I had a most bizarre periodontal exam. I am getting a new dentist after moving. I went to an establishment that looked well appointed and had a decent reputation. The dental exam on the gum, however, was rather weird. I never had an exam that hurt before. The dentists I have had in the past touched the gum to taking a reading but never jabbed into it as far as I could feel. The new dentist not only jabbed but also twisted once deep in. Is that normal? More importantly, would a bleeding gum show differently in an X-ray? He showed me the X-ray which seemed indicated a rapid deterioration. Since the last X-ray 8 months ago, I didn’t notice any symptom outwardly, bleeding, swelling, etc. often associated with infection. Can an infection set in so fast without ever bleeding? I had a teeth cleaning in May. It didn’t bleed during the cleaning. Wouldn’t that mean there was likely no infection? In mere four months, the bone deteriorated too deep to support the tooth?
@dentmom4 Is a dentist - if they are still on here - they were helpful for an issue my daughter had several years ago.
I’m still here, but not as much.
@Iglooo I’ll respond this afternoon, with explanation and a few questions.
That’d be great. Of course, welcome any questions you have.
have had a periodontal probe for charting pockets. Expert hygienist was quick and fast, sore but not painful. She retired. Her replacement can hit a root every so often which is not so fun. Bleeding? Yes. Should not matter to an x-ray machine. (think about all the saliva in your mouth.)
There is cleaning, then there is deep cleaning.
Unfortunately, I am familiar with both cleaning and deep cleaning. For my dentist, hitting the root it didn’t seem accidental. No idea what he was doing.
I’d get another opinion.
The periodontal probing should not hurt. Unless you’re seeing a periodontist, the hygienist usually does the probing. If the hygienist is inexperienced, s/he may not have learned to do a fairly painless exam yet. The perio probe should gently follow the tooth surface until it stops. It should never be pushed or twisted as that can damage the attachment of the tissue to the root. Your experience is not normal.
A bleeding gum will not show on an xray. You would possibly see bone loss, depending on the area that has a higher number on the probe. Did the dentist say you have bleeding on probing, and what was the number? And yes, you can have a pocket develop without any symptoms noticed by you. 4 months is very quick, but a 3 to a 4 can happen in that time frame. Do you have the same hygienist for every appointment?
Did the dentist give you a diagnosis and treatment plan, and what was it? Let’s start here.
That’s what I thought. It was a periodontist examining. He literally jabbed his tool on two places. It felt like he was tearing out the gum. On the second one he went in deep and then twisted. I am new in the area. This is the first time to the dentist. His treatment plan is to remove two teeth. The X-ray taken in January doesn’t show bone loss as far as I can tell. The new one from the other day shows almost complete bone loss. Yet the teeth are firmly in their place, not loose. I don’t know how these things go but, there was no bleeding ever. If the infection was so bad, shouldn’t there be a lot of bleeding? Also, if it is all infected, would I feel it when he went deep in? It hurt pretty bad and I have a high pain threshold. I’d think it’s the healthy tissue that feels the pain.
Time for a second opinion. 
Does this dentist do implants? That might be a reason why there is a need to pull those teeth.
Yes. Pulling out teeth isn’t cheap, either. If that’s needed, I am letting my old dentist whom I know well do it, not a total stranger.
Actually, I’m going through an implant procedure as we speak, and tooth extraction is a relatively minor cost compared to the overall cost. $300 to $4,000.
I’ve had my first implant this year. Overall cost is above $4k. I’d def get a second opinion. Also tooth extraction is (obviously) something that can’t be reversed. My goal is to keep as much of my natural teeth as possible for as long as possible.
@BunsenBurner I should come to your dentist. My guy gave me an estimate without me asking, over $2,000 for extraction.
I spoke by email to @igloo yesterday. For clarification, the “tooth” in question is a restored implant that is failing and must be removed. She sent the X-rays and it is very obvious. It was beginning to lose bone in January; the current X-ray shows major loss. The tooth behind may or may not need to be removed, depending on healing after removal of the implant and the surgeon’s decision.
The remaining threads of the implant are still anchored in the bone so it is not loose. It may or may not bleed. He is pushing with the perio probe to determine the depth of bone loss. The tissue still has nerves, that’s why it hurts. When the bone loss gets all around the implant, it will feel loose and hurt when you chew.
This does not need a second opinion (though you may certainly get one if you want). Implants are not 100% successful. With a failed implant, you are best treated with an oral surgeon to remove, graft, and place a new screw. Your personal dentist can restore the implant.
The importance of explaining things to the patient is underrated. @dentmom4, thanks for helping all of us understand the situation … but especially for helping @Iglooo with a thorough explanation.
Thank you for explaining this perfectly and adding the important details. This is not a simple extraction, indeed (unlike in my case).
Thank you for all the help you provided. My personal dentist is a periodontist. He did a very clean job of extracting my tooth last time when he installed the implant. I am not going back to this new dentist. I’ll be automatically getting a second opinion. The forceful probe was beyond necessity. If I can articulate properly, I think you’d agree. He also said I lost cavity fillings. I never had a cavity. Not sure how the total bone loss happened. It was deemed slow and stable as late as in May.
My husband had a failed implant. The oral surgeon said this does happen in a very small percentage of cases. The good news was…they corrected the situation (for him it was a new implant and everything involved in getting there) at no charge to DH. We would not have been thrilled paying for this…again.
I hope @Iglooo gets this resolved. Tooth issues are never fun!!