Any dentists that can help? So confused?

[DentalConfusion]

My DH has just been to the dentist and been told he has pockets of varying depths (over 3mm) along his front top teeth - one tooth has a pocket of either 6 or 7mm, he can't remember. The dentist said it/they might need deep cleaning, but then has just told him to come back in 6 months and he'll review. He also said he teeth were very clean and the pockets aren't caused by poor hygiene. He had a hygienist appointment a week or so before and she said the same thing ie that his teeth are clean but he had some pockets - speak to the dentist.

So I don't understand - what could suddenly be causing this pocketing? Is this still gum disease even if the teeth are clean? Everything I've read online says a 6/7mm pocket needs a deep clean as you can't get that deep with at home cleaning methods, so why would his dentist just have left it for 6 months - is it possible this will get better of its own accord? What could he be thinking?

The other weird thing he is has absolutely no symptoms. He has had no bleeding on brushing/flossing etc - he said he did get some v minor bleeding around the tooth with the biggest pocket when the hygienist cleaned it, but nothing when clean himself, and the gums look visually light pink and flat. It's very weird. I periodically get a bit of gingivitis and it's very obvious - minor swelling, bleeding etc, so how has he gone from nothing to a 6/7mm pocket with no symptoms?

My DH also about a year ago was found to have a cracked tooth. First dentist said there's a deep pocket (everything else looked fine), it's cracked below the gum line, so it needs to come out. We were referred to an implant dentist. He looked at it and did a CT and said he didn't think it was cracked below the gum line and referred us to a endodontist who looked at it, and agreed it could be saved and did a root canal. The implant dentist also said that my DH had a wisdom tooth with some pocketing and that also needed to come out.

Saw yet another dentist for the crown which was fitted. No mention made then or since about the mysterious pocket, or the wisdom tooth.

What I don't understand is why there was a 7 mm pocket when the tooth wasn't cracked below the gum line? What caused this and why hasn't anyone addressed it? Could it have resolved itself? And why is no-one now mentioning the wisdom tooth?

Really confused. I don't think it helps that my DH doesn't ask about these issues brought up previously, he just lets them look and get on with what they think? And he doesn't ask the right questions or remember exactly what was said so it all gets a bit muddled!

If any dentists can shed any light on any of this, I would be very grateful!

Definitely needs to ask for a referral to a periodontist for further investigation. Gum disease can be genetic ie oral hygiene is good but still bone loss and attachment loss occurs. Pockets can be localised and even in one area if caused by other factors like trauma and cracked teeth .

It's normal not to be able to remember everything or ask all the questions as it's a nervous experience being at the dentist.
Pockets can shrink after a hygienist appointment. Sometimes malalignment of teeth can cause pockets as well as genetic propensity for pockets. I don't know why he wasn't referred to a perio specialist. He can ring or email the practice and ask this, the dentist should get back to him or invite him back to speak face to face. Dentists are used to follow up enquiries from patients as it's common not to remember or ask everything. Don't be hard on your husband over this.

I have gum issues too and believe it is genetic. I always get told that my oral hygiene is very good but have to see a hygienist every three months to keep on top of it.

After thirty years of perfect teeth and no issues I was told recently by a new dentist that an area in my mouth was bad in some way. Said something about pockets and maybe needing to see the hygienist (for the first time in my life). I've no idea why, I also have no issues, clean and floss regularly, no bleeding etc. he also sent me away for six months.

I was hoping it was maybe just an over exuberant newly qualified dentist but I've no idea, I'll see what happens in six months but I'd really rather not start shelling out for hygienists if I can avoid it. Cost me £90 for a ten minute check up last time.

My DH isn't nervous at the dentist. He just isn't great at remembering and relaying what's been said! I'm not being hard on him at all, not sure why you think that, just very worried for him and he is really worried so we are trying to get to the bottom of it together.

I think we are going to email the practice to get an answer to some of these questions. Particularly why he hasn't been referred. I am not sure what the dentist thinks might happen in the next six months. Everything I've read says it won't sort itself out and you can't clean it at home. It's too deep.

He already sees a hygienist every three months. He's seen a dentist at least three or four times in the last year for check ups and due to his cracked tooth/root canal/crown. He also brushes twice a day religiously. Flosses and tepes once. And water flosses once.

Both dentist and hygienist said his teeth are very clean and he's doing everything he should be so it's not that. It's so frustrating knowing this has happened when he can't do any more than he's doing! And worrying about it happening more (as we don't know why it's happening) and getting severe bone/gum/tooth loss. 🥲

I would go to the hygienist if I were you and nip any issues in the bud. I had quite bad gum disease in my twenties and had to have a lot of painful and costly treatment and I am left with gum recession as a result. Once your gums are receded it's much harder to keep your teeth clean (you don't want to know my teeth cleaning regime to keep on top of them!!!).

The hygienist can also give you advice on teeth cleaning if there are areas you are missing so even if it's only gingivitis (which is fully reversible) she can make sure you are cleaning it properly so it goes away before developing into periodontitis which usually means deeper cleaning, bone loss, tissue damage and recession.

If you get it early and quickly it can be reversible or minimised.

maybe needing to see the hygienist (for the first time in my life)

I'm puzzled - why did you not see a hygienist up until now? If you are interested in having healthy teeth, you need to get your teeth cleaned once, preferably twice a year.

I've been to the dentist every six months all my life (apart from
Covid when it was a year). same dentist, no issues, check up, scrape and clean a bit of calculus that may have built up and a polish. Always said my teeth are perfect.

He retired, new dentist arrived and starts talking about a hygienist. I have no idea why I've never seen one before?

And of course I'm "interested" in having healthy teeth. What a fucking ridiculous thing to say.

Hi,
it’s not easy to comment about a patient without a full examination however while bacterial plaque is the main cause of periodontal pockets, they can be caused by genetic , smoking habits , poor teeth alignment and filling/crown margins that are extended below the gum level as well .

if there has been a cracked tooth , even though tooth has been saved , chances are restoration is extended beyond gum margin .

please remember that treating dentist is the best person to give advise as has your records .

I hope this helps.