Hey Perio experts....

On Friday I saw a patient who had been scheduled by the dentist for SRP. He did not have xrays, probe depths etc. The Pt requested that we only do BWX. I did and while they were developing I began to probe. So here I am on #2 I get a 4 3 7. I immediately think to myself ok here we go.... Then I get to #3 and I get 7 12 5. I was a little surprised to find a 12 on the straight buccal. So I reprobed the tooth and got 7 12 5. I continued probing #4 was 6 9 6 #5 was 6 6 6 #6 was 5 9 6 etc. All the buccals were so deep. # 8 buccal was a 9. I sat him up and strongly recommended that I take a FMX. He then told me he had received perio tx 4 yrs ago from another dentist in town. He asked me what his probe depths were so far and I told him. He admitted that they were deeper that before and agreed to the FMX. I finished probing and throughout his whole mouth all buccal/palatal/lingual readings were significantly deeper that the interproximal. I have not seen that before. The xrays showed bony defects in all those areas-consistent with my probe depths. I told the pt I recommended he go to a periodontist---in St George. He was not excited about going out of town for treatment. Then my dr came in and told him we would keep him in office. I was a little mad. This pt had depths on all first molars of no less than 10 and my dr wanted me to get down there into those furcations and guarantee that he would not loose his tooth. I am trying to become a ninja scaler but I have a hard time with furcas especially that deep. Later my dentist said that whenever he sends someone to the periodonist in St George the come back and ask to have their teeth removed and dentures put in. So he thinks it is a waste of time to send them down there. So I cleaned this patients mouth. I worked on him for 3 hours. I did not have any patients coming in later and he had time so we scaled on. He did not want to be numb. I told him that I was not going to be nice because he was trying to tough it out. He said ok. So I went for it. I admit I brought tears to this man's eyes. I hurt him but he claimed that it was better that being numb. So that was my day.

My question now is....what causes bony defects to be on the buccal and palatal/lingual but not interproximal? There was no radiographic calc and it was light/moderate. I was confused. It must be from a systemic problem rather than a local (calc) one. The pt claims to have no health problems and stopped smoking 4 months ago. I figure his perio state is due to his 35 years of smoking-but it was a little unusual. Let me know if you guys have seen anything like that before.