First Time Seeing a Periodontist

Fair warning, I am writing this post fresh from my first visit to a periodontist and since I am in significant discomfort, I am not in the best of moods. As you know if you have been reading along, dental care has been a real challenge while we have been on the road.  It’s been a problem since the beginning, but unlike other challenges I have yet to find the solution. I wasn’t worried because I had near perfect teeth when I went on the road and had consistently seen a dentist twice a year for many years.  But I understand on some level how important routine maintenance was to proper dental care and if I wasn’t worried for myself I was certainly worried for Lee who had a brush with gum disease that had required several very deep cleanings.

Initially I thought we would use Aspen Dental and I was very excited about leveraging their national network as we traveled.  Unfortunately I was told that the different locations wouldn’t always accept the x-rays of other locations so we would be treated as a “new patient” every time we went to the dentist.  That was crazy to me, and I even called Aspen Dental headquarters to verify this was indeed the case.  I was told that despite the alliance each office was independent and they didn’t have to accept the exams/x rays of other offices.  This was 3 years ago, and their policy may have changed, but getting new x-rays was not only time consuming but costly.  When I had dental insurance it wouldn’t cover the x-rays and even in offices with “free exam and x-rays” the results often required one or more “deep cleanings.”  So Lee or I tried Aspen three different times in the beginning, but each experience figuratively left a bad taste in my mouth and ultimately I determined that I would never go back.

At this point we decided to listen to RVer conventional wisdom and try getting our teeth cleaned in Mexico.  That experience went better than expected, especially because we went with our friends Ellen and Mario who are fluent in Spanish, and I not only trusted the doctor but also only paid $30.  Perfect solution, except our travels don’t always take us close to Mexico and it was almost a year before we were in a place long enough to make an appointment.  This time it was in  Alaska  and again we had a really good experience.  The doctor worked with many patients who lived in the wilderness and was used to helping people with unusual lifestyles.  Not only did they do our cleanings, but the dentist gave up his lunch break so he could fill two cavities for me and although it cost me $500 out of pocket I thought it was well worth it.  At this time, the hygienist was concerned about our gum health, but she recommended Phillips Sonicare toothbrushes and gave us some tips for keeping our teeth clean while we travel.

So this last year I relied primarily on home care and although I wasn’t 100% vigilant with flossing, took better care of my teeth than I ever had.  With our work schedules, we didn’t get that 6 month cleaning, but as soon as we arrived in Oregon I started looking around for a dentist.  Our trainer, who comes here every year, was very happy with her dentist, so we made an appointment for early August.  I hated to wait that long, but this job (unlike any other we have had) actually has dental insurance so of course we waited the 60 days until the benefits kicked in.  Initially, things went well.  I explained that we traveled when setting up the appointment and the office was very good about getting our insurance information lined up prior to arrival.

Finally on August 15th the appointment came and I was very excited about getting my teeth cleaned.  Yes, I know that is odd, but I am weird like that and I looked forward to “resetting” the dental clock and not having to worry about paying for the exam and cleaning.  Because we had to drive an hour, Lee and I both had “double appointments”.  They required a full new patient exam and then said they would do our cleanings as long as we didn’t have gum disease.  Fair enough, I thought and since the dentist was recommended I felt confident we would get our cleanings.

Unfortunately this was not to be, as once my exam was done I was told I required two “deep cleanings.” I immediately got upset and asked to talk to the dentist, who was younger and was obviously playing things “by the book.”  I was trying to talk through my options with him, but he didn’t seem to understand or care that we were leaving in less than a month and at some point I realized this was the wrong guy for me.  So I went to the waiting room and explained what had happened to Lee and at that point we both decided to leave.  This isn’t the first time we have walked out of a dentist office by the way while on the road.  I had set up a couple of appointments early on that ended up with the same result, because they were recommending costly procedures, but this time was worse. I actually had insurance and could have afforded the treatment, but I just didn’t trust the diagnosis.  Basically I had a bad feeling and trusted my gut and left.

At the end of that experience I was beyond frustrated.  I didn’t completely dismiss the claim that something was wrong with my teeth, but I also needed to work with a dentist I believed in.  After a few days of feeling sorry for myself  and worrying I was going to ultimately lose my teeth over these issues I decided to buckle down and try again.  I finally decided to start cold calling dentists.  I googled dentists in our area and started at the top of the list and worked down.  I said we “were traveling in the area” and would it be possible to get cleanings.  The first dentist office started talking about new patient exams and the need for two appointments and I thanked her and hung up.  The second office was very different.  She actually listened to me and started talking about my options.  Yes they could do a cleaning and they would do the best cleaning they could.  The doctor did need to have an exam and bite-wing x-rays, but since I had just gotten x-rays done, if I came in and signed a records release she would get them from the other dentist. OK then.  They also had appointments on our days off and would get us in by September 1st.

When we went into the office to sign the forms it looked like an “old school” dentist,  No fancy schmancy waiting room, or “boutique” vibe, just a good old-fashioned dentist’s office, like the ones we went to when we were kids. It wasn’t substandard or out of date, just homey, welcoming and comforting. We made appointments for September 1st and I felt much better about the whole experience.  This time I made Lee go first and he had the detailed exam.  A detailed exam is where they measure the gaps in the gums and based upon the numbers decide what kind of cleaning you need.  Despite doing a great job of flossing this year, Lee had a few fours and fives, but unlike the other dentists we had seen this office was willing to tackle those in a regular cleaning.  They did spend a little extra time on him, but he came out with nice clean teeth and armed with some ideas for maintaining them while on the road.

I was next and after his experience was feeling good about the situation.  While I was waiting, the dentist (who didn’t have any procedures that morning), talked to me quite a bit about RVing.  Turns out he has been RVing for 25 years and is fascinated by the full timing lifestyle.  Dr. Thoreson was extremely nice and I even gave him my blog information and my level of comfort with him was much greater.  They are a “conservative” dentist office and not only understood our situation, but wanted to help us.  Unfortunately when I had the exam the results once again came back poor.  This time I had numerous 5’s, 6’s, and even a couple of 7’s and this meant gum disease.  Obviously I was upset, I couldn’t understand how this had happened so quickly, but both the hygenist and Dr. Thoreson explained it to me and we talked through my options.

They were concerned enough that they wanted me to see a periodontist, but I didn’t think there was any way I could get an appointment before September 24th.  Dr. T said he would call in a favor to make sure I got seen and the hygienist even called on her day off to lock in an appointment for me. I can’t tell you how grateful and relived I was at this point.  OK, I had gum disease, but through some miracle I also had dental insurance and even better a dentist who was looking out for me.  Dr. T even fixed the bond on my front tooth that was sticking up a little and absolutely refused to charge me because he said it “was fun for him.”  That’s my kind of guy.

On Wednesday, I heard back from Dr. T’s office and then I called Dr. Compton, a periodontist in Happy Valley. His office was already informed about our unique situation and scheduled an immediate exam and blocked off two time periods for deep cleanings, under the assumption that I would need them before my insurance ran out.  OK, that was new.  Normally dentists will never book appointments in advance of the exam and once again the whole tone and vibe was comforting.  So I went in for the exam but this time instead of a hygienist the periodontist did the number rankings.   It was actually worse when he did it, I had more 6’s, 7’s and even an 8, but he seemed less concerned.  Maybe it’s because he sees the worst of the worst, but he was confident we could stop the damage and he could address the issue.  I left with two cleanings scheduled and a good feeling, although I was concerned overall about how all of this would play out long term.

This morning at 8am I had the first of the two appointments.  Rachel, the hygenist who is VERY interested in RVing and volunteer camp hosting, spent about 30 minutes talking through how I cleaned my teeth and putting together a plan for me that I could use on the road.  At first I felt like I was a kid again learning how to clean her teeth, but soon realized that this was valuable information.  Think about it, you learn how to clean your teeth as a child, but then years pass and the situation (and available tools) change.  The time was well spent and probably the best thing I learned was they recommend 30 seconds of gargling with Listerine twice a day.  Wow, that was old school, but it’s all about fighting bacteria and Listerine is still a great way to do that.  They didn’t care what flavor (except stay away from the whitening version) and once in the morning and once at night gargle. That along with flossing, and more detailed brushing would help keep the bacteria under control.  Everyone has bacteria by the way, and you are fighting a war in your mouth on a daily basis, so constant vigilance is pretty much required.

Afterwards, Dr. Compton came in and first he numbed my teeth and then shot them to numb them more.  The shots weren’t that bad and my mouth was pretty numb, which was a good thing because he really had to scrub in several areas.  He mainly focused on the problem teeth (two front teeth and the ones on the side), but also addressed the ones in between.  It took quite awhile and the worst part was my jaw hurt from keeping my mouth open that long, but when it was done I had no doubt that what he did would have an impact.  I have one more appointment scheduled on the 19th for the other side and then hopefully I can keep things at bay with good daily maintenance.

The problem is that once you have gum disease, you have it forever.  There might be some recovery, but my exam numbers are going to come back high from now on.  And since I have had so many issues finding dentists to clean my teeth when I had no issues, I have no idea what this looks like going forward.  Dr. Compton did include a follow-up exam for next year if we come back to the area, but this cleaning he did was $1100 and although my portion of that was only $300 because of insurance, I can’t afford to pay that out of pocket every six months.  In all fairness, I shouldn’t need this level of cleaning every time, but if I can’t find a dentist/periodontist who is willing to accept his exam results then I will need to start over every time.  Except now, starting over will always require more expensive cleanings and honestly I am not sure how this is going to work.  Dr. Compton and Rachel did say they would do everything they could to help.  They emailed me a “packet” with all of the information and are more than happy to pass their findings along to any doctor I choose.  I guess we will find out 6 months from now when I try to schedule a cleaning and if nothing else I suppose I can go the Mexico route because they don’t seem to care about any of this.

The whole situation stinks though.  I freely admit that this could have happened if I would have stayed in Keene and kept my regular dentist, but my gut tells me it never would have gotten this bad. Even if it had, I wouldn’t need to start over every single time and having a trustworthy dentist who is working a course of treatment with you is no small thing.  But to some extent it is what it is and I am at least grateful that for right now I feel comfortable that I have done everything I could possibly do.  Lee’s teeth and gums “bounced back” some after he had this work done a few years ago, so maybe I will get lucky and the same thing will happen.  It’s not an insignificant problem though and I am not a special case.  One of our fellow camp hosts is going through the exact same thing, and she as I believes it is because of the difficulty in getting regular cleanings. At least I am not alone in dealing with the problem.

Well thanks for listening, and if Rachel or Dr. T is reading this, thank you VERY much for doing everything you could to help.  As always, I will keep you posted and we will see how this plays out.

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5 thoughts on “First Time Seeing a Periodontist

  1. I am glad you took what they said seriously and had the deep cleanings. The health of your mouth can affect the rest of your total health. Bill struggles with his dental health and should have more frequent cleanings (we called them PMT( perio-maintenance treatment) visits). That is one negative in this lifestyle – dealing with on-going health and dental issues. Proper and diligent home care helps a lot. He still has a few pockets deeper than is preferred, but he does the best he can. Swooshing with Listerine is a great tool. I’m sure you can improve those numbers!

  2. Glad you found someone that you can trust…that’s the hard part and hopefully they will help you as you maneuver as you move around. I’ve been lucky to be able to be back in PA frequently enough that I haven’t had to deal with finding a dentist…but it would be traumatic for me to switch dentists. Took forever to find one I trusted!!

  3. If you are serious about your health quit smoking. My wife and I have had excellent dental and medical care our entire lives. We are in our late 60’s, I quit smoking 30 years ago and my wife still smokes. Over the years my semi annual dental check ups have been uneventful, a couple of crowns, a filling or two and I still have all my teeth. My wife sees our dentist and a periodontist every 6 months yet she has lost teeth and has ongoing issues with her gums. She had an aneurysm two years ago and has a persistent cough. The first question her neurologist asked was do you smoke? Quitting is not easy but it will be one of the best decisions you will ever make.

    • I agree Barry and absolutely am sure that the smoking is having a significant impact on the gum situation. Hopefully the steps I am taking will mitigate that and of course stopping smoking has been on my list of things to do for quite some time. If it was that easy though I already would have done it, but I appreciate the advice and the concern.

  4. Pingback: Third Year – The Emotional Arc – Camper Chronicles

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