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 had some gum disease and now I use an alcohol free mouthwash with chlorhexidine. I don’t think ANY bugs can survive it! Also flossing, using interdental brushes, and Gengigel.

I've come across gengigel mentioned a few times when I've been reading up about gum disease, I'll stick it on my list of things to buy. Thank you!

I had exactly the same thing - fobbed off for years by a shit dental practice. Tbh all they wanted to do was sell whitening or Invisalign. I do wonder what professional standards Demtists really have, I called them but they were not helpful. have gone private and spent about £2k last year on my teeth and have more treatments to do this year, I just don’t have the money. My periodontal treatment really helped and I’ve got used to the little black triangle at the front . The gums have improved massively. I complained at the time but got nowhere.

I'm really sorry to hear this is I happening to you. But I can really sympathise as I am in exactly the same position as you. I go to the dentist every 6 months, and the only problem I've ever had was 2 small fillings 15 years ago. I've been through 4 NHS dentists in about 5 years at the same practice as they keep leaving. They might clean my teeth of a bit of tartar on my middle bottom teeth once a year, occasionally twice, but they have never mentioned a problem. Two months ago I attended my regular 6 month appt and it was another new dentist. He took one look, took an X-ray and told me I have 50% bone loss at the bottom front 4 middle teeth. I had to have them cleaned after having an anaesthetic because it hurt so much.
I was so stunned at the time I just accepted it and cried all the way home, really traumatized (I don't like the dentist anyway!)
But like you I've been doing my research and now realise this should have been caught/mentioned much earlier so that I could have at least prevented any further damage as much as I could. I am so angry and I'm now getting facial paralysis, feelings of like ants walking over my chin and it hurts when I bite. I didn't have any of this before the last clean!
I am seriously considering reporting the dentist but have too much going on elsewhere to have the strength to do it.
Also the dentists advice to manage it was "just get an interdental brush". I was already doing this!
Honestly I get the feeling that NHS patients are an inconvenience as we don't make them enough money.

I'm so sorry you're going through this op, it's incredibly frustrating.

We had very similar issues. Ds7 needed a filling, so the dentist did that. A week later it fell out and was causing him pain so took him back for emergency appointment and saw a different dentist. The new dentist said ds' teeth were terrible, 7 teeth had decay and he was referring us to hospital to have them all extracted! But because of NHS waiting lists that would take over a year. I asked him why the previous dentist hadn't mentioned the decay and he told me its not the dentists fault, but mine for not making him brush.

I was absolutely devastated. Ds has autism so diet and brushing is a challenge but I never expected that. I did some research and found an incredible Bupa dentist and she has saved ds' teeth. He had 1 extracted under local anesthetic and she has stabilised the rest. Turns out he has problems with his enamel, possibly due to antibiotics when he was a baby. She paints some sort of resin on the teeth and he has regular fluoride treatments.

I'm not a violent person but I could happily punch that shit dentist in the face for making me feel like a terrible mum.

It is really difficult to diagnose gum disease in young smokers. And despite continually warning people about the risks of smoking it often falls on deaf ears. In addition young smokers assume that it will be years before smoking does any damage.
Aggressive periodontal disease can also rapidly destroy bone and gum attachment in a matter of months.
Ask your periodontist to explain the genetic cause. It is usually related to an over reaction of your own immune system. Oral hygiene on a daily basis is key to treatment. Regular visits with a hygienist will only help if you are meticulous about cleaning your teeth daily.

Periodontal disease is much more complex than just not brushing your teeth and it affects less than 10% of the population. Most of us will develop gingivitis if we don’t brush but this is reversible. Those unlucky to have the genetic predisposition will start to see problems in 2-3 days of not brushing.

Although deep scaling is necessary the first thing your periodontist should have done is to go through all the techniques required to clean your teeth to prevent further damage.

OP sorry to hear this. You mention you're on a weight loss program, are you entirely sure you don't have diabetes? Have you had your H1ABC tested if your BMI is over 25?
You may already have read about this, but smoking (also ex-smokers) and diabetes are the risk factors that are the crucial ones used in the UK :

www.bsperio.org.uk/

If there is diabetes, it's really important to get it stable as periodontitis is REALLY difficult to control otherwise.

Best wishes.

To be fair ,OP, having your teeth cleaned every three months will have no effect on your perio disease if you are not cleaning them thoroughly on a daily basis.

I use to spend a lot of time demonstrating brushing, advising on brushes and products. Now we have the internet, there are some brilliant videos showing you how to use products. In addition there are electric toothbrushes that use apps to visually show whether you have cleaned everywhere.

Spend some time watching a few videos. There are better ways to clean rather than oil pulling. Water picks are more effective, jet washers for teeth. You can also add medicated mouthwash to the water.
A combination of general brushing, interproximal brushing and water pick and floss for smaller gaps, is required.

Set aside a good 15 per day for cleaning. You don’t have to do everything at the same time, I tend to use floss and interproximal brushes while I’m watching tv in the evening. I can often spend 20mins cleaning. Then brush using an electric brush before bed or in the shower.

Dont despair. I have had plenty of patients who have managed to control their perio disease. From experience home care is the most important part of treatment and one which you can control.

I don’t get what you wanted the most recent dentist to do?

Previous ones didn’t mention the gum disease and you’re upset, but the one who did diagnose it and start treating it you’re considering reporting??

It’s not their fault if your teeth have not been cleaned properly or you have bone loss which means a clean will hurt afterwards.

Op, you have my sympathy. I’ve recently had a traumatic time with a dentist and it’s left me in a mess. Just a word of caution, you’ve had a lot of good advice regarding products going forward but it wouldn’t be advisable to use them all together. Do your homework on all of them and chose the ones that will help the most, get advice if necessary. I’m the same and panic buy a lot of stuff (happened with vitamins) and it’s an expensive mistake.

Posting a link to a dentist in America, you can sign up for his newsletter and he gives all his info for free. He goes into the breathing problem too and explains how to correct it. He’s big on carnivore for health (not sure if you will be interested in that?) but it’s there if so. I make sure to eat as much meat and fish as I can. https://www.kevinstock.io/

We are seeing the results now of a very broken health system, it is no longer a worry for the future, it’s been going on in dentistry for a very long time, insidiously so.

Would be very interested to see how you get on and welcome any updates. (No pressure though, I know devestating it is and how you will be feeling).

Good luck.

I have an nhs dentist but pay privately for whole family to see a hygienist every 3 to 6 months.

Also genetic over here, went private 6 weeks post partum as my gums had gotten awful as part of pregnancy. I had quarterly scale and polish pre covid at my nhs dentist so it wasn't new news. Found out I had an impacted wisdom tooth, a filling need replacing and that I had some bone loss. I also got sent with private referral to a specialist who again said I couldn't do any more with my hygiene and that it was genetic ( I don't smoke etc). Had intensive three time deep clean with hygienist then signed up to the private plan with two deep cleans a year but I usually do one extra although that's now dropped off. Now totally stable and dental team happy but I still have pockets but they weirdly don't bleed or cause issues so I'm abit of outlier. Anyway just to say it can be made better.

Oh fgs don't be ridiculous

Its negligence

On whose part though. It’s no secret that smoking causes longterm health problems. Is the patient negligent for smoking?

@Angrymum22 the OP seems to think the dentist is negligent. She should get some free advice to work out whether she could have a claim. I’m not a lawyer but that’s my advice to OP. See a lawyer and get advice.

If it is negligence and she wins a case she might get money she could put towards future dental treatment etc

I had a very similar experience & now have a mouth full of implants & an empty savings account. I fly to Albania annually for my remaining few natural molars checking, I don't trust UK dentists. I feel like I've been hit twice by these profiteering crooks, I was one of the thousands of children who were abused by dentists in the 70s - unnecessary fillings & extractions all in the name of profit. I'll never visit a UK dentists again & neither do my children.

Get a grip of yourself woman. It's negligent for a health care professional not to make a patient aware that they have a serious disease, how could you think that it isn't?

As poor a choice smoking may be, it's completely unacceptable to withhold the diagnosis and rob somebody of the opportunity to tackle the issue at the earliest opportunity... just because they used to smoke.

Fucking ridiculous.

The amount of negligence we see in children’s dental health is criminal. The majority have never seen a dentist. The negligence is from parenting.
If people neglect their teeth then they are just as much part of the problem.
Well before the current health crisis over 40% of the population never saw a dentist, through choice.
It is easy to blame a dentist but I have seen hundreds of patients over the years with perio disease over the years, informing the patient can have several outcomes

1. they ignore all advice because they don’t think there is a problem
2. after fully explaining the cause and treatment they accuse you of trying to con them out of money and flounce off. I frequently see flouncers from other practices and confirm they need treatment. They argue that appointments with the hygienist are a waste of money and flounce again
3. the patients who nod along while you carefully explain and then tell you that they trust that you will sort it out. At every subsequent appointment they have made zero effort to clean their teeth because they assume you have a magic wand - we don’t!
4. the super indignant patient who spends a fortune on nails, Botox and lip fillers whose mouth is like a cesspit because the budget doesn’t extend to a toothbrush. Well if it does it remains unused. These are the ones who claim you have no idea what you are talking about and they can’t possibly have period disease because they brush 60trillion times a day.
5. and then there are the truly wonderful patients who remember what you tell them and engage with the treatment plan, fess up if they have let their standards drop and put it right. Those are the patients who will keep their teeth longer. But throughout they are aware that there is no cure and they may potentially loose all their teeth eventually.

It is awful having to tell a patient they have perio disease, particularly if they have had a healthy mouth up until then.
Being brutally honest doesn’t always go well, in the past I have tried the gentle route but patients often fail to understand the gravity of their situation. So now I go brutal and paint the worst case scenario so that even if the patient goes into denial I can record that we have given them all the information. They may go elsewhere but at least they have all the info they need.

Negligence can be applied to the patient who fails to acknowledge their diagnosis. It can also apply to parents and carers who neglect the health and well being of children and young adults.
The definition of negligence
negligence

noun

1. failure to take proper care over something.

So I would argue that after a lifetime of working in dentistry most patients are negligent to varying degrees in the care of their teeth.

@Angrymum22
I recognise all those scenarios you describe. Been there and got the T-shirt 🥲

I'm also brutally frank about the clinical situation nowadays. It's the only way. I present the clinical FACTS, up to patients what they want to do with the information from there on in. I'm very sympathetic when patients and parents are then subsequently upset but it's really important to use clear language and not sugarcoat the message.

Whether the OP in this case,was given the true clinical picture 🤷‍♀️ v hard to say- without being there at the time. I'd have to read the clinical notes to decide.

I was in this position a few years ago, and asked the dentist why, as I had been going every 6 months all my life, had this not been spotted.
Their reply..ask the Practice Manager !
I did and of course what could he say.
Anyway, I had deep cleans, one quarter of my mouth at a time, and it did the trick. Gums perfectly tight and healthy.
Now I have issues with old crowns that have slipped, decay below, and have to replace privately. Very expensive.
I hope you get your treatment sorted out ASAP. Good luck

20 years ago I was told I would need extensive treatment by a periodontist. Handed a bill for over £600.

25 years ago I had seen an NHS dentist for a check up. The very same evening my face was swollen, one area of my gums red and in agony. Three lots of antibiotics later this dentist tried to claim it was gum disease.

For several years I had a very small area which felt "itchy" I saw many dentists and NHS maxifacial specialist. No answers. I also developed a burning sensation in the roof of my mouth. I was told how to brush, what dental sticks to use. The last NHS dentist I saw told me "you are brushing your gums away" yep.....all that advice followed but they still had to blame me.

Five years into this hell that last NHS dentist made the periodontist referral. I was told "it's fine we have caught this in time" here's a bill to pay up front. I never went back. I couldn't afford it.

I have since only seen a private dentist with access to regular hygienist. Every 6m for a few years. She diagnosed oral allergy syndrome. Told me I was indeed brushing my gums away.

I discovered oil pulling. When I saw the hygienist she said "I don't have anything I can do" you don't require this appointment" she was amazed.

In short, NHS dentist introduced a terrible infection into my gum. I suffered for years, and was told it was my fault. I was told I'd loose my teeth without expensive treatment. My oral allergy syndrome was also apparently due to my inability to brush my teeth "correctly" and then to over brushing my teeth.

I have all my teeth, I no longer even require the hygienist. The "itch" occasionally crops up in that one small area of gum. I have antibiotics if required. It seems that will perhaps never be completely resolved, and no one can tell me why. My gums are fine, the bone fine, teeth white and no fillings whatsoever. Never had a filling because.....you guessed it I looked after my teeth!

Oil pulling......try it, its fab. Whatever you do next, only do so after you have a second opinion. And best wishes

But do you think it's acceptable to withhold such a serious diagnosis? Because I don't.

Well I can assure you I wasn't.

Whatever the notes say, the information wasn't shared with me.

I didn't even know what periodontitis was until I came across it via Google.

But as long as its on my notes then that's his back covered isn't it 🙄

I was googling because I wanted to know what was going on with my gums, If I was made aware of the disease I'd already have known and wouldn't have had to go looking and diagnose myself.