Q: Can a periodontal pocket be caused by trauma or something other than a disease process?

A: Yes…a good question…..a periodontal pocket can be caused by the inflammatory process (disease process) and also from trauma. This means your bite, the way your teeth meet and touch,  or any trauma might cause a periodontal pocket.  Other possible causes include root or tooth fracture, failing root canal, dental decay below the gum line, iatrogenic dentistry, a foreign object embedded below the gum, systemic disease, pregnancy, hormonal changes, and  traumatic impact to the face.

Of course there are many other causes too numerous to mention here that can cause a periodontal pocket, but I think we have discussed the major factors.

Q: What gum is best to chew if you have dental implants?

A: If the implants are finished and restored with properly fitted permanent crowns, then chewing gum of any kind should be fine. We usually recommend sugarless gum.

Q: I have a 7mm pocket with bone loss. I am getting surgery in #30 tooth. What is the recovery time? Do I have to change my diet?

A: What kind of surgery?  Laser surgery?  The recovery is quicker and virtually painless if you have the FDA-cleared LANAP procedure.  You would need to get an opinion from a certified laser periodontist who offers both the traditional and the FDA-cleared laser approach to treating bone loss and gum disease.  In our practice, we utilize the laser approach whenever possible.  The healing is rapid and the procedure is much less invasive. The results are equally impressive. Your diet would be adjusted according to the type of surgery and how many areas are treated.

Hi

I live in Naples, I am looking for a better deal and estimate for the following:

FULL MOUTH (LL:LR:UL:UR) – D4260

Extraction-surgery – D7210 (Tooth 1; 16; 32 )

Thanks

Hello. How are you? Are you from Naples, Florida or Naples, Italy? I would be happy to answer your question, but I need a lot more information. For starters, here are some examples of information I would gather from a new patient. I need to know what type periodontal classification you are. Do you have pocketing around all the line angles of your dentition? How many teeth have signs of disease? Do you have any recession? Do you have furcation involvement? If so …what class? Do you have posterior bite collapse? What is the prognosis of each tooth involved? Do you have a limited opening? Have you been given the option of a FDA cleared laser procedure (LANAP)? Are you referring to traditional gum surgery? Do you need or have you been offered bone grafting? If not…why?

Do you take any medications? Is there a family history of gum disease? Any mobility of teeth requiring splinting? Do you have a night guard? What is your general health? Are your wisdom teeth impacted? If so what is the angulation? Any teeth close to the mandibular nerve? Any history of bleeding problems? Evaluation of digital x-rays…I could go on and on, but I just want you to understand the reasons why it is unprofessional to give a quote over the internet or phone without evaluating a patient.

Each patient presents differently and fees can vary depending on many factors too numerous to list in its entirety.

By all means, I recommend getting a second opinion if you have any concerns. Concentrate on getting the best diagnosis, and a presentation of all your options that would be appropriate for your situation. In our office, we will often spend 1-1.5 hours on the consultation, examination and treatment plan. We don’t encourage or recommend that anyone get a quote for treatment over the phone or the internet unless they have been examined by a qualified, laser periodontist specialist.

Best regards,

Dr. Eric Linden

Q: I had gum grafting done Wednesday and today some of my packing on the teeth are loose should I be scared? Thanks.

A: Generally this is not a problem. However, I would check with your periodontist in the morning and see if they want to re pack the area or leave it alone.

Q: I recently had a tooth removed. I have gum recession where the tooth was removed. Can a periodontist build that back up so I can get an implant?

A: Typically, when we extract teeth we do an immediate bone graft and laser procedure (socket preservation) around the extraction socket. If a patient has not had a socket preservation done, then an evaluation for a secondary procedure or possibly more would be necessary to build up the area for a future implant.

Q: My husband is going through the lengthy process of getting two implants which as you know is quite costly. We are getting lots of denials from the insurance company, but pursuing.  Do you know what the rationale would be for our dentist to have done four gum treatments on the same day for two teeth?  Does that make any sense? Thank you.

A: It is very difficult to know what type of gum treatment was done on the two teeth you are referring to. Was it soft tissue grafting?  Did he have a bone graft?  Ridge augmentation? In our practice, it is not uncommon to perform multiple procedures on the same day depending on the needs of the patient.

Q: Would you recommend a full mouth debridement before LANAP?

A: No, we do not recommend a full mouth debridement before LANAP.

Q: I am 56 years old and have pain in my last left upper molar. My dentist says a root canal will not help. Instead he said LANAP surgery might help. I have deep pockets in my mouth. Why are they saying that root canal will not help and LANAP will?

A: Did you dentist pulp test the tooth?  (A test to determine if the tooth’s nerve is dying.) Did you see a specialist (Endodontist) to confirm this diagnosis?  Is there any decay in the tooth?  Root exposure?  Root fracture? As you can see a thorough diagnosis is needed to give you an accurate treatment plan.

Q: Is deep cleaning safe for kids with gingivitis from orthodontic braces? Starting what age is it safe to do? What is an alternative treatment? Thank you.

A: How old is the child? If there is gingivitis, frequent cleanings are highly desirable to keep the inflammation down to a minimum. We try to avoid the use of local anesthetics if possible. We also would consider (in addition to better oral hygiene) some mouth rinses safe for children. Once the braces are removed, it will be easier for the child to brush effectively.