First time at dentist in 13 years. Questions/concerns

A

aveytare

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So due to lack of insurance and a pretty large fear, I did not go to the dentist for around 13 years. I am 28 years old now and unfortunately do smoke. I went last week and it didn't go super great. I have eight teeth with cavities, one confirmed root canal, two other possible root canals, and gingivitis. I'm incredibly anxious and beating myself up over the state of my oral health. I brush twice a day, use mouthwash and I have started flossed every day for the past couple years. I have two cavities scheduled for the end of this week and a cleaning the following week. I have some questions/concerns. If anyone can help ease my anxiety I would be super grateful

  • One of the teeth I'm getting filled this week was a possibly root canal. Is there an increased chance for pain during the filling because of this? Or in general do deep fillings in general cause pain during drilling?
  • Both of my top 2nd molars are root canal possibly candidates. The other option is extraction. Would extraction be a terrible option other than financially?
  • I've been prescribed diazepam 5mg to take before procedures. Will this make a difference?
  • How common is it that a doctor isn't sure if a tooth is a for sure root canal?
  • What is the D4346 cleaning? Not quite a regular not quite a SRP. Will this hurt?

Thank you in advance, it really means a lot.
 
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Ladydi1724

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I can only respond about the diazepam. I recently had 14 extractions at one time. I took 5mg an hour prior to the appointment and another 5 mg once I got there. I have a horrible phobia about the injections. I had numerous shots. Felt absolutely nothing. Was calm through the entire procedure. So, yes it will work. Keep us posted on how you do at the visit. Good lyck
 
Gordon

Gordon

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1) No, not usually
2) Might not be a bad idea. Have you got wisdom teeth and how are they placed?
3) Yes, the response varies a bit between patients but usually works pretty well. Make sure you've got an escort to take you home afterwards, do NOT drive!
4) Quite common, x-rays and so on only give you a partial clue, you need to get into the cavity to see what's really going on sometimes
5) No idea, sounds like a US insurance code. Nothing should hurt, if it does, complain until it's sorted.
 
A

aveytare

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I do still have my wisdom teeth. My dentist said he could do the top ones but would need to refer me elsewhere for the bottom as he wasn't comfortable. On the xray the bottom ones looked sideways.

I hate the idea of extraction. But I also hate the financial burden of root canals. Would the presence of those impact the extraction being a good or bad idea?

In terms of the deep cavity, I'm worried about the idea of infection making me not able to be frozen. I will say I do not have any pain currently on any of my teeth. Some spots are sensitive but in my memory they always have been, even when I was younger.

Thank you for your time and insight Gordan.
 
G

geos

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5) No idea, sounds like a US insurance code. Nothing should hurt, if it does, complain until it's sorted.
Exactly, D4346 is the code for “scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation” according to the American Dental Association. At this point you haven’t experienced any bone loss, so that’s great.
 
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aveytare

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Exactly, D4346 is the code for “scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation” according to the American Dental Association. At this point you haven’t experienced any bone loss, so that’s great.
The hygienist said there was a "little bone loss", but said she thinks we can get the gum lines back to normal with the cleaning and after care. The idea of that worries me.

I'd say I'm more worried that one of my teeth may be infected. And when they go to numb it it won't work. Would I know if there was an infection? No pain. Only sensitive when drinking cold things in certain spots.
 
Gordon

Gordon

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Regards to the upper second molars, it might well be worth removing them and waiting to see if the wisdom teeth erupt into the new space.
It's a bit of a myth that acute infections stop local anaesthetic from working. 99% of the time they don't.
Signs of infection are pain/swelling and mobility of the affected teeth. You'd know if you had any :)
 
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aveytare

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Thank you so much everyone. I will report back tomorrow after the two cavities.

I'm going to try to get my x-rays/bite wing. Gordon if you could take a look at those I would really appreciate it.
 
Gordon

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aveytare

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Well I'm back. I didn't really feel the Valium but they also had nitrous waiting for me though I never asked. Honestly not sure if I felt that too much either. Shots weren't a huge pain. There were moments where the drilling was quite awfully uncomfortable. I just grabbed the chair tight.

The one he wasn't sure about a root canal on he now says it's a 50/50. He seemed optimistic but I don't know if I like those odds. The other one he said the cavity sort of wraps around? Therefore he suggested a crown. He said the 'build-up' could last me a year. Not sure what to think about that.
 
Gordon

Gordon

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Thanks for the update.
It's really difficult to give odds on whether a tooth will need RCT or not. They are very unpredictable. 50/50 is just sensibly hedging his bets :)
 
A

aveytare

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So is was really difficult to floss near that tooth. I was trying and noticed this afterwards. Any idea what it is? Non-food substance. Almost rubbery.
 

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Gordon

Gordon

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Looks like my wife's cheese sauce :)
Was rubber dam used, we sometimes use sort of elastic band things squeezed between the teeth to hold the dam on. Looks like the right colour.
 
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