Do I look for an oral surgeon for my condition or any dentist can do the job?

[Zitrone]

Background : Dental phobia - aggravated by frequent gag reflex during brushing and sitting on a dental chair. I don't have a regular dentist whom I can depend on his expertise. I've just cancelled a dental appointment because of a panic attack.

I broke my premolar.
Can this tooth be saved?
Must it be removed?
If the stump must be removed, do I need a specialist such as an oral surgeon to do the job or any dentist with a BDS can do the job?

Appreciate your opinion.....but don't tell me in detail how it gets done.

 

[Dr. Daniel]

Dear Zitrone,

My impression is that it is better to have the tooth extracted but I have to mention that it is unsound diagnose since I have not seen you in person.
A dentist will have to make an X ray. Some dental practices use for that sensors which are supper thick, rapped in nylon and has a wire. In other words, not very friendly for a developed gag reflex. I would recommend searching for a dental practice that uses phosphoric plates for X rays and also has the option to make a panoramic X ray (also called OPG). That is the best way to ensure a successful imaging which is essential for treatment.
Regarding the extraction itself: it really depends on the dentist. Some dentists (especially less experienced) might find it too difficult but I believe that most regular dentists would be willing to extract. Of course, and oral surgeon is the specialist hence it will be faster but I would consider a general practitioner who can work with you slowly and patiently. In addition, there is a cavity on the tooth next to it, so a general practitioner will be able to do both teeth in the same session but an oral surgeon won't because they don't treat cavities.

 

[Zitrone]

Thank you for your explanation. I read your reply numerous times but I frozed.
One nasty scare from a private GP (before I sought this forum for help)who said I needed a specialist and quoted a $$$ price tag (which could be reimbursed by insurance). I was very troubled and I chickened out from one dental appointment in May.
But I finally had it resolved today. I went to a dental polyclinic and she took an xray (phosphoric plate)and a mere 5min to extract for 10% of the price quoted by that private GP.
Now planning to revisit the same clinic to look at my other tooth.

 

[Enarete]

Hi Zitrone,

so glad you had a good experience at the polyclinic and even consider to get back! Very well done!

All the best wishes and keep us posted

 

[Zitrone]

I don't think i have got out this dental phobia yet.

I have stopped visiting the dentist during the covid period..........now I have dental issues. I don't have a regular dentist anymore. I have a molar which has a hole and i think the hole has gone bigger. Not sure if I can still get away with a filling. Can a GP do root canal treatment and crowning on molar ? Or must i visit a endodontist?
Secondly, I think I have teeth grinding problem. I woke up with teeth pain, upper and lower and I felt I might have clenched my teeth when I sleep. So, go to the same dentist to get a mouth guard?

 

[Zitrone]

.....actually i did try to get the molar filled. But the dentist at the polyclinic decided that I need scaling really badly, and he did scaling instead. A few months later, covid hits and I didn't chase after the polyclinic for another appointment......my fault.

 

[Gordon]

Can a GP do root canal treatment and crowning on molar ? Or must i visit a endodontist?
Secondly, I think I have teeth grinding problem. I woke up with teeth pain, upper and lower and I felt I might have clenched my teeth when I sleep. So, go to the same dentist to get a mouth guard?

Yes probably
Yes again, even if they can't do the treatment themselves then they can refer you on to somebody more suitable.

 

[Zitrone]

Thank you so much for your quick response.

I made a cold call to a new dental clinic which I have never visited on Feb 24. The GP saved my two teeth......the molar with a big hole and my premolar with I broke it because I grind my teeth during sleep. Both teeth had root canal treatment. I have to do a follow-up on the root canal treatment today to 'remove the medication' and do a crown lengthening (is that a job of an endodontist too?) And yes, that GP says she could do crowning as well......(charging more than my regular GP though)

My regular GP objects strongly to a non-endodontist doing root canal treatment and insists on referring me to an endodontist.....who, of course, completes the root canal treatment in one sitting and charged $300-$400 more than a GP. That is the reason I did not want to return to my GP and had no one to consult.

I am perplexed. Besides the difference which I mentioned above, I am trying to understand what is the difference between finding a GP who is willing to do root canal and finding a endodontist to do the job?

 

[Gordon]

Not everybody is equally good at everything That's why we have specialists.

Your GP clearly doesn't think they're good at root canals so refers them out to a specialist, others don't like taking teeth out so refer them to an oral surgeon. In fact if they tried to do work that they knew they were not competent to do then they'd be in loads of trouble with the authorities.

Crown lengthening is usually a job for a periodontist, but again you might find a GP who likes doing it and is good at it.

 

[Zitrone]

How would I know if this GP i am visiting is competent?
But I have become less scared after each visit.

As far, I am not having any pain after the treatments. i know i need extensive repair jobs because of my dental phobia and gag reflex(triggered by menthol). I hope I am not wrong in getting help from a private GP who says he can do all the repairs step by step, over a period of time. I am paying for a one-stop service instead of going to a government clinic(....get first consultation with a GP....then get a referral to see specialists.....and wait few months before the first job gets done and then get bounced around to different specialists.)
I had another bad experience with a GP at a government clinic few months ago. He wanted to test if each tooth is alive....and started testing it with an electrical pulse(???) .....i jumped after the first jolt and he switched to a cotton swab sprayed with liq. nitrogen.....I don't understand. i merely asked him to do a filling. Do dentists from government clinics have a time limit with each patient? .....like 30mins is up, get off the chair!

 

[Gordon]

How would I know if this GP i am visiting is competent?

You wouldn't. Some things you have to take on trust. If you don't trust them, don't go

I had another bad experience with a GP at a government clinic few months ago. He wanted to test if each tooth is alive....and started testing it with an electrical pulse(???) .....i jumped after the first jolt and he switched to a cotton swab sprayed with liq. nitrogen.....I don't understand. i merely asked him to do a filling. Do dentists from government clinics have a time limit with each patient? .....like 30mins is up, get off the chair!

Most general dentists are pretty competent at everything. The trick is to know your limits and what to refer on to a specialist.
Not sure if that's a serious question. But no.