How long before I die from this?

[jakesmith]

First molar had stage 3 cavity (examined via x-ray) on first molar upon x-ray exam a couple months ago, no treatment was done. Bottom-right corner of it as shown in photo has cracked off completely today as shown below. It doesn't feel cracked below the gumline. Currently doesn't hurt. I guess it might hurt if I chew chew crunchy foods on it, not sure, don't wanna try. Before the crack it would very rarely hurt while eating very crunchy foods. No other teeth have issues or cavities.

I have severe fear of dentist's office/procedures. I also have severe fear of leaving my house, which I haven't done much in years. My last experiences with dentists were traumatic, the last extraction was done against my will while awake and 70 pounds lighter, he just started doing it after I said no lmao. Then I called EMS during it. I kinda feels traumatized by it. My health is also not good enough to power through the anxiety of a wide awake procedure I don't think. I don't feel any abscess, no abscess was noted before crack happened, a couple months ago during x-ray. I couldn't stand to be in the dentist office more than 3-4 minutes for the x-ray.

I have a few questions.

1. How long before I die from this untreated. I know there's no way to say anything anywhere conclusively, but I'm curious about the damage and risk. ChatGPT makes it sound dire and I dunno if that's true.
2. Is there something I can swoosh in my mouth daily to prevent dying from this
3. If pain or obvious severe infection arrives and become unbearable how can i get this extracted under general anesthesia from a hospital with Medicaid. My closest hospital I doubt has an oral surgeon but there's also a few hospitals in my populous area of Northern VA.




Thanks

 

[jakesmith]

now there's a tiny dark spot inside the portion of the inside tooth it exposed, still no pain. dunno what it is. thought i was being careful with it. if it's pulp exposure could they just put some MCA on it and then SDF on the rest, i really don't want a drilling. But there's also no pain currently, so maybe it's not pulp exposure.

 

[Gordon]

1. How long before I die from this untreated. I know there's no way to say anything anywhere conclusively, but I'm curious about the damage and risk. ChatGPT makes it sound dire and I dunno if that's true.

How about never? As in not a chance, nope.

2. Is there something I can swoosh in my mouth daily to prevent dying from this

Anything you want, I'd recommend a nice 12 year old single malt, maybe a Speyside one Don't waste it by spitting it out though.

3. If pain or obvious severe infection arrives and become unbearable how can i get this extracted under general anesthesia from a hospital with Medicaid. My closest hospital I doubt has an oral surgeon but there's also a few hospitals in my populous area of Northern VA.

Sorry that's a US question. No idea.

 

[Gordon]

if it's pulp exposure could they just put some MCA on it and then SDF on the rest, i really don't want a drilling.

Nope, wouldn't work. That cavity is nowhere near the pulp right now. Looks like a really easy fix actually, almost no drilling required.

 

[jakesmith]

How about never? As in not a chance, nope.


Anything you want, I'd recommend a nice 12 year old single malt, maybe a Speyside one Don't waste it by spitting it out though.


Sorry that's a US question. No idea.

It's still a stage 3 or worse cavity but no pain. Considering I can get significant hypertension from panic during long dentist visits is it ok to just wait on this and then opt for sedated treatment if an infection arises? Wouldn't a chance of dying from a forever untreated stage 3 cavity be at least like 0.1% of something?

I'm also trying to weigh the odds of general anaesthesia with OSA comorbidity to extract tooth vs the potential mortality of never treating this tooth with cavity. I really won't be able to sit in a dentist chair awake for more than a few minutes.

Nope, wouldn't work. That cavity is nowhere near the pulp right now. Looks like a really easy fix actually, almost no drilling required.

The x-ray showed the cavity very close to the pulp 2 months ago, with a thin layer of dentin between, hence why I called it at least stage 3. They showed me the x-ray and said it was close to the pulp. If there is no pulp exposure I might just try SDF? You said it wouldn't work but I dunno if that was a comment on the MCA or the SDF. SDF I read can work on stage 3 cavities if re-applied every 6 months.


Thanks for your attention

 

[Gordon]

Considering I can get significant hypertension from panic during long dentist visits is it ok to just wait on this and then opt for sedated treatment if an infection arises? Wouldn't a chance of dying from a forever untreated stage 3 cavity be at least like 0.1% of something?

Why not get the tooth fixed under sedation while it just needs a simple filling? It really does look like an easy job.

Not a chance in hell of you dying from a tooth infection under any circumstances, unless you've got very, very significant underlying health issues, full blown AIDS for instance. In which case you've got bigger problems.

It was a comment on the MCA, it won't help if the pulp is compromised without removing most of the non-vital tissue first. It's not magic.
I'm not familiar with any long term studies on SDF yet, it might be fine for a short term but don't know about longer than that.

You probably could help matters by literally rubbing some fluoride toothpaste into that cavity with a finger tip last thing at night and just letting it sit there overnight.

 

[jakesmith]

Why not get the tooth fixed under sedation while it just needs a simple filling? It really does look like an easy job.

Not a chance in hell of you dying from a tooth infection under any circumstances, unless you've got very, very significant underlying health issues, full blown AIDS for instance. In which case you've got bigger problems.

It was a comment on the MCA, it won't help if the pulp is compromised without removing most of the non-vital tissue first. It's not magic.
I'm not familiar with any long term studies on SDF yet, it might be fine for a short term but don't know about longer than that.

You probably could help matters by literally rubbing some fluoride toothpaste into that cavity with a finger tip last thing at night and just letting it sit there overnight.

I am physically dependent on 12.5mg Diazepam daily for anxiety/panic, and have been on it 15 years so I am don't think benzos ("twilight") would affect me like a regular person, and run a larger risk of under or oversedation. Because I'm on it daily, a significant amount is in my bloodstream from the active metabolites accumulating. It's half life is 56 hours and also decomposes into other benzos, also in my bloodstream.

General anaesthesia uses propofol or gas, but I am still a bit concerned about oversedation, especially as I also have obstructive sleep apnea and dysautonomia.

I don't want the sedation to be more risky than just doing nothing.

Risks of general anaesthesia in people with obstructive sleep apnoea - PMC

pmc.ncbi.nlm.nih.gov

"Patients with obstructive sleep apnoea are at high risk of developing complications when having surgery or other invasive interventions under general anaesthesia, whether or not the surgery is related to obstructive sleep apnoea"

I called 2 mobile dentists near me yesterday as I would be more comfortable in my own home. One quoted me $550 just to look in my mouth and comment on it, with no treatment done the first day, and long wait times btw appointment, and the other says driving 15 minutes to see me is too far.... My parents have no interest in my dental health and are hesitant to help with paying for anything.

Feels like no one cares to consider my issues except you, oh well. For now I just leave it be as it is not hurting. At least I'll never die from it given what ur saying. It is only one tooth after all, the rest were fine on x-ray.

 

[Gordon]

Inhalation sedation would be a decent option instead of IV then...
(TBH I've happily used Midazolam to sedate people taking Diazepam, given you've got IV access then you can very accurately titrate the dose to get just enough sedation without going too far.) It's also possible to use Propofol for IV sedation so you can avoid Benzos completely if necessary.

A GA is really overkill for a simple filling, I don't think the risks justify the benefit.

 

[jakesmith]

Thanks for your time, have a good day

 

[jakesmith]

Inhalation sedation would be a decent option instead of IV then...
(TBH I've happily used Midazolam to sedate people taking Diazepam, given you've got IV access then you can very accurately titrate the dose to get just enough sedation without going too far.) It's also possible to use Propofol for IV sedation so you can avoid Benzos completely if necessary.

A GA is really overkill for a simple filling, I don't think the risks justify the benefit.

Can I use an emery board or drug store dental wax to smooth down an outer edge that is sharp and occasionally cutting my cheek, making it bleed for a few seconds?

 

[Gordon]

Sure you can.