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Advice desperately needed

Kim

Kim

Well-known member
Joined
Mar 4, 2012
Messages
1,859
Location
Hertfordshire
I would be so grateful for some professional advice. I have a broken crown that is over 25 years old. I have 10 further crowned teeth, and no back teeth, having had these removed when I was a young teenager. I have seen a dentist who has said that he will try to replace the crown, but if this doesnt work, then he can do an implant.

He has said that my remaining crowns are not too strong, but will hopefully hold out. I also have a lot plaque at the back of my teeth which is going to be removed. My worry is that when impressions are taken, they may break some of the other crowns, or when the plaque is removed, this may happen. My dentist said this is unlikely, but if that happens, they can treat that too.

My dilemma is that I will be sedated which is why I have to sign the paperwork to give the go ahead. If the crown works, this will cost almost £600. If this doesn't work, the implant will be in excess of £3000. My husband has agreed we can go down this route, and for that I am eternally grateful. However, niggling at the back of my mind is if something else goes wrong. We are not in a position to replace all of my crowns with implants at this stage, and so should I have a 3rd option (and believe me, this would be the hardest decision for me to make) in that if anything did go wrong while I was under the sedation, should my 3rd option be total extraction and go down the denture route with a view to getting either implants, or implant retained dentures when we have the funding.

I haven't discussed this with my husband yet, as I want to get the appointment made and then have the discussion then. I dont want to get into a situation whereby once one tooth goes another goes, and the costs spiral, and I am left having to have total extraction anyway. The stress would kill me.

Any advice would be greatly appreciated from anyone, but especially from a professional, just to see whether they have ever had that happen with one of their patients etc. I can think of nothing else, and need to get some other input.

Thanks so much.

Kim
 
I'm not a dental professional but I have gone through something almost exactly like what you are describing. Broken crown, mine could not be saved and did require the implant procedure. I have a couple of comments. I opted out of being sedated. That allowed me to decide what to do if something unexpected happened. In my case nothing did, but I felt safer knowing that I was in control. If your reason for being sedated is that you have very strong fears of drilling sounds or smells, then of course you probably do need the sedation, but sedation here is very expensive compared to local. I do not know what the situation is where you are.

A couple things I am wondering. It sounds like from your post that the dentist feels that something he is going to try might cause a pulp exposure? I'm not a professional so I am not really clear on why if he cannot fix your existing crown you would need an extraction otherwise. Do you know if a root canal would be possible? Implant is much better than a bridge but a root canal if possible might last you a very long time. One of mine lasted over 20 years. Modern root canals should be painless. My latest two were, and I was able to eat a normal lunch. Far cry from the first one I had at age 12. Things have really changed. The other thing I am wondering is whether that fee you were quoted only covers the implant post, and may not cover the tooth that goes on it later.

I don't want to scare you but I did just lose a second crown very close to where my implant post was put in. I don't know yet whether it is related. It seemed fine until my dentist had her tech polish my teeth.
 
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However, niggling at the back of my mind is if something else goes wrong. We are not in a position to replace all of my crowns with implants at this stage, and so should I have a 3rd option (and believe me, this would be the hardest decision for me to make) in that if anything did go wrong while I was under the sedation, should my 3rd option be total extraction and go down the denture route with a view to getting either implants, or implant retained dentures when we have the funding.

Hi Kimbo
No way should you go under i/v sedation, having signed up for that third option...in fact I have my doubts about what you have agreed. How hard will they try to re-do your crown if you have already consented to an implant?
Your imagined 3rd option would be unethical. The cost of i/v sedation is not so high that the scenario you describe would ever transpire.

Why can't you get all the gunk cleaned off and then re-evaluate? It is usually a bad idea to leap into treatment plans without knowing the state of the underlying teeth.
It seems your need for sedation is driving inappropriate care to some extent or at least you are running that risk. Is the dentist you are seeing experienced at implants?
As TimidLady said, why is a failed crown fix an automatic extraction, it could be a root canal by an endodontist and a new crown.
Maybe get a seocnd opinion all round. The scenarios you have dreamt up for yourself are unnecessarily pessimistic probably but the dentist doesn't seem to have a firm grip either, so it's not your fault.
Lincoln Hirst is in Hertfordshire, maybe he could help with a second opinion and not scare you to death in the process?
 
With people talking about the cost of IV sedation..

The cost at my dentist would have been £50 all together, for the original checkup and then the IV sedation and tooth extraction, the same price as it would be without any sedation.

So for me it would have cost nothing so I assume its the same across the NHS? or no..
 
Hello all

Thanks for input. Timidlady, I dont know about pulp exposure. A previous root canal may have been done over 25 years ago, but not sure. He is going to try to do the crown, but has already said that my other teeth are not the strongest. He doesn't think I will lose teeth because of the impressions etc, but I know what my teeth are like, and know that they aren't overly strong, so I am looking at this possibility if it arises. If the crown option could be done, then it would possibly have to be done using some sort of post due to decay, but he wont know that until he starts the work. If this were the case, he would have to remove the tooth altogether and go down the road of an implant (if my memory from his letter serves me right).

If you knew how ill I am making myself, and how terrified I am of this whole thing, you may be able to understand my reasoning for this a little more. I wouldnt be able to get anything done without the sedation, and so it is being done privately because the NHS dentist I saw referred me to this guy. And when I spoke to him, he said he would do his best with the crown option. What I dont want is that if what I am asking should happen, and they go ahead with the crown/implant, then when I am back to being 'normal' from the sedation, I dont want to be told that another tooth will need to be done, as we simply dont have the money. As it is, it has taken me several long discussions with my hubby, and he has agreed to help with the finance whether it be the crown or implant, but the cost of the implant will be in excess of £3000, and although that is including everything, sedation, implant and final crown, we simply couldnt afford to have to go through this again, and if it did, I would be in a situation where I would have no choice but to go down this route having paid all this money out anyway.

And so I thought it best to think of all of this beforehand to make it easier on myself when the appointment comes. I have booked it - 1st May at 12.30!!:cry:
 
Forgot to say Brit, I hope I dont come across as being bad tempered in my last thread, just trying to get things straight in my own head with the least amount of stress as possible.

Thanks as always for your input, and to be honest, I dont think I could go down the route of seeing someone else, it is as much as I can do doing this:(
 
Hi
Crowns which break up during the impression are not strong enough for chewing. If indeed something breaks during impression, that means it would break soon regardless.
Regarding teeth cleaning: if the oral hygienist uses hand instruments or a cleaning instrument on a low force level, there should not be any danger of breaking any crowns.
Regarding option 3: you can talk with your dentist though and come to an agreement that this will not take place during the treatment, meaning: if the dentist sees that the condition of the teeth is very poor (more than expected) he would finish the treatment without extracting any teeth but simply cementing/build the teeth up as a temporary solution, and later talk with you about the definitive treatment plan.

As brit wrote, implants are not a complicated treatment but a good educated and experienced dentist is needed, and even more important a good treatment plan (that means taking impressions and X-rays and with them to plan where to place the implants. Since implants are so expensive, it is also OK to ask for recommendations and maybe a second opinion with another dentist.
 
Dr Daniel

Thank you so, so much for this. I had a letter typed out to my dentist with a view to discussing it with my husband tonight and faxing the letter to my dentist tomorrow asking for my 3rd option to be done there and then. I hope you dont mind, but I am taking your advice and putting that into the letter, having removed my 3rd option at this stage.

In all honesty, I dont really do much chewing on my teeth, because they are so weak, and am extremely limited by what I would try. I wont even now bite into any sort of bun as I am so scared they will snap also.

I am truly grateful for all the help I am offered on here, am in such a panic with it all because I am so scared, and then cant 'see the wood for the trees'.

I will let you know how it goes, and thank you once more.

Kind regards.

Kim
 
Good luck for May 1st.I will be thinking of you and holding you hand in spirit.
 
Quick update for you all. Brit, you suggested Lincoln Hirst in WGC. Well, I have come home from work and shown the letter I had written to my current dentist, and he then told me that when I went for my very first consultation, and the dentist referred me on to current, the dental nurse rang the house and said the first dentist had said that a crown would NOT be an option as there was not sufficient to work with, but that as I was in such a state when I was there, she didnt want to freak me out anymore.

My husband was going to tell me nearer the time, so we have discussed getting another opinion and I am going to e-mail Lincoln Hirst as soon as I have done this, to arrange to get another opinion.

I have looked, as you can imagine thoroughly through his website, and read reviews etc, and feel better about it. I have been a bit worried that I have only had one x-ray done at the very first dentist, and the second one is going on all of that, and the dentist in Scotland has mentioned that a thorough check of the condition of my gums etc should be done, and all the second dentist has done is look.

So I will away now and e-mail Lincoln Hirst.

Still really freaked out, but feel somehow a 'bit' better. I am going to cancel for the time being, the appointment with my current dentist.
 

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