Periodontal disease... Stage 4. Anyone able to recover from this?!

[Nickname1980]

Just that really. As I've posted on a couple of other threads, my periodontal disease is pretty bad. And I am getting a tooth extracted next week. And have the four quadrant cleanings booked with antibiotic injections.

Are my teeth screwed always?! Anyone recover from it?!

The dentist said they'll look ugly after as the gum shrinks and I'll get the "black triangles". I used to have a good smile! I'm totally gutted.

I didn't see this coming at all! Have been busy producing kids though. I'm so diligent at cleaning my teeth. Dentist reckoned it could be genetic.

[Mrsmorton]

There are several factors involved in periodontal disease and whilst reversal is almost impossible without surgery, stopping it progressing is doable.

When you say "stage 4" what do you mean? Is your "BPE score" 4? (BPE is the number we call out when looking at your gums).

Have you had a full pocket charting yet? They measure your gum pockets on all of your teeth in 3 places on each side. That generally also looks at the amount of bleeding present which is the best indicator of active disease.

Good luck anyway! There are options for the black triangles once you've got everything under control but AFAIK they'd only be available privately. I don't treat patients anymore and things have moved on even in the 12 months that I've been out of surgery.

[Nickname1980]

Thank you for your reply, mrsmorton! I don't have the pocket scores yet. The dentist said he'd do that when he did the deep cleaning under general and after I had my tooth removed. (I'm terrifed!)

I just can't believe how bad it is. I am so so careful with my brushing and flossing and have been for years.

I believe BPE stage 4. He said 1 is the best and 4 is the worst and I have 4.

What surgery is an option?

[Mrsmorton]

The pocket chart will be more informative that the 4, 4 means pockets over 5.5mm. I'm certain that we reckon people can clean pockets up to about 4mm by themselves with a bit of education so when they get deeper, bacteria can create what's called a biofilm at the bottom and that 's what causes the bone loss which means the pockets get deeper. (does that make sense...)

As the disease gets under control, the gums will recede and hopefully the bone levels stay the same so the pockets are less deep and you can maintain them yourself.

Surgery can either make the pockets smaller more quickly, it can make parts easier to clean, e.g. where the root divides into 2 on your molars, very difficult to clean if the bone loss has affected it, by modifying it, can make it easier.

There's also guided tissue regeneration which I know uses membranes of some description however, I've never seen to done or met anyone who has had it done. I think it's intended to provide a perfect environment (under the gum) to allow new bone to grow.

Gums were never a thing I found particularly interesting so my knowledge is limited and my hygienist was totally amazing so I would generally refer for specialist opinion if the patient wanted.

[antimatter]

Is your dentist a specialising in periodental medicine.
I had my treatment done in November. I had 2 visits for clean up. My dentist was only able to tell me how many teeth are affected after taing lots of xrays and measuring pockets during initial one hour check up. So there were 3 visits in total.

[Nickname1980]

He's not a specialist periodontal dentist, antimatter, but he says it's a field of interest for him. He took a bunch of X-rays and poked about with the sharp thing. He did seem very competent.

How are your teeth now? Did you lose any? Are you managing it?

He told me my new hygiene routine would be 10 mins day and night and be v tough!

[Nickname1980]

Thank you, mrsmorton! That helps me understand it a bit better.

I'm feeling pretty freaked out. I'm only in my early thirties and - on the surface - have "nice" teeth. I am willing to do anything to stop them from getting worse and improve them!

Wow guided tissue regeneration sounds great. Perhaps one day that will become more readily used!!

Another question: I have kids already. My dentist said pregnancy and breastfeeding probably accelerated this. i wonder. Would having one more baby be a bad idea for the health of my teeth?!? I have always felt they get worse after each pregnancy and I tend to breastfeed for around a year.

[Mrsmorton]

Your gums are a bit more difficult to control during pregnancy but IMO, once you have it under control it won't make a difference. I would definitely not not have a baby because of this.

[Nickname1980]

Thank you, mrsmorton! Can I pick your brain one more time: my dentist isn't a specialist peridontalist. But, like I mentioned above, he has an interest. Should I be getting a second opinion about the tooth extraction as it's something I can't reverse?

My gum above that tooth is painful. It's inflamed and swollen and infected. I have to wait until Tuesday for the extraction and goodness knows how I'm going to deal with that pain all weekend!

My dentist said the tooth was wobbly and worried that it was going to destroy the teeth nextdoor to it.

Just don't know if I should go to a total periodontal specialist. Though this dentist seemed good and I liked him (I haven't seen him before today, which is why I'm anxious).

Thank you again for your advice so far!

[Mrsmorton]

I think you're fine to really grill him about whether to tooth has to go and what options are available if you were to see someone else. If you trust him though, I'm sure you'll not go in gunning for a second opinion because that can be a bit off putting sometimes. Like you trust google more IYSWIM

[PannusAngelicus]

Hello, I had this diagnosis three months ago and was devastated.

The hygienist says you can reduce pockets and can heal them completely in nine months. Make sure you get a copy of your periodontal chart, this will help you focus. Brush twice a day,use interdental brushes, but you need to really have to work them in without force. I've been taking vitamin c, niacin and oilpulling and also night a water glossed, buy do not rely on that alone.....the interdental brushes are the most important bit. (I trust her completely as she was the only person to flag up gum disease and I've never missed an appointment). My pockets are tighter, not quite reduced by 1mm yet but mygums are so pink and flat now, I hadno idea they were even inflamed until they improved.

[Nickname1980]

lannys - did you get the deep cleaning with the antibiotics and the numbing injections?

What is niacin? I am googling!

Did you end up with those "black triangles"? Apparently I will 😫

[Nickname1980]

I meant to say pannus - not sure what autocorrect did!!

[farfarawayfromhome]

I'm teeth obsessed and find it scary that this can happen to you even with good dental hygiene and regular dentist visits. What were your symptoms OP?

[dirtywindows]

You poor thing I feel for you because I've just been through this. My dentist sent me to a specialist periodontist for the deep cleaning- cost me £1300! I'm dental phobic and although I brush regularly I'd not been to dentist for years and I had no idea I should have been seeing a hygienist. Treatments were awful. But means I might not lose any teeth. Wasn't offered antibiotic injections. Left with big gaps between teeth and some really really sensitive teeth. Got my 3 month review at end Jan when I'll be told how successful it was or not and what to do next. My 'pockets' measured mostly between 6-8 deep. Was never told what stage it was. Hated it all but glad it's been done. Wouldn't wish it on anyone.

[dirtywindows]

Oh and the only symptom I had was a slightly wobbly tooth which is what forced me to go to dentist....

[FeralBeryl]

I have a big pocket
My symptoms were for years - feeling an odd sensation when biting down - had numerous dental X-rays at practice but felt fobbed off. I was lucky enough to arrange a full OPG X-ray at my work which showed a giant 9mm pocket. This was not visible on the smaller films somehow.
I had dental surgery using embryonic porcine cells yes baby pig tissue which reduced the pocket to 7mm. I have since reduced it to 5mm with religious poky brushing and 3 monthly hygienist visits.
We're currently on stage 2 of a 3 stage periodontal chip. It's placed deep in the pocket after cleaning (professionally) and swells to fill the gap and restore growth. (Will update at end)
You really need to seek out people with a special interest in it otherwise the consensus seems to be 'nah, s'fucked'

[ICJump]

I have reduced my pockets from 9s to 1 and 2s, I reduced tooth mobility from 3 to zero. I had deep cleans from a periodontist every 5 months for 3 years and am
Main ting now with six monthly hygienist visits.
My front tooth is long but no blackness

[Footle]

I can't vouch for this but a friend had a similar diagnosis and reckons he improved the outcome massively by taking a high dose of vitamin D over six months. Obviously you'd need to research this.

[donajimena]

I don't know what stage I'm at because I wasn't given one but I have had severely bleeding gums for over a year.
I went to boots looking for a corsodyl mouth was and ended up buying a product called Genigel. The improvement in my gums has been nothing short of miraculous. They have stopped bleeding. I'm not out of the woods I don't think but the fact that they aren't bleeding after such a long time of spitting blood is a miracle.
If you are not using it I'd have a Google and see the 'success' stories.
I'm still keeping up with the corsodyl and electric toothbrush regime and will also try vit D /c

[BillStickersIsInnocent]

It will ok but you need to get on it.

I was diagnosed in my mid twenties (after family dentist fobbed me off for years - I knew something was badly wrong). Mine is genetic and aggressive, compounded by smoking (I gave up on diagnosis)

I had deep cleans under local anaesthetic at a dental hospital. My gums receded hugely (inflamed gums re tightening around smaller bone mass after healing) but I haven't lost any teeth and my gums have been stable now for nearly 15 years. My dentist always tells me how super clean my teeth are.

Also:
Regular 6 month hygienist and dental apps
Electric toothbrush
Tepe interdentals
Exercise will get blood flowing better and support healing
I don't use mouth wash as can cause staining which enables bacteria to grow, but follow guidance from your dentist on this

Re. The black triangles. I wear a veneer to cover these, sort of like a thin denture (without teeth!). It clips on, it's comfortable and mostly I don't notice it. It was made for me (I've had two now in 15 years), they cost about £100.
Gives me the comfidence to smile and just get on with things. No-one has ever noticed it, even dentists are a little surprised when I tell them.

Good luck

[TDHManchester]

What a terrible situation. I guess most people have seen the ad where a certain brand of mouthwash has the straplan "for people who spit blood when brushing their teeth".

Im not a dentist but IMHO if you spit blood when brushing your teeth, you definitely need to see a dentist.

My opinion but i think the era of the electric toothbrush has instilled a certain laxity in some peoples dental routines.

Now i have a basic electric touthbrush (oral B), but most times i brush with a soft bristled small heaed oral B tooth brush. Apart from the morning and evening brush, i will likley brush at least once during the day using just clean tap water. I only use toothpaste in the evenings before bed and of course leave it on. Regular use of tepe interdental brushes..

Making sure all surfaces of the tooth are brushed i.e all sides and the biting surfaces,,very imprtant especially so for rear chompers..

[donajimena]

Interesting about the mouthwash. I've actually run out. I might not replace.
Going back to the Genigel (I do not work for them) you can either get a gel or mouthwash but its not like you would imagine the wash. Its more of a gloop which clings to your gums

[Nickname1980]

*dona - do you use the gel or mouthwash? Or both? (Genigel)

[donajimena]

Both! I use the gel on the worst inflammation.

[Nickname1980]

Thank you! I've ordered