount of bone loss showing up on your X-rays indicate the disease has (if not currently, at least at one time in the past) been doing its dirty work, far and away the leading cause of tooth loss in adults of the species. However, you may be lucky and they catch it early enough that they can go in and surgically remove the plaque and bacterial abcesses below your gums and give you a fresh start.

I was shown X-rays with bone loss of my own mouth about 10 years ago - and that scared the living crap out of me. I underwent the scaling routine (it’s really not that bad - demand the nitrous!) and have been a conscientious brusher and flosser ever since (goody for me, right?). So far, so good. No more bone loss.

I watched my father lose all his teeth when he was in his forties, and I vowed to never let that happen to me. So… if you think your dentist is just trying to rip your ass off, (what is it with this cynicism and doctors?) smell your floss or just wonder idly about that blood you’re spitting out when you brush. Smokers - BEWARE - your gums generally do NOT bleed as much as normal people’s, even in advanced cases.

Your teeth? Just ignore them. They’ll go away.

I don’t know enough to answer your question, however I was able to avoid the procedure when it was recommended for me with a six month program of brushing with a sweeping motion at a 45 degree angle so as to remove stuff below the gum line. The depth of the pockets was reduced to normal and I have been able to keep them that way for 4 years. I do use an Interplac (sp?) electric brush now.

I managed to cure, on my own, what my dentist told me was periodontal disease. My gums would swell and you could actually mash them and force pus out around the base of my teeth. Since my circumstances at the time meant that I would have to wait several months before undergoing treatment, I invented my own ‘procedure’ to try to minimize the effects until the procedure could be done. Voila! 3 months later the disease was gone and hasn’t returned. Don’t know if this would work for everyone, and I certainly recommend following your dentist’s advice, but if anyone wants to try it, this is what I did:

Bought a very soft toothbrush so that I could brush my gums with minimum damage. Got some of that anti-placque stuff and brushed my teeth and gums with it - didn’t just rinse my mouth, but actually brushed with it. Flossed. Followed that with a thorough brushing with baking soda. Then dipped my brush in a strong antiseptic (Dr. Tichenors mouthwash/antiseptic, undiluted) and brushed teeth and gums with that (followed by open mouth breathing till the fire went away!). Did this 3 or 4 times a day, also after any snacks, etc.

That was seven or eight years ago, and the disease is gone and I’ve not had a recurrence. I still use this brushing procedure every night before going to bed - the rest of the time I just brush regularly.

I have as much authority as the Pope; I just don’t have as many people who believe it! - George Carlin

It seem people are more or less, objecting to the cost. IF this is the case I have found a simple and effective way of determainig whether it is a scam or not.

Simply tell your doctor or dentist (without mincing words) I cannot afford this procedure. If you feel it is necessary I can pay you $10.00 a week till it is paid. It may take years but I’ll pay.

I have had two dentist simply say sorry they can’t treat me. One said fine my teeth are important and took my offer. And I have had several MDs work out other just as effective cheaper arrangements.

You have to be really honest with dentists and MDs(DOs) as they a lot of times can’t relate to “you just don’t have the money.” My stupid insurance pays 50% on root canals but 100% to pull the tooth. It’ll give me a complete set of upper and lowers for $700.00. A root canal is between $1000-$1300. This is an isane pricing. As it is (at least in my experience) next to impossible to find a dentist who pulls teeth anymore.

BTW If anyone lives in Chicago and wants the name of a great dentist (he’s done a lot of work on me with virtually no pain) e-mail me. He’s on the northside.)

[[My stupid insurance pays 50% on root canals
but 100% to pull the tooth. It’ll give me a complete set of upper and lowers for $700.00. A root canal is between $1000-$1300.]]

Dear God, you must have my insurance. I swear, I’m really starting to think about having all my teeth yanked out and replaced instead of trying to fix all the ones in need of root canals.

Oh, sure, I could afford the root canals, so long as I didn’t mind living out of the back of an abandoned car with my kids. But hey, my teeth would be great.

Maybe you didn’t understand my question. My question was not whether scaling and planing is sometimes necessary. Rather, my question concerned whether the procedure is being recommended more often than necessary.

For example, my gums do not bleed (and I don’t smoke). My dental floss has no foul odor. I have no fillings. I brush regularly. I recently had a scaling. But my dentist recommends that I endure another scaling soon. This strikes me as odd, partly because my brushing habits haven’t changed, and this is the first time in more than three decades that any of my dentists has ever recommended a scaling. I can understand the recommendation for one scaling, but two?

Meanwhile, my friends and family also are telling me that their dentists are recommending scalings. For them, it’s also the first time any dentist has ever recommended the procedure. Is it really plausible that our teeth are going bad simultaneously? Maybe. Or maybe there’s another reason so many dentists seem to be recommending scalings all of a sudden. Could the proliferation of dental HMOs have anything to do with it?

Maybe the dentists have come to recognize periodontal scaling as a procedure they can easily bill through the dental HMOs, with no questions asked–even if the procedure isn’t really necessary. I’m simply raising the question: Is that what’s happening?

I’d appreciate it if you, as a moderator, would post a reply that responds to the question I asked. Thank you.


You aren’t here saying that bone loss causes most tooth loss, are you? I guess what you are saying is that bone loss is an indication of “periodontal disease”, and that the latter causes way most of people’s loss of teeth. So then we have to decide what gets legitimately put under this nice professional sounding umbrella name, one whose basic function is to define the profession of periodontics. In the case of the bone and tooth loss here mentioned, it appears that we are, by definition (‘perio-’ = around), putting the blame on various bacteria in tissues surrounding the damaged teeth or bone. These are no doubt the same range of bacteria that damage teeth from above the gum line. So, unless you break a perfectly good tooth, or knock it out, we can probably blame all loss of teeth not from theese causes on one certain range of bacteria, which would, of course, support your “far and away” statement if referenced simply to these bacteria. However, by inventing themselves as the mysterious doctor-dentists that go underground to get at the “root” of problems [read, make dentistry into medicine and get higher status and payment], periodontists and periodontics exclude themselves from caries in the upper parts of teeth; so your “far and away” must refer only to loss of teeth from damage to them or the jaw bone, which occurs only under the gum line. I don’t think even the majority of teeth are lost from decay at that level. What is your proof of this?

Ray (If it quacks like an MD, while claiming to be a DDS, treat it as an MD, and duck it. You cannot trust MDs.)