Quick periodontal question

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#1 Post by **SideKick3QT** » Wed Jul 18, 2007 6:15 am

btw I havent gotten my braces yet, but my ortho wants me to get checked at a periodontist for a slight recession on my 2 bottom teeth. My question is, do people tend to get gum grafts before or after braces treatment? Or does it just depend on the severity of the recession?

#2 Post by **PCPFORMULA** » Wed Oct 17, 2007 1:18 pm

KK,

Did you end up getting a gum graft? if so how did you get on, did it fix the prob, im post op and think I may need something down on my lower front teeth.

thanks

#3 Post by **discomom** » Fri Oct 19, 2007 11:34 am

In my situation, my orthodontist wouldn't begin any treatment until I went to a periodontist. I ended up having a gum graft on my lower bottom front teeth. I wish that I could say that it was a breeze, but I cannot. I know that some people get through it absolutely fine, I thought it was miserable. That's my take on it. I know that my ortho was please with me getting it done before and he feels that this will cause less recession once braces are put on. Good luck with what ever your ortho decides. Lori

#4 Post by **QKate** » Fri Oct 19, 2007 11:38 am

I had gum grafting before braces, but my recession was so so so severe! My grafting was fine- I think cause I used an excellent periodontist who does microsurgery and is really at the top of his game. Microsurgery seems to do a really delicate job. You might want to wait till after the braces though.

#5 Post by **PCPFORMULA** » Fri Oct 19, 2007 1:21 pm

QKate,

Did you lose any teeth due to recession, also do you have any wobbley teeth?

#6 Post by **QKate** » Fri Oct 19, 2007 4:09 pm

PCP>
I have not , thankfully, lost any teeth due to perio disease- except I did cause my first perio was an IDIOT ( do I sound mad?!!) and had me extract 4 perfectly good wisdoms which I miss a lot.
But no teeth fell out. None are super wobbly except my bottom 4 front have only the littlest bone and they supererrupted- which means they grew up out of the bone, so tons of root is exposed.I guess if I wiggle them they might be a tiny bit wobbly, and I certainly don't eat with them. They are getting intrueded with the braces so I hope that will help. And I have a lot of bone loss and had recession followed by bad perio surgeries- a big ol' mess. I feel that my teeth look worse than most others' on this board cause of the bone and gum loss. I may post my pics in my braces journey story tonight so you can see. Somehow though, they aren't really loose, thank goodness!
Are yours?

#7 Post by **Gennel** » Sat Oct 20, 2007 8:55 pm

Qkate. Have you found a periodontist or does your ortho have one he can recommend? Deffinately have a perio check out that gum recession ,Xrays that zoom in that area to see how much boneloss you have. I had a similar situation with 1 bottom front tooth #24,it had receeded so much that a lot of the root was exposed .My dentist,hygienist were afraid to touch it because they thought I would scream. In fact it did not hurt me. As soon as the ortho put the bracket and wire on that tooth it came severely loose and was EXTREMELY painful 24hrs a day. I knew in my heart that I would lose this tooth. The periodontist confirmed that putting braces would cause my tooth to fall out. I had a choice to "try" and get a bonegraft and gum graft done. Let it heal at least 4-6 weeks and see if the tooth would stay put. I had no guarantees so I decided to have the tooth pulled

The periodontist told me if I was not going to put braces on the bottom teeth ,that I should get the bonegraft,gum graft done and it had a higher chance of saving the tooth. But the problem is that braces will move teeth and sometimes they move teeth a lot and my tooth was not going to survive all the movement that needed to be made.
I could have stayed with crooked bottom teeth and not loose a tooth. Remember the choice is yours. My gap has closed a lot in the past 4 weeks . I did not need a bonegraft since the surrounding teeth had enough bone and once you close the gap ,the gum recession would be squeezed together and bond...if that makes any sense.
Find a Periodontist that you are comfortable with and always ask what options you have.I like it when doctors tell you" You can do this or that"
Not when they say " what we're going to do first is yada,yada,yada" like if you're a child and have no choice in the matter. Do some google research on gum recession,boneloss and the effects of braces with this problem.
It was a very difficult choice for me to go ahead and have the extraction of my bottom front tooth but for me it was the right choice, I know it. I never had pain in that tooth until they put the wire attached.The tooth went completely forward in like 2-3 hrs and was throbbing like it was going to fall off. You just know your body and that will help you ask the right questions.

sorry for babbling on ,when I read your thread I was like " OMG I just went through this a few months ago!"

Gennel

#8 Post by **Gennel** » Sat Oct 20, 2007 9:00 pm

Forgot to mention that my tooth with boneloss/gum recession was never loose. It became severely loose as soon as the braces were put on.Once they took the wire off because we both knew that tooth had to go. At the moment the wire was taken off, that tooth was very,very wobbly. If I touched it ,it felt like I could just twist it off myself!

#9 Post by **QKate** » Sun Oct 21, 2007 7:43 am

Hi Gennel,
Well, fortunately after I had really bad experiences with periodontists I did TONS of research for a long time and found an excellent periodontist. I had to fly from New England out to California (!) numerous times to work with him. BUt he did gum grafting for me on 14 teeth ( in 2 procedures at diffferent times). He also sent me to a prosthodontist and an ortho in California who he works with. These are top notch people who I love. So they put together a treatment plan for me- which included braces. Then he recommended the orhto I am using, who I travel 5 hours on a train into NY city to use. So all these top people addressed my issues and said I should not lose any teeth! They said braces will be very helpful for me to get the teeth positioned corectly and help the bite and esthetics. They said if I keep it clean (this for me means professional cleanings every 3 months or possibly every 2 months! UGH cause those hurt my roots!) then there should be no more bone loss.
My orthodontist said the teeth will loosen up during treatment ( I am SO not looking forward to that!!) but they will tighten up afterwards and be as tight as they are now.
So I trust these people as I have learned how to find good practicioners finally. And I have a new periodontist close to home to get cleanings from.

So why did your tooth loosen up during treatment? Was it a lower middle tooth? Did you have perio disease?

#10 Post by **Gennel** » Sun Oct 21, 2007 1:10 pm

yes it was my bottom front tooth #24. I had boneloss in the front of thetooth . I had bone on each side of the tooth and also on the back . The problem was when I got that tooth connected to the archwire, the tooth went forward (no bone to support going forward) so it was so loose that it had to be taken out. THe boneloss there was due to some sort of injury because I only had it in that 1 tooth. Either incorrect rough brushing could have caused this he said. They did not do a bonegraft to attempt to save it because so much movement was going to be required on that tooth.

If I would have not done the bottom braces and did the bonegraft/gumgraft , I would not have lost the tooth.
I'm glad you've found great doctors that are working together for you

Gennel