I feel so let down by my dentist, diagnosed with severe periodontitis

[FuckedFuckedFuckedIt]

2 years or so ago my gums started to bleed when I brushed my teeth, not every time and not a great amount but bled nevertheless. I had a lot of sensitivity around one area in particular and thought there might be a problem with the tooth.

My dentist wasn't concerned about it, said the tooth is fine and assured me that most peoples gums bleed at some point or other.

I've had a handful of dentist appointments since then and on two of them X-rays were taken (I needed a filling, and wanted to replace an old silver filling with a white one)

No mention of periodontitis/gum disease.

Regardless, I mentioned wanting to see a hygienist to my dentist as I had a little stain on my front tooth (i was a big tea drinker). I was told that I don't 'need' to see a hygienist because he (dentist) can do all of that. It turns out my practice doesn't actually employ a hygienist. The dentist did a superficial polish on one occasion.

Still no mention of periodontitis.

Fast forward to a few weeks ago the bleeding has ramped up and upon close inspection I can see there is obvious receding of the gum line. I started researching and drew the conclusion that I might have periodontitis. I looked into what I needed to do to manage it, bought an electrical tooth brush, water pik and learned about interdental brushes. After implementing the new routine for 2ish weeks black triangles started to appear between my teeth! I now understand that this is because the inflammation is reducing.

I booked an appointment to see the dentist and said I'm concerned that I have this condition. Only then does he tell me that yes it looks like periodontitis but not to worry as it's treatable and in my case very mild.

I was gutted, but he said he would refer me to see a periodontist.

I saw that periodontist today. I have severe periodontitis that has advanced to bone loss and I would have had this condition for years slowly getting worse. News to me!

If I'd have known, I would have without a shadow of a doubt gone private to have deep cleans and preventative treatments. I'd have started using the interdental brushes, made more of an effort with flossing, bought the water pik much earlier etc.

The periodontist thinks genetics are a factor in my case due to my age and the fact my dental hygiene is reasonably good, although I do admit I haven't always been great with flossing.

I will now be having two deep, deep cleans under the gum line to try and shrink the pockets but have been warned that due to the bone loss - I'm going to be left with sizable gaps between all of my teeth 😔

I asked if my dentist will have known I have this and she said yes, of course he would.

So why remove a superficial stain whilst telling me I don't need to see a hygienist, when you know I have sodding periodontitis and that was exactly what I needed to do.

Why not advise me how I could manage my condition myself? Why was it me, the patient, having to diagnose myself and read up about what I can do to help myself.

I'm devastated and feel like he has completely failed me. If the funding isn't there to treat perio on the NHS then ok, but jesus christ atleast tell me that I have the disease so I can make an informed decision on how to proceed. I would have found the money somehow and could have stopped it progressing this badly.

AIBU to say he has completely failed me?

I think I'm going to give it a go although I don't have much hope. From my limited reading I can see that dentists can refute the claim for nondiagnisis of perio on the basis of a patient being a smoker, or ex smoker in my case.

God knows how that's an acceptable reason to withhold a diagnosis though, and that is the basis on which I will be basing any claim.

Thank you I'm definitely going to give it a go. I've ordered some on amazon and it's due to be delivered tomorrow.

I've been watching some videos about it and It's all quite encouraging stuff, I'll take whatever optimism I can at the minute.

I found organic coconut oil to work better than the regular ones. It has honestly really helped my gums so hope it works for you too!

If you want to pm me I have an on going claim for this exact thing. Happened to me 30 years nhs. I'm 32 and devastated.

There's also some groups on Facebook you can join which are very supportive x

I'm going to PM you now, thank you!

As others have said, oil pulling is very good for gum disease and gentle on the gums. Take care not to be too aggressive with brushing etc so as not to cause any more damage. Sounds like you have stopped the infection and hopefully you well see some improvement.

Ultradex mouthwash is very good also and will help to get rid of the bacteria that are irritating your gums.

It's possible to get rid of any pockets too. Best of luck.

I don’t know what other nhs dentist practices do….that’s just mine….ours definitely do bridges but you have to have good bone support…maybe that’s why she couldn’t get the

I pay £18/ month and that covers two visits to the dentist and two to the hygienist per year. I’ve just paid £275 for two white fillings.

I am so sorry to hear this. I am a dentist and I would like to give my perspective.

Firstly, well done on being motivated enough to do everything you are doing to improve your oral health, and on quitting smoking. This is the best thing you can do to help with the disease. Please do not despair, and follow the advice of the periodontist to get the best possible outcome for the future.

I honestly live in fear of ever missing diagnosing a case like this, and I’m sure your dentist will feel absolutely terrible about this once the full extent of your diagnosis is known to him.

If you think he was a lovely, caring dentist prior to finding out about this, chances are you are correct and he has missed the diagnosis rather than wilfully ignored it. As severe bone loss is rare for someone your age, and smoking can mask the inflammation usually seen with the disease, in an otherwise spotlessly clean mouth it can be hard to see the usual signs we would use to diagnosis periodontitis. We are all human and do make mistakes.

That said, missing the diagnosis is negligent and has had a really negative impact on you. You definitely deserve compensation for this. This is why dentists are insured, so that when we have made a mistake that causes you harm, you can be justly compensated.

I would recommend leaving the GDC out of it, there is no financial recourse for you from going down that route, and it is not a bad enough failing that the dentist would be struck off etc.

I would also recommend leaving the no win no fee lawyers out of it, they will take an absolutely huge percentage of any pay out, leaving less for you to compensate you for the situation.

I advise you make a formal complaint to the dental practice, this will trigger the dentist to involve their insurance company, who are well versed in cases like this and will be very likely to agree a settlement payment with you. I believe this would give you more compensation in the simplest and fastest way compared to a no win no fee lawyer. The dentist would also reflect, retrain and hopefully be very careful to make sure they never miss this again on another patient.

I am so sorry this has happened to you, periodontitis is such an awful disease, I wish it was more painful in the early stages so that patients could be alerted to it so much earlier.

You are completely justified to be very upset about this, but don’t lose hope, it is a very treatable condition as long as you remain motivated which you definitely seem to be.

@FuckedFuckedFuckedIt as a dentist I'm sorry you've been given this news. I'm also so glad to hear how proactive you are being.

I tell multiple people a week they have gum disease and they need to improve their brushing, clean interdentally, stop smoking, avoid vaping and it's really hard to motivate and change peoples' habits. Often I've told them the same thing at previous appointments too.

Periodontal disease is really common and affects up to 50% of the world's population. It can't be cured only managed and needs someone to be really motivated to get it under control. Smoking is a massive risk for it and it masks the signs of the inflammation. In smokers often the gums just don't bleed when we probe them. Your increased bleeding and inflammation sounds like it started round about when you stopped smoking. So until then, your smoking was hiding the trouble. Anecdotally I rarely seen periodontal disease in 20-30 year olds just lots of inflammation and bleeding (although I currently have a 20 something who has aggressive disease who I will refer if they stop smoking) So anyone reading this who keeps being told they really need to clean interdentally and target their gum line we're not nagging we really recommend doing it.

@Denticula you sound like a lovely dentist.

Thank you for the replies, it's great to have the perspectives of dental professionals too.

I'm definitely motivated and I'll do whatever I can to save my teeth.

Is the general consensus that my dentist has missed the diagnosis then, as opposed to wilfully withheld the information from me?

What confuses me is that he has done multiple X-rays in the past couple of years which I assume would have revealed this bone loss, and he never told me.

He only confirmed the perio after I told him I had 'diagnosed' it myself.

Although that being said, before he looked in my mouth on that day when I went in saying I was worried about it, he was trying to reassure me in advance that I'm not in the right age bracket for perio and it's something you see in much older patients.

Only once he'd had a proper look he confirmed I likely had it but only 'mildly' and 'just starting' which was later corrected by the specialist who said nope it's severe, advanced and there is bone loss.

I'm so confused 😔

I can see there are a few of us who've had similar experiences and it does seem to be the case that some dentists (a small % I'm sure) don't act in the patients best interests.

MillyMolly and Dentula you both sound like good dentists, thank you for caring about your patients. If either of you are in S.E London and have room on your books for somebody like me, or can reccomend a reputable clinic, I'd be very grateful 😥

@FuckedFuckedFuckedIt I would say a missed diagnosis, and periodontal disease can deteriorate rapidly. The patient I mentioned upthread went from me going I'm really not happy about your gums to yikes in about 12 months. You are very young to have severe disease hence the periodontist talking about genetic predisposition. You are right if you've had xrays your bone or lack of it should have shown and your BPEs would have been measured at check ups- they're not always that useful as they are not throughout the mouth and pocketing can be missed.

If you have siblings and they haven't had a check up recently make sure they go (and after your experience) ask if their gums are healthy. They may have those same genetic risk.

Dentula's advice on how to complain is spot on and the way to proceed if that is what you feel you want to do. You have been let down by not getting a prompt and timely diagnosis. Without seeing xrays and records everyone can only speculate on when you might have been diagnosed.

I'm in the SW so nowhere near you unfortunately. With the help of the periodontist and their team they'll be able to get you in better oral health and help you stay that way. Interdental brushes, interspace brushes and an electric toothbrush will be your best tools. The work you are putting in is already making things healthier.

I am surprised you weren't at least informed you had gingivitis.

This woman has lots of helpful and informative posts:

What Is Perio Charting & Why Is It Important? (teethtalkgirl.com)

Reminds self to check when my next hygienist appointment is.

I feel your pain. It took a long time to get help with my gum issue. My dentist would be useful for caries and fillings, but I just kept getting more even though I flossed/used a water flosser.

For the last 2 years I have been seeing a dental hygienist every 4-6 months. I haven't had any further dental issues, and my dentist has put me on a 12 month call back (previously it was 3 months).

I am frustrated that it wasn't discussed with me due to the high level of caries that required 3 monthly call backs that a dental hygienist would be something that could prevent harm.

I would encourage a report to the GDC. Not to get recourse from the dentist but so the GDC can collect information on people's experiences. It may show a hole in the communications and help dentists get resources on how to talk to patients about their gum disease and next steps.

I would report him to the professional dental register this will be much MUCH more damaging to him than getting sued. Healthcare professionals have insurance for being sued and lawyers will fight it out but having to answer to the register is a huge deal where he will have to defend his actions and they will do a completely impartial investigation which will change his practice in the future if he cares about his job also if the regulatory body finds him guilty it would add huge weight to then suing him

I hear you OP. This has happened to me too. I was seeing a hygienist every 12 months but in 15 years I wasn’t given an x ray and they were not monitoring it.
They said it was due to being a previous smoker but quite frankly I’ve seen crack addicts with better gums than mine.

My husband and friends are all ex smokers without gum issues so they too are thinking it could be hereditary factors
Like you I’ve been told my teeth are healthy and my brushing is good and despite repeatedly asking if they will pull my teeth out to save my gums they won’t.

i had intensive orthodontic treatment as a child and teeth removed which shouldn’t have been removed and when I’ve looked into this, this also could have a massive bearing as this weakens the bones so could have been a contributing factor

i already have bone loss too. I’m so anxious now when I go to the dentist and the way I’ve been spoken to on occasions like it’s my fault despite 15-20 years of banging my head against a wall!

I'm sorry that happened to you too, bakebeans.

It's so frustrating. I know what you mean about there being drug addicts with better gums than ex smokers.

The periodontist explained why some people are more predisposed than others and why, in those cases, the person is at a higher risk regardless of an ex smoking status.. so just because you once smoked that's not to say the disease starting is our fault. It doesn't help matters of course, but it isn't the root cause.

She also spoke about the different types of good and bad bacteria and how those of us with perio tend to have a more aggressive type. I'm sure the dentists among us can expand on that as I was a blubbering wreck at that point and can't recall word for word.

Now I know what I have I've realised that my mum and aunt likely both have it too. My mum lost teeth and needed a partial denture and my aunt has massive gaps between all of her teeth. They just didn't really speak about it. Embarrassment most likely. My mum never smoked.

I've been thinking back on my last several appointments with my dentist and just remembered something else which has now just pissed me off even more.

On one occasion, two or three visits ago, after I mentioned wanting to see a hygienist and him telling me I didn't need to, I asked whether he would be doing a clean for me and he told me that I could do it and that it was my "homework"

What the hell is that about? That's not acceptable is it?

Oh and apparently stress is an an aggravating factor too. She asked me about my stress levels in general, which are through the roof. I have ADHD and a disabled child so I'm practically running on overwhelmed mode.

So others in my position, it's something to bare in mind, try and keep your stress levels at a minimum where possible.

That is terrible. My dentist is very thorough, I hope! I was quite surprised when he said I only had gum disease in one tooth!
Definitely complain to the practice initially, then it could be escalated to the legal route or the GDC.
I was just wondering, do you take a strong medication for your bones/osteoporosis?
There is one medicine that causes osteonecrosis of the jaw, ie bone loss. I was told I shouldn't take it as my teeth were dodgy at the time. Quite a few women I know have got this after taking this medicine for several years.

Hi @FuckedFuckedFuckedIt Just a couple of other (easy/cheap/free) things whilst I remember. Xylitol is very good to reduce the bacteria too. I buy a bag from the health food shop and swish a half a teaspoon around after eating/before bed. Mouth breathing is very bad for teeth too so if you do that it would be good to try to stop. Sipping drinks through the day is also not great as it dilutes your saliva which is full of the beneficial bacteria and protects teeth and gums.

No medications for bone issues no, I was taking baclofen for 18 months or so but that's a muscle relaxant.

Thank you for the helpful pointers and suggestion to get some Xylitol, i'm on it 🙂

Mouth breathing - I think I must do it during the night as I tend to wake up with a dry mouth. I'm drinking a shed load of water throughout the day at the minute as I'm on a weight loss journey, I could make a point of having a pint every so often rather than constantly sipping throughout the day.