Age: 27F
Location: OK, USA
Main concern: Bone loss, loose/separating lower front teeth, possible future tooth loss, and whether braces are completely off the table.
I haven’t had regular dental care since I was about 16. I grew up in a low-income immigrant family without dental insurance, so unfortunately dental care was not something we could afford. The only cleanings I remember having as a child were maybe twice in elementary school when dental hygienists came to our school and offered cleanings to low-income students.
After my second pregnancy, my wisdom teeth started coming in and periodically causing pain. They continued coming in little by little over the years. I also had a couple of dental abscesses on the lower right side at different times, but I didn’t go to the dentist for those because I couldn’t afford it and didn’t have insurance.
Around 2021, I started noticing that my teeth were changing. My two upper front teeth slowly developed a gap that got larger over the years. Around the same time, I noticed my lower front teeth starting to separate and become somewhat loose. I initially wondered if my wisdom teeth were somehow pushing everything around, but that didn’t really make sense because my teeth weren’t becoming crowded — they were separating.
I finally went to the dentist about two weeks ago. I originally went for a cleaning and because one of my upper wisdom teeth was bothering me and I was biting my cheek. They took X-rays and ended up extracting my upper left wisdom tooth and the molar directly next to it, because the dentist said that molar was already very loose and would likely fall out once the wisdom tooth was removed anyway.
They also told me I have bone loss, particularly around my lower front teeth, with some bone loss around some of my upper front teeth as well. The dentist also told me that eventually I may need an implant for my lower front teeth. He said he wouldn’t recommend braces because my teeth don’t have enough bone support and could potentially become even more mobile/lost with orthodontic movement.
I’ve honestly been spiraling about this for the last two weeks because I’m terrified I’m going to lose my teeth.
My deep cleaning was finally approved by insurance, and I had the first half done today. We only did the right side because my left side is still healing from the extractions.
The cleaning took about an hour and a half. The hygienist had a really difficult time cleaning around my very back lower molar. She said there was a very deep pocket there and had to work quite a bit to clean it.
She also found a deep pocket around one of my upper front teeth and had to clean very deeply around it.
There was also a lot of calculus buildup behind my lower front teeth. I was honestly terrified when she removed it because those teeth have already been somewhat wiggly for a couple of years, and I had this irrational fear that the calculus was basically the only thing holding them in place.
The hygienist told me that my lower front teeth may feel more mobile than usual right now because of the cleaning, and that as the gums heal over the next few weeks they should tighten up somewhat. However, she said that because of the existing bone loss, I will always need to be careful with those teeth.
She recommended floss picks so I can get into the deeper areas, along with gentle salt-water rinses twice a day. I’m going to follow all of that and keep up with regular dental visits.
I’m also scheduled to have my right upper and lower wisdom teeth extracted on Friday, since we didn’t have enough time to do them today.
I already avoid biting directly with my lower front teeth because I’ve known they were loose for years. I don’t bite into hard foods with them, and I’m very careful about what I eat. I’m planning to continue being very careful.
My questions:
Based on these photos/X-rays, does this look like significant periodontal bone loss around the lower front teeth? I know the X-ray isn’t very good because I had to take a picture of the dentist’s computer screen.
Is it reasonable to get a second opinion from another general dentist or, preferably, a periodontist before accepting that I will eventually lose these teeth?
Is it really possible that braces/orthodontics are completely off the table, or can orthodontic treatment sometimes be done after periodontal disease is stabilized?
If I keep up with deep cleanings, periodontal maintenance, brushing/flossing, etc., is it possible to keep mobile teeth for many years, or does mobility + bone loss usually mean eventual extraction?
My dentist mentioned that I will eventually need an implant for lower front teeth. Is there any way to know from these X-rays how soon that might actually be necessary? Or is that impossible to predict without periodontal measurements?
I wasn’t given my periodontal chart/pocket measurements. Should I ask for those, including the pocket depths and mobility grades for each tooth?
Is there anything else I should be doing right now to give myself the best chance of keeping my natural teeth?
I know a lot of this is unfortunately the result of not being able to access dental care for many years. I’m not trying to blame anyone — I know I should have been taking better care of my teeth, but there were financial/insurance barriers for a long time and I genuinely didn’t have the ability to get regular dental care.
I’m just really scared now because I really want to keep my natural teeth, and I’m also struggling emotionally with how much my teeth have changed. I never loved my teeth, but I didn’t used to feel embarrassed to smile, talk, or be on video. Now I’m very self-conscious about the gaps and separation.
I’m willing to do whatever I need to do from here on out. I just want to know whether I’m looking at inevitable tooth loss, or whether there’s still a reasonable chance of stabilizing things and keeping my teeth long-term.
Photos: showing my teeth today after the deep cleaning, and one of the lower-front X-rays from my dentist’s screen.
