Just went to my Dentist for a cleaning, they measured my gums with the little needles and said I need Deep Cleaning on I use a Sonicare toothbrush everyday and have for several years, they want to charge me 169 per section and they want to do 3 sections...507.00 dollars. How do I know if I really need a deep cleaning or is it just another way to get money for cleaning..While I was there they did complete oral exam, x-rays and what they called a full mouth debrediment, which seems like a high pressure cleaning and cjarged me 208 for that. But thay say thats not good enough and I need a deep cleaning very badly but they cant do it for 2 months, if I needed it that bad why would they take so long to work me in to get it done. Isnt there something a person can do on his own to do up under the gums.

Hi Jody,

When they poked your gums with 'needles' what they were doing was measuring the depth of the pockets surrounding your teeth with a Periodontal probe. It has measurements in increments of millimeters. What this will do is tell the hygienist what state of health your gums are in. Generally, if the numbers are 1,2,3 the gums are healthy (barring recession) and anything above a 4 indicates areas of bone loss or gum disease. The higher the number (up to about 12 mm) indicate the worst areas of disease. Usually, if there are generalized 6mm and above or localized areas of 7mm or above then a deep cleaning is necessary. There are other factors but this is a basic idea. If you could remember the numbers they read or were told to you, that would help me a great deal.

So, back to the cleaning. First and foremost, the Sonicare is not the answer to everything tooth related. People sometimes think that the Sonicare will be the cure to every tooth related malady. However, if you went in and all they could do today was an exam and debridement, sounds like you had a tremendous amount of calculus or tartar buildup. Probably most of it was beneath the gumline and between the teeth especially. A general debridement removes the bulk of the buildup, allowing us to get a more accurate reading of the gums as well as a visual look for decay on roots, recession measurements and so on.

This in no way is an opportunity for us to make money off of you or anybody. I am well aware that it does cost a great deal of money, and I personally will work my butt off to keep the appointments down to help with the cost. Now, when you have years of build up on the teeth and covering the entire root surface it takes time to remove it. We cannot do a thorough job in an hour. If you hypothetically missed the last 3 years of cleanings, you have then missed 6 cleanings. That would be 6 hours of scaling. Or put that into a cost of $120 per visit or so. Thats a lot more than what you are paying now. Just in one lump sum rather than being spread out over the last 3 years. And for each cleaning you missed, that build up becomes harder and harder as more minerals become embedded in that buildup. I have seen tartar that could have passed for concrete.

So, the reason we break it up into quadrants for scaling is it allows us to thoroughly clean one area of the mouth at a time. Then we move on to the next. Sometimes anesthesia is required and that allows us to again do a good job and we cannot numb up an entire mouth.

If lets say you have not flossed your teeth regularly and that means at least several times a week then you will have massive build up between your teeth. On the xray if you ask you will likely see ledges of tartar between the teeth. Remember you are only able to see tartar on the xray between the teeth, but that same amount is covering the entire root surface. And if you have a tooth that has 7mm of bone loss that entire root is covered.

As far as the length of getting an appointment, are you requesting an evening? Most people that work 1st shift also ask for evenings, it is simply a high demand time. There are only so many hours available and to suggest that if this was so necessary why can't I get this done tomorrow, is not fair either.

Please also bear in mind this. Who's responsibility is it to take proper care of your teeth and gums? Sorry if I get a little cranky about this, but I have had so many patients like yourself who think that we are just in this for the money and that must be the only reason why we are telling you that this is necessary. What we hygienists do is NOT a cakewalk. After 10 years, I now have carpal tunnel in my wrists, arthritis in my neck as well as beginning of deteriorated disks as well. So, I would not subject myself to hours of unnecessary scaling to make a buck and I doubt other hygienists as well.

Tank you for such a quick response to my problem and you have explained it quite nicely. My #'s werre between 8/s and 9/s so I guess I do need the deep cleaning, am I right?
Thanks again for yoir input on this problem

OMG, you DO need the cleaning. You might check around for someone who does laser gum treatments. I had that done on 2 teeth 6 mos ago. Was just checked today, and everything is PEACHY and I had one 10 mm pocket!

Kiki

Jodi,
Jennifer explained it well. She is good at her job. Every office is different. I know my hygenist (depending on the depth) does all four quads in one appointment. Usually what she refers to has stm2 or 3. If it's a stm 4 (this is the name of the deep cleaning you are getting) she only does half of the month right and then week later the left. It just depends on which side she thinks need the attetion. As far as you waiting to get this done in 2 months because they can not get you in is a little concerning for me. Yea if you were set on a certain time then maybe they would have trouble getting you in. If you where willing to do any time or day then i would think they would get you in asap. In the office i work in the hygenist makes sure that she see the patient asap. She has time in her schedule for these types of appointments so that the patient doesn't have to wait. This is a very important matter, I am sorry they made it sound important and then schedules you so far out. Like Jennifer said is they where measuring around the teeth the health of the gums and the bone surrounding the teeth. If you let the infection go wiht out the cleaning the the infection keeps taking away the bone. If you have don't have bone then you can not keep your teeth. The bone is what hold your teeth in. Plus now gum disease has been assosated with heart disease and strokes (there have been some new studies about this and i just went to a semiar about this, not everyone gets this). You should ask your dentist or hygenist about this. Also arestin is something our hygenist uses in our office. She believes in it. It is an antibotic that is placed around tooth that has a reading of 5mm or more. It helps the infection. remember you cannot get rid of the gum disease you can only maintain it so is does't get worse. There is no way to get back the bone u have already lost. Good luck with this. I don't think it's away for them to make money cause this is something really important

Jody,

After hearing the depths of the pockets, I would STRONGLY, STRONGLY urge you to have them refer you to a periodontist. I cannot stress enough how desperately you need to have this dealt with asap! With pockets at 8 and 9mm, you very likely also have mobility and furcation involvement. Furcation is when (picture a whole tooth where you see the roots) and that tooth has 2 'legs' furcation is when that bone level has dropped below the crotch of the tooth (kinda like a tree branch) and it is extremely difficult to get that area cleaned out and maintained, especially by a general dentist. I am not saying that it is not possible, but it is very difficult.

So, why do I suggest you see a periodontist now?! I honestly would have referred you that first day! Us hygienists in general practice can do a very good job with scaling and root planing (cleaning the roots and teeth). However, when you are dealing with advanced gum disease, such as yourself, you need very aggressive treatment to get a hold of the disease. And I will be very honest in saying that gum surgery is probably a given with you. And that is NOT to scare you, but for you to know that if you really, really want to keep your teeth, that is the likely road. I have had patients that refused to see a specialist, so I do all that I can, and have had good results. But, with a specialist there are tons more options for them to treat you where the general dentist can't or is not as well 'versed'.

I am in no way putting down a general docs abilities, but a periodontist has years of specialized training in just dealing with periodontal disease. If you are going to spend that money to get this going, spend it with a specialist, and do it as quickly as you can. There will likely be a wait, but do everything you can in the mean time to keep your mouth as clean as possible. Which means, flossing daily, brush at least 2x a day as well as using an antimicrobial mouthwash nightly.

Best of luck to you and post and let us know what you will do.

Thanks Browneyez..I think I will call my dentist and see why the got my appointment so far out..I am like you, this is important so why do they think I should wait 2 months..Thanks again for your reply
Jody

Thanks everyone for their input on this..Now I am really freaking LOL...just kidding..I appreciate all your inputs..
Thanks again,
Jody

Good luck. I hope they move your appointment up. It's important. I wish you well.

[QUOTE=JenniferWalker]Hi Jody,

So, the reason we break it up into quadrants for scaling is it allows us to thoroughly clean one area of the mouth at a time. Then we move on to the next. Sometimes anesthesia is required and that allows us to again do a good job and we cannot numb up an entire mouth.
QUOTE]

I have a questions that you might be able to answer, you seem very knowledgeable on the subject. I went to a dentist for a treatment plan when my insurance changed and where my other dentist had told me I needed a few good cleanings, this dentist told me I needed root scaling. I realize my gums are not in the best of shape, as they bleed sometimes for no reason and my gums get sore if we have something like steak for dinner, requiring lots of chewing and when it gets down between my teeth. I floss daily, so I also realize that's probably helped them from getting worse then they are. Anyway, the dentist told me that they could divide it up in to 8 visits. I'm not too 'dental friendly' so I told him to divide it up in to 4. I went for the first one, took maybe 2 hours for the scaling on the upper right and then had to wait 30 minutes for the dentist to fill 2 cavities also on the upper right. Anyhow, I get my EOB from my insurance and there are 2 root scalings billed, both at 205.00. The hygenist that cleaned my teeth did a great job, and it didn't take maybe an hour for her part, she even commented that my tartar was coming off a lot easier then she'd thought it would and said it was the easiest she'd worked with in a while. My insurance of course denied one of the procedures, stating that each quadrant could only be done once a year which I can understand.....so why did they bill it that way? The dental office said they divide my mouth in to 8 sections, so in essence I'll have to pay out of pocket for 4 sections at 205.00 each! That also puts me over my maximum per year so I'll end up paying out of pocket for a crown as well. Is this the norm to divide the mouth in to 8 sections but still do them in 4 sittings/office appointments? My deepest pocket was a 7 in the very back, so is it because of that? Thanks for your help....just trying to understand the procedure a bit more and the norm in how it's performed.

I am reading this and wish my insurance would pay for such deep cleaning. When you are considered one of the "Working Poor", the only break you get is state insurance paying for tooth removal. At least it will pay for children's needs and glad for that.

But as an adult, all it pays for is pulling teeth. I am looking at deeping cleaning too with $700 for all four quadrants and trying my best to scrape the money together to get it done, ASAP. Still have most of my lower teeth...but only nine uppers. The three fronts (loose) and one canine. Three molars/bicuspid in upper right and two on left. If I lose anymore from there.....I will have trouble chewing.

My family has a history of peridontal disease. The pits.

By the way, I am 52