Metal Mouth Message Board

Hi There! I'm looking for some advice regarding my suitability for braces after finding out that I have periodontal disease. My dentist hasn't given me much information. I know that it can be difficult to predict but any experiences are appreciated!

I decided in January this year that I wanted to straighten my teeth privately. However I haven't been to the dentist in 18 years..very bad I know! I naively thought that taking care of my teeth, and not suffering any aches/pains meant that I didn't need to go to the dentist. To be honest the time went by and before I knew it it was 18 years! No excuse though!

I did it all back to front of course, booking a ortho consultation before registering with a dentist. After finding out that the ortho would quite rightly need to liase with a dentist I booked for an initial examination before going to the ortho. My new dentist told me that my teeth are good and strong and clearly I have looked after them well...I don't need any fillings..impressive after 18 years! BUT and it's a big but...because I haven't been in so long I have generalized periodontis, and bone loss because of this. He said if I had left it another 5 years I would've lost my teeth. So less than two weeks after this diagnosis I had a deep clean and was advised that I buy interdental brushes,and told to carry on cleaning as I have been already as my daily cleaning is fine, and said that I can go to the ortho in 4 to 6 weeks. I have another appointment with him in 3 months for another clean...not as extensive whereby he will check my gums and decide if I can go back every 6 months instead or if I have braces to possibly go back every 3 months for a clean.

My question lol which I should have queried at the time!..is it likely that I will be able to have braces given that my dentist has said I can go to the ortho? How much weight does a dentist have on that decision? I really want to straighten my teeth but have read mixed reviews about them and periodontis. At present I don't know the severity of my periodontis, but I have no teeth mobility, dont need any extractions based on dental treatment, and wouldve thought if my periodontis was moderate to severe he would have said to leave the ortho appointment for 6 months to a year at least?? Any advice/experience is much appreciated as it is another 3 weeks until my ortho appointment. I just can't seem to find much info regarding having good teeth but bad gums! More bad teeth and bad gums! Thanks. Carolyn

Hi Caz. I am in a similar situation. I have attended an ortho appointment and I have peridontal disease with some bone loss. I have started this later in life-late 40s. I have pockets of 5mm and before I can start ortho treatment I need to have pockets less than 3.5mm. I am hoping I can reduce the pockets. The dentist has advised you can reduce pockets with good flossing brushing etc. I have had deep clean. I am just pondering whether to see a private peridontist to help me get my gums in good condition. I am in UK.

Hi Caz, you didn't say where you live. In Canada most orthodontist would not start any treatment until patient goes to periodontist who does an assessment and tell if it is reasonable to start orthodontic treatment, they gum assess pockets depth and recession,
Ortho treatment can cause more recession , longer treatment - more chances of all sorts of complications, again why you decided to go for ortho treatment, if you have problems chewing , teeth are chipping of, it is one thing, if you mostly want to do it for esthetic purposes - then it is different.Most important -find reputable orthodontist, who would not try to sell you treatment which may be not necessary.

Hi both!!
Sorry I didn't realise I had had replies, I thought I would've got an e-mail.
Hi Clare - Thanks for the info. :) I would imagine then that my ortho will say similar to me, I am actually with mydentist and the ortho is as well which will make it easier for them to liase with each other. I will definitely make sure I ask lots of questions regarding what my dentist will have sent over to him. Yes my dentist advised the same about brushing, and using the interdental brushes...I'm addicted to using them now! I have also been using a mouthwash specifically for gum disease. You'll have to let me know how you get on! I will pop an update when I have been to the orthodontist.
Hi Nika - Thanks as well for the info. :) I live in the UK. My dentist didn't mention going to a periodontist, I think that he wants to firstly see how I get on with the deep clean, and as my brushing isn't an issue see if there is a positive change in my pockets. He checked my pocket depths and did an x-ray before then doing the deep clean. I am expecting definitely that the treatment will take longer than a more typical case if I am a good candidate for braces. I'll make sure I get lots of information from the orthodontist before I decide anything, and that my periodontis is under control. My issue is that my teeth are really crooked at the front, and some of my back teeth are way out of line, I have read that orthodontics can aid gum health and reduce recession if it makes the teeth easier to clean. If he says wait a year or two though or advises against it I will just have to leave it, but I hate my teeth....I'll end up having them all removed and implants put in ha ha!!
I'll let you know how it goes and thanks for the advice!
Caz

Can I just ask Clare, has your orthodontist advised when he would like you to go back to assess if you have reduced pockets to then have braces? I'm just wondering if my dentist advice of having the consultation after 6 weeks of deep clean is sensible.
Thanks!
Caz

My orthodontist wrote to my dentist with his report and he sent me a copy. In the letter it states what he would like the dentist to do, check etc. He advised he is hoping that 3-6 months to hear back from the dentist when my periodontal disease is stable. He recommended scale and debridement. I have had scale and cleaning and wasn't sure if this cleaning is debridement. In the Midlands where I live locally we don't seem to have peridontist. I have arranged an appointment with one in the bigger cities. I am probably in a worse situation than yourself has I have some crowns, lots of fillings and require braces and jaw surgery has I have a 9.5mm overjet (protruding front teeth) and 100% overbite which means my front teeth totally cover my bottom. At the moment I am learning the process of how dental services work etc

Aww right! I thought my dentist would've said more towards your timescale. I'm the same as you with understanding the process. I thought it would be more that the dentist would be advising the orthadontist about the gums but not necessarily the case. Hope everything goes okay for you and you're able to have it all done soon. I don't think periodontists are readily available in the Yorkshire area either as far as I'm aware and im not sure what debridement is! Im going to have a lost next time I go to the dentist. I think I might have a slight overbite, I'm guessing I will need fixed braces because of how crooked they are at the front. Def too much to do to have invisalign. Are any of your teeth mobile from the periodontis?

I am not sure about mobility. Although I needed to have an extraction in December due to infection. The dentist said it wasn't possible to save it as it was mobile. From the orthodontist letter I read it that the orthodontist will wait to hear from the dentist that my gum disease is stable which he estimates to be about 3-6 months. I have read that in some cases braces are needed to stabilise gum disease as if the teeth are crooked then thorough cleaning can be difficult to achieve causing gum disease to get worse.

Yes I've read that as well that it can help straightening the teeth. Has your orthadontist still set up a full plan of action with you for when you are ready? Decided on braces etc? I've paid for my initial consultation and I'll be annoyed if the ortho tells me they can't plan anything yet, because the dentist has said I can go, and knows i have paid for it, especially when they're the same company

I would get the periodontal disease sorted out first and with regular cleanings thereafter. I went thru the same thing, you can read about my story here: viewtopic.php?f=13&t=37452

Thank you 😊 and for the link. It's good reading other people's experiences. I've already had my first clean and im going back to the dentist in June to assess my gums, so when I go my ortho in a couple of weeks I can at the very least find out what his thoughts are on my mobility etc. Like your experience I don't think I have any mobile teeth either but he might say different when I go! As far as im aware i dont need any surgery, just the cleanings but we'll see when I go back how much the pockets have reduced. Thanks

Just a little update... I've been to the orthadontist for an initial consultation and have been told I am a potentially a good candidate for invisalign and fixed braces. He didnt recommend damon braces for me. Invisalign cost just under 4k and fixed cost 3500k. I have gappy front teeth and an overbite on my left side. He does need to see my dentist xrays as i told him about my bone loss and periodontis and do his own xrays etc before we decide anything definite. So my next appointment is in two weeks whereby we can discuss if the periodontis is an issue. As it stands it looks like I have the milder periodontis. Will update when I go back....

Since I last posted here I went back to the orthadontist and had more detailed xrays, moulds done and photos taken. He could see that there was some bone loss and calculus but much improved from when I went initially to the dentist in February. He wasn't concerned but asked me to take my xrays along with a letter to my dentist to check that it was okay to go ahead. My dentist said it was fine, so I've had them professionally cleaned, and have a 3 monthly check up on Thursday this week, get spacers on the 26th June then fixed traditional braces on the 3rd July 👍👍

As it stands my gums don't bleed anymore or rarely and they're looking a much paler pink..hopefully the dentist will say on Thursday that my pockets are reduced fingers crossed!

All good news! Hope you will be able to join us in braces very soon!

So you are really lucky :)
In my case , as I have also "bad" saliva , after a deep clean session ( lasted 1,5 hour! ) I had 3-4 sessions for cleaning and stabilise the periodontists , and then they give me the ok to go to orthodontist .
And to be honest - I still have 2-3 pockets that are not possible to complete cure , because of the crooked teeth . Its impossible to full clean them as they are unreachable .
But I am happy that i waited a year for fix periodontitis , as I had a surgery and a massive expansion in my upper ark . If I still had periodontist , I will most probably missing a couple of tooth :P
Braces can be quite strong to the teeth , so I am trying to keep them in the best condition .

What also help a lot with periodontists ( and Its the most amazing thing now with the expander/braces ) is the water flosser ( Waterpick , Waterpulse etc ) .
In combination with the interdental brushes + paradontax toothpaste and paradontax mouthwash , made a huge difference for me .

What also its a must - in case this apply to you - its to stop smoking . What an amazing difference !