Is tooth mobility normal after scaling and root planing?
Patient's Query
Hello doctor,
After years of dental anxiety, I finally went to the dentist. After an X-ray and examination, I was diagnosed with advanced periodontal disease and told I needed scaling and root planing with a periodontist. My gums were too inflamed for an accurate pocket depth reading, but the dentist mentioned bone loss.
I was prescribed two weeks of antibiotics and a medicated mouth rinse before the procedure, followed by another two weeks of the same treatment. It has been two weeks since the procedure, and one of my front teeth now feels slightly loose when I try to wiggle it. I am panicking at the thought of losing my tooth.
Is this normal, or will my teeth tighten over time? I have a follow-up soon, but I am extremely anxious in the meantime. Please help.
Thank you.
Hi,
Welcome to icliniq.com.
I read your query and understand your concern.
Based on your clinical history, it appears that you may have either aggressive periodontitis (rapidly progressing gum disease) or chronic periodontitis (slow-progressing gum disease). Another possibility to consider is refractory periodontitis (a persistent form of gum disease that does not respond to conventional treatment despite good oral care), which may require a different treatment approach.
Periodontal conditions like these typically require a comprehensive treatment plan. This involves multiple visits for professional oral prophylaxis, monitoring, and follow-up care. Proper management is essential to control disease progression and maintain long-term oral health.
To provide an accurate diagnosis and the best course of action, I recommend sharing clinical images or investigative reports such as dental X-rays. These will help confirm the condition precisely and determine the most appropriate treatment sequence.
Once I have the necessary details, I will be able to guide you through the treatment protocol step by step, ensuring a personalized and effective approach to managing your periodontal health.
Please revert so I can assist you further.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
I went back to the dentist two weeks after having a full-mouth scaling and root planing (SRP). He said my gums have improved significantly, but he still needs to refer me to a periodontist for ongoing treatment. Based on my X-rays, he mentioned that I have significant bone loss, though he is unsure of the extent.
I have spent the entire weekend feeling extremely anxious. What does this mean for me at this point? Is it too late for treatment, or am I at risk of losing my teeth? The dentist mentioned several treatment options that the periodontist might consider, but my biggest concern is how severe my bone loss really is.
Any insights would be greatly appreciated. I regret not addressing my fears sooner, but now I am here, feeling completely overwhelmed. Here is the X-ray from my initial visit.
Thank you.
Hi,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Based on the radiographic interpretation (attachments removed to protect the patient's identity), I recommend the following treatment approach:
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Upper right quadrant (first quadrant): There is vertical bone loss in the first and second molars. This will require flap surgery with grafting, but fortunately, the prognosis is good.
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Upper left quadrant (second quadrant): A similar procedure will be needed—a modified Widman flap with grafting.
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Lower left and lower right quadrants: There is a combination of vertical and horizontal bone loss in all molars. In this case, a Kirkland flap procedure (a periodontal surgery that involves lifting the gum tissue to remove diseased tissue and tartar, promoting healing and reattachment to the teeth) is usually performed.
To promote bone regeneration and repair, grafting with DFDBA or demineralized freeze-dried bone allograft (a bone graft material that promotes new bone formation by releasing growth factors) or FDBA or freeze-dried bone allograft (bone graft material that provides a scaffold for bone growth but relies on the body's natural healing process for regeneration) will be done.
Most of the bone loss appears to be age-related but still has a good prognosis. I strongly recommend proceeding with flap surgery (a surgery where the gums are lifted to clean infected areas and repair bone damage before being sutured back in place) under local anesthesia. This is a routine procedure—not invasive, though thorough debridement will be performed.
I hope this helps.
Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
I truly appreciate it. I will be following up with the periodontist as recommended next week.
Thank you.
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