Bone Loss

[Gellia]

Does anyone know the percent of bone loss a tooth has to have before it is no longer able to be saved?
Thank you.

[mamaboulet]

if it is loose it is a goner. If it regularly gets infected it is a goner. Any tooth at that stage of periodontal disease needs to be removed or it will compromise the teeth nearby.
Most likely, if you are asking about a tooth in trouble, it probably needs to be removed. Periodontal bone loss is mostly hidden and silent until it is too late for the tooth.

[mamaboulet]

And if you are already into bone loss phase, you should consult a periodontist immediately. There is gum surgery that can save your other teeth, but only the ones not past the point of no return.

[Gellia]

Hi,
I'm in treatment now.  One dentist said that my two laterals had "enough bone" but there was 70% loss in one front tooth and 30% in the other.  My laterals are genetically inclined to twist so my periodontist thought I might want four implants.  I'd rather hold onto the laterals but need to know what the percents of bone loss are for a compromised tooth.  
I already know the one is going to have to be extracted.  My hope is saving at least two or possible three of the others.  

[Gellia]

BTW, the other three are not loose at all.  They have never been infected.  Only the one, and that is why I sought treatment.  It's loose and I understand it will not tighten, but my hopes is saving the other three as they are not loose at all and I don't understand why I would need four implants.  Does 30% bone loss make the tooth a goner?
Thanks!

[mamaboulet]

I don't know percentages. Your dentist or periodontist should know. If the xray shows that the bone is still all the way around the tooth (think of it like grasping a big tooth root in your fist) and it isn't loose, you should be able to at least postpone the demise of that tooth with proper treatment and care. I've gained anywhere from a couple of years to more than ten years on compromised teeth that were caught and treated in time. But I had to have extensive gum surgery (peel and gortex). The extent of my eventual bone loss, plus extreme dental phobia, makes me a very poor candidate for implants. I have 15 teeth left, 4 of which are holding up my large upper bridge.
Basically what my periodontist did with my very advanced periodontal disease was to pull all loose and infected teeth that lacked sufficient bone, and then do gortex surgery on all the rest. The surgery worked best on my lower teeth, slowing down the bone loss significantly and rebuilding bone/tooth connection (that's what the gortex is for. That type of surgery is even more advanced now, I think). It didn't have as much success with my more advanced upper teeth.
You have to identify all compromised teeth and undergo aggressive treatment (surgery, root planing..), and then take very good care of your teeth and gums for the rest of your life. You have to have dentist appointments at least twice a year for cleaning and checking for trouble teeth. You have to have terminal teeth removed as quickly as possible because they will affect teeth next to them and decrease the general health of your bone and gums. You can never let an infected tooth run its course. Treat it with antibiotics to avoid silent bone infection.

[Gellia]

Thank you so much for your answer.  Boy, have I found out about periodontal disease!  I never knew I had a problem until I walked into a plate glass door and got an infected tooth.  Next thing I know, it's the four front teeth that need to be pulled and replaced.  I freaked.  I'm having root planing and scaling on my entire mouth and all the rest of the teeth seem in good shape.  As I have read some advice, including yours, I'm beginning to understand alot more about this.  
I'm going to be finishing up with the periodontal treatment and will continue that for life.  My DH does the same. Every three months.  He has had exactly the same treatment as you with all the gum splitting surgeries done repeated times.  He finally had to have 7 implants, but all on the back teeth.  When I'm finished with my perio work I'm going to have a consultation with the implant surgeon.  If he thinks I can save the two laterals, I'm for it.  I'd have them crowned if it will help.  It will certainly look better.  If he feels all four is warranted, well, I'm really going to mourn loosing them but will do what is necessary.  I don't want this to wind up taking the rest of my teeth.  Most importantly, due to other heart related health issues, I can't afford infections.
I appreciate your information.  Thanks again.
Gellia

[mamaboulet]

I'm glad to see another person on the road to good mouth health. Periodontal disease is a silent disease that does an incredible amount of damage. By the time you see it, you are in trouble.
If you have kids, go ultra proactive on their dental health practices and teeth cleanings NOW. "mommy doesn't care if you don't like to floss. Do it or I will do it for you." lol

[Gellia]

"By the time you see it, you are in trouble."  That is a statement worth noting.  I had no idea my teeth were in such bad shape.  It has been very depressing.  As I had always tried to care for my teeth, it was a big shock.  I guess I will wait and see if the implant guy even thinks I'm a suitable candidate for implants.  I hope so.
You have been SO helpful and I thank you so much.