Is extraction of teeth required to treat infection ?

[TR33704]

I'm 45 and thru neglect, I have developed some periodontal disease.  Its extent is unknown until I am examined.  My dentist has recommended that all my teeth be removed because of the size of the pockets on most and their looseness.  Although I neglected to address the teeth that fell out, the remainder look and feel healthy although some are slightly loose.  However, because I want to get implants, they are hesitant to perform bone grafts unless the infection is treated and they feel that it can only be successful if all the remaining teeth are extracted.

My questions:  Are there alternatives in treating infections without removing teeth so bone grafts are successful?
                      Is this the only viable option moving forward to successful implants?

[scottma]

Please keep in mind that bone graft is not panacea, there are indications. Very often , bone graft was misused and ended up futile result, although there was generally no harm .Seeing a periodontist is advised.

[TR33704]

Thanks.  My dentist wanted me to decide before seeing my periodontist but I told him I'd wait until I had his assessments.  But can you tell me if the deep pockets found on each tooth is an indication that they may have to extract or are there treatments now available to reverse this and save the tooth (or teeth) ?

[Gellia]

Hi,
Implants have to be placed next to healthy disease free teeth.  I am having four teeth removed due to periodontal disease so that I can have implants done.  I was told this was necessary because of one infected loose tooth.  
It's the bone holding the teeth that is important.  Out of the four teeth I have to have removed, only one is loose, but the other three have been bone compromised.  
If you have loss of bone nothing will save the teeth.  Many times they feel tight because the periodontal ligament (PDL) is still tight but there is no real bone to hold them.
Pockets can be deep or not.  It's the bone that's important.
Good luck with your assessment.  I'm sure your periodontist will tell you if you have enough bone left to save your teeth.

[TR33704]

Thanks for everyone's reply.  Just read from someone that had LANAP or Periolase treatment, which supposedly treats deep-pockets by cleaning out bacteria, dead tissue, and roots and allowing bone growth and gums to reattach to the tooth.

Anyone have this procedure done?  

website given on post: http://www.youtube.com/watch?v=vJsFLnKwkaE

[Gellia]

Hi again,
I mentioned that treatment to my periodontist.  As it is relatively new, naturally he doesn't do it (figures!).  I think it is only suitable if your pockets are not too, too deep  and there must be enough bone completely surrounding the tooth in order for any hope of regeneration.  I have heard that once the tooth can be wiggled from side to side and not just front to back, the tooth is a goner.
My pockets are a maximum of 5mm so I will hold those teeth at deep cleanings every three months although my perio wants me to have the gum surgery.  Any treatment that cleans out bacteria and dead tissue has to assume that there is enough bone left to clean it off from.  Did your dentist tell you if you have enough bone left for these treatments to be successful?  If there isn't, no matter what you do, there is no way to save the tooth.  
I have my four coming out next week for the same problem.  No bone holding them in, just the gums and periodontal ligament, tightly, I might add.  If I hadn't had three consults and gone over my own xrays I wouldn't have believed it.
Have you ever considered implanted full dentures?    They remove the teeth, place 6 to 8 implants (S\sometimes less) in strategic places, and the full denture is permanently fixed to the implants.  They also have ones that snap in and out with mini implants, I think.
I do hope you are successful in whatever you decide to do.  It can be a very stressful decision.
Best to you,
Gellia

[TR33704]

Thanks for your input.  Everything you stated is exactly what I will have to inevitably face. I haven't consulted w/my periodontist yet but I will see one of the first to be certified in LANAP for a consultation tomorrow.  I know anything deeper than 5 to 6 mm will probably not be suitable but looking at the pictures on the net on other cases gives me some hope but my gut says I may have to "bite" the bullet.   My concern is the 18 month procedure, the loss of bone mass from my jaws while the gums and bones are treated and the cost of having implants.  Like I've heard before, sometimes the commercial aspects of implants get in the way of proper treatment because its a cash cow for dentists (no offense).  Good luck to you as well and I join you in your stress and anxiety.

[Gellia]

Please let me know how you do.  My perio wants me to have the gum surgery but I'm having the implants on the front teeth done first and because my pockets are a maximum of 5mm, I think I may just do the deep cleanings every three months instead.  Having implants and then the surgery is more than this dental phobic can even think about right now.
Loosing my front teeth has been stressful so I can relate to your intense desire to save your teeth.  
The implants are expensive.  Mine, for the implant part alone, is $8K for the four (that includes the four extractions, bone grafts and a GTR) and then I had to pay for a temp partial to use ($1175) while the implants heal and then the 4-unit bridge after.  Probably another $8K or so.  
Then the battle to save the rest of my teeth will be on..... a forever battle, too.  Deep cleaning every three months forever and a whole new oral hygiene routine.
Again, please let us know how you do with the laser cleaning.  I'm very interested and I wish you the best of luck in your quest to save your teeth.  
I join you.
Gellia