Extensive dental work needed, need advice

[Goober135]

Probably going to need fairly extensive dental work done. Have some questions and would like advice!

Hello everyone! New guy here, and I've got a bunch of questions for you all! I hope you can help me!

To begin, I'd like to provide everyone with a little "dental" background information on myself. As child, I was not very good about constantly brushing my teeth, which of course lead to a fair amount of cavities as I got older. Once I was older, I did a better job of taking care of my teeth, but still wasn't great at keeping up with brushing. When I was 20 (23 now), I went through a pretty dark time in my life that lasted almost 2 years. I won't go into details, but suffice it to say that during this time, dental hygiene was the last of my concerns. Unfortunately, because of that lapse in judgement, I am now paying for those extremely poor decisions. I've been taking very good care of my teeth for a while now, but alas, I feel that the damage has already been done. Also, I hate to admit this, but I have not been to a dentist since 07-08. That fact is actually a big reason on why I am here. Now, let's move onto the issues at hand.

The first issue I'd like to address is my wisdom teeth (third molars). The last time I was at the dentist, I was told I should have my wisdom teeth pulled before I'm 25. I still haven't taken care of that. By no means am I an expert, but to my knowledge, my bottom wisdom teeth are fully in, and my top wisdom teeth came in partially. My bottom two wisdom teeth are fine (I think). It's the top two I am having problems with. Both have had pieces crack off near the back of them. I'd say my left is 50% gone and my right is 25% gone. Also, just recently, I cracked a piece off of my first molar on the right. The piece that came off was on the outer side of the tooth, in the back. I would guess that the piece consisted of about 15% or 20% of the tooth. Other notable issues would be that I have some tooth decay near the gum line. The most extensive tooth decay on the gum line being on my top second molar on the right, followed by my top second molar on the left. All other areas are not very noticeable, but still there. I'm sure it'd be safe to say that I probably have a fair amount of regular cavities as well.

Questions:

1. What would you advise to get fixed first? (pull wisdom teeth, fix cracked first molar, gum line decay, other cavities)
2. Is it possible or even reccomended to get this all done in one visit? If not, how many visits should it take?
3. What would you advise to do about my cracked first molar? (crown, implant, bridge, etc...)
4. Where would you advise to go for a consultation to see what exactly is wrong and needs to be fixed? What would a consultation cost? (roughly)
5. Would you advise to go to a dentist or to an oral surgeon for this kind of work? What is the price / quality difference between the two?
6. What am I looking at cost wise to get all this fixed? (roughly) How much does dental insurance typically cover? (roughly)

As for my current dental hygiene routine & products, they are as follows:

• [2x Daily] Oral-B Triumph 400 ProfessionalCare Series
• [2x Daily] Sensodyne Pro Namel Gentle Whitening
• [2x Daily] Advanced Listerine with Tartar Protection (before brushing)
• [2x Daily] Listerine Total Care (after brushing)
• [Every Couple Days] Dentek Floss Picks

Is this adequate, or should I be doing anything else / using other products?

I believe I've covered everything, but please let me know if I have forgotten to post some needed information that would aid in answering my questions or giving advice! I appreciate any kind of help or advice you all can provide!

Thanks in advance!
John

 

[decan]

Re: Probably going to need fairly extensive dental work done. Have some questions and would like adv

1. Wisdom teeth can be pulled as other work is being done. As far as which to address first needs to be decided by the extent of the decay process. I would tackle the teeth with the biggest cavities first.
2. Usually no. # of visits depends on how much work there is to be done. Multiple teeth can be restored per visit.
3. Most likely a crown. Extraction and implant if the restorability of the tooth is questionable.
4. A general dentist. Consultation fees depend on the dentist.
5. Oral surgeon for the extractions. General dentist for everything else.
6. Depends on the fees of the dentist and how good your insurance is.

Rinse with mouthwash before you brush. After you brush, spit the toothpaste out and don't rinse with water OR mouthwash. This allows the fluoride on your tooth to stay around for longer.

I hope this helps, and good luck!

 

[Jaylah]

Re: Probably going to need fairly extensive dental work done. Have some questions and would like adv

Hi John,

Just to add a bit to what Decan said:

I don't think you'll find a US dentist that will tell you s/he is okay with you only flossing "every couple of days." They want every day. And while those Dentek Floss Pics are great for removing something stuck between your teeth or whatever, they aren't really a good substitute for flossing because it's virtually impossible to clean the whole gum line between teeth with them.

Hmmm, kind of hard to explain here.... You know how, when you wrap a piece of floss around your fingers, you can sort of wrap the floss around the back of your tooth, then slide it up and down to clean the whole back tooth surface? The length of floss in the Floss Pics isn't long enough to allow you to do that. So there's a strong possibility that you are missing a lot by using those.

Dental insurance plans here in the US vary widely on how much they will pay for certain procedures, or even which procedures are even covered. Since dental offices work with so many different plans, they can usually tell you what will be covered, at what rate, etc.

The charges for procedures will vary depending on the cost-of-living in the part of the country where you are. For example, a dentist in a rural part of Indiana probably won't charge as much as a dentist in New York city would. However, I live in Iowa, I recently had an estimate drawn up for some work I needed and I can give you a bit of an idea from that.

Comprehensive dental exam: $70.00
Full x-rays = $113.00
Surgical tooth extraction = $227.00
Amalgam (filling) = $173.00
Deep Scaling (cleaning) = $265.00 per quadrant (multiply this X4 for full mouth.)


I would advise you to make an appointment with a regular dentist first for an exam and xrays. That dentist will then be able to make specific recommendations as far as what to fix first, etc., based on the exam that it is impossible for us to make just based on what you wrote. He will also be able to tell you whether you need to see a specialty-dentist (such as a dental surgeon or a periodontist, etc.) for any or all of the work. (Most "dentists" here in the US are board-certified "oral surgeons" anyway.)

If you have a dental insurance plan, take that with you for your first appointment. When you are finished with the dentist, the people in the front office will be able to help you determine how much your plan will cover and how much you will have to pay on your own.

If you find that your dental plan is still going to leave quite a bit of money for you to pay on your own, you might look into Care Credit. This is a credit card for health care (including dental) expenses, but the advantage of this as opposed to a regular credit card is that, if you pay off your balance within a certain length of time (depends on how much you charge), there is no interest charged. Most dentists now accept this card instead of making re-payment plans directly with their patients.

Hope that helps.

 

[Jaylah]

Re: Probably going to need fairly extensive dental work done. Have some questions and would like adv

Rinse with mouthwash before you brush. After you brush, spit the toothpaste out and don't rinse with water OR mouthwash. This allows the fluoride on your tooth to stay around for longer.

One other thing: Most US cities fluoridate their city water supply. So if you're on city water, and you don't use bottled water to brush your teeth, you're getting plenty of fluoride between your toothpaste and the water you're using to rinse.

However, if you live out in the country and you have your own well, this would be a good idea.

 

[decan]

Re: Probably going to need fairly extensive dental work done. Have some questions and would like adv

(Most "dentists" here in the US are board-certified "oral surgeons" anyway.)

This is not correct. While general dentists are fully capable of doing extractions, there is still a difference between a general dentist and a board certified oral surgeon. I, for one, would refer a fully impacted third molar to an oral surgeon because I believe that is outside my scope of practice. Another dentist who has more experience in the area may choose to do the extraction himself.

One other thing: Most US cities fluoridate their city water supply. So if you're on city water, and you don't use bottled water to brush your teeth, you're getting plenty of fluoride between your toothpaste and the water you're using to rinse.

However, if you live out in the country and you have your own well, this would be a good idea.

City water has 1ppm fluoride. Toothpaste has a lot more. I would still not rinse after brushing.