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#1
Old 01-24-2010, 11:22 PM
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Location: Bay Area, California
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Dental Question--is Irrigation worth it?

So I went to the dentist after a few years of neglect and found out my gums aren't in the best of shape, so they recommended a Deep Cleaning. Fine, who am I to argue?

The problem: the total cost comes to $750 after insurance! However, I can get this reduced to $200-something if I decline the irrigation and the "direct placement of antibiotic into the gums" (for which I forgot the technical term.)

So does anyone know how effective those two are? Is it worth the massive price-tag, or is a normal deep cleaning sans those good enough?
#2
Old 01-24-2010, 11:33 PM
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Location: Norman, OK
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I have similar issues, and I know the antibiotic is not cheap. It cost me about $30 per application, and each area they have to treat is fairly small, it usually takes 5-7 "applications" when I had it done in the past.

The irrigation I think uses some kinda of sonic (wrong word probably) scraper combined with a lot of water. As far as I know, those are the only two things that are included in my previous deep cleanings.
#3
Old 01-25-2010, 02:18 AM
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Bump! Need answer fast! (well, by tomorrow morning)
#4
Old 01-25-2010, 03:06 AM
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Join Date: Feb 2003
Location: Maui
Posts: 830
It depends on whether you wish to retain your teeth into middle/old age. Gum disease (pyhorrea) is probably the main cause of teeth loosening and falling out. It's real. I am not saying that this treatment is the only way to go, there are herbal methods that people talk about as well, but the "disease" itself is a bummer.
#5
Old 01-25-2010, 03:37 AM
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Location: South of Toronto, Canada
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I am not a dentist, but I think they use doxycycline tablets instead of inserting the gel into your gum pockets. It is worth asking about, at the very least.
#6
Old 01-25-2010, 10:46 AM
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Location: Plano, TX USA
Posts: 664
IANAD, I don't even play one on TV so this is my personal opinion...

The fact that insurance does not want to cover the irrigation or antibiotic is a strong indication that there is no (or only a little) evidence it really helps. Your dentist believes it's a good thing, your ins co does not agree. It's up to you what side of the debate you pick.

I had the same situation as you a few years back and did a deep cleaning + antibiotics. Out of pocket was about $400. The gum reading improved after the cleaning, but then slowly started reverting back again. My dentist has long been trying to get me to switch from an old fashioned tooth brush to a sonic doohickey. I finally did a few months ago and at the next visit the gums had improved as much as with the deep clean. In fact, after only a month with the sonic brush I only have a few pockets left, and even those are much shallower.

So one thought would be to try that, and go back to the dentist in a month. A delay of one month for your deep clean is not going to make your teeth fall out.
#7
Old 01-25-2010, 11:50 AM
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Also not a dentist, but I've heard/seen a bit about dental practices related to the OP. I can't be very specific, but the gist is that many dentistry corporations really push "gum disease" and the need for "cleanings". It's a huge profit maker, and at least one corp has weird Glengarry-style sales meetings relating to the number of cleanings that were sold. The antibiotics thing also sounds iffy -- you should get a second opinion from another dentist (and make sure they don't work for the same corporation!)

Anyway, I think it's very very likely that in the near future, at least one of these dentistry companies will be sued for fraud and a couple of other consumer protection law claims, which might bring some of these practices to the attention of the consumer and maybe to the state/federal enforcement branches.

ETA: the gum disease being pushed is not an actual diagnosis -- a lot of patients have gotten second opinions from non-affiliated dentists, who found no conditions that would be helped by a "cleaning".

Last edited by ivn1188; 01-25-2010 at 11:53 AM.
#8
Old 01-25-2010, 01:59 PM
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Location: Lethbridge, AB.
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I just went through this with my dental hygienist, and my bullshit meter was going off through the whole process, too. I have an "infection" in my gums? What am I infected with? Did you take a swab and culture it? What about antibiotics? My teeth are horribly, horribly dirty? No, they're not. I brush twice a day, floss nightly, clean my gums with a toothpick device, and go to the dentist regularly. Because my teeth are weak to start with, I don't want to take a chance with losing them to gum disease, but I don't trust what they're telling me and that they're giving me the best care FOR ME, not just for their profits.

Regarding getting your teeth cleaned with the ultrasonic cleaner versus a regular scraper - the ultrasonic thing was like biting on tinfoil for me (very sensitive teeth), so I went back to manual scraping. They said it is virtually the same cleaning procedure as just getting your teeth scraped manually, so if they're going to charge $500 extra for it, I'd just go for the scraping.
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#9
Old 01-25-2010, 03:17 PM
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Location: NW Indiana
Posts: 25,802
You can always ask for a second opinion.

Due to years of neglect in my early 20's (because poverty sucks that way) I had significant gum disease at any early age - I mean obvious symptoms that a non-dentist such as myself noticed, like visibly receding gums and bleeding when I bit into food like apples and carrots. So when I got dental insurance I "invested" in getting all that cleaned up. And it really has gone into remission, except my gum line is permanently receded in some places.

Fast forward about 15 years, 15 years of regular cleanings and proper hygiene. I go to a new dentist who suddenly "finds" severe gum disease. He claims my gums are receding (well, yes, I knew that) and swollen gums (um... no they're not. I've had swollen gums, I know the difference) and tells me my teeth are loose (no, they're not) and tries to get me to "admit" to bleeding gums (trust me, I know when that happens). Then he tries to hard sell me not only on Very Expensive Cleanings but also tooth whitening and veneers and.... well, my BS meter was ringing by then. I suspect he'd done a wallet biopsy (this was back when I had money - he heard I flew airplanes as a hobby and I think he concluded I was a gold mine).

So I got a second opinion. Well worth the $110 (not covered by insurance, of course, but a thorough check up by an impartial 3rd party). Signs of prior gum disease, but still in remission, no need for all that other crap, just continue regular cleanings and good hygiene. Oh, and I wound up going with dentist #2 as a regular thing and ditched the other guy.

So, sometimes you need the Very Expensive Stuff and sometimes you don't - if you have a question, get that second opinion before shelling out hundreds of dollars.
#10
Old 01-25-2010, 04:01 PM
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About four years ago I changed dentists, and during a routine cleaning, upon measuring the millimeters, the hygienist and dentist said I needed to have the Deep Cleaning. They wanted to set up an appointment to have that done, and I said I didn't want to do it at that time. The hygienist got kinda annoyed and said "You know you're going to lose all your teeth, don't you?"

About a month later, I went to visit my Dad (a semi-retired dentist) over the holiday and told him the story. We went into his office that weekend to get his opinion. After taking a look, he said "I see no reason to recommend the deep cleaning".

That first appointment did inspire fear in me, however, so I increased my flossing frequency from about once a week to almost every day, and made sure to brush 3 times a day. At my next appointment with that first dentist, the millimeters significantly improved, and they removed the recommendation for the deep cleaning. They seemed somewhat surprised.

Thus, I'd also recommend getting the second opinion.
#11
Old 01-25-2010, 04:07 PM
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Location: Charlotte, NC
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Quote:
Originally Posted by zwede View Post
My dentist has long been trying to get me to switch from an old fashioned tooth brush to a sonic doohickey. I finally did a few months ago and at the next visit the gums had improved as much as with the deep clean. In fact, after only a month with the sonic brush I only have a few pockets left, and even those are much shallower.

So one thought would be to try that, and go back to the dentist in a month. A delay of one month for your deep clean is not going to make your teeth fall out.
What sonic toothbrush did you go with?
#12
Old 01-25-2010, 06:50 PM
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Quote:
Originally Posted by vertizontal View Post
That first appointment did inspire fear in me, however, so I increased my flossing frequency from about once a week to almost every day, and made sure to brush 3 times a day. At my next appointment with that first dentist, the millimeters significantly improved, and they removed the recommendation for the deep cleaning. They seemed somewhat surprised.

Thus, I'd also recommend getting the second opinion.
What surprised them most was probably that you actually changed your habits. Most people don't.
#13
Old 01-25-2010, 11:08 PM
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Location: Lethbridge, AB.
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Broomstick, that was my experience too - my parents (God love 'em) didn't actually teach us to do more than brush once a day, and I had fairly early onset gum disease followed by changing my ways with much better dental care and hygiene, too.
#14
Old 01-26-2010, 11:18 AM
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Location: Plano, TX USA
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Quote:
Originally Posted by melodyharmonius View Post
What sonic toothbrush did you go with?
The Philips sonicare. It's the type that has a regular looking rectangular head the vibrates side to side. About $70 at the local grocery store.
#15
Old 01-26-2010, 11:48 AM
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My dentist uses the Cavitron (awesome name, BTW) sonic scaling device but it isn't a "special service" it's just what they use - its much faster and less tiring for the hygenist than hand-scaling. They do touch up by hand. Since it is faster+less tiring, the hygenist can take more patients in a day. Profit! The machine only costs about $500-$1000. I'm amazed that some places treat the cavitron like some super special device.
#16
Old 01-26-2010, 12:27 PM
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Join Date: Dec 2000
Location: South Carolina USA
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Quote:
Originally Posted by zwede View Post
The Philips sonicare. It's the type that has a regular looking rectangular head the vibrates side to side. About $70 at the local grocery store.
Awesome product. I used to have some gum problems, but since I started using the Sonicare they've been perfect.
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