Dental cleaning concerns

[WorryPot]

Hi all

I realise I may be overthinking things, but just wanted to get some advice.

I’m 30 years old and have had all my wisdom teeth out. I’ve never had any issues with my teeth growing up and so I really don’t have a fear of the dentist generally (although I do admit being a bit neurotic at times!) I brush regularly and floss, I avoid sugary foods/drinks etc, and am pretty meticulous with my teeth. However, I did start smoking again this year.

Ordinarily I would see my dentist every six months but on this occasion a year had gone by (a relative fell ill and passed away and so it’s been a tough year in general). I went in for a routine check up and clean. The dentist said my gums were looking good overall but that there was one spot where my gums were receding a little, and gave me a bit of a talk about brushing and suggested I start using piksters. No worries.

The dental hygienist then gave me a clean and suggested i come back in a week. She didn’t really say why, but, hey, I do what I’m told. I got a bit worried about this, because I’ve never been asked to come back like this after a clean, but I figured this must just be their protocol or something.

I’d been extra careful about brushing and flossing and started using piksters, and wasn’t worried about the upcoming appointment. A different dentist saw me (apparently my usual dentist was off sick) and she said she doesn’t normally work at this practice. She had a look at my teeth, agreed that there was some receding, but that this was in a completely different area to the one the other dentist mentioned. She then suggested I come back again in another two weeks. She said she’d book me with my usual hygienist, but struggled a bit with the computer software, so she said she’d book the appointment for an hour but that it wouldn’t take that long. It would just be another check up. Again, I’m a bit worried by now, because I’ve never been asked to come back after a scale and clean, let alone twice. I spend the next two weeks continuing to be really careful about brushing my teeth.

Two weeks later I go in for my appointment and a fourth dentist comes and gets me. I didn’t ask why she was seeing me and not my usual hygienist. She immediately says we are doing another clean that day, which is not really the information I had been given two weeks prior. But whatever, fine, I’m happy to get another clean if they think I need it. It seems to be like a usual clean, just a lot more thorough and more painful than I’m used to. This whole thing goes for about 45 mins. She tells me there’s only a thin layer of plaque but that it’s quite tenacious. I was honest in the paperwork that I had started smoking again, but felt quite embarrassed when she asked me if I was a smoker. I wondered if it must be obvious that I smoke, even though this has never been raised as an issue before. She tells me that smoking doesn’t cause plaque but that it dries your mouth out and hardens plaque a lot quicker. She tells me I have “lovely teeth” and I nearly burst into tears, because how can that be true if I’ve now been asked to come back twice and needed to get a second clean. She encourages me to book an appointment for another clean in four months, which I realize is a shorter time than usual. By now I’m totally confused and worried I have some serious disease they are not telling me about.

When I get home from the appointment my gums are sore all over, but this passes for the most part after an hour. Except for in one corner where my wisdom tooth used to be. I noticed this little hole which was the source of the pain, and figured she must have stabbed me accidentally with that little hook thing they use. It’s now been five days and the pain is still there. I’ve been brushing the area more than usual, flossing etc and when I stick the pikster in there it bleeds. I had no issues with bleeding gums before all this started.

It’s the last thing I want to do, but I’m wondering if I need to go back in to get this soreness checked out. I know googling your symptoms isn’t a good idea, but I’ve been reading all this stuff about abscesses so now I’m worried that’s what I have back there. Mostly I’m just confused about what all this fuss is about. I thought that maybe I’m brushing and flossing too hard, but the third dentist assured me this isn’t the problem.

I would really welcome any thoughts or advice!!

 

[MattKW]

Plaque is rarely tenacious, although it can become quite sticky - it's usually seen in grotty teenage boys! However, subgingival calculus (tartar) can be rightly described as tenacious, and you'll see it as dark margins under your gums. This is usually seen in patients who don't get regular cleaning and don't maintain hygiene - this doesn't sound like you at all.
However, we all pick up extrinsic stains from foods, and obviously smoking. It's fairly easy to spot a smoker from the distribution of stains. That said, such staining might be unattractive, but it is not harmful, and it reforms quickly. It can take a bloody long time to take it all off. I don't always take it all off unless someone requests it.
I think this is what has most likely happened to you. You've gotten into the hands of an over-zealous dentist or hygienist who has probably thoroughly cleaned your teeth, more than was necessary for your health. Repeated scaling and cleaning will damage your teeth, so I would go back to your usual check-up schedule with your usual dentist. But still keep working on giving up the fags.

 

[honestdoc]

It is not ideal to constantly see different providers. You don't have the continuity of care and you hear different and confusing opinions and suggestions. I worked at various group practices where the dentists are always leaving and a new, inexperienced one would take over. Try to find an experienced dentist that has been at the same location for a while (may be a rare case, he/she may be very popular and booked way out). Hopefully you will feel comfortable with the dentist and stick with him or her. When you are booking your next visit, make sure you know who you are seeing. If you see a new dentist for any reason and not sure about the treatment, reschedule with your preferred dentist.

For example, I work with a lot of inexperienced and other part-time dentists, and many don't do surgery and root canals. The inexperienced dentists may see emergency patients in pain. Very quickly they will refer or "dump" those cases to me charting the wrong tooth and wrong diagnosis. In many instances, the pain does not require root canals or extraction. After their initial visit, almost all of the referred patients wanted me to be their dentist because I listened, asked many questions and can perform the referred difficult procedures.

 

[WorryPot]

Plaque is rarely tenacious, although it can become quite sticky - it's usually seen in grotty teenage boys! However, subgingival calculus (tartar) can be rightly described as tenacious, and you'll see it as dark margins under your gums. This is usually seen in patients who don't get regular cleaning and don't maintain hygiene - this doesn't sound like you at all.
However, we all pick up extrinsic stains from foods, and obviously smoking. It's fairly easy to spot a smoker from the distribution of stains. That said, such staining might be unattractive, but it is not harmful, and it reforms quickly. It can take a bloody long time to take it all off. I don't always take it all off unless someone requests it.
I think this is what has most likely happened to you. You've gotten into the hands of an over-zealous dentist or hygienist who has probably thoroughly cleaned your teeth, more than was necessary for your health. Repeated scaling and cleaning will damage your teeth, so I would go back to your usual check-up schedule with your usual dentist. But still keep working on giving up the fags.

I think you might be right... I appreciate having the stains removed but it would be good to know what’s going on at the appointment.

I have patches ready to go! Thanks so much for your response

 

[WorryPot]

It is not ideal to constantly see different providers. You don't have the continuity of care and you hear different and confusing opinions and suggestions. I worked at various group practices where the dentists are always leaving and a new, inexperienced one would take over. Try to find an experienced dentist that has been at the same location for a while (may be a rare case, he/she may be very popular and booked way out). Hopefully you will feel comfortable with the dentist and stick with him or her. When you are booking your next visit, make sure you know who you are seeing. If you see a new dentist for any reason and not sure about the treatment, reschedule with your preferred dentist.

For example, I work with a lot of inexperienced and other part-time dentists, and many don't do surgery and root canals. The inexperienced dentists may see emergency patients in pain. Very quickly they will refer or "dump" those cases to me charting the wrong tooth and wrong diagnosis. In many instances, the pain does not require root canals or extraction. After their initial visit, almost all of the referred patients wanted me to be their dentist because I listened, asked many questions and can perform the referred difficult procedures.

Thank you for your response. I think it need to be a bit more assertive with them, or insist on seeing the same dentist each time. I have a sense that if things had been communicated to me properly, it would’ve saved me a lot of anxiety!