Repositioning Jaw Bones (Mandibulas)

Hello @csmiller. Welcome to Mayo Clinic Connect.
Could you tell me a little more about your dental issues please? I’m a retired certified dental assistant with 30+ years under my belt so hopefully I can steer you in the right direction. I’m not able to offer treatment or diagnose but I’m familiar with dental related diseases, worked extensively in oral surgery and orthodontics.

Bear with me because I have some questions for you. I want to get a clear picture of what you’re experiencing.
You mentioned being disappointed with your periodontist. A periodontist specializes in preventing, diagnosing, and treating gum disease. They would have little to do with repositioning mandibular or maxillary bones. The mandible is your lower jaw and not associated with your sinuses so I’m a little confused as to what you’re trying to accomplish.

Do you have active periodontal disease or any abscesses of your teeth? If you have, that can cause considerable pain and sometimes an infection can drain into the sinuses. In that case you’d be referred to an Endodontist who would perform a procedure called a root canal to treat the infection. If there’s an infection around your gum tissue only, then the Periodontist would treat that. But either way, moving teeth or repositioning bones would not be a solution to sinus infections.

Have your teeth shifted? You’d like your mandibular bones returned to their original and correct position, is that right? Oh golly, I’m really at a loss. The lower jaw is one solid bone so I’m not sure what you mean by having ‘them’ returned to original or correct position. I’m really trying to understand your dental situation.

An orthodontist is the specialist with whom you’d work to reposition teeth while an oral surgeon would be the doctor to see for reconstructing and repositioning bone. But that’s a significant surgery and again, having lower jaw surgery would not impact the sinuses.

Have you had a recent full mouth X-ray called a Panorex to check the position of your teeth, check the bone support, and look for any anomalies in your bones, tissues or sinuses? What led you to feeling you need jaw surgery to help reduce your sinus infections?

Thanks for your reply. I have been told that I have periodontal disease. Both my upper and lower jaw bones have receded from their original position. The upper bone receded so far that it caused an infection of my sinuses. I had two upper molars extracted that were causing the sinus infection. About 3 weeks ago, my two lower molars came loose in my mouth and came out. Two months ago I had a periodontist gave my upper and lower teeth and through inspection and told me then that I didn't have periodontal disease. This diagnosis was changed last month and I am scheduled to have my gums "packed" so that I may receive and implant. However, I had rather see an MD for this problem, if that is possible. I think this may be the beginning of more teeth lost and maybe further infection. I'd like to save the teeth that I currently have. I have an appointment with a periodontist next week that I'd like to cancel. Would really like to see an MD.

You’re welcome! Thank you for your detailed answers to my questions. That’s really helped me understand what’s happening so now I can explain it to you a little better.

First let me explain periodontal disease. It’s a progressive disease that starts out with inflammation around the gum line. In a healthy mouth, gum tissue comes up to form a little protective cuff around the tooth. Over time, food and bacteria can collect under that little cuff and cause irritation if it’s not cleaned out daily with flossing and brushing.

The material that builds up is called plaque. It is very hard, brittle material and eventually keeps building, pushing the tissue out of the way and destroying the bone around the tooth. When that happens teeth become loose and are lost. It can happen to just one tooth or be widespread and effect several or all teeth. Periodontal disease can also contribute to other serious health issues such as heart problems and diabetes.

In your case, your bone loss was significant, creating large, deep pockets around your upper molars which held bacteria causing infections. That apparently migrated to your sinuses. With the teeth removed that area will heal over and your sinuses should be better.
The goal is to eventually have the sockets fill in with bone growth and be able to support an anchor for implanting new teeth. The same with your lower molars which were lost, though they don’t impact the sinuses. I’m not sure what the packing is. Are you talking about bone grafting?

In my opinion I’d really suggest that you do not cancel the appointment with the periodontist. He/she will work together with your general dentist to give you the best possible outcome to your dental situation. The periodontist specializes in treating periodontal disease and bone loss.
An MD is not the person to see for dental health. They would refer you back to your dentist.

I know this sounds like a lot to go through but you really don’t want to lose any more teeth or incur any more bone loss. So now, it’s really important to have regular professional cleanings, floss and brush daily to keep your mouth squeaky clean.

Why do you feel you need to see an MD?
https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html

Hi @csmiller Just dropping in to see if you have any more questions about your dental concerns. I know you have an appt this next week with your periodontist. It might be a really helpful to write down any questions or concerns to ask them at that time. Did you decide to keep the appointment?

Thanks. They cancelled the appointment because they can not fill all the unemployed slots. Will see them soon or I'll make another appt. with someone local.