toothless - bone degrading issue

ali-t

Hi, I am looking for experiences or info about options available when teeth are at risk of falling out.


My partner went to his dentist for cosmetic whitening a few weeks ago and the dentist refused to do it until his tooth/gum/bone issues are resolved. He is going back for another appointment this week to look at treatment options but I would like to have more info for us to be able to make a decision about the options, particularly when it looks like it has the potential to be very expensive.


He has been told that the bone in his jaw is disappearing, most likely due to having been a smoker for years. He gave up a couple of years ago but the damage has been done. Potentially in 2 years his teeth will have all fallen out as the bone can't hold them in.


We did a bit of reading online about bone transplant type things but most of the info was American rather than British so I couldn't identify approximate costs or how effective it is perceived to be in the UK.


Would anyone who has experience of this type of thing be willing to share their experiences or any professionals (Toothsmith/Brook2Jack) be able to point me in the direction of relevant and easily understood literature.


If it is relevant to any info shared he is in his early 40's, doesn't smoke now and would be willing to try almost anything to keep his teeth. Thanks

brook2jack

You can't really say without looking at x Rays, and the patient in the chair and their medical and social history.

Gum disease is never cured it is only ever controlled. The number one thing he has done to help is give up smoking.

Periodontal treatment is virtually non existent on the nhs so for advanced treatment you will be looking at private charges.

Firstly will be a series of simple hygiene visits and root planing , normally £40 to £60 a session and he may need ten or more visits.

If things are not resolving and there is sufficient bone to warrant it a referral to a periodontist may be next £150 ish for assessment and then cost of treatment on top. Bone grafts, gum grafts etc are suitable for small areas of bone loss on individual teeth but are not a cure for gum disease. They are merely treating the symptoms. Excellent, continuing and meticulous cleaning, no smoking or e cigs , and good control of diabetes , if present , are critical.

However even with this some or all of the teeth may not be able to be saved.

If this is so what his options to replace missing teeth will depend on how well he can control his gum disease and general dental health. Eg implants have a very poor prognosis on someone with active gum disease.

Toothsmith

Getting advice from the dentist who has seen you and knows first-hand what is going on is much more reliable than anything we can guess on.

If there is still enough bone to support the teeth as they are - then the first stages of stopping the process are quite straightforward.

He's stopped smoking - that is hugely important and the best thing he can do.

He will then need all the accumulated crud on the teeth removing. The plaque and tartar which probably still has traces of the toxins in it from when he smoked, and are still poisoning his gums. This will probably take a few visits to the dentist or hygienist and will be done in sections under local anaesthetic. This will improve the health of the gums.

Then - he will have to learn how to keep things REALLY clean himself. This in not just a couple of minutes with a toothbrush once or twice a day. But a good few minutes with the brush, then lots of work with interdental cleaners (the hygienist should recommend the most appropriate ones for his gaps) to really keep every surface of every tooth plaque free.

It might be that some teeth that are deemed to be really hopeless might have to go - in order to help preserve the others that are more healthy - but the dentist will explain this if relevant.

All those things together have a decent chance of stopping the destruction of the bone, and hopefully saving the majority of the teeth.

Only when he can demonstrate that he's really good at cleaning his teeth would it be appropriate to try more advanced measures to rebuild bone and preserve more teeth - because if he can't do that, it doesn't matter what you try - it will ultimately fail.

But if he can really get on top of the self-care - then they may not be necessary anyway.

Listen to the dentist/hygienist, and remember that the cleaning advice is just as, if not more, important than what they actually do!

It will ultimately be HIM that cures the problem himself.

Toothsmith

Ha - Brook is about 10 mins ahead of me today!!

brook2jack

Ready,steady............

ali-t

Thanks for the info, pretty depressing reading. I will show him the responses and see what the dentist says this week. Thanks again.

ali-t

Feedback from the dentist is approx 5 years of teeth left. 1 is coming out this week and high flouride toothpaste on prescription. Was also advised to use an oscillating rather than sonic toothbrush. Its now all in place and as you both said, commitment from him to follow the treatment plan is what is required now.

brook2jack

The only thing to mention is high fluoride tooth paste is for tooth decay or for treatment of sensitive roots not gum disease itself.

He should also ask for advice on how to use tepe brushes for in between the teeth.

Tigsteroonie

brook2jack wrote: »

He should also ask for advice on how to use tepe brushes for in between the teeth.

Are the latest fad, a move on from flossing with string?

brook2jack

Less than 30% of people floss. Of those who do floss less than 20% use it correctly.

Where someone already has gum disease they are likely to have large gaps between teeth. Floss is even more difficult to use around large gaps. Tepe or similar brushes are easier to use and more effective in large gaps.

If you are not flossing and/or using tepes you are not cleaning 30% of the tooth and you are not cleaning the place gum disease is most likely to start.

Owain_Moneysaver

Tigsteroonie wrote: »

Are the latest fad, a move on from flossing with string?

Interdental brushes are wonderful.

(Dental floss is great for getting gunk out of cooker knobs though.)