Grades 1 and 2 mobility in teeth

[NooNooHead]

Argh. Just saw the dentist for a checkup and have grades 1 and 2 in a couple of molars apparently 😳

I'm 44, perimenopausal, and not on HRT. I've been having lots more problems with gingivitis since having started perimenopause, and never had bleeding gums before. I think I'm pretty meticulous with my oral health, using an electric toothbrush, floss, interdental brushes, mouthwash, but clearly I need to do something else to prevent my teeth getting worse 😬

Having said that, maybe I am being a bit OTT, and it's just age 🤔 😅 I don't have any pain with the teeth mobility, so I might just watch and wait rather than jump to the worst conclusion!

Getting older sucks 😕

Any wise words would be appreciated please, to stop me panicking a bit!

How much bone loss have you got on your x rays, do you know what your gum health scores were do you grind your teeth as well?

Do you smoke or vape , have you got diabetes or dry mouth?

Have you seen a hygienist and have they shown you how to clean your teeth effectively?

Unless your dentist recommended stop using mouthwash , most do very little clinically, they interact with toothpaste and wash fluoride away.

What has your dentist said about treatment?

90% of treatment of gum disease is up to the patient , getting rid of factors which promote it like smoking and increasing effectiveness of cleaning.

I don't know the bone loss as I didn't have an x-ray as I get worried radiation might affect my movement disorder symptoms (silly, I know!)

I should have one, obviously.

Don't smoke or vape, never have done.

Saw many hygienists and a gum specialist at the start of my perimenopause symptoms 5 years ago, nothing was untoward then. I think i brush quite well, I was shown which size interdental brushes to use and I floss once a day too.

Most of the risk factors I can think of are probably hormones. I did have gestational diabetes so am at greater risk of type 2, but I don't have a bad diet with lots of junk etc.

My gum health scores were OK when I saw the hygienist before but I've noticed more receding since perimenopause.

Calcium and vitamin D are deficient in many diets and perhaps more relevant to women of a certain age. It never hurts to make sure you're getting good nutrition.

https://pubmed.ncbi.nlm.nih.gov/36537578/

Dental x rays contain less radiation than a one way plane trip to Spain.

You really cannot know what is going on with bone levels until you have x rays done , so make an appointment have the x rays , find out what your gum scores are and go from there . Grade 2 mobility is not good and gum disease can rapidly become worse.

Have you had your hba1c levels checked recently? Ie your blood glucose ? Some chemists will do it but with a history of gestational diabetes you should have it checked regularly and most gps will be happy to do it as part of your well woman checks . Get it checked.

At the moment without x rays and without gum health scores and knowing your diabetes situation any advice would be given in the dark .

Blood test for hba1c is booked for next week, and I will call the dentist to see if I can book an x-ray.

I know that it's most likely if I have gingivitis, it will progress on without goid treatment. But I've never been lax with my oral health in the past few years, nor have I noticed any loose teeth. That's why I was a bit shocked at what the dentist said 😳

This is not gingivitis , it is probably periodontitis , and gum disease normally gives very few signs or symptoms until the damage is done and teeth become loose.

You will probably need several x rays to survey all the bone levels on all the teeth . One dental x rays had the same radiation as eating two Brazil nuts so several is still a tiny amount , less than that flight to Spain.

This is why regular x rays are so important .

Weird though how the gum specialist told me it was ok.and my probing scores were OK too.

I guess a lot can probably progress in a few years 😳😪

But even if the extent of bone loss is known, what is she to do about it if she already does all of the above which sounds very rigorous and has a good diet?

Things can get much worse in months, under the right conditions . If you’ve had gum disease it is never cured it is only ever kept under control.

Regular check ups and x rays at intervals determined by your risk factors can help spot problems early.

I would get my arse straight to a perio specialist in your situation. You can self refer. If you have mobility then you have bone loss. You need to find out if it’s vertical (ie affecting a few teeth) or horizontal (affecting lots of teeth). Horizontal bone loss is the bad one as it needs to be stabilised or else the bone loss will continue abd you will lose your teeth. Vertical bone loss responds well to LANAP which is a laser treatment and the group I’m part of people are seeing some bone regrowth after treatment. Just go and find out and get the treatment you need.

It may well be vertical bone loss if your probing depths were generally good. That’s something that can be treated.

Most people’s cleaning is not effective and if she is following recommendations from years ago they may not be right now.

If she has poorly controlled diabetes that can really fuel gum disease , which is why it’s important to get that checked out.

The rest depends on what the x rays show . Mobility of this type is mostly down to gum disease but eg grinding or clenching your teeth can also make it worse , so taking steps to alleviate that can help.

Without knowing what x rays , bleeding scores , plaque scores , gum health scores show and without knowing about blood sugar levels it’s impossible to say which of the many interventions that are possible are the right ones.

I did see a perio specialist in Norwich and they were very good. Bloody expensive but I guess i need to see them again now!

Not sure what else i can do with regards to oral health. I am doing everything they recommended 😳😬🤔

Not necessarily . Grinding or clenching can also cause mobility. Impossible to say without x rays what the problem is .

But if things have changed then eg the size of interdental brushes you should use might have changed.

Have you been seeing a hygienist regularly since seeing the specialist? Gum disease is never cured only controlled and needs life long maintainance.

True, and i try to use the best sized one (mostly the biggest ones that fit comfortably).

I'm actually quite worried now. I've always had good oral health but didn't floss for a few years when younger so maybe that's particularly had an impact. Grr. I like my teeth 😬 and I feel terrified of losing any 😪😫💔

It's a really impossible thing to see a hygienist with the NHS now and I think the last one i saw was privately. I'm going to book to see them again now!

This is true , but if you have had gum disease it is important to commit to lifelong maintainance and that will probably be privately .

Depending on how things are and how well you control your gum problems you will probably need to be seen ,once things are stable, between every three months to twelve months , for life .

Things can change rapidly and gum disease is never cured .

Very true 😟 I think my gum pockets were 1 to 2 when I had them measured last time.

I'll need to book a hygienist appointment for next week now I think too!

Unfortunately scores of 1 and 2 meant your gums were not healthy when you last had them measured a few years ago. 1 means your gums were bleeding and 2 meant that there was tartar (plaque) , in other word your cleaning was not totally effective. Seeing hygienist is a good first start , you may need several appointments , but having x rays for them to see is a must . Some hygienists/therapists can do x rays without a dentist input.

https://www.dentalrooms.co.uk/cosmetic-dentist-wimbledon/wp-content/uploads/2024/01/gum-health.pdf

Grinding won't cause grade 2 mobility without bone loss!

You need xrays, if you have grade 2 mobile teeth you will likely have fairly significant bone loss. Why did you see a perio specialist 5 years ago? You wouldn't need to see a perio specialist just for bleeding gums, you must have add periodontal disease? Did they take xrays then?

If you've developed sudden mobility and your BPE scores are good, you don't have pocketing or bleeding, then you need xrays to rule out other underlying causes. It is most likely bone loss caused by periodontal disease, but without xrays you have no idea where you stand

I’ve seen grade 3 mobility on a grinder with no bone loss . I was amazed , you could push the anteriors up and down . Came off the meds that were aggravating and in a week back to normal .

I actually saw the perio just for bleeding gums as they suddenly became severe literally out of nowhere after my youngest daughter was born in 2020. Before that, I had no gum pockets, bleeding or gingivitis whatsoever. 😫

I think the dentist today said the grade 2 was only on one tooth, and the grade 1 was several teeth.