Periodontal Disease
in [Dentistry]
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From: oralhealth on 4 Sep 2008 19:00 On Sep 4, 1:22 pm, New Mexico Tom <nmto...(a)aol.com> wrote: > I am 64 yrs old and relocated to New Mexico from California. My first > visit to a dentist here resulted in the dentist refusing to do any > dental work until I resolved my periodontal issues. I had some > cleaning and scaling from the periodontist, but he said I would not be > "good to go" unless I had a bone replacement surgery, which my > insurance would not pay, and it was going to cost $5000. What are my > options? I contacted two other dental offices and they said the same > thing. Unresolved periodontal issues get no dentistry. Thanks for > reading and I hope you have suggestion. You shoild read my book, "Insider's guide to gum disease, orthodontics and dentistry. What is not taught in dental school." You do not need bone replacement surgery. The question is why do you have periodontal problems? David DiBenedetto, DMD
From: tenthmed on 4 Sep 2008 19:09 Therapy is supposed to be done in phases. Kind of axiomatic. Phase I = filling of carious lesions, extraction of hopeless teeth, and inflammation control by scaling and root planing. Phase II = gum surgery and final crowns, partials, implants Of course there can be alterations to a treatment plan, but the above is the standard of care as far as I know it.
From: New Mexico Tom on 4 Sep 2008 13:22 I am 64 yrs old and relocated to New Mexico from California. My first visit to a dentist here resulted in the dentist refusing to do any dental work until I resolved my periodontal issues. I had some cleaning and scaling from the periodontist, but he said I would not be "good to go" unless I had a bone replacement surgery, which my insurance would not pay, and it was going to cost $5000. What are my options? I contacted two other dental offices and they said the same thing. Unresolved periodontal issues get no dentistry. Thanks for reading and I hope you have suggestion.
From: Mark & Steven Bornfeld on 4 Sep 2008 14:32 New Mexico Tom wrote: > I am 64 yrs old and relocated to New Mexico from California. My first > visit to a dentist here resulted in the dentist refusing to do any > dental work until I resolved my periodontal issues. I had some > cleaning and scaling from the periodontist, but he said I would not be > "good to go" unless I had a bone replacement surgery, which my > insurance would not pay, and it was going to cost $5000. What are my > options? I contacted two other dental offices and they said the same > thing. Unresolved periodontal issues get no dentistry. Thanks for > reading and I hope you have suggestion. "Resolving your periodontal issues" is generally a good practice before doing restorative treatment. Having a rigid policy not to do routine fillings until you have undergone extensive periodontal work is not (IMO) the best thing. For one thing, you do not want to shun patients who cannot or will not go through perio therapy; and secondarily if you do wait for the completion of periodontal therapy some of the small cavities may well progress to need root canals or even extraction. This is not a theoretical risk; some periodontists are quite good at evaluating patients for decay and returning them to the general dentist for treatment; some have severe tunnel vision and won't pick up on cavities (ain't my job) until they are hugh. Not only that, but after active treatment some perio offices will want a patient back for routine maintenance 3 or 4 times a year. Some will alternate with the patient's general dentist; some want to do 3 or 4 a year themselves. Patients can be forgiven if they think that if they are being examined 3-4 times per year by a dentist (general or periodontist) that they will be alerted to any cavities or other problems not directly the responsibility of the periodontist. I can tell you that unfortunately this is not the case in some periodontal offices. Sorry for the rant--I've gotten off track on one of my pet peeves. I believe that in the case of your contacting the other offices, if you asked them about treating you with perio disease, you are very much "leading the witness". Of course we're supposed to get your gums in order! But I believe that if you presented to a new general dentist and told them that you need a few cavities filled, that you're under treatment by a periodontist but need some cavities treated now, I can't imagine a dentist turning you away. There are exceptions, however. If you were anticipating crowns on teeth in the area that gum surgery is planned, you should know that the position of the gumline can change after surgery. This is a good reason to not crown teeth permanently until after the gums have healed. Doing the surgery afterwards will likely lead to an exposed gum margin, which in some areas of your mouth will not look very nice at all. Steve -- Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
From: Steven Fawks on 6 Sep 2008 00:27
Newbie(a)bix.nex wrote: > On Thu, 4 Sep 2008 16:00:37 -0700 (PDT), oralhealth(a)comcast.net wrote: > > >>You shoild read my book, "Insider's guide nothing." > > > > No one shoild read your vanity book. Shoild or shoildn't? I don't know. Pay for or believe what's printed, no way. ;-) Steve |