Is Extracting All Teeth My Only Option for Severe Gum Disease?

Posted by AllSmiles

I completed two scaling and root planing visits in October. At my follow-up, the hygienist noted improvement—my gums looked pinker, and my deepest pocket measured 9 mm. My dentist recommended that I see a periodontist for ongoing care, which I did about three weeks later.

That visit left me confused and discouraged. The periodontist measured pockets as deep as 12 mm and noted bleeding and pus around many teeth. I don’t understand how the measurements could change so dramatically in such a short time. She told me my teeth would not tolerate laser treatment and recommended extracting all of them, adding that even implants would not prevent future gum disease.

Although I neglected my teeth for years, I renewed my commitment to caring for them. I was surprised that the specialist wasn’t concerned about preserving my natural teeth whenever possible. I also wondered why she did not recommend antibiotics for the infection or discuss other treatment options, such as periodontal trays. Complete extraction seems drastic to me. The idea of losing my teeth at 44 is scary. How do I know if the periodontist overlooked other options? Thanks. Karletta from MD

Karletta,

A change from 9 mm to 12 mm in just a few weeks is unlikely to reflect true worsening of periodontal disease. Measurement variability is common, particularly in advanced cases.

Inflamed gums and root deposits can easily affect probe results, leading to inconsistent readings.

• Hardened tartar can block the probe and give a false impression of pocket depth.
• Inflamed tissue can allow the probe to penetrate beyond its actual attachment level.

Is Extracting All Teeth My Only Option for Severe Gum Disease?

Advanced periodontitis is severe, but moving straight to full-mouth extraction raises reasonable questions. Most teeth labeled as hopeless show significant looseness, and that doesn’t seem to describe your entire mouth.

It’s also essential to allow time for healing and response to therapy.

• Years without professional care can explain severe inflammation at the start.
• With proper treatment and committed home care, some teeth may stabilize or improve.

Finding a Periodontist Who Focuses on Tooth Preservation

Dentists differ in their philosophy about saving teeth. While extraction can sometimes be appropriate, periodontal specialists are typically trained to explore all reasonable options first.

Your willingness to improve your oral health is a strong positive factor. Getting a second opinion from a periodontist who emphasizes tooth preservation may give you a clearer picture of what can realistically be saved.

Chandler, Arizona, dentists Dr. William Walden and Dr. Tyrel Beavers sponsor this post. Read about what they do to provide some of the best dental care in Chandler.