Periodontal deep clean

[MrsBartlet]

I have various different dental issues going on at the moment and I am seeing different specialists for assessment before my dentist decides which is the best course of action. I have a 7mm pocket between two of my front teeth and some bone loss. This is localised as I don't have general gum disease. One of these teeth also has a sinus tract issue going on which will be dealt with separately. My dentist sent me to the periodontist who has suggested a non-surgical deep clean but I am concerned how that will leave my gums looking afterwards when the pocket reduces and the gums receed. I have been reading about black triangles between teeth and a sort of cuff above your usual tooth being seen once the healing takes place after treatment. Does anyone have experience of this and how bad it looked? To further complicate things, I have old crowns on these teeth which will get replaced but not until after all the periodontal treatment is done. They are the old porcelain and metal crowns so the treatment will expose the metal margin.

My dentist is also now wondering if I should just get implants in these two teeth as the other treatments options could fail anyway but obviously the process of getting implants is not an easy one either, especially for two front teeth and needing some sort of temporary solution for months. I am trying to weigh up the pros and cons of each option but can't find much in my research about how bad to expect my teeth to look after cleaning with receded gums. Can anyone help? Thanks!

You will get a black triangle but keeping your own teeth is always preferable to implants, and can be hidden with composite once your gums are healthy again.

Implants are expensive, not as good as real teeth, and have a life time as well. Implants require impecible cleaning and gum health, so if you don't get on top of it now your suitability for implants will diminish, also 7mm pocket sounds like you have a lot of bone loss meaning you may need a bone graft for an implant anyway.

Thanks @SundaymorningcallaI think my main concern with the deep cleaning is being left with the root of the tooth showing which doesn’t look great and I am not sure that this would be covered up when I replace my old crowns.

The alternative is you lose the tooth. You could try a gum graft if the exposed root is bothersome.

I’m confused, what is the alternative to getting the deep cleaning done?

I don’t see how you can proceed with any work until you have the gum problem under control. Yes it will result in some recession but this is unavoidable.

The dentist is considering an implant instead. I don't have general gum disease, just very localised to this tooth which has the 7mm pocket and the bone loss (and a root canal from when I had a fall as a child). She is concerned the deep cleaning won't stabilise the tooth sufficiently and that I will end up needing an implant anyway. And there is a tooth next to it with a failing root canal so she is considering an implant for that one, too.