I am confused by a long list of planned procedures suggested by dentist.

Hello,  I've been given an extensive list of Dental procedures broken up into three sections. I have no clue as to which procedures are necessary and which are not.  The first section lists the "necessary" procedures for cleaning my teeth. All I want is a simple teeth cleaning, the one you get twice a year from a hygienist. The dentist office gives me an extensive list of necessary procedures as part of their "Deep Cleaning 3-step Process" to treat periodontal disease. Here is a list of their "necessary" procedures:   --Chlorohexidine --Flouride varnish  --Perio RT Planing/QD, Surface UR --Antibact Irr/Quad, Surface UR --Perio RP 1-3 Th/Quad, Surface UL  --Antibact Irr/Quad, Surface LL --Perio RP 1-3 Th/Quad, Surface LL --Perio RT Planing, Qd, Surface LR --Antibact Irr/Quad, Surface LR --And Finally, four laser treatments on Surfaces UR, UL, LL, LR. The next section lists procedures to provide fillings for two teeth. They are as follows:  --Composite Post 2 Sur, tooth 31, Surface: OD  --Composite Post 1 Sur, tooth 31, Surface: B5  I'm assuming that "Sur" stands for surface. However I'm unclear what the procedures mean overall.  The third section is treatment for the extraction of three teeth that they say cannot be saved. The procedures are as follows:  --Surg Extract (Spec) tooth 17 --Bonegraft Ext (Spec), tooth 18  --Surg Extract (Spec), tooth 18 --Rem Part Bony (Spec), tooth 33 I realize that any information you provide is limited without examining the x-rays and any other diagnostics. I just hope you'll be able to provide at least SOME help in (1.) Untanding these terms and (2.) Knowing the level of importance for each procedure.  I really want to make an informed decision. Any assistance you can provide is more than I already have.  Thank you for your time!  Lee Griffin  LeeG.Entertaiment@yahoo.com  713-825-5334

Answer: Treatment plan confusion

By Sarah h

Receiving a treatment plan can be overwhelming and many times questions arise after you leave the office.  You provided a great deal of information which I can hopefully explain in easier terms for you.

The dentist is recommending a deeper "cleaning" in some limited areas of the mouth.  This type of periodontal therapy is diagnosed with the use of dental radiographs and a full periodontal charting.  You may recall the dentist or hygienist taking measurements of your tissues.  They will call out numbers 1-10mm, taking 6 readings (probing depths) per tooth.  Any numbers over 3mm indicate inflammation and the beginning of periodontal disease.  The higher the number, the more extensive the disease.  The description is perio RT planing/QD for a full quadrant of the mouth and Perio RP 1-3 th/QD for a quadrant with 1-3 teeth involved.  Chlorahexadine is an antimicrobial irrigation you will take home and rinse with for several weeks after your therapy.  It is very important to understand, periodontal disease is not curable, however it can be controlled.  Having a regular "cleaning" when peridontal disease is present, is a disservice to the patient. It will not remove the harmful bacteria in the deep pockets that will continue to thrive in the mouth and blood stream causing high blood pressure, heart disease, and contributing to plaque throughout the body.  Usually, because the dental hygienist will be removing buildup from the root surfaces of the teeth, you will need to have local anesthetic in the area.  After the procedure, fluoride varnish is recommended to seal the root surfaces of the teeth and help with sensitivity.  

Once the periodontal therapy is completed, you will be seen for a routine visit every 3-4 months in order to stay ahead of the life cycle of the harmful bacteria.


Composite Resin indicates a white or tooth colored restoration (filling).  You have 2 seperate areas on your lower right second molar (tooth #31).  The first is along the gum line, B5 is the surface and the second involves the back of the tooth and the chewing surface.  These types of fillings are usually due to a lack of flossing, which also contributes to peridontal issues as well.


Lastly, the dentist has recommended 3 extractions.  Tooth #17 is your lower left wisdom tooth and #18 is your lower left second molar (the tooth in front of your wisdom tooth).  They are also recommending a bone graft after tooth #18 is removed which is the standard of care.  Think about removing a large tree from your yard, the hole has to be filled with dirt in order to regain a solid foundation.  Removing a tooth is very similar, a bone graft will replace the missing structure and allow your jaw to heal.   Tooth #33 doesn't exist, unless you have an extra wisdom tooth.  


Hoping this brought some clarity to your treatment plan.  Please feel free to ask additional questions if necessary.

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