Peridontal work and the NHS

pickledonionspaceraider

Hello there

I have been advised I have 90% bone loss by my NHS dentist, and suffer from wobbly teeth. They suggested it may be due to osteoporosis which I suffer. NHS dentist says there is nothing he can do, other than what he has already done - give them a good clean and for self care at home to try and keep the teeth intact for as long as possible. Basically he expects me to loose my teeth and end up in dentures

Is this normal, that NHS can't or won't do anything else?

I have looked and there are options such as root planing etc, but the NHS dentist will not consider doing any of this and I feel fobbed off

brook2jack

In general osteoporosis does not affect gum disease. However other factors like smoking, diabetes does.

90% of controlling gum disease is what you do at home eg not smoking , controlling diabetes, effective use of tepe brushes, floss and tooth brush.

Earlier stages of gum disease there may be things a dentist can do to help someone improve their gum care. Root planing has gone out of fashion somewhat as has periodontal surgery and most interventions are aimed at helping someone control their gum disease by cleaning and lifestyle changes.

However if you have 90% bone loss and wobbly teeth then you are probably past the stage of saving these teeth and a tooth with 90% bone loss is likely to fall out by itself. The best that can be done is to plan for the tooth loss and save any others for as long as possible.

It is very unlikely that if all of your teeth show 90% bone loss that many can be saved. If they can it will mean major lifestyle changes for you and , as there are virtually no NHS periodontists , any advanced periodontal treatment would probably have to be private.

suki1964

I'm in the same boat, very little bone left in my upper jaw and I'm losing at least one tooth a year now and have had a partial denture for the past 15 years

I see a hygienist at least every six months, use tepee brushes, electric brush, a water irrigator thingy, and still I'm resigned to the fact I will lose the lot before I'm 60

But it's my own fault, years of heavy drinking and smoking. I stopped both for 12 years and halted the progression but started again

If only I had known the effects of smoking back then I'd never have started

pickledonionspaceraider

suki1964 wrote: »

I'm in the same boat, very little bone left in my upper jaw and I'm losing at least one tooth a year now and have had a partial denture for the past 15 years

I see a hygienist at least every six months, use tepee brushes, electric brush, a water irrigator thingy, and still I'm resigned to the fact I will lose the lot before I'm 60

But it's my own fault, years of heavy drinking and smoking. I stopped both for 12 years and halted the progression but started again

If only I had known the effects of smoking back then I'd never have started

It's horrifying.

I do (what I thought to be ) good care for my teeth as you do yourself, the teepe brushes, water irrigator, and brush three times a day - and always have.

Always been to the dentist for check ups, and they never mentioned there was any problem until the last visit when they did an xray as I mentioned two teeth were starting to get wobbly.I feel really let down by the NHS and Not really sure why this is happening to be honest. Its only the top jaw, all my bottom teeth are, at the moment, sturdy. Ive never smoked and a rare drinker. Am in my late 30's.Dentist even did a disclosing tablet check and no signs that there is any plaque build up. He seems as uncertain as I do other than to blame osteoporosis

From what people are saying it is likely I will end up with a denture then. I even considered having implants, but doubt this is feasible with 90% bone loss there would be nothing to attach to

brook2jack

Less than 25% of people clean their teeth effectively. Less than 28% of the small percentage of people who use floss use it properly. Here is a thorough video demonstrating disclosing, tepees, floss, electric and manual brushes http://youtu.be/QVvEuxFQcDc

nyc_451

pickledonionspaceraider wrote: »

From what people are saying it is likely I will end up with a denture then. I even considered having implants, but doubt this is feasible with 90% bone loss there would be nothing to attach to

I think they can do something for the bone loss if you opt for the implants.

I have two on each side holding a bridge of three teeth, that is to replace my six molars. I didn't get the most expensive implants but they feel like my own teeth.

GwylimT

pickledonionspaceraider wrote: »

It's horrifying.

I do (what I thought to be ) good care for my teeth as you do yourself, the teepe brushes, water irrigator, and brush three times a day - and always have.

Always been to the dentist for check ups, and they never mentioned there was any problem until the last visit when they did an xray as I mentioned two teeth were starting to get wobbly.I feel really let down by the NHS and Not really sure why this is happening to be honest. Its only the top jaw, all my bottom teeth are, at the moment, sturdy. Ive never smoked and a rare drinker. Am in my late 30's.Dentist even did a disclosing tablet check and no signs that there is any plaque build up. He seems as uncertain as I do other than to blame osteoporosis

From what people are saying it is likely I will end up with a denture then. I even considered having implants, but doubt this is feasible with 90% bone loss there would be nothing to attach to

An ex colleague of mine had implants on his uppet jaw, he had a bone graft from his hip to do this, so it is possible for some people with a lack of bone in the jaw.

brook2jack

The problem is if you don't tackle the cleaning and other issues that caused the gum disease in the first place then you will get gum disease around the implants and lose the implants to gum disease as well.

In some cases you may not have the right quality or quantity of bone to implant even with bone grafts and if you eg smoke the failure rates for implants are much higher.

pickledonionspaceraider

Hi again

I had an appointment today with an extremely expensive private dentist. I just wanted to see what options there may well be as I feel so desperate looking for answers to this and have reached a brick wall regards to NHS dentists.

The upshot is that private dentist feels there is at least one definite loss imminent and two possible losses dependant on what I do next - he did many xrays and advises that it is not 90% bone loss all round the jaw, just odd areas. He said he felt that the cause was genetic and although couldn't find any plaque could tell there was bacteria present as the gums are inflamed all round

Treatment plan is suggested at private dentist
Specialist peridontal cleaning (mouth disinfect, he called it) with oral antibiotics, total cleaning time 2.5 hours includes one tooth removal of the worst offender, plus two follow up reviews and assessments plus oral hygiene instruction for the grand sum of £905

There are no guarantees that this will work (to get rid of the gum disease) and is clearly an expensive procedure.

If this doesn't work, private dentist said that we would be in the perimeters of surgery to stabilise the teeth that are worth saving

I have had a clean a couple of months ago at the NHS dentist, and he took about 40 minutes to do the entire mouth numbed up. The private dentist said there were different levels of cleaning = and I take this to mean ''you get what you pay for''

I am really in two minds now, try the private expensive option and give it a go....I don't want to end up regretful that I didn't try it out in ten years when i end up with a full set of dentures

Has anyone tried the more expensive private dental route? Obviously a better/deeper clean may yield better results, but I am not sure if I will be literally throwing money away

what do other people think?

pickledonionspaceraider

anyone?

brook2jack

The treatment will only have a chance of success if you make the lifestyle and cleaning changes for life that will give your gums the best chance to heal. That means you will have to employ a vigorous cleaning regime that will take longer than your present regime and that will have to be kept up every day.

The dental treatment is only to help you control your gum disease, on its own it will do little.

If nothing else hygiene appointments to show you how to maintain your mouth are a good investment on their own.