Conflicting Dental Opinions: Periodontal Issues and Treatment Options

Periodontal issues

I am someone who places great importance on dental hygiene and visit a dental clinic for cleanings every year.
The senior dentist at Clinic A, who regularly examines me, always says that my teeth are well-maintained.
However, recently I have noticed black spots and small cavities on my teeth, and triangular gaps are forming between my front teeth and the lower middle teeth.
Additionally, the roots of my lower right third and fourth molars appear to have about a quarter of the bone structure missing, which makes me suspect calcium deficiency or that bacteria from periodontal disease are causing bone loss.
I have not experienced any gum swelling, bleeding, or sensitivity due to exposed roots.
During my cleaning, the dentist stated that I do not have cavities and that my teeth are stable.
He insists that the changes are due to natural age-related resorption and my aggressive brushing technique, and he only filled the bone loss with resin.
Later, I went to Hospital B for X-rays and examination, where the doctor diagnosed me with periodontal disease and mentioned that surgery might be necessary.
When I returned to Dr.
A, he still insisted that my teeth are in good condition and warned that surgery could lead to regret, as it might further reduce my gum tissue.
The opinions of the two doctors are vastly different.
What should I do?

Lan, 50~59 year old female. Ask Date: 2016/10/09

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Lan,
Hello! Both doctors are excellent.
Your teeth have some indentations, and there is gum recession, which is likely due to aggressive brushing.
The issues surrounding your teeth are related to periodontal disease.
If you have any questions, please visit a major hospital! Be sure to communicate more with your doctor.
Thank you! Wishing you safety!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2016/10/09

More Info

It sounds like you are experiencing a frustrating and confusing situation with your dental health, especially given the conflicting opinions from different dental professionals. This is not uncommon, as dental issues can be complex and may require a thorough examination and sometimes multiple opinions to arrive at the best treatment plan.
From your description, it appears that you are facing several dental concerns, including the appearance of black spots and small cavities on your teeth, the development of triangular gaps between your teeth, and significant bone loss at the roots of your lower teeth. These symptoms could indeed be indicative of periodontal disease, which is an infection of the tissues that hold your teeth in place. Periodontal disease can lead to gum recession, bone loss, and ultimately tooth loss if not treated properly.

Understanding Periodontal Disease
Periodontal disease is primarily caused by the accumulation of plaque and tartar on the teeth, which can lead to inflammation of the gums (gingivitis) and, if left untreated, progress to periodontitis. The black spots you mentioned could be a sign of decay, but they could also be related to the effects of periodontal disease. The triangular gaps between your teeth may indicate gum recession, which is common in individuals with periodontal issues.

Importance of Accurate Diagnosis
The differing opinions from your dentists highlight the importance of obtaining a comprehensive evaluation. While one dentist may downplay the severity of your condition, another may recognize the need for more aggressive treatment. It's essential to have a clear understanding of your dental health status, which may require diagnostic imaging (like X-rays) to assess bone levels and the health of the periodontal tissues.

Recommended Steps
1. Seek a Third Opinion: Given the conflicting advice, it may be beneficial to consult with a periodontist, a specialist in gum disease. They can provide a more focused evaluation of your periodontal health and recommend appropriate treatment options.

2. Consider Comprehensive Treatment: If periodontal disease is diagnosed, treatment may include deep cleaning (scaling and root planing), antibiotics, and possibly surgical interventions to restore gum health. Early intervention is crucial to prevent further bone loss and tooth mobility.

3. Maintain Good Oral Hygiene: Continue to practice good oral hygiene, including brushing twice a day with fluoride toothpaste, flossing daily, and using an antibacterial mouthwash. However, be cautious not to brush too aggressively, as this can contribute to gum recession.

4. Regular Dental Check-ups: Regular dental visits are essential for monitoring your condition. Ensure that your dentist is aware of any changes in your oral health and that they perform thorough examinations at each visit.

5. Discuss Treatment Options: If surgery is recommended, discuss the potential risks and benefits with your periodontist. Understanding the rationale behind the recommendation can help you make an informed decision.

Conclusion
Navigating conflicting dental opinions can be challenging, but it is crucial to prioritize your oral health. By seeking a third opinion from a specialist, maintaining good oral hygiene, and staying proactive about your dental care, you can work towards resolving your dental issues effectively. Remember, your oral health is integral to your overall well-being, and addressing these concerns promptly can prevent more serious complications in the future.

Similar Q&A

Navigating Conflicting Dental Treatment Recommendations: What to Do?

Hello. In mid-November, I felt discomfort around the root of my first premolar and went to Clinic A for an examination. The dentist performed a teeth cleaning (during the process, the dentist mentioned that my brushing was fairly good, but it was more painful when cleaning the fi...

Dr. Lin Jiayong reply Dentistry
Hello: According to what you mentioned, Clinic A did not provide you with a follow-up treatment plan. Clinic B suggested that you undergo further periodontal treatment. The attending physician at Hospital C stated that you can choose to proceed or not. In other words, it is optio...

Deciding Between Dental Treatments: A Patient's Dilemma

Recently, I received laser treatment for periodontal disease (costing 70,000 TWD), and the treatment has concluded (saying that laser treatment is painless is really misleading). However, there was no improvement (my teeth were very painful the week after the procedure), so I tra...

Dr. Wu Jinjun reply Dentistry
Hello: The treatment for periodontal disease currently relies on traditional methods such as plaque control, debridement of periodontal tissues, and effective oral hygiene education and training for better outcomes. The efficacy of lasers in the treatment of periodontal disease h...

Exploring Alternatives to Tooth Extraction for Severe Periodontal Disease

The doctor said that my periodontitis is severe, and the bone around my upper molars may be gone, suggesting extraction. I have the following questions: 1. Is there any option other than extraction? 2. I found information online about bone grafting and other methods to promote th...

Dr. Huang Tingfang reply Dentistry
Dear Ms. Liu from New Taipei City, Hello! Dental issues can indeed be quite troublesome. If the condition is too severe, extraction may be necessary. I recommend that you visit a major hospital and consult a periodontist for treatment. They will provide you with a comprehensive ...

Is Orthodontic Treatment Suitable for Patients with Gum Recession?

I have a significant issue with gum recession in my lower teeth, and two or three of my teeth have periodontal disease. Additionally, I have teeth that have been heavily filled due to cavities. My main reason for wanting orthodontic treatment is to straighten my misaligned teeth ...

Dr. Yang Hui reply Dentistry
If periodontal disease is not severe, orthodontic treatment can be performed, but it is essential to maintain good oral hygiene. Otherwise, there is a risk of chronic gingival inflammation, which can cause discomfort or affect the outcomes of orthodontic treatment. Maintaining or...