"You need to have all your teeth taken out", may be one of the most devastating statements that a dentist can make. The thought that even one tooth needs extraction is a life changer for some. The consequences for that decision may be dentures or dental implants, but whatever the treatment, it is bound to change your lifestyle or make a dent in your pocketbook. But let me tell you, as a periodontist, as one who is responsible for determining 'predictability' or prognosis of your dental treatment plan, there are some people who are told that they need their teeth extracted that may be able to save their teeth.
Sometimes, a dentist or hygienist makes assumptions about periodontal disease that seem logical to him or her but may not be correct. There are countless examples in my practice of patients who were told to have their teeth removed because of periodontal disease who still have their teeth today. Of course, I have always held that most teeth can be saved in health and found it to be true for over 30 plus years of periodontal practice. Based upon the skills and experiences of periodontists themselves, they may not agree.
Now you would think that all treatment plans are the same, that if one dentist comes to a conclusion, that must be the conclusion. But you also know that there is the magic of the second opinion. The second opinion, whether in dentistry or medicine, sometimes finds a way that wasn't considered by the person making the first opinion. Let's give an example. A patient presents with a chief complaint of bad breath, some teeth that are loosening, tooth roots that are cold or hot sensitive, and many deep periodontal pockets. The patient is told that the disease is so severe that the teeth need to come out. We test the bacteria and find that the bacteria on the roots of the teeth are so aggressive that they are resulting in an exaggerated amount of bone loss for the teeth. We prescribe an antibiotic and within days, the bad breath is gone, and the teeth start to tighten. We then treat the disease by cleaning the roots of the teeth, treat the hot and cold root sensitivity and the teeth do better. They continue to tighten up. In a matter of months, the teeth are back to normal again.
If you are told that you have periodontal disease that will result in the extraction of teeth, the first thing that you should do is to get a second opinion with the right periodontist. The right periodontist has diagnostic and treatment tools that will help you reverse the disease in many cases. And if not, the right periodontist is the final judge on tooth longevity. You'll have peace of mind knowing that you saw a specialist before making a life-changing decision.