A good ortho will look for signs of periodontal disease before beginning treatment, especially on adults. My ortho that I am using noticed some gum recession on a few teeth, which is one sign of perio disease (but can also be caused by other factors). He won't go ahead with the braces until I get a clean bill of health from a periodontist. The perio consult has fit pretty nicely into the schedule anyway, between the records and the final ortho consult.
Things you should be looking for are red, swollen gums, pain, bleeding, and gum recession. Although in the early stages you might not notice these. The periodontist (and some dentists) uses a little tool to check for periodontal disease. X-rays can show the status of the bone.
Really bad problem, any idea's? updated x-ray pictures
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If your ortho has already put your braces on and you're concerned how would you guys broach the subject and ask? Should I talk to my regular dentist who cleans my teeth or my ortho?
Is a periodontist a totally different type of dentist?
Is a periodontist a totally different type of dentist?
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2 Corinthians 4:17
"Be kind for everyone you meet is fighting a battle." -Plato
2 Corinthians 4:17
"Be kind for everyone you meet is fighting a battle." -Plato
You could ask your ortho about it. Maybe mention that you weren't aware that gum problems could be so severe or serious when you started braces, so you didn't ask about it then. But now that you know about it, you just wanted peace of mind that you are in good shape. That should get your ortho talking about it, at least. He'll either tell you that he looked at your x-rays and gums and that they look fine, or he'll give you a blow-off answer. Hopefully, he'll do the former!
If he blows off your concerns or says anything that makes you think that he's not fully considering your complete oral health, definitely go see your dentist to discuss your concerns there. You may then also have to have a discussion with your ortho about your desire for a straight, healthy smile. You could also talk to your regular dentist about what other oral health concerns may come up and what to look for, as well as asking your dentist to check up on them if you aren't sure that your ortho is. Although if you really feel that your ortho is disregarding your overall health, it may be time to consider a new ortho!
Any dentist (including your ortho) should have the knowledge to check out the status of your gums and jaw bone health. Orthos are dentists specialized in fixing your bite and straightening your teeth. Periodontists are dentists specialized in the gums and bone that support the teeth. But all dentists should have at least some background knowledge on gums. So, if you aren't satisfied with the answer your ortho gives you, your regular dentist should be able to evaluate your gum and bone health to see if you are okay or if you should see a specialist. (Sort of like how a regular doctor can tell you whether or not you have sinus problems, but may refer you to an ear, nose, throat doctor for treatment.)
I'm including the list of specialties recognized by the American Dental Association, for your reading pleasure.... All of these are dentists who then have extra training.
From www.ada.org:
Definitions of Special Areas of Dental Practice
Approved by the Council on Dental Education and Licensure, American Dental Association
Dental Public Health: Dental public health is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. (Adopted May 1976)
Endodontics: Endodontics is the branch of dentistry which is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. (Adopted December 1983)
Oral and Maxillofacial Pathology: Oral pathology is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. (Adopted May 1991)
Oral and Maxillofacial Radiology: Oral and maxillofacial radiology is the specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. (Adopted April 2001)
Oral and Maxillofacial Surgery: Oral and maxillofacial surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. (Adopted October 1990)
Orthodontics and Dentofacial Orthopedics: Orthodontics and dentofacial orthopedics is the dental specialty that includes the diagnosis, prevention, interception, and correction of malocclusion, as well as neuromuscular and skeletal abnormalities of the developing or mature orofacial structures. (Adopted April 2003)
Pediatric Dentistry: Pediatric Dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. (Adopted 1995)
Periodontics: Periodontics is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. (Adopted December 1992)
Prosthodontics: Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. (Adopted April 2003)
If he blows off your concerns or says anything that makes you think that he's not fully considering your complete oral health, definitely go see your dentist to discuss your concerns there. You may then also have to have a discussion with your ortho about your desire for a straight, healthy smile. You could also talk to your regular dentist about what other oral health concerns may come up and what to look for, as well as asking your dentist to check up on them if you aren't sure that your ortho is. Although if you really feel that your ortho is disregarding your overall health, it may be time to consider a new ortho!
Any dentist (including your ortho) should have the knowledge to check out the status of your gums and jaw bone health. Orthos are dentists specialized in fixing your bite and straightening your teeth. Periodontists are dentists specialized in the gums and bone that support the teeth. But all dentists should have at least some background knowledge on gums. So, if you aren't satisfied with the answer your ortho gives you, your regular dentist should be able to evaluate your gum and bone health to see if you are okay or if you should see a specialist. (Sort of like how a regular doctor can tell you whether or not you have sinus problems, but may refer you to an ear, nose, throat doctor for treatment.)
I'm including the list of specialties recognized by the American Dental Association, for your reading pleasure.... All of these are dentists who then have extra training.
From www.ada.org:
Definitions of Special Areas of Dental Practice
Approved by the Council on Dental Education and Licensure, American Dental Association
Dental Public Health: Dental public health is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. (Adopted May 1976)
Endodontics: Endodontics is the branch of dentistry which is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. (Adopted December 1983)
Oral and Maxillofacial Pathology: Oral pathology is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. (Adopted May 1991)
Oral and Maxillofacial Radiology: Oral and maxillofacial radiology is the specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. (Adopted April 2001)
Oral and Maxillofacial Surgery: Oral and maxillofacial surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. (Adopted October 1990)
Orthodontics and Dentofacial Orthopedics: Orthodontics and dentofacial orthopedics is the dental specialty that includes the diagnosis, prevention, interception, and correction of malocclusion, as well as neuromuscular and skeletal abnormalities of the developing or mature orofacial structures. (Adopted April 2003)
Pediatric Dentistry: Pediatric Dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. (Adopted 1995)
Periodontics: Periodontics is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. (Adopted December 1992)
Prosthodontics: Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. (Adopted April 2003)
Thanks, you guys, for the feedback. I have appts in January and that's #1 on the list. That is something to be very aware of. I want to keep my teeth and if it means they have to be crooked so be it! Better for them to be there.
Poor, Jackie. Dang, that is really a horrible story!
Poor, Jackie. Dang, that is really a horrible story!
[url=http://www.TickerFactory.com/]
2 Corinthians 4:17
"Be kind for everyone you meet is fighting a battle." -Plato
2 Corinthians 4:17
"Be kind for everyone you meet is fighting a battle." -Plato
Thanks for all the words of encouragement from all of you. My situation seems hopeless.
As I posted earlier, the last perio I went to wanted to remove the braces and pull 8 teeth immediatly, then there were 6 questionable in his report that most likely would need to be pulled, which left 6 teeth that he wanted to do all kinds of scaleings, root planeings, and bone graphs to in an attempt to save them.
How far would all of you go (pain, time and money included) to attempt to save a few teeth? I have had all these procedures in the past, without good results obviously. It had gotten to the point that the front teeth were flairing out and really ugly that I asked about having them pulled (my teeth are not black or brown like you would ususally see with perio problems at this degree, they are white and smooth), it was my perio that sugested braces. It seems that they don't like to pull anything without trying to save it, which is not bad, but sometimes it is not the best course of treatment, as in my case, it just delayed it for a few years, cost me time, money and pain. Living with ugly teeth longer than I had to, and a lot of greif and tears over the prospect of being toothless at 40.
I am due to be back at my ortho this week, I will let you all know what happens, if he removes the braces I am afraid I will leave there with missing teeth.
Jackie
As I posted earlier, the last perio I went to wanted to remove the braces and pull 8 teeth immediatly, then there were 6 questionable in his report that most likely would need to be pulled, which left 6 teeth that he wanted to do all kinds of scaleings, root planeings, and bone graphs to in an attempt to save them.
How far would all of you go (pain, time and money included) to attempt to save a few teeth? I have had all these procedures in the past, without good results obviously. It had gotten to the point that the front teeth were flairing out and really ugly that I asked about having them pulled (my teeth are not black or brown like you would ususally see with perio problems at this degree, they are white and smooth), it was my perio that sugested braces. It seems that they don't like to pull anything without trying to save it, which is not bad, but sometimes it is not the best course of treatment, as in my case, it just delayed it for a few years, cost me time, money and pain. Living with ugly teeth longer than I had to, and a lot of greif and tears over the prospect of being toothless at 40.
I am due to be back at my ortho this week, I will let you all know what happens, if he removes the braces I am afraid I will leave there with missing teeth.
Jackie
Oh, honey! I'm so sorry that is happening!! It is an eye opener for a lot of us though to be careful and to be informed.
For me, I would go to lengths for straight teeth and teeth period. I don't know how much I would put into them. My brother was a heavy smoker and most of his teeth are damaged or missing. I think to fix his smile it would be like $10,000. Still cheaper than a car. I'd do it if I could pay installments.
I know it must be tough being so young and having to face this but hey it is what it is and I have faith it'll all get worked out! I have a friend who is 30 yrs and I just found out she has dentures!! You can't even tell!!!
I'm rooting for ya. I'll be praying for you.
For me, I would go to lengths for straight teeth and teeth period. I don't know how much I would put into them. My brother was a heavy smoker and most of his teeth are damaged or missing. I think to fix his smile it would be like $10,000. Still cheaper than a car. I'd do it if I could pay installments.
I know it must be tough being so young and having to face this but hey it is what it is and I have faith it'll all get worked out! I have a friend who is 30 yrs and I just found out she has dentures!! You can't even tell!!!
I'm rooting for ya. I'll be praying for you.
[url=http://www.TickerFactory.com/]
2 Corinthians 4:17
"Be kind for everyone you meet is fighting a battle." -Plato
2 Corinthians 4:17
"Be kind for everyone you meet is fighting a battle." -Plato
OMG , I read your story and I can't imagine just how you feel 
I have some boneloss on mylower front tooth and on my lower right side because I had a cavity for MANY years and basically all I had was the roots left and and like 1/3 of the top of the molar. I was terrified for years to visit a dentist and this caused more decay and boneloss. I was told I had mild/moderate perio disease. I had the decayed 2 molars extracted and several cleanings done. I have been told that I have a big chance of losing 1 lower front tooth. It is scary and I have been getting myself ready for this possibility . The tooth that has boneloss ,hurt very much when I got the archwire and the tooth moved forward a lot within 2-3 hours of getting bottom braces on. It hurt until everyday until my next adjustment. You might not lose as many teeth as you are fearing. I have no words to say how sorry I feel. I know that you have been keeping your teeth cleaner than ever before. I brush at least 4 times a day plus I use the waterpik at least 2 times a day and floss once a day.
Do you have a link to your story that you can post here?
my ortho has removed the bottom archwire for several weeks now and my bottom tooth is not loose anymore.
Gennel
I have some boneloss on mylower front tooth and on my lower right side because I had a cavity for MANY years and basically all I had was the roots left and and like 1/3 of the top of the molar. I was terrified for years to visit a dentist and this caused more decay and boneloss. I was told I had mild/moderate perio disease. I had the decayed 2 molars extracted and several cleanings done. I have been told that I have a big chance of losing 1 lower front tooth. It is scary and I have been getting myself ready for this possibility . The tooth that has boneloss ,hurt very much when I got the archwire and the tooth moved forward a lot within 2-3 hours of getting bottom braces on. It hurt until everyday until my next adjustment. You might not lose as many teeth as you are fearing. I have no words to say how sorry I feel. I know that you have been keeping your teeth cleaner than ever before. I brush at least 4 times a day plus I use the waterpik at least 2 times a day and floss once a day.
Do you have a link to your story that you can post here?
my ortho has removed the bottom archwire for several weeks now and my bottom tooth is not loose anymore.
Gennel
finally wrote: I think to fix his smile it would be like $10,000. Still cheaper than a car. I'd do it if I could pay installments.
.
The periodontist said a full mouth of implants would cost between $80 to $100 thousand dollars. I don't know what dentures or partials cost because he never gave me the oportunity to discuss it with him.
Jackie
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missy bigsmiles
- Posts: 36
- Joined: Thu Nov 23, 2006 2:26 pm
- Location: Aberdeenshire, Scotland
Jackie,
I'm sorry to hear about your situation. I am not familiar with your story other than this post..and after reading the others responses, the only thing I could think of was to possibly look at any systemic problems which may be exacerbating the peridontal / gum problems, for example a thyroid imbalance or diabetes.
I hope things improve for you
Kind Regards
Missy
I'm sorry to hear about your situation. I am not familiar with your story other than this post..and after reading the others responses, the only thing I could think of was to possibly look at any systemic problems which may be exacerbating the peridontal / gum problems, for example a thyroid imbalance or diabetes.
I hope things improve for you
Kind Regards
Missy
I'm so sorry that you're going through such a horrible experience.
My ortho also put braces on me without any concern for my gum condition.
I later found out that normally orthodontist will not treat patient with gum problems but mine did.
So you can imagine it has gotten really bad real fast.
My brother got his braces last year and his ortho sent him to a gum specialist befor the braces were put on.
I'm very upset with my ortho but what can I do?
It's up to us to do all the research and select a right doctor and I think I made a huge mistake by going to the less expensive one..... :cry
My ortho also put braces on me without any concern for my gum condition.
I later found out that normally orthodontist will not treat patient with gum problems but mine did.
So you can imagine it has gotten really bad real fast.
My brother got his braces last year and his ortho sent him to a gum specialist befor the braces were put on.
I'm very upset with my ortho but what can I do?
It's up to us to do all the research and select a right doctor and I think I made a huge mistake by going to the less expensive one..... :cry
mother of one.
I do have hypothyroidism (low thyroid) and a family history of diabetes, no dentist has asked about this before, is that a known trigger for periodontal problems?missy bigsmiles wrote:Jackie,
look at any systemic problems which may be exacerbating the peridontal / gum problems, for example a thyroid imbalance or diabetes.
I hope things improve for you
Kind Regards
Missy
-
missy bigsmiles
- Posts: 36
- Joined: Thu Nov 23, 2006 2:26 pm
- Location: Aberdeenshire, Scotland
Hi Jackie,
As for the hypothyroidism, it sounds like this is being monitored already.
I was trying to think laterally about the problem to offer some suggestions...
Hope this is of some use
Missy
I don't think that diabetes is a trigger for peridontal problems, but it may be that a person with elevated blood glucose levels( diabetes, glucose intollerance, impaired fasting glucose) and established peridontal problems may have symptoms which may be exacerbated by raised glucose levels. It may be that you don't have diabetes, but it might be worth a check with your doctor.I do have hypothyroidism (low thyroid) and a family history of diabetes, no dentist has asked about this before, is that a known trigger for periodontal problems?
As for the hypothyroidism, it sounds like this is being monitored already.
I was trying to think laterally about the problem to offer some suggestions...
Hope this is of some use
Missy
http://pictures.aol.com/bw/allThumbnail ... =jacquiemz
Here are a couple of x-rays of the worst sections of my teeth. Note the bone loss, one is of the front lower incisors, and the other is of 2 rear molars that the braces pulled forward.
Does anyone else with braces have this extensive bone loss?
Jackie
Here are a couple of x-rays of the worst sections of my teeth. Note the bone loss, one is of the front lower incisors, and the other is of 2 rear molars that the braces pulled forward.
Does anyone else with braces have this extensive bone loss?
Jackie
I wnet for my adjustment on Thursday Nov 30, and my ortho talked to me about what he and the new periodontist discussed. He feels that the guy is to quick to pull teeth and that if they are not bothering me to try to keep them. From his office I went to my original periodontist office to schedule another appointment to get his opinion on this new periodontist approach, his office staff was great, they got me in to consult with him immediatly, he did another evaluation (by the way, where the new periodontist was reading 7, 8, 10, or 12mm on the pockets, he was getting 2, 3, and at the most 6, so who is correct??) I explained to him that when I go to my general dentist they don't give me a good cleaning, they seem afraid to really clean my teeth with the braces on and the perio problems I have, so he got me in for a cleaning immediatly and put me on antibiotics because I do have active problems again with the periodontal infections from the bad cleanings I have been getting.
So all said and done I am again up in the air as to how to proceed with my braces, do I keep trying to maintain healthy gums and bone and move the teeth into a better position, or do I give up and pull them, I really don't like the idea of having dentures, so I think I am going to hold out and try to make the best of my bad situation. I have another periodontist and orthodontist appointment in 3 weeks after my gums heal from the last cleaning, they are going to get together and talk to me, their offices are just a few doors away from each other in the same complex, so I will get to see them both and get a full idea of what is going on and how to proceed.
Jackie
So all said and done I am again up in the air as to how to proceed with my braces, do I keep trying to maintain healthy gums and bone and move the teeth into a better position, or do I give up and pull them, I really don't like the idea of having dentures, so I think I am going to hold out and try to make the best of my bad situation. I have another periodontist and orthodontist appointment in 3 weeks after my gums heal from the last cleaning, they are going to get together and talk to me, their offices are just a few doors away from each other in the same complex, so I will get to see them both and get a full idea of what is going on and how to proceed.
Jackie