I got a 2nd opinion from a different periodontist and his treatment plan is completely different. The 1st perio didn't mention any pockets (I had the impression that I didn't have *any* deep pockets) but this guy says I have pockets in the upper and lower back teeth. He wants me to do a deep cleaning (scaling) and wait a month and see if the pockets go away.
He said I don't need osseous surgery or bone grafts because they won't help in my case. Bone grafts help more if there is a hole in the bone (like from a missing tooth, I guess).
After the scaling, if the pockets are still there, he could do periodontal surgery. He said this is not the same as osseous surgery, because osseous surgery implies leveling or shaping of the bone. The purpose of the periodontal surgery is to open a flap in the gum and just clean up the roots (I think).
About the looseness--he said it doesn't mean I will lose my teeth and he believes they will stabilize over time. All I can do is keep 'em as clean as possible and get them professionally cleaned regularly.
I've had a deep cleaning done before with another periodontist during my time in braces (he worked around the wire and brackets and everything) and it wasn't a big deal. This doc did say that the contacts between my teeth were pretty loose though--I may need to get further orthodontic treatment to get that fixed (like maybe an Invisalign type system). I would definitely not go back to my old ortho for that.
![Rolling Eyes :roll:](./images/smilies/icon_rolleyes.gif)
He said the loose contacts is a concern because I would get food stuck there and it would aggravate my periodontal disease.
This perio seemed much more thorough. The first one only did a pocket and mobility check, but this guy did all kinds of things the other didn't do, like checking my jaw for TMJ, checking my tongue and cheeks, and other stuff I don't even remember.
So for now, I have appointments for scaling with a hygienist. I feel much better about this treatment plan and also like this doc much better.
![Smile :)](./images/smilies/icon_smile.gif)