Wife gums and bone level question.

[lost_in_translation]

Hi

My wife was looking at her medical records and her dental appoints were tagged with "chronic periodontitis" but she said no dentist has ever mentioned that she has that to her. As I had a bad experience with our last dentist (getting a wisdom tooth pulled) and we were due for a checkup we made an appointment with a new dentist. We are in a non English speaking country so it is harder for me to speak to the dentist.

I did some research online before the appointment and we asked and were told that my wife does not have periodontitis. I asked about why her bone levels seem low, they did some quick probing and told us based on the x-ray, probing (no bleeding) and how the gums look that my wife doesn't have periodontitis. They did not say why her bone levels seem low.
They did say that she has some risk for developing periodontitis though and she needs to floss.

My wife is now flossing almost every day (misses the odd day every so often) and brushing twice daily 3 minutes with a sonic toothbrush along with a anti-cavity rinse 3 - 4 times a week. We have also committed to seeing the dentist every 6 months.

They also said that she has a cavity between her teeth (I didn't catch where) but that it was small and would be a shame to have to fix it as it needs to be drilled from the top. They said that they would keep checking if it progresses. I don't know which tooth it is but have circled the two possible locations I can see based on what I learned from the internet.

I have attached the recent X-rays and a different x-ray from 6 months ago along with a picture showing my wife's gums. We know that my wife has notches near the gums on some teeth but she says they have been like that for more than 10 years and haven't got worse.

Can I get your opinion on my wife gums, bone level and cavity? My wife is kind of freaking out about things currently (not so much about the cavity as she has had many before but her gum issues). My wife is 36 and we don't want her to end up losing her teeth at 50 or something.

 

[MattKW]

Yes, her bone levels are lower than I'd expect to see. It is possible that she had chronic periodontitis in the past but that it has stabilised. No sign of calculus deposits on the xrays. I'd be cautious and go see a periodontist for a good assessment.
With gaps between her teeth like that, I'd recommend interdental brushes because the floss may not get it effectively. If you can find them wherever you are, Piksters are a good brand - maybe a size 3 or 4 for her.
Those are small holes that don't require fillings. They should be reviewed every 2 years with Xrays and shouldn't progress with a good diet and hygiene.

 

[lost_in_translation]

Thanks for your reply.

I did think about that but as far as I know she v had v

Yes, her bone levels are lower than I'd expect to see. It is possible that she had chronic periodontitis in the past but that it has stabilised. No sign of calculus deposits on the xrays. I'd be cautious and go see a periodontist for a good assessment.
With gaps between her teeth like that, I'd recommend interdental brushes because the floss may not get it effectively. If you can find them wherever you are, Piksters are a good brand - maybe a size 3 or 4 for her.
Those are small holes that don't require fillings. They should be reviewed every 2 years with Xrays and shouldn't progress with a good diet and hygiene.

I did think about that but as far as I know or she knows she has never had any special treatment for periodontitis (other than the regular scaling they give everyone) before and my understanding is it doesn't just stabalize by itself.

I will mention to her about seeing a periodontitist.

We tried interdental brushes a while ago but she had trouble positioning them at the back as she has all four wisdom teeth things go back a long way and ended up stabbing herself.

I thought her gaps don't seem that bad or much different than mine although mine are probably caused by aggressive brushing as a teen as my gums are fine.

Dentist told her to floss and make sure to floss all the way down between the tooth and gum. Would a brush clean that area? I can see it would be good to clean the space though.

It's good to know the cavities aren't an issue yet, the top one looks visible in the previous x-ray but I wasn't sure the size because of the overlap in the new one. Hopefully the improved care at home (flossing etc) and diet (not sure how much has changed there) will keep it stable.

Dentists here get a bad rap from foreigners as either slack and not treating until severe or overtreating due to health insurance. It's nice to know that we seem to have found a good one

Thanks

 

[lost_in_translation]

Is the top molar actually have a cavity and how deep is it? I am trying to look up details online about remineralization but it depends how deep it is.

 

[MattKW]

The lesions are monitored these is by Xrays; that's the only way to see if it's active or inactive. So the next set of Xrays should be in 12 months, then maybe stretch it to 2 years but no longer. They don't always remineralise to the point of disappearing from an Xray - think of them like a scar.

 

[lost_in_translation]

Thanks,

They told me their policy is they will take x-rays every 12 months unless there is a reason to take more frequently.

With my wife's history of cavities every couple of years (as can be seen above ) we will make sure they keep a close eye.

Hopefully her improved cleaning routine and diet will put an end to them as my wife still thinks cavities are pretty much inevitable.