Anytime i have flap surgery = extraction. maybe, the periodontist missed pocket depths. cleaning/exam every 3 months and do not neglect. comments?

Last ditch effort: I'm assuming that flap surgery is done to gain better access to cleaning the teeth with the deepest pockets. This may be a last ditch effort in order to save those teeth but the teeth do not respond in such a way that they can be saved. You don't mention how many times this has happened, but if you find yourself in a similar predicament in the near future, i would suggest to get a second opinion.

Expected vs actual: Just as sometimes a person requires exploratory abdominal surgery to be able to actually visualize what cannot be seen, even with sophisticated diagnostic tools, so too, when a periodontist can visualize bone topography, it may change what we "expected" to see vs. What is actually present. It sounds like your periodontist is doing his\her best. Don't be discouraged.

Not normal: The periodontal surgery(flap surgery) goal is to clean out sites where pocketing allows bacteria to fester and harm bone. It should help you to maintain your gums better. A new surgical technique using a laser called lanap has shown great results. Less pain. With your hygiene and frequent cleanings, you should expect a good prognosis. Tenacious plague with high bacterial level? Diabetes ?

PerioProtect (PP) : Use of this non-invasive system may be able to slow down your periodontal bone loss and has actually tightened teeth that are loose. Periodontal disease has many factors, but bacterial reduction on a daily basis has been shown to be very effective. Pp uses easily worn (daily), soft, comfortable trays filled with peroxide, bacteria cannot become resistant! treat the cause, the patient heals.

Dr Ali agreed

Re-vist DDS: Flap surgery is broad . Why are they flapping your tissue back. To clean? If periodontist is observing a hopeless situation once the flap is retracted he/she may remove the tooth instead of deep scaling it because of many reasons. Your three month recalls are all you can do besides excellent home care and not smoking etc... I would be your own advocate and ask the reasons before extractions, .

Dr Ali agreed