I have periodontitis and severe bone loss after going years without insurance or regular dental care. In September, my dentist completed two sessions of scaling and root planing, and the hygienist saw real progress—pink gums and a deepest pocket of 9 mm. Three weeks later, I saw a periodontist whom my dentist had referred me to. She measured pockets up to 12 mm and said almost every tooth had blood and pus around it. How did the numbers change so quickly from my hygienist’s measurements? The specialist said my teeth wouldn’t withstand laser therapy and recommended extracting all of them. She also warned me that dental implants do not guarantee that I won’t get gum disease again.
I expected a periodontist to try to save my teeth, not give up on them immediately. Shouldn’t she have prescribed antibiotics for the infection? Would perio trays help reduce the pockets? Losing all my teeth feels overwhelming. I haven’t decided whether to accept the periodontist’s recommendation for extractions. What are the alternatives? I asked for a few weeks to process all of this. Thanks. Kyla from NY
Kyla,
A jump from a 9 mm pocket to a 12 mm pocket in three weeks is unusual. Periodontal measurements can easily vary. Tartar along the root can stop the probe early, creating a shallower reading. On the other hand, when gums are severely inflamed, a probe may slip through fragile tissue, making the pocket seem deeper than it is.
What Causes Differences in Periodontal Measurements?
Pocket depth readings can shift depending on tissue health and root conditions. These issues often include:
- Tartar deposits that block the probe and create a misleading shallower reading.
- Inflamed or delicate tissue that allows the probe to puncture through, making the pocket appear deeper.
Concerns About the Recommendation to Remove All Your Teeth
We can’t determine whose measurements are most accurate, but your experience raises reasonable concerns.
Periodontal pocket measurement
Recommending the extraction of every tooth is a serious diagnosis. Usually, a tooth becomes unsavable when it’s loose or has lost too much supporting bone. Your description doesn’t suggest that every tooth meets that standard.
Another concern is the dentist’s willingness to give up before giving your gums the chance to respond to treatment. You’ve acknowledged going years without care, and that history can easily create severe inflammation. However, improvement can occur once the infection is treated and home care is optimized.
Why a Second Opinion Makes Sense
Dentists vary in their efforts to save teeth. Some see extraction as a last resort; others move toward it too quickly. A periodontist should fall into the first group. The fact that you felt dismissed suggests you may benefit from another perspective.
Look for dentists in your area with numerous positive and detailed patient reviews that demonstrate their commitment to tooth preservation. You get a referral to another periodontist who will work with you to determine how to preserve as many of your teeth as possible
The Monroe, Louisiana, dentists at Bayou Dental Group sponsor this post. Please read how Dr. Finley and his team strive to offer some of the best dental care in Monroe.
