Gingivitis and bone loss questions.

Discussion in 'Dental Archive' started by Royler, Nov 25, 2004.

  1. Royler

    Royler Guest

    Hi,

    Posted here before. Briefly: in my 20s and have largely neglected
    dental care since 14 or so. Saw a dentist in February who diagnosed me
    with gingivitis. Improved home care and got a cleaning done in June.

    Went to a different dentist this past week (now have insurance and
    wanted to start fresh - didn't like the old one) and had another
    cleaning. The hygienist also confirmed a "little" bone loss but seemed
    really unconcerned. Just told me to improve home care and get some
    fillings taken care of.

    Once gingivitis progresses to bone loss, isn't that now irreversible?
    The dentist told me my teeth look great for not having any work done
    in over a decade, though my gums are red in spots.

    Is it possible to have bone loss but not periodontal disease? I guess
    I'm just surprised by their lack of real concern, though everyone is
    very nice.

    Does "bone loss" in the jaw actually change the shape of your face, or
    is it not that radical a problem? What am I missing here?
     
    Royler, Nov 25, 2004
    #1
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  2. On 25 Nov 2004 09:41:23 -0800, (Royler) wrote:
    X-rays would tell more of a story ....... bone loss is part of life in
    much of the population. Maybe it needs treatment maybe not.

    No way to tell from here.

    Joel M. Eichen DDS
     
    Joel M. Eichen, Nov 25, 2004
    #2
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  3. Royler

    W_B Guest

    On 25 Nov 2004 09:41:23 -0800, (Royler) wrote:
    Yes, in some respects. Once bone loss occurs the disease is
    called periodontitis. The progress of the disease can be halted,
    and sometimes (rarely) somewhat reversed.

    Keep getting those regular professional cleanings.
    Yes, once the disease process is halted.
    Meticulous home care and regular professional care is
    of the utmost importance if you wish to keep your teeth.

    Everyone ? ;-)

    --
    W_B



    Take out the G'RBAGE
     
    W_B, Nov 25, 2004
    #3
  4. Royler

    StovePipe Guest

    Perio disease is a bit like other CHRONIC DISEASES: there are
    exacerbations and remissions. Generally, bone loss is not reversible,
    but can be halted like W_B says. I would seriously consider having
    cleanings at AT LEAST six month intervals and if the gums are still
    inflammed at those, reduce the interval to every four months, and if
    needs be every three months. You want to prevent the osseous
    inflammation.

    JMO, HTH, YMMV, not responsible for lost or stolen items, one cross to a
    prisoner, etc....
    Cheese
    SP
     
    StovePipe, Nov 26, 2004
    #4
  5. Royler

    Dr. Steve Guest

    Perhaps the " bone loss" is abfraction.
    ...
    Stephen Mancuso, D.D.S.
    Troy, Michigan, USA

    Writing on a tablet PC,so forgive me if the PC misreads my poor handwriting.
     
    Dr. Steve, Nov 27, 2004
    #5
  6. Royler

    Winston Guest

    Royler wrote:
    They are very nice now. They figure you are *not* going to improve your
    homecare and are looking forward to many many boat payments directly
    from your account to theirs. They like that a lot.

    As your homecare improves, they will get increasingly nastier.



    Welcome back!

    Time to get your teeth clean and your gums back in shape.

    If I had been told this at your age, I could have saved enough
    money to buy a couple cars. I am quite serious.


    Supplies:

    Sonicare toothbrush. You can use any toothbrush, of course.
    The Sonicare just 'feels' more effective to me.
    If it feels too 'violent', try the Braun.
    Electric brushes are more fun than the manual type.

    Toothpaste (Plain white stuff, not gel). Most gel pastes don't
    have fluoride. Fluoride is good.

    Floss
    (Johnson & Johnson waxed. Flat, measures about 0.005" thick)
    (Not the store brand, because that cheap stuff shreds and sticks
    between your teeth, driving you crazy.)

    Hydrogen Peroxide Solution, 3% concentration.
    Found hidden on bottom shelf, near the first aid supplies.
    Often in a dark brown plastic bottle.
    The label will say "For treatment of minor cuts and abrasions."
    And "For use as an antiseptic gargle or rinse."
    Get a couple of the smaller 16 oz bottles. It becomes ineffective
    over time and / or if it is heated much beyond 86 F.
    Try not to shake the bottle. Leave tightly capped.

    The bottle may say "dilute with an equal amount of water."
    I rinse with the stuff full strength. No problems.

    Forget mouthwash. Stuff is completely ineffective for longer than a few minutes.
    Forget breath mints. Most contain sugar, which grows oral bugs like crazy.
    Forget chewing gum like 'Dentyne'. Lots of sugar.
    Read the label first. You will be surprised at times.

    First thing in the morning and after every meal and snack,
    rinse out with an ounce of Hydrogen Peroxide. The stuff is very safe to rinse in
    your mouth and will not cause discomfort if it comes into contact with
    oral bugs. Swish a few times and spit. The oral bugs will konk out and be rinsed
    down the drain. Peroxide foams a little when in contact with bacteria.
    The stuff has a delicate 'mediciny' taste.

    After rinsing, floss. Yank about 24" out of the container and wrap the end
    around either index finger. Saw the floss between each tooth to get the bad
    stuff out. There will be blood. There may be pus. This is normal, until your
    gums are back in shape. After each tooth, wrap the used floss on your finger and
    use clean floss for the next tooth. When you are done with both upper and lower
    jaws, rinse with another ounce of Peroxide.
    The stuff is very inexpensive. You are giving the antiseptic better access to
    the bacteria in the gaps between your teeth. Swish and spit.

    *"Brushing teeth" is just a figure of speech.*
    Brush only those surfaces that you want to be clean. So in addition to all
    surfaces of every tooth, you will want to also brush the bacteria off of all
    other mouth surfaces, to slow the bugs as much as possible.
    Feel free to rinse the bristles under hot water and reload the brush with
    a little paste to clean another area. Toothpaste is cheap.

    Brush all surfaces, including but not limited to:
    * Gums, (tongue - side and outside surfaces. Use side-to-side cleaning motion.)
    * Tongue. Top and bottom.
    * Roof of your mouth.
    * Inside surface of your lips.

    Take your time. This is a lot more pleasant than a root canal.
    Ask me how I know that. Go ahead. Ask. :)

    The first few dozen times that you attempt to clean the rear part of your tongue
    and perhaps the rear part of the roof of your mouth, you will gag.
    Don't worry, everyone reacts the same way to pressure in these areas.

    You aren't gonna lose your lunch. But stay near the sink anyway.
    After a while, you will react with much less enthusiasm.

    Soon, you may not gag at all.


    Want to know what your breath smells like to others?
    1) Sniff one wrist to get a baseline.
    2) Lick that wrist and allow it to dry.
    3) Sniff that wrist again. This is pretty much what you are radiating.

    That is about it.
    When you have kids, please show them the dental litany every day, follow up
    with them as they grow up because they are not going to think to do this
    themselves.

    They will grow up to be much happier people.

    Best to you.

    --Winston
     
    Winston, Nov 27, 2004
    #6
    calcium48 likes this.
  7. Royler

    StovePipe Guest

    true... I hadn't thought of that.
    SP
     
    StovePipe, Nov 27, 2004
    #7
  8. Royler

    Royler Guest

    I've heard nothing but good things about the Sonicare. It's on my XMas
    list.
    I bought into the hype and bought some Colgate Total.
    Here's where you lose me. It's fairly impractical to rinse and floss
    after every meal. I brush 2x a day, floss once, and rinse once with
    Fluoridex, supplied by the dentist.

    Yank about 24" out of the container and wrap the end

    My gums never bleed, except for when I picked up flossing several
    months back. (Never bothered with it before.) I guess that's not a bad
    thing. I'm not certain I'm getting way down into the gumline with the
    floss, though. And what really bothers me is that every time I floss,
    both my fingers and the floss really stink after coming out of my
    mouth, unless I've just had a professional cleaning.

    Believe me, I will be a taskmaster when it comes to this stuff.

    Thanks for all the advice...but what's "abfraction"?
     
    Royler, Nov 27, 2004
    #8
  9. On 27 Nov 2004 08:33:35 -0800, (Royler) wrote:
    What do you believe it can do?

    Its a toothbrush you know.

    A toothbrush.

    Joel

     
    Joel M. Eichen, Nov 27, 2004
    #9
  10. Royler

    Bill Combs Guest

    Mostly good advice, but a couple of items need correction and
    clarification. Hydrogen peroxide is not a panacea. If periodontal
    prevention came in a bottle, then nobody would have had periodontitis
    since the 1970's. Back then, there was a fad in gum care which
    utilized hydrogen peroxide.

    It didn't work.

    No rinse or mouthwash is a substitute for preventive oral hygiene
    using a brush and floss. Short-term use of chlorhexidine gluconate or
    even Listerine can be an adjunct to a planned episode of treatment.




    Highly speculative on your part. If it is true, based upon your own
    experience, you ought to consider switching dentists. Most dentists
    are not like that. Why stay with one whose motives you suspect??

    You REALLY need to switch dentists. The vast majority of dentists will
    applaud any improvement in home hygiene effectiveness! Or are you
    making this up?


    Fluoride is indeed good, but most gel pastes DO INDEED have fluoride!
    I can't recall any that don't, though some may exist. As a matter of
    fact, the only NON-fluoride toothpastes I remember in local stores
    were the white kind.

    The vast majority of major-brand toothpastes have fluoride. Aim,
    Aqua-Fresh, Colgate, Crest, MentaDent, and so on -- they all have
    fluoride. To be sure, just check the label, where it will be listed as
    the "active ingredient."



    I've seen "store brands" that were just as good as the major brands.
    Dump the brands that shred, and use the ones that work well.

    Unnecessary in the treatment and prevention of periodontitis. Simple
    rinsing with hydrogen peroxide will NOT get it down into the gingival
    sulcus where all the periodontal action takes place.

    Some dentists may use it as a part of a short-term treatment plan, but
    its value in long-term prevention is dubious, to say the least.

    Are there any LONG-term studies which show safety in regular daily
    oral use of hydrogen peroxide, which is a powerful oxidant?


    Most of the rest of the advice is good. Careful brushing and flossing
    to remove all plaque is the key. Because calculus cannot be removed
    with home care, and because periodontal destruction can occur without
    outward symptoms, it is also necessary to have a thorough exam and
    cleaning at least once every six months.

    Best regards,

    - dentaldoc
     
    Bill Combs, Nov 27, 2004
    #10
  11. Royler

    Winston Guest

    Royler wrote:
    Good! I like mine a lot. I bought one on the advise of my dentist and
    decided I didn't like the aggressive-feeling action. Tossed it and
    went back to the Braun. Really missed the effectiveness of the Sonicare
    so I bought another. Never looked back. It works great.
    Even most inexpensive commodity pastes have everything you need.
    Check the label. Crest is just fine.
    You have several dental emergencies in the making. It is time to head off
    as many of them as possible. A healthy tooth way less expensive than a post -
    and - crown.

    Make time to do your dental care after every snack and meal and you will get a
    similar report to the one I got from my hygenist. 2 mm pockets all around. One
    'trouble spot' it was *4 mm*. Not too bad. She called me a 'hygenist's dream'.
    No kidding.
    This is good. Get that plaque out from between every tooth and below
    the gumline. Those bugs are eating you and you need to lose them.

    Make a choice: Gross for you or gross for the people around you.
    Good. You will feel better and have more money in your pockets.
    One each bogeyman. Have a look at http://www.atlantadentist.com/abfraction.html
    In the bad old days dentists believed in the existance of real witches and in the
    possibility that brushing one's teeth too hard could actually damage them.
    Turns out that neither of these things is true.

    When you discuss healthy homecare, dentists like to raise the spectre of
    some horrible fate likely to befall the hapless patient.
    You won't have to listen very hard. They will scream 'Cancer!' and 'Abfraction!'
    Hey if my paycheck depended so much on an uneducated patient base, I might also
    do my best to keep them frightened and uninformed, too....

    Nah, forget it. That would be wrong.

    --Winston
     
    Winston, Nov 28, 2004
    #11
  12. Royler

    Winston Guest

    Bill Combs wrote:
    No argument from me about the synergy of brushing, flossing and rinsing
    with an antibacterial. Nowhere and at no time did I ever hint that
    dental homecare could be done with just one technique. That would be silly.
    Hydrogen peroxide continues to work better for me than any other mouth rinse
    because I use it in conjuction with brushing and flossing.

    Listerine is an alcohol based (26.9%!) oral rinse.
    I found it totally useless for more than about a minute after rinsing.
    Despite the television commercial graphics, I feel the stuff is no better
    than any other brand of snake oil.
    Well, ok. Perhaps they are buying investment property rather than a boat.
    That is not the point.
    I switch dentists like most people switch socks.
    The Reader's Digest report was a love letter to the profession in
    comparison to my experiences.
    No, I am not making anything up.
    Feel free to use Google Groups and search for the subject
    'Controlled Substances?' from July 27 of 2004.
    That is the most serious example, but my experience follows the same
    trend.
    We are in 'violent agreement'. Like I said, check the label.
    I recently stumbled across a brand that is every bit as good as the
    flat waxed stuff from J&J at half the price of the 'brand' product.

    You are right; they are out there. It does take some research.

    Until an emergency patient gains confidence in the use of floss, he
    or she should use a good quality brand. That patient simply cannot
    risk getting turned off to good homecare for any reason.

    The risk to their health, happiness and wallet is just too high.

    After the patient is in the 'safe zone' they can experiment with
    cheap floss all they want. They just need to go back to a quality
    floss rather than drop the whole regimen out of frustration with
    an awful product. Many cheap and not so cheap flosses are awful.
    Like I said, Rinse, brush, floss, rinse. The peroxide must find its way
    into the sulcus under those circumstances. My hygenist affirmed that
    during my most recent checkup. The effect is too real and too pronounced.
    I respectfully disagree.
    I am unaware of any.
    If you can manage to find an honorable, competent dentist*, I could not
    agree more with the above sentence.


    * Check between Santa Claus and the Unicorns.

    --Winston
     
    Winston, Nov 28, 2004
    #12
    calcium48 likes this.
  13. Royler

    Winston Guest

    Joel M. Eichen wrote:
    I believe the Sonicare is the most effective toothbrush I ever purchased.
    That may be entirely subjective, just because it feels like it is scrubbing
    really well. I like how clean my teeth feel after using it. I really liked
    the comments my hygenist had for me as a result of using the Sonicare.

    Never having seen an independently produced, peer-reviewed, double-blind test
    of tooth brushes, I can't say that it is the best for everyone.
    I just like the heck out of mine. It is way more fun to use than a manual
    toothbrush. I'm much more likely to use something I consider 'fun' than not.

    Believe it or don't, I have no financial or familial connection with the
    manufacturers of this product. I'm just astonished that Philips could make
    a product this good.

    Thassall.

    --Winston
     
    Winston, Nov 28, 2004
    #13
  14. Good to hear ... THANKS.

    Joel
     
    Joel M. Eichen, Nov 28, 2004
    #14
  15. Royler

    StovePipe Guest

    the hygienists have done this... I remember one of mine showing me the
    study, because I wanted to know where OUR brush fit in (RotaDent by
    ProDentec). Perhaps try Googling for studies on mechanical toothbrushes
    by hygienists.
    then this is the brush for you... just remember to PAY ATTENTION when
    you use it... don't be looking over your shoulder at the TeeVee or
    whatnot... Listen for the motor; it should not start forcing and you
    should not hear the revs drop off, or you are applying too much
    pressure, and your gum line will be in danger.
    Cheers
    SP
     
    StovePipe, Nov 28, 2004
    #15
  16. Royler

    StovePipe Guest

    I aggree re: abfraction, BUT... aggressive brushing will ruin your GUMS.
    It is a fine art to brush thuroughly were it counts (at the gumline)
    without traumatizing it.
    JMO
    SP
     
    StovePipe, Nov 28, 2004
    #16
  17. Royler

    Winston Guest

    StovePipe wrote:
    Thanks for that, 'Pipe.

    Short of autism or severe mental illness though, I am hard pressed to imagine
    that someone could be so reality-impared as to actually damage their gums
    with a toothbrush. 'Course some folks choose to hang from hooks, so it is
    *possible* I guess. :)

    --Winston
     
    Winston, Nov 28, 2004
    #17
  18. Royler

    Winston Guest

    StovePipe wrote:
    Roger that.

    We will need a different metric for the Sonicare, though. The oscillator
    that drives the brushhead will remain at the same frequency from full
    unload to full stall. I tried it just now, 'strue.

    I will worry about brushing too thoroughly right after I have resolved
    all the issues I have about being underweight and too wealthy.

    (Grin)

    --Winston
     
    Winston, Nov 28, 2004
    #18
  19. Royler

    W_B Guest

    Ahem,

    When you are Rogering yourself what is the frequency of ocillation ?



    --
    W_B



    Take out the G'RBAGE
     
    W_B, Nov 28, 2004
    #19
  20. Royler

    Winston Guest

    W_B wrote:
    http://www.googlism.com/who_is/o/ocillation/

    Oh, did you mean 'oscillation'? Thanks for asking, you little rascal.

    My girlfriend and I roger about halfway between Wilco and 10-4.
    Takes about 30 minutes to get to over-and-out.
    Two, three times a week. Still, not too bad for an old guy.

    What's the frequency, Wubba Ruth?

    73's, :)

    --Winston
     
    Winston, Nov 29, 2004
    #20
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