Periodontist

Heiser

I had an abscess in my gum recently that was very painful. After a visit to the dentist she said I had pockets in my gum, one of which was 6mm deep and that I need to see a periodontist immediately. She referred me to the perio and they just rang me to tell me they're next available appointment isn't until May.
I want to get this looked at straight away while it's in my head.

I've a few questions. Can anyone advise how much this sort of work costs? I imagine it's a root planing and scaling I need. How long does this treatment usually take? I'm going away in April and was wondering if I could get it done cheaper while abroad? Also, can anyone recommend me a (cheap!) periodontist cos I'm going to get the phone out this week and start calling some.

Any other info or experiences from people that have been through something similar would be appreciated.

Thanks

Dianthus

Cost& length of time taken to complete treatment - totally variable from patient to patient. A treatment plan & estimate can only be formulated after a clinical examination & xrays.
(They'll have to take into account a tonne of things---smoking status, oral hygiene routine, medical history, frequency of dental attendance, localised/generalised periodontal disease, mild/moderate/severe, family history, access, prognosis, anatomical & restorative factors, ect ect)
If the cost of living & wages are lower in a country, then likely the cost of dentistry will be too. Unfortunately periodontal disease is a lifelong condition which needs to be controlled, monitered& maintained. The active phase of treatment can take many visits over many months.
Have a look at periodontist websites , &/phone their practice receptionist , to assess their various range of fees.

btkm8unsl0w5r4

Heiser wrote: »

and they just rang me to tell me they're next available appointment isn't until May.


Thanks

Now this always amuses me in private dentistry. If a clinic is allegedly booked that far in advance for a consultation, (3 months), half the appointments will get cancelled or moved in the interim. They are basically either so busy your better off going elsewhere, or they are screening the referrals and only taking on certain types of work and putting the rest on the long finger. Also if you go in 3 months and they say...yes Heiser you need X Y and Z....how long before they can do the actual procedures which require more time and appointments than a consultation.

Plenty of periodontists out there, pick one that can see you in a timely manner. Please inform your general dentist that the referral was unsatisfactory as they could not see you in a reasonable time frame and ask for a referral elsewhere. You dentist will appreciate knowing this.

Gum disease needs ongoing care, you need a local person to look after you.

WardonGordon

Did they mention why you need to see a specialist?

Heiser

WardonGordon wrote: »

Did they mention why you need to see a specialist?

She said my gums were bad and I've a 6 mm pocket where the infection was and a periodontist would need to decide on the best course of action.

I was at another dentist getting a general cleaning 6 months ago and she said my gums weren't great and told me to brush and floss better, which I have been doing, but no mention of needing to see a periodontist

WardonGordon

I agree with the local practioner idea.

In my experience the first round of root surface debridement is rarely completely successful. Fine you might get some pocket improvement but you'll likely get some staying the same and some deteriorating.
What you want is success and stability and this often takes more than one round of treatment.

Is that you were offered a referral and took it or that your case is complex and requires specialist treatment?

Heiser

WardonGordon wrote: »

I agree with the local practioner idea.

In my experience the first round of root surface debridement is rarely completely successful. Fine you might get some pocket improvement but you'll likely get some staying the same and some deteriorating.
What you want is success and stability and this often takes more than one round of treatment.

Is that you were offered a referral and took it or that your case is complex and requires specialist treatment?

If more than one round is needed cost will be a big factor for me too, from what I see online prices seem to range for full mouth scaling from 245 to way way beyond that. 245 is doable, anymore than that could start being a problem.

I think my case was complex, my dentist told the periodontist it was an emergency referral. My dentist wouldn't give me antibiotics for the infection at the time as she said it would only mask the problem and it needed periodontist treatment. The pain got much worse for me and I had to go back to the dentist and get antibiotics prescribed.

btkm8unsl0w5r4

any treatment with a specialist periodontist will be a lot more than 245 euro. The consult and X-rays will soak up at least half that, full mouth root planning will be around that per quadrant.

Heiser

I went to a consultation at a periodontist. I felt it was quite rushed and was given this quote at the end. Only getting to look at the quote now. What's the difference between the study and cleaning and the deep cleaning?

I was quoted the following:

Periodontal study and cleaning.
Periodontal picket examination and charting. Appt includes periodontal cleaning. Approx one hour. €250

Periodontal deep cleaning (full mouth scaling).
Deep periodontist clean of upper and lower arches. €600

Periodontal maintenance. €
Check up,cleaning and maintenance. €200

Does this look like an ok price?

WardonGordon

First cleaning probably just a basic scale and polish. Then they measure your pocket depths and which ones bleed or are mobile etc etc...
Then you know which teeth and which sites on each tooth require the deeper cleaning. A deep cleaning in basic terms means placing the scaler below the gums to clean the pocket of plaque and tartar and is more likely to require local anaesthetic. After 3 months you re do the measurements , compare them to the first ones and see what needs to be done next.
Periodontal maintenance is essential to success.
None of this works without your home care being excellent.

Heiser

WardonGordon wrote: »

First cleaning probably just a basic scale and polish. Then they measure your pocket depths and which ones bleed or are mobile etc etc...
Then you know which teeth and which sites on each tooth require the deeper cleaning. A deep cleaning in basic terms means placing the scaler below the gums to clean the pocket of plaque and tartar and is more likely to require local anaesthetic. After 3 months you re do the measurements , compare them to the first ones and see what needs to be done next.
Periodontal maintenance is essential to success.
None of this works without your home care being excellent.

Thanks for the replying. My home care has hugely improved over the last few months.

Would it be the norm to have a regular cleaning before having a deep cleaning? Doesn't really make sense to me?

Heiser

Has anyone any experience on the periodontal study and cleaning I'm being quoted €250 for? Would this be the norm to have done before the full mouth scaling?

Going to email my periodontist tomorrow and ask about it but if anyone can shed some light that would be great

Fishorsealant

Think about it logically.
If you don't find out where the deep pockets/active sites are how are you supposed to know where to clean during the deep cleaning? You can't just guess...
How will you monitor your progress if you have no baseline records??

Yes normal to do full mouth scaling. Get rid of the tartar and plaque above the gums first as this usually isn't as sensitive. Maybe some cleaning just below the gums too initially.

Then for the root surfacing debridement or the "deep cleaning" you will be cleaning pockets generally greater than 5mm and this takes time and also is likely to require local anaesthesia..
In my experience patients don't tolerate this without LA.

If you are going to a periodontist it is likely the disease severity is greater and will take more time to treat.

Dianthus

It's probably best to ask the above questions of your periodontist. Online research & advice is useful to a point, but you need to establish good communication with the actual practitioner themselves about your own specific case.
Open dialogue, clarity, rapport& trust are vital. Plus, a proportion of what you pay them is for information,& also to save you the time& hassle& stress of trying to analyse it all yourself.

Heiser

Fishorsealant wrote: »

Think about it logically.
If you don't find out where the deep pockets/active sites are how are you supposed to know where to clean during the deep cleaning? You can't just guess...
How will you monitor your progress if you have no baseline records??

Yes normal to do full mouth scaling. Get rid of the tartar and plaque above the gums first as this usually isn't as sensitive. Maybe some cleaning just below the gums too initially.

Then for the root surfacing debridement or the "deep cleaning" you will be cleaning pockets generally greater than 5mm and this takes time and also is likely to require local anaesthesia..
In my experience patients don't tolerate this without LA.

If you are going to a periodontist it is likely the disease severity is greater and will take more time to treat.

Thanks for clearing that up. I presumed a deep cleaning would include cleaning all the pockets, regardless of where they were, and that's why I'm paying for a full mouth cleaning. Didn't know I had to pay to find them too! And that the deep cleaning again would include a regular scaling. I only got a scale and polish last month so not sure I need it done again, I'll see what my periodontist days when I see her.

Thanks for clearing that up

Heiser

Dianthus wrote: »

It's probably best to ask the above questions of your periodontist. Online research & advice is useful to a point, but you need to establish good communication with the actual practitioner themselves about your own specific case.
Open dialogue, clarity, rapport& trust are vital. Plus, a proportion of what you pay them is for information,& also to save you the time& hassle& stress of trying to analyse it all yourself.

Yep true but I like to find out as much as I can to educate myself and so I know what questions to ask!

Heiser

Went for my €250 periodontal probing, charting and cleaning earlier in the week. Mostly had pockets of 2's and 3's with about 3 or 4 6's around my wisdom teeth which I'm going to have removed.

He told me he could do the full mouth scaling in a one hour session at our next appointment. I said great, cos I presumed this meant my teeth weren't so bad and needed less work. The original €600 quote I presumed was for a few hours work, the worse case scenario. But he said no, that the charge would be €600 for the one hour of deep cleaning!! I gasped and he went on the offensive when I challenged him on it.

I feel I'm being totally done here, surely the cost of one hours work be €600? The 45mins today only cost me €250 sure. So I'm out. Won't be getting the work done now. Will be in Turkey later in the year and will get the wisdom teeth out and a deep clean done over there. Or can I get a hygienist over here to do a deep cleaning?

btkm8unsl0w5r4

Rethink the wisdom tooth thing, there are some serious risks that are worth paying somebody good to do the job. Remember when you pay a expert your paying them not an hourly rate, but the for time it took them to be able to do it well in the time. The only thing more expensive than paying a professional is paying an amateur.

Heiser

Milan Obedient Ford wrote: »

Rethink the wisdom tooth thing, there are some serious risks that are worth paying somebody good to do the job. Remember when you pay a expert your paying them not an hourly rate, but the for time it took them to be able to do it well in the time. The only thing more expensive than paying a professional is paying an amateur.

Cheers. I'll research a good dentist in Turkey and go to them. The periodontist I'm seeing hasn't done anything to show me he's really good, in fact quite the opposite if he thinks he can do a full mouth scaling and root planing in one one hour session.

Heiser

Heiser wrote: »

Went for my €250 periodontal probing, charting and cleaning earlier in the week. Mostly had pockets of 2's and 3's with about 3 or 4 6's around my wisdom teeth which I'm going to have removed.

He told me he could do the full mouth scaling in a one hour session at our next appointment. I said great, cos I presumed this meant my teeth weren't so bad and needed less work. The original €600 quote I presumed was for a few hours work, the worse case scenario. But he said no, that the charge would be €600 for the one hour of deep cleaning!! I gasped and he went on the offensive when I challenged him on it.

I feel I'm being totally done here, surely the cost of one hours work be €600? The 45mins today only cost me €250 sure. So I'm out. Won't be getting the work done now. Will be in Turkey later in the year and will get the wisdom teeth out and a deep clean done over there. Or can I get a hygienist over here to do a deep cleaning?

Why not just go to a dental hygienist to get the deep cleaning?

btkm8unsl0w5r4

Heiser wrote: »

Cheers. I'll research a good dentist in Turkey and go to them. The periodontist I'm seeing hasn't done anything to show me he's really good, in fact quite the opposite if he thinks he can do a full mouth scaling and root planing in one one hour session.

I know a lot about this, rethink the Turkey thing. Thats all I will say. Good luck.

WardonGordon

Could you not find a dentist who is cheaper than a periodontist to do the cleaning?
The pocket depths you mentioned aren't so bad that only a specialist could clean them...

WardonGordon

WardonGordon wrote: »

Could you not find a dentist who is cheaper than a periodontist to do the cleaning?
The pocket depths you mentioned aren't so bad that only a specialist could clean them...

By the time he gets an initial exam, an x-ray etc it probably wouldn't work out much cheaper though would it. Sounds like a hygienist could if done the work from the start though

btkm8unsl0w5r4

Hygienists work on prescription from a dentist, you will have to get a consultation, X-rays etc before being referred to the hygienist.

I warned him in post 8 it would be expensive seeing a specialist, and 600 euro is actually good value IMHO to get somebody of that experiance. I would say though after his last interaction the specialist has very little interest continuing treatment and will allot the time to other more willing patients.

Heiser

Can the full mouth deep cleaning will be done in only one hour, considering I do have periodontal disease? I've been reading about the procedure online and most places state it's 45 mins per quadrant. Which would be 3 hours of cleaning (and I thought this was €600 and fair enough). Can it be done properly in one hour? If so, then why do most places say 45 mins per quadrant?

Perifect

Have you looked at prices in the north?

tretorn

Yes, that price is about right.

WardonGordon

Heiser wrote: »

Can the full mouth deep cleaning will be done in only one hour, considering I do have periodontal disease? I've been reading about the procedure online and most places state it's 45 mins per quadrant. Which would be 3 hours of cleaning (and I thought this was €600 and fair enough). Can it be done properly in one hour? If so, then why do most places say 45 mins per quadrant?

I don't know how many times it has to be said.
Most cases being treated by a periodontist are of greater severity and more complex. They therefore take longer.

You might get 4 quadrants cleaned in a visit if it's a simple case or you might get one quadrant cleaned if it's severe with many sites with deep pockets around each tooth and furcation involvement etc..

You said yourself you have mostly 2s and 3s and some 6s around wisdom teeth which you are getting extracted. This isn't going to take a specialist long to clean.

Dianthus

Something isn't adding up.
The only severe pocketing is around the wisdom teeth which are scheduled to be extracted, & the remainder of your teeth only have 2-3mm pocketing? It doesn't make sense.
Get a 2nd opinion from a trusted dentist/periodontist - someone who can assess you in real life, not online. Trying to tailor your own treatment plan yourself can often end in tears.

btkm8unsl0w5r4

Dianthus wrote: »

Something isn't adding up.
The only severe pocketing is around the wisdom teeth which are scheduled to be extracted, & the remainder of your teeth only have 2-3mm pocketing? It doesn't make sense.
Get a 2nd opinion from a trusted dentist/periodontist - someone who can assess you in real life, not online. Trying to tailor your own treatment plan yourself can often end in tears.

Yes this.......