To feel like a minger at the dentist

[Anotherdayanotherusername]

I've always tried to look after my teeth. I brush twice daily with an electric toothbrush, floss & use those little brushes to clean in between. I visit the hygienist at least every 6 months, every 3-4 months at their suggestion at times, but it's pricy!

However, within a couple of weeks of visiting the hygienist the tartare starts building up and is hard to control. I've even tried chipping it off with dentist tools I bought in Boots with limited success. By the time I go back to the hygienist, there's a significant amount to remove & I can tell she's not impressed. I once caught a glimpse of my notes which read "poor oral hygiene" which was mortifying. However, a dentist once told me that some people produce more plaque than others so need to work harder to control it. The gaps between my teeth are also very narrow so harder to reach.

I've just seen the dentist who says I have gum disease and bone loss. She's recommended a "non-surgical treatment" which is basically an hour long hygienist session but if that doesn't work I may need surgery to save my teeth. I'm so upset. She said that while they can do their best, a lot of it is up to me.

I'm wondering what I could've done to prevent this. Maybe brush my teeth after every meal or snack, which is not really practical. Turns out the brushes I've been using are the wrong ones for my teeth so have bought new ones, but probably a bit late. I would add that my teeth don't look bad. They're not as white as I'd like but I haven't needed a filling in years (don't eat much sugary stuff) and the gums don't bleed when I brush which I thought was a sign of gum disease.

Am I just unlucky or actually a minger?

Google Topsmile https://top-smile.com/?gadsource=1&gclid=EAIaIQobChMIgIC7idv4hAMVwo9QBh1lvAspEAAYASAAEgLNMPDD_BwE. We use it all the time it's a game changer!

Maybe try xylitol gum after every meal? I feel for you, I've got sjogrens and so struggle with oral hygiene as I can't produce enough saliva.

If no one has mentioned it yet look up oil pulling. You basically swish coconut oil around in your mouth for 15 mins in the morning. Works wonders

OP, what is your actual diagnosis ?
What type of periodontitis?
Generalised or localised?
What is your stage and grade? Is it stable or unstable?
Do you have any risk factors? (diabetes or smoking).
Once you have that, dentists on MN can advise you further.
Mouthwash is clinically useless by the way. Plus mouthwashing after toothbrushing is actually detrimental to oral health as it washes /dilutes away the optimal fluoride composition of the toothpaste you should have used.

Start with googling the modified bass technique and get to grips with that. Then you need a mouth map plan from the therapist /hygienist with which TePe brushes to use where. Improving your periodontal health is all about those two things -modified bass tech of brushing and the correct TePes, occasionally flossing if the spaces are just too tight for a pink TePe.

As an aside, we have to record oral hygiene status in your clinical records. Any patient with calculus (tartar) with or without plaque, will be recorded as ineffective plaque control (or poor oral hygiene as you've read). Not to record this at every examination is professionally negligent.

If you smoke, the very best thing you can do for trying to be to stabilise your periodontal condition is explore smoking cessation. Your dentist can signpost you to local services.

If you're diabetic, have a think about whether it's controlled or not because that has an enormous effect on periodontal health.

Its not your fault.

My DH is like you - he has gum disease, sees a periodontist regularly, and spends ages brushing, flossing, using his teeny brushes. It is just bad luck/genetics.

I on the other hand brush twice a day, never floss, and don't have any problems.

You are not a minger, but you need to accept your dental health is going to take more time and money - I would suggest seeing a specialist periodontist (but you still need to see your normal dentist too unfortunately!).

I wish I could find a dentist who has the ability to tell me that there is a problem with my teeth without making me feel like an absolute failure and not want to go back. My son has SN and on more than one occasion I have had to stop the dentist pushing him close to tears. The same with hygienists - what is it about the job that gives them this superior edge. I also think there is a lot of upselling. I look after my teeth - do all the suggested things but was told by my NHS dentist that if my plaque didn't reduce by my next visit he would stop treating me (knowing that it is impossible to go elsewhere because of the lack of dentists).

Chew gum (sugar free)
Plaque-disclosing tablets
Water flosser daily
Check your vitamin b12 and iron levels - linked to gum health

I'm sorry but if you don't bleed...what exactly is the signs you have gum disease? Did the dentist do that check where they stick the metal hook down your gum and give you a grading of 1, 2, 3, 4 - 4 being very bad a sign of gum disease?
I am wondering if they are trying to see you extra services...when I get bad disease my gum's bleed.

They don’t exist 😂

Which electric toothbrush do you use? I have Sonicare and it's excellent for plaque removal/prevention. It's paid for itself many, many times over and I've even been complimented by dentists on how I look after my teeth since having it.

My gums used to bleed after brushing but then I got a water flosser and I use it with salt water twice a day, no bleeding ever again.
My dentist says that my gums have receded because of over vigorous brushing but I have no gum pockets, I have now got the message and I use my electric truth brush the proper way holding it stationary on each tooth then moving it along rather than 'scrubbing' as I used to do.

Brushing alone doesn't prevent plaque (especially if you have a higher tendency for it). Use interdental brushes and an electric toothbrush and it can really help.
I say this as some who has had gum disease, surgical treatment and at my most recent hygienist visit (after1 year since the last one) was told that I have zero trace of a history of gum disease and practically no tartar.

Do you floss and use interdental brushes daily?

My dentist said my oral hygiene is great but due to other factors I really need to keep on top of caring for my gums to avoid pockets of potential gum disease around my back teeth.

He recommended using a interspace brush (specifically a CTS brush which I got from eBay for £3). You use it in an up and down motion on the gum line and in-between the teeth. I either put the brush in some toothpaste or mouthwash when I use it

Like you, I have a very special talent for manufacturing plaque. I was also excellent at breast feeding and could have set up a wet nurse business ! I can chip the plaque off from behind my 2 bottom teeth probably every other day and I do use those little interdental tree brushes. I think though it's wrong if you are being made to feel bad in the hygenist. I go every three months so it costs a fortune but I am lucky I can afford it. You can't help it, it's like an optician pulling their face at a patient who has bad eyes.

They do, all three at the practice I go to are lovely, I'd mentioned that am allergic to sls in toothpaste so can only use Sensodyne and the last time I went she'd noticed that on my notes and had googled other toothpaste I could use. Private though - does that make a difference?

You are paying your hygienist to give the advice you ask for here. S/he is the expert and they're expensive. They can be variable, ask lots of questions. They are the ones with answers.

My brother really looked after his teeth and has loads of fillings. I didn’t and only had 1. I think sometimes genetics come into it.

You've done nothing wrong, OP. However if you are suffering from gum disease and bone loss, your dentist should have referred you to a specialist periodontist to start treatment to stop the gum disease from getting worse,

Years ago, I had my then dentist telling me that losing teeth because I had gum disease was inevitable. I talked about it at work and was told the advice was crap, and got a name to a different dentist. He took a look at my mouth and referred me to a periodontist. I ended up losing two molars but they stopped the gingivitis. Since then, I've been seeing my periodontist every 6 months for a gum deep clean.

Instead of asking if you are unlucky or a minger, find a new dentist to refer you to a specialist.

I've had to see the hygienist every 3 months for the last little while, we will move to every 6 once it's under control. One thing she said to me, which I found interesting, is that some people get an immune response to plaque and tartar, your body attacks it and it inflames your gums. Not everyone gets this, it's nothing to do with your hygiene, just bad luck but does mean you have to take extra care.

So my stupid smug husband saying I'm being OTT and he's never flosses and his teeth are fine, he just didn't get the same immune system as me.

It could be a bit of both - poor technique and being prone to plaque build-up.

If you can find a dental practice that looks at the whole picture rather than focussing on just one aspect you will be in good hands.

My upper 4s have been missing for around 20 years and I've always wanted them restored. This was never possible because my dental hygiene score was never high enough in spite of what I thought was my very best efforts. The score was always 3 in all quadrants of my mouth. Then in 2021 I found a new dental practice and the hygienist taught me how to brush my teeth properly. Within 6 months my score was 1 and the implant work is at long last starting next month - it's been a long journey because I needed stabilisation work and major orthodontic treatment first.

I totally feel for you OP! I have, by most people's standards, terrible teeth. Fillings, breakages, discolouration etc. I would say that I have a fairly good oral hygiene routine, and especially if I compare to some people who seem to be eating sweets/snacks all the time and have much better teeth on the face of it (obviously I don't ask too many people about their dental journeys...!)

But almost all my close and extended family have the same issue. We are not a family of dirty people, and yet we all have extensive dental issues. And yet genetics doesn't ever seem to be talked about as a cause - it has ALWAYS been the dentist telling me I have poor hygiene or I need to brush better or I shouldn't eat for 4 hours after a meal or anything really that just puts all the blame on me and what I'm doing. Or not doing. And because of that I have a terrible relationship with dentists and feelings of shame and anxiety. And it's sooooooo expensive! But I really do feel that some people draw a shorter straw than others so that anything short of constant brushing seems to have much more impact than other people.

No advice really, just I see you!

Since going private my gum health as improved immensely
My hygienest uses Air flow and now only see my hygienest twice a year opposed to 4 times a year in the first year I was registered with them
Air flow cleaning is the best
Much gentler and very effective
It's well worth looking into OP.

In answer to some of the questions, the diagnosis was on the basis of xrays that showed bone loss, don't recall her using a probe or giving me a staging. While my gums don't bleed, they used to a few years ago but using an electric toothbrush and brushing the gums as well as the teeth sorted it. I used to see a different dentist at the practice and he never seemed concerned about my teeth, just encouraged me to keep up with seeing the hygienist to keep the build up under control (which I have).

I was joking…