Dilemma: Which Teeth to Lose

[bcjch]

Hi all, I wonder if any of you have had to make a decision like I'm facing.

I need a LOT of work done on my teeth over the next little while, including several crowns - and likely 1 or 2 root canals in the process. I'm unable to afford it and absolutely, positively cannot take on more debt to cover the work. (Also note that I'm in the USA, so whatever NHS might do in this case does not apply to me.)

The only way I have to attack this is to have the work done little by little - but there's no telling which existing problems will go bad first and not be able to wait.

I think the bottom line is that I need to figure out which teeth I can/should keep and which I can live without. That way, when a tooth in question finally goes bad, the decision about fixing vs extracting it will already be made.

I don't think this is something I can ask a dentist. You probably all know the song and dance I'd get from one about how you should do everything possible to save a tooth ... but what can I say, the available means affect the possibilities.

Have any of you ever encountered a question like this? If so, who or what helped you decide?

 

[Dr. Daniel]

Hi,

I think your question should be answered by a dentist because in the end it is a professional question. The financial aspect is a factor in choosing a treatment plan.
As you said, there are dentists who would not answer this question (they just want to perform their treatment plan). I do suggest you ask your dentist about that. If you get no serious answer, maybe you can put your X-rays in the forum and let one of the dentists here give you advice.

 

[Torrentula81]

Hi bcjch. I've seen you around the forums and thought you deserve some input. I agree with daniels that this is a question you need to ask a dentist. I would go as far to say if you can't make a treatment plan at the office for what you can realistically pay in full by 6 months, you are at the wrong place. That isn't a bad thing, just reality. If someone got work done where it would take them 2 years (paying and getting work done little by little) I think the chances of them actually finishing the treatment plan wouldn't be all that high. They would say well, this is getting expensive. All my money is going into my teeth when I want/need other things. My car broke down, the holidays are coming,, a new emergency tooth issue, and even entertainment. To stick to putting every last available cent into an expense for that length of time would become exhausting.

So the goal is pay for treatment in say 6 months or a year, whatever is reasonable. I see two ways of getting closer to that goal. 1) Get the work done at some place cheaper like a dental school or clinic with sliding fee scale. I would look into each one for a treatment plan for a choice. 2) Find cheaper solution in the treatment plan itself. For me getting partials was doable vs implants. You might have alternatives available. If I couldn't afford crowns and root canals within a reasonable time frame then those really aren't an option in the first place. We all have to make do with what we have. Again get a treatment plan you can realistically pay for in the near future so it becomes a reality, not a I wish I could or when I get the money.

Easier said then done but that is my 2 cents

 

[bcjch]

Cost is exactly why I'm considering extractions instead of the proposed treatment. $8000 in 6 months isn't gonna fly - it'll be hard to have that much to spare in 2 years (<cough> <cough> <kids college> <cough>) ...

The dental school might be a good idea - I hadn't thought of that, so I'll have to figure out where to look for one. Nobody I know ever mentions one. What do you think about the quality of work at a place like that, though, when experienced professionals often don't do so well?

 

[Dr. Daniel]

In most cases you get a good quality treatment in a dental school, because the students are constantly supervised and guided by experienced dentists. With a dental student you pay with time rather with money, meaning that it takes much longer and it's much cheaper.

 

[carole]

Hi I am in the UK but we have dental schools here as you will have there. I have had work done at a dental school on a few occasions and the treatment has been first class. There is a tutor/professor there all the time and the students only do the work they are capable of, so if a rct is needed then the tutor has full confidence in them to do it. They do things in stages and at each stage the tutor comes along to check that things are done properly, if there is something the student isn't sure of then the tutor will show them on your tooth.

The students are lovely and are more than willing to do a good job and they want you there so I found they went out of their way to make sure I was happy and comfortable at all times. I was extremely nervous and I shook in the chair and by the third visit I was shake free and had full confidence in the student I saw.

The other alternative is to ask your dentist as Dr Daniel suggested what they advise is best to do. There may be some teeth that can wait a bit longer than others and the dentist may be willing to work on the most urgent first until you can afford the others treated. Taking the most urgent first and working through the others may take longer but it would help you get them done over time. Some dentists will let you pay so much over months as well as has also been suggested and this may be an option for you.

All the best to you and if you have x rays Dr Daniel or one of the other dentist will be able to have a look and if they are a good copy may be able to offer you some advice, the dentists on here are very good and will be honest.

 

[bcjch]

Just how many dental schools are there on your side of the pond? Turns out there are only 65 in the United States, and only one is within 3 hours' drive of me.

Both dentists who have given me treatment plans have prioritized the work that needs to be done. Those priorities are by urgency, and they're pretty much the same. I don't feel the need to post anything here, because most experts would also say the same. However, Carole, that's not the question here.

This is a situation where I don't want to end up with 6 or 7 molars/bicuspids having no opposing teeth and chewing practically impossible. If my plan is playing hopscotch from worst tooth to worst tooth, things could end up that way, especially if one of my teeth goes south faster than expected. Professional opinions about tooth longevity are not prophecy. Further, teeth don't wait to go bad until one has the money to fix them.

It seems to be that it would all be better in the end if I have a functional set of teeth. "Functional", however, does not mean "full" - it means something I can live with that will mostly get the job done.

I think I need a plan in that says something like, "When it's time to work on tooth #x, extract it instead of doing a root canal and crown". That would allow tooth #y (the next on the urgent list) to get attention sooner if the extraction is half the cost. If I interpret it correctly, that's what Torrentula81 said.

Yeah, I've made this bed and have got to lie in it. I need no reminder of that.

 

[CHANGES]

Dental schools now are NOT FREE! But very effective if you can wait in line to get in one, most about 6mon.waiting period. Like the others here said they have professionals watching almost every step the students take.

The cost is about half private offfice dentist. According to what you have done. Also its cash up front usually. And don't even think of missing an apt. or like I did argue with a rude spoiled brat student which is usually not the case most are sweet well mannered young people.

They can be on the pushy side not the students but the professors,haha.

There is also the clinics in The Carolinas which I have no experiance with but a couple freinds went and had no problems. Pulled what needed to be pulled and dentures same day. Of course this was years ago check out online. Or go to Mexico for treatment.

 

[carole]

Your question was what we thought you would be best doing and we have all made suggestions, including a couple from a dentist on here.

If the answers are of no help to you what is it you are wanting to know?

 

[carole]

Just to add further a dentist will not advise you to save a tooth that has no hope so they will only advise treatment to save the tooth if they think it has a very good chance of lasting you years.

The profession of dentistry is to save teeth of course the same as a doctor is trained to save lives. If you don't trust the dentists you see please find one that you can trust.

 

[bcjch]

Some follow-up ... surprisingly, my dentist gave a specific answer. He had recommended a crown (and a likely root canal) for a back lower molar which has no opposing upper, but he said he was willing to extract it rather than treat it. He thought the more forward teeth do most of the chewing in a normal mouth.

Although I didn't ask this part, I rather think that eventually, I'm more likely to end up with dentures instead of getting implants. So from that point of view, it's sensible for me.

I think he's the exception, not the rule, when it comes to questions like this. I don't think he's a slouch when it comes to expertise. For further explanation, please see the recommendation for him I posted in the dentist recommendations section (Arlington, TX).