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I'm extracting one tooth and am nervous for various reasons.

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pet1984

Member
Joined
Sep 17, 2016
Messages
22
To start off, I'm 32. In my mid-20s, my mom had a severe stroke, and I moved home to take care of her and her business since my older siblings were not willing to pitch in. Haven't heard from them in a while so I've given up on them ever helping me out.

Fast forward, I've put so much work into helping her I forgot to take care of myself and my teeth. I developed a cavity that progressed for the worse in my lower second premolar on the right a few years ago. I am just now getting it taken care of, and my DDS suggests a root canal. He does not perform them. An endo gave the same opinion, and I scheduled a RC for next month at a chain dental clinic next month.

The sad truth is that I can't even afford the root canal and restoration (I have a cheap Humana HMO, but those "cheap" prices don't mean much when you add on the extra fees to the base total). Plus the tooth's gum line is receding (very early periodontal disease, started full deep clean last month and only had two quads cleaned so far). The base of the tooth has that dark line where it's been exposed. My gums don't look sick, but periodontal disease is a silent killer, I'm told. And the DDS said my teeth will fall out otherwise.

I'm conflicted. The problem is I pay my mom's mortgage (on average $2,500 a month) on top of her other bills (we barely make enough from the business, our source of income, on a monthly basis). Without my mom's survivor benefits from my father's death, we'd be really lost. So I've gone without in many regards (personal, social, etc.). I figured I'd just get the tooth extracted and maybe get a partial denture for the missing premolar to help ease my mind about teeth shifting/developing TMD. My jaw alone after the dental visits ache enough - definitely don't want a bad bite and TMD. Don't really care about the aesthetic value at this point.

So... I know only I can answer this and it my life, but for whatever it's worth, am I doing the right thing? I feel embarrassed and ashamed that I let my health get to this point. I can't even afford a root canal.

My DDS did a pulpotomy on the bad cavity and put in a sedative filling. Before then, the tooth never really hurt (not a good sign as that just means necrosis of the pulp). Now it feels ache-y. The endo's assistant asked if the tooth was already root canal'd based on the photo she saw of it. My DDS seems to think so, but my previous dentist doesn't even do RCs.

I feel really scared and sad, but I also have clinical depression so that doesn't help the situation at all.

P.S. I had a lower left molar taken out when I was a teen and the molar behind it did shift. Of course my bite was still forming back then so it didn't seem to have much of an effect on me. I have 31 teeth right (my wisdoms all grew in), and I'll have 30 after extracting this premolar on the other side.
 
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ScaredyCat22

Well-known member
Joined
Nov 14, 2014
Messages
1,344
To start off, I'm 32. In my mid-20s, my mom had a severe stroke, and I moved home to take care of her and her business since my older siblings were not willing to pitch in. Haven't heard from them in a while so I've given up on them ever helping me out.

Fast forward, I've put so much work into helping her I forgot to take care of myself and my teeth. I developed a cavity that progressed for the worse in my lower second premolar on the right a few years ago. I am just now getting it taken care of, and my DDS suggests a root canal. He does not perform them. An endo gave the same opinion, and I scheduled a RC for next month at a chain dental clinic next month.

The sad truth is that I can't even afford the root canal and restoration (I have a cheap Humana HMO, but those "cheap" prices don't mean much when you add on the extra fees to the base total). Plus the tooth's gum line is receding (very early periodontal disease, started full deep clean last month and only had two quads cleaned so far). The base of the tooth has that dark line where it's been exposed. My gums don't look sick, but periodontal disease is a silent killer, I'm told. And the DDS said my teeth will fall out otherwise.

I'm conflicted. The problem is I pay my mom's mortgage (on average $2,500 a month) on top of her other bills (we barely make enough from the business, our source of income, on a monthly basis). Without my mom's survivor benefits from my father's death, we'd be really lost. So I've gone without in many regards (personal, social, etc.). I figured I'd just get the tooth extracted and maybe get a partial denture for the missing premolar to help ease my mind about teeth shifting/developing TMD. My jaw alone after the dental visits ache enough - definitely don't want a bad bite and TMD. Don't really care about the aesthetic value at this point.

So... I know only I can answer this and it my life, but for whatever it's worth, am I doing the right thing? I feel embarrassed and ashamed that I let my health get to this point. I can't even afford a root canal.

My DDS did a pulpotomy on the bad cavity and put in a sedative filling. Before then, the tooth never really hurt (not a good sign as that just means necrosis of the pulp). Now it feels ache-y. The endo's assistant asked if the tooth was already root canal'd based on the photo she saw of it. My DDS seems to think so, but my previous dentist doesn't even do RCs.

I feel really scared and sad, but I also have clinical depression so that doesn't help the situation at all.

P.S. I had a lower left molar taken out when I was a teen and the molar behind it did shift. Of course my bite was still forming back then so it didn't seem to have much of an effect on me. I have 31 teeth right (my wisdoms all grew in), and I'll have 30 after extracting this premolar on the other side.
A premolar leaves a small gap, not a big giant noticeable gap. You might find that you don't even miss it and you might find it not even worth the hassle of getting a partial denture for just one tiny tooth. You will be fine. not everyone can afford the cost of root canals and crowns, and sometimes people who do get them live to regret it anyway. Only you can decide what is right for you. Some people get along fine with a missing tooth or 2, other people find they miss their lost tooth very much. You will have 30 teeth which is still more than the 28 that most people end up with because most are unable to keep their wisdom teeth. Do what you feel is best for you.
 
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Scarlett88

Well-known member
Joined
Aug 16, 2016
Messages
117
To start off, I'm 32. In my mid-20s, my mom had a severe stroke, and I moved home to take care of her and her business since my older siblings were not willing to pitch in. Haven't heard from them in a while so I've given up on them ever helping me out.

Fast forward, I've put so much work into helping her I forgot to take care of myself and my teeth. I developed a cavity that progressed for the worse in my lower second premolar on the right a few years ago. I am just now getting it taken care of, and my DDS suggests a root canal. He does not perform them. An endo gave the same opinion, and I scheduled a RC for next month at a chain dental clinic next month.

The sad truth is that I can't even afford the root canal and restoration (I have a cheap Humana HMO, but those "cheap" prices don't mean much when you add on the extra fees to the base total). Plus the tooth's gum line is receding (very early periodontal disease, started full deep clean last month and only had two quads cleaned so far). The base of the tooth has that dark line where it's been exposed. My gums don't look sick, but periodontal disease is a silent killer, I'm told. And the DDS said my teeth will fall out otherwise.

I'm conflicted. The problem is I pay my mom's mortgage (on average $2,500 a month) on top of her other bills (we barely make enough from the business, our source of income, on a monthly basis). Without my mom's survivor benefits from my father's death, we'd be really lost. So I've gone without in many regards (personal, social, etc.). I figured I'd just get the tooth extracted and maybe get a partial denture for the missing premolar to help ease my mind about teeth shifting/developing TMD. My jaw alone after the dental visits ache enough - definitely don't want a bad bite and TMD. Don't really care about the aesthetic value at this point.

So... I know only I can answer this and it my life, but for whatever it's worth, am I doing the right thing? I feel embarrassed and ashamed that I let my health get to this point. I can't even afford a root canal.

My DDS did a pulpotomy on the bad cavity and put in a sedative filling. Before then, the tooth never really hurt (not a good sign as that just means necrosis of the pulp). Now it feels ache-y. The endo's assistant asked if the tooth was already root canal'd based on the photo she saw of it. My DDS seems to think so, but my previous dentist doesn't even do RCs.

I feel really scared and sad, but I also have clinical depression so that doesn't help the situation at all.

P.S. I had a lower left molar taken out when I was a teen and the molar behind it did shift. Of course my bite was still forming back then so it didn't seem to have much of an effect on me. I have 31 teeth right (my wisdoms all grew in), and I'll have 30 after extracting this premolar on the other side.
I hope one of the "on-website" doctors pop in to answer this, as these are just advices from non-doctor degree people and your situation sound complex.

First of all don't burden yourself with blaming yourself of what happened. It happened it is now in the past. You are at a point now that however you choose to proceed it will only get better!!! :there-there:

Not an expert but I am pretty sure root canals should show up on an x-ray.

I think theoretically it is always the best to conserve the tooth as much as possible, hence they suggested root canal + crown. This way your natural "structure" can be preserved better, the root can stay at place and should serve you for a long time.

When loosing a tooth there are some underlying effects. It seems from your writing you are kind of aware of them. And yes Scaredy is right, there are people who are happily living without some tooth. But there is also biology worth considering. Missing a tooth has effects. As far as I understand it might matter when you experience those effects, are you in your 20s, 30s so those effects will be with your for 30-40 more years. Or are you in your 40s,50s, so you only have to endure those effects for another 10-15 years?
Tooth loss can cause a number of problems when they are not replaced. Like a domino effect.
- the opposing tooth has nothing to "clash with", it has no pressure on it so it can loosen, it can decay, if it decays then the 2 next tot the opposing tooth can decay as well.
- the shifting, movement of the opposing tooth can cause contact, pain and cavities if it gets in contact with the remaining teeth next to the missing one
- the adjacent teeth may move to fill the "empty place", especially with molars which endure a lot of pressure
- underneath your tooth you have gum and bone. If there is a gap, there is a gap in the gum and there is a gap in your bone. So when a tooth is lost the lack of stimulation causes bone loss gradually. The younger you are and the later you replace the missing tooth the more time goes by and the more bone loss you have. This in a long run can also effect the adjacent teeth because obviously the structure won't be strong enough to hold them. They can get loose, they can get decayed. You could end up with having 3-4 bad teeth in the next 10-15 years.
- and I think you are also more at risk for gum disease

Is there a chance or a way you can get like a payment plan to pay it off in parts? I think there was talk in other topics that there is something like this in the US? So you could do the RCT and the crown?

If you extract it you could get a partial for a a few years and then look at option to replace the tooth?
 
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kemmie777

Member
Joined
Aug 11, 2006
Messages
65
Don't feel bad. Many people can't afford the dentist. It's expensive and insurance helps but usually not a lot of you need more than a couple basics fillings. Most do what they can and make tough descisions. There is nothing to feel embarrassed or ashamed about.
 
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pet1984

Member
Joined
Sep 17, 2016
Messages
22
Not an expert but I am pretty sure root canals should show up on an x-ray.
unnamed.jpg

unnamed (1).jpg

This is the preliminary x-ray of the affected area. Until now, I wasn't sure how to read it. Still am a bit confused. The big white areas indicate fillings, right? And the dark areas on the teeth are cavities?

Anyway, my dentist already filled the top cavities (which still ache after 3-4 weeks and an adjustment... at least they don't squeak anymore when I bite on them...). I think that big white spot on the bottom molar is just my old amalgam fillings I had done when I was younger.

unnamed (2).jpgunnamed (3).jpg

Here are photos of the bad premolar in question (photo was taken in a mirror so that's why it's flipped). See the sedative filling? That's where the cavity is. I'm concerned more about the restoration cost than the root canal (my HMO plan says a bicuspid root canal costs $270 USD, but that's probably before whatever fees they add on to the root canal cost). I feel like I can't afford a crown. I imagine they're at least $1000 USD after they build up on the $400 USD base price. And no one told me if an onlay/inlay would be okay. In fact, very little has been told to me about what's going to happen. In the U.S., you can get a CareCredit card (like a credit card) that lets you pay monthly, but you got to be careful to pay for it all within the "interest free" period or they'll hit you with like 24% interest. If I can't afford the root canal and restoration now, how can I pay for it later?

The place that would do the root canal said that they have the consultation with me on Oct. 19, and if I wanted to go through with the root canal, they'd do it then. That's a little over a month away - I'm not sure I can be patient enough for that.

Plus my HMO plan (it's not really dental insurance, as the term "dental insurance" doesn't exist in all honesty... an HMO just charges you set co-payment fees that you pay at your appointments and there is no deductible) only allows one assigned dentist per month. Once you change it, you're with that dentist for the month. And frequent changes could get your plan cancelled. If I wanted to do the extraction with my current dentist (who is my assigned HMO dentist), I have from now till the end of September to do it. If I want to go ahead with the root canal on Oct. 19, I need to contact my HMO company before Oct. 1 in order for the change to be applied in time for the Oct. 19 appointment. It's very stressful as I want this done soon - one way or the other. On top of that, our $2,500 monthly mortgage payment is due on the 25th of September. Not to mention our other bills (utilities, business fees, over $6000 USD in property taxes every year which steadily rise due to the economy). I didn't mention that my mom took out a $160,000 USD second mortgage to invest in a friend's business in 2007, but the friend stole the money and now my mom is stuck with the note. Yet she's partially paralyzed from a stroke so she can't even work on her own... that's why I help her out. She still owes $84,000 USD.

So it's more of an issue with money and whether or not it's worth it to fix now as the tooth may need to come out later anyway because of a future issue. I've seen a lot of stories of people saying this is what happened to them after a root canal: the tooth became un-salvageable down the road and the procedure and restoration was just a big waste of money. In the above photos, if you can tell, the tooth is discolored (de-mineralization?), and the gum line on the tooth has been exposed so it's darkened in that area. I feel an indention in the gums below where the tooth is now, and that could be the early onset of gum disease causing that (mind you, I've only had two deep cleaning sessions so far... two more to go when I can afford it). The premolar just doesn't seem healthy, which is why I am debating the root canal or an extraction.

Root canal and restoration puts us in further debt and there is no certainty that the tooth will be good for the rest of my life; extraction will still cost money down the line as I'll need some kind of replacement to avoid the possibility of extreme shifting. I figured I could get a partial denture (cheapest option here) for that single missing tooth and to help with the structure issues. It's not a permanent fix, but a single implant in the U.S. costs on average $3000-4000 USD. Bone loss is also an issue as I'm 32-years old, but I feel like that's already set in in that specific tooth's area. It's hard to explain unless you were me and could feel what I feel in my mouth.

I've left a message with my primary dentist to schedule the extraction on Sept. 22 (I can cancel or reschedule within 24 hours of the appointment), and the root canal session has been scheduled on Oct. 19 with the endo office 40 minutes away. My primary dentist does not do root canals, which is why I'm being referred elsewhere if I want the procedure. To go through with the extraction with my current dentist, I don't need to call my HMO plan and change my primary dentist choice. To go ahead with the root canal, I need to call before Oct. 1 so that the plan can update my primary dentist choice to the root canal endo at the other practice. That way, the change is effective starting Oct. 1 and for the rest of the month (and basically until I change it again if need be). Someone from the endo's office contacted me yesterday, but she has yet to get back to me about an estimate. And I know that estimate will not be accurate anyway because that's how it always is.

This is a lot of information and feelings, but I stress out easily. Can you tell? It's all part of me having a social disorder (avoidant personality) and heavy depression, and being concerned over my mother's well-being. She honestly would die without me because no one would help her out, and I don't want her last few years to be full of more struggles than need be. If anything, I'm glad I can vent over this somewhere as I don't have anyone to talk to about it with in real life. My siblings are not really in the picture, and they're in no position to help me financially either (one has multiple kids). Nor would I want them to as they've practically abandoned my mother once she got ill.
 
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ScaredyCat22

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Joined
Nov 14, 2014
Messages
1,344
If it makes you feel any better my husband had 1 wisdom tooth extracted 20 years ago, and the top wisdom above it never super erupted into the space so far.
He also had 1 upper first molar extracted 5 years ago that he never replaced and does not miss since he has wisdom teeth to chew on.

I had a tooth extracted that I did miss very much, which I tried to replace with a bridge, but that turned disastrous. I really can not afford (nor would I want) an implant. I am currently living with missing teeth that I may or may not replace with a partial denture.
whatever you decide you will be ok.
My tooth was first refilled, then crowned, then root canaled before it was extracted. So yes I regret going through all that for nothing
 
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ScaredyCat22

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Nov 14, 2014
Messages
1,344
I meant to say too that I noticed you said if you had it done it would be at one of those "chain dental clinics"
Those places tend to be bad news. That is not just my opinion, the dentists on here have said the same thing.
 
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pet1984

Member
Joined
Sep 17, 2016
Messages
22
If it makes you feel any better my husband had 1 wisdom tooth extracted 20 years ago, and the top wisdom above it never super erupted into the space so far.
He also had 1 upper first molar extracted 5 years ago that he never replaced and does not miss since he has wisdom teeth to chew on.

I had a tooth extracted that I did miss very much, which I tried to replace with a bridge, but that turned disastrous. I really can not afford (nor would I want) an implant. I am currently living with missing teeth that I may or may not replace with a partial denture.
whatever you decide you will be ok.
My tooth was first refilled, then crowned, then root canaled before it was extracted. So yes I regret going through all that for nothing
What was wrong with the bridge?

Yes, I'm worried about the possibility of all this root canal/restoration being for naught down the road. If I didn't take care of my teeth before all this, who says I won't return to my old ways later? I have terrible buyer's remorse so I don't want to be like, "Ugh, that root canal/crown money could've been invested towards my mom's debt." She wouldn't blame me at all, but I would.

Yeah, my dad had two molars removed years ago (one on each lower side) and he didn't have any shifting or above eruptions. Nor does he have TMD or bite issues that I know of. He replaced a missing tooth with a removable denture, but he said it hurt a lot at the beginning. Mainly because it was ill fitting and had metallic clasps. It was the '90s.

Some people are luckier than others with the shifting issues. I had a first molar on my left side removed as a teen, and the neighboring second molar collapsed a bit and it now touches the second premolar. As far as I know, it hasn't caused a bite issue. If anything, it's the right side that bothers me more now. All these procedures are just making my jaw tired and sore. Hence my wanting to get it over and done with at this point.

I don't know if I could get a bridge for the second premolar if I go through with the extraction. At least not without a big hassle. As the first premolar now has a small filling on the edge facing the second premolar, and the first molar behind the second premolar is full of older fillings on multiple surfaces. Don't they need to shape the neighboring teeth in order to put a bridge in for the missing middle tooth? Doesn't sound like that first molar is in shape to be filed for a bridge wing.

When my dentist asked why I was thinking of getting an extraction, he gave me a maybe judgmental "Why not?" I stated it was for personal reasons and he only replied, "Well, think about the root canal." And with people who have avoidant personality disorders, we do not cope well with criticisms or even the notions/insinuations of them. So I took it personally. He doesn't seem to care a lot anyway as he never explains the procedures ahead of time and he just goes into it unless I ask (which I don't always do because of my trusting nature). He still has other fillings to do on the left side and I'm scared of getting those done as the ones he did a few weeks ago on the right still feel weird (even after them being adjusted). I can't remove my left side's wisdom because then I'll have only one molar there. The wisdom's surface has some caries, too.

A lot of sites seem to frown on partial dentures and say implants are the right/only good way of replacing teeth. I mean, I can see the appeal of implants but the cost is too much for me. No wonder I've read about people traveling to Mexico to get the procedure done for 1/3 of the U.S. price.

I was hoping maybe one of these Nesbits could help calm my fears of immediate teeth shifting.

Nesbit-Denture.jpg

I hope they're not costly. Anyone have one?

I meant to say too that I noticed you said if you had it done it would be at one of those "chain dental clinics"
Those places tend to be bad news. That is not just my opinion, the dentists on here have said the same thing.
Oh, yeah, it's a chain clinic that would be doing the root canal. They don't have a resident endo either - they rotate them from branch to branch. :/ Again, doesn't help calm me down. She wouldn't even look at my case till the morning of the procedure if I choose to get it done.
 
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Scarlett88

Well-known member
Joined
Aug 16, 2016
Messages
117
View attachment 1354

View attachment 1355

This is the preliminary x-ray of the affected area. Until now, I wasn't sure how to read it. Still am a bit confused. The big white areas indicate fillings, right? And the dark areas on the teeth are cavities?

Anyway, my dentist already filled the top cavities (which still ache after 3-4 weeks and an adjustment... at least they don't squeak anymore when I bite on them...). I think that big white spot on the bottom molar is just my old amalgam fillings I had done when I was younger.

View attachment 1357View attachment 1358

Here are photos of the bad premolar in question (photo was taken in a mirror so that's why it's flipped). See the sedative filling? That's where the cavity is. I'm concerned more about the restoration cost than the root canal (my HMO plan says a bicuspid root canal costs $270 USD, but that's probably before whatever fees they add on to the root canal cost). I feel like I can't afford a crown. I imagine they're at least $1000 USD after they build up on the $400 USD base price. And no one told me if an onlay/inlay would be okay. In fact, very little has been told to me about what's going to happen. In the U.S., you can get a CareCredit card (like a credit card) that lets you pay monthly, but you got to be careful to pay for it all within the "interest free" period or they'll hit you with like 24% interest. If I can't afford the root canal and restoration now, how can I pay for it later?

The place that would do the root canal said that they have the consultation with me on Oct. 19, and if I wanted to go through with the root canal, they'd do it then. That's a little over a month away - I'm not sure I can be patient enough for that.

Plus my HMO plan (it's not really dental insurance, as the term "dental insurance" doesn't exist in all honesty... an HMO just charges you set co-payment fees that you pay at your appointments and there is no deductible) only allows one assigned dentist per month. Once you change it, you're with that dentist for the month. And frequent changes could get your plan cancelled. If I wanted to do the extraction with my current dentist (who is my assigned HMO dentist), I have from now till the end of September to do it. If I want to go ahead with the root canal on Oct. 19, I need to contact my HMO company before Oct. 1 in order for the change to be applied in time for the Oct. 19 appointment. It's very stressful as I want this done soon - one way or the other. On top of that, our $2,500 monthly mortgage payment is due on the 25th of September. Not to mention our other bills (utilities, business fees, over $6000 USD in property taxes every year which steadily rise due to the economy). I didn't mention that my mom took out a $160,000 USD second mortgage to invest in a friend's business in 2007, but the friend stole the money and now my mom is stuck with the note. Yet she's partially paralyzed from a stroke so she can't even work on her own... that's why I help her out. She still owes $84,000 USD.

So it's more of an issue with money and whether or not it's worth it to fix now as the tooth may need to come out later anyway because of a future issue. I've seen a lot of stories of people saying this is what happened to them after a root canal: the tooth became un-salvageable down the road and the procedure and restoration was just a big waste of money. In the above photos, if you can tell, the tooth is discolored (de-mineralization?), and the gum line on the tooth has been exposed so it's darkened in that area. I feel an indention in the gums below where the tooth is now, and that could be the early onset of gum disease causing that (mind you, I've only had two deep cleaning sessions so far... two more to go when I can afford it). The premolar just doesn't seem healthy, which is why I am debating the root canal or an extraction.

Root canal and restoration puts us in further debt and there is no certainty that the tooth will be good for the rest of my life; extraction will still cost money down the line as I'll need some kind of replacement to avoid the possibility of extreme shifting. I figured I could get a partial denture (cheapest option here) for that single missing tooth and to help with the structure issues. It's not a permanent fix, but a single implant in the U.S. costs on average $3000-4000 USD. Bone loss is also an issue as I'm 32-years old, but I feel like that's already set in in that specific tooth's area. It's hard to explain unless you were me and could feel what I feel in my mouth.

I've left a message with my primary dentist to schedule the extraction on Sept. 22 (I can cancel or reschedule within 24 hours of the appointment), and the root canal session has been scheduled on Oct. 19 with the endo office 40 minutes away. My primary dentist does not do root canals, which is why I'm being referred elsewhere if I want the procedure. To go through with the extraction with my current dentist, I don't need to call my HMO plan and change my primary dentist choice. To go ahead with the root canal, I need to call before Oct. 1 so that the plan can update my primary dentist choice to the root canal endo at the other practice. That way, the change is effective starting Oct. 1 and for the rest of the month (and basically until I change it again if need be). Someone from the endo's office contacted me yesterday, but she has yet to get back to me about an estimate. And I know that estimate will not be accurate anyway because that's how it always is.

This is a lot of information and feelings, but I stress out easily. Can you tell? It's all part of me having a social disorder (avoidant personality) and heavy depression, and being concerned over my mother's well-being. She honestly would die without me because no one would help her out, and I don't want her last few years to be full of more struggles than need be. If anything, I'm glad I can vent over this somewhere as I don't have anyone to talk to about it with in real life. My siblings are not really in the picture, and they're in no position to help me financially either (one has multiple kids). Nor would I want them to as they've practically abandoned my mother once she got ill.
Oh my goodness that US healthcare system sound so complicated! :(
I meant the monthly payment as not delaying it for later, but it might be easier for you to pay smaller parts in a long run then one big part at once.

Lets start with the easy ones. :giggle: On that Xray you defo didn't have any root canals before, otherwise 60% of the tooth would be white, and instead of the dark within the roots there would be a white filling. Although I don't think your premolar is on the Xray picture that you posted.
Also I am not a doc so it is hard to give advice on pictures =( I am only going through... pretty much a wide range of dental procedures as I had decayed, broken teeth, wisdom teeth, infected tooth with cyst, extraction surgery, loads of fillings, currently a work in progress RCT with crown and an inlay/onlay and later down the line implants. So I only observe the treatments I am going through what and why the doctors choose to do.
So the difference between the inlay and the crown I think is mainly on how much of the tooth needs to go above the gumline. My inlay/onlay tooth is missing about 50% but it is still steadily above the gumline so hence they can do the inlay. The other one was gone 80% and they had to go below the gumline (even cut my gums back) so it will need a crown.
Those rootcanal stories that keep going around. Yes they can have complications. Everything can. It is not because RCT are not effective. If done right then they are very effective. The trick is to be super aware when cleaning the root to kill all the nerve and clean all the pulp. For that the doc needs to be able to measure correctly the lengths of your roots, then be able to clean everything properly, then let it be for like a week and see if you feel any sensibility or pain. If yes then something is still alive, either case before filling the root they should check for pain, then filling the root, then x-ray to double check. The tricky part is if they miss something still alive at the tip of the root and that can get an infection or complication. Also with a crown you need extra care with the cleaning. I think mostly what happens is that patients or doctors rush it or the roots are hard to clean.

I think it would be worth checking with maybe both of your doctors how vital that tooth is if it is really worth saving. And make them explain to you the options in detail. See if you can move the consultation ahead. For e it would be logical to have an initial check up, consultation detailed treatment plan with costs for all scenarios so you can make a decision. Not just go in treatment by treatment and pay. Don't be shy to ask, it is your body, your health your money, you have the right to know whatever you want to know.

Bless you honestly. You sound like genuinely caring and nice person and with everything you are doing for your mom you should get a chance for your own health!
:grouphug:
 
S

Scarlett88

Well-known member
Joined
Aug 16, 2016
Messages
117
Yes, I'm worried about the possibility of all this root canal/restoration being for naught down the road. If I didn't take care of my teeth before all this, who says I won't return to my old ways later? I have terrible buyer's remorse so I don't want to be like, "Ugh, that root canal/crown money could've been invested towards my mom's debt." She wouldn't blame me at all, but I would.
Or now that you are healed you know how good it is to take care of them to avoid further problems? It is like a do-over in a way. Like a second chance?


I don't know if I could get a bridge for the second premolar if I go through with the extraction. At least not without a big hassle. As the first premolar now has a small filling on the edge facing the second premolar, and the first molar behind the second premolar is full of older fillings on multiple surfaces. Don't they need to shape the neighboring teeth in order to put a bridge in for the missing middle tooth? Doesn't sound like that first molar is in shape to be filed for a bridge wing.
Not an expert but my guess would be it is unwise to build a bridge on already unhealthy teeth.

Are those filling temporary or final fillings? I think it is okey for them to feel funny for 1-2 days. But pain after that doesn't sound ok to me.

Well all the replacement, treatment would be a combination of your condition and your finances obviously. So even if implants might be biologically the best they are pricey as .... . So we are still around the if it is worth saving then RCT or partial denture idea. It is understandable why people thrown on it, but in some cases it is still better then nothing.

Oh, yeah, it's a chain clinic that would be doing the root canal. They don't have a resident endo either - they rotate them from branch to branch. :/ Again, doesn't help calm me down. She wouldn't even look at my case till the morning of the procedure if I choose to get it done.
Do you have the chance to go around and look for something else? This sounds very dodgy. :(
 
P

pet1984

Member
Joined
Sep 17, 2016
Messages
22
Are those filling temporary or final fillings? I think it is okey for them to feel funny for 1-2 days. But pain after that doesn't sound ok to me.


Well, they're kind of large/deep amalgam permanent fillings on the top teeth. Two premolars and the first molar were filled about 3-4 weeks ago. Initially, one or two of them squeaked whenever I chewed on them. I finally asked my dentist about them earlier this week (on Tuesday, today is Saturday for us), and he adjusted them with his tools (had me bite down on that blue paper, too, to see my bite). They no longer make a squeaking noise, but I also haven't been chewing on them too much. Before it didn't take too much for them to start squeaking. The pain I feel in them is... well, it's not exactly a sharp pain or a pain really at all. It's almost like they're very alert now and I feel something with them, but I wouldn't call it pain either. I do recall them being sensitive to cold water during the squeaky time period. Not helpful, I know. I read on here that the healing time for larger fillings can take either a few days after the initial procedure, or even 1-2 months depending on the patient. So if those specific fillings were high and unadjusted for like 1-3 weeks, then it's only been a 5 days since they've been adjusted. I read elsewhere that the inflammation may still take time to ebb at that point. I'll ask him again about them next time I see him. Could easily just need another adjustment. Don't even want to think of the worst possible outcome (i.e., he ruined my teeth and drilled too much so now I need an additional root canal in the upper teeth!).

Or now that you are healed you know how good it is to take care of them to avoid further problems? It is like a do-over in a way. Like a second chance?
Oh, I know. I am water flossing after meals (need to buy a more portable one so I can start eating outside of the home), using a plaque rinse before brushing, and using an electric toothbrush to help get my teeth cleaner. I use a fluoride rinse 1x day after brushing with my fluoride/densensitization toothpaste, too. I'd like to think I'll keep this going down the road as I know the damage of sub par hygiene can take on you. Plus avoiding dentists and not getting enough calcium (I didn't eat dairy as much as before, and I should've taken more supplements to offset that).

Although I don't think your premolar is on the Xray picture that you posted.
Sorry, I posted the wrong photos. I really don't understand the x-rays they emailed me. The big white spot on that molar is from the old filling on a molar, I assumed.

unnamed (4).jpgunnamed (5).jpg
I think these are from my left side as the molars are tilting due to the first molar being removed years ago.

unnamed (6).jpgunnamed (7).jpg
And this is from my right side? Like the big white spot in the first lower molar is I think from my old amalgam fillings from when I was a teenager. The smaller white spot on the second lower molar was filled earlier this week. The last lower molar is a wisdom tooth (all my wisdoms are grown in, which could be attributing to the crowdedness of my mouth). The lower cuspid/premolar next to the first molar with the wide white spot on the surface is the problematic one (#29) in need of a root canal. I'm guessing that thick dark line down the middle of the tooth indicates the need for a root canal.

I wish my dentist had sat down with me and explained these x-rays to me (as in, how they correspond to my teeth). I feel like he just doesn't think about that kind of thing with patients - he just assumes they know unless they ask. Really, a doctor should always assume their patient is ignorant and explain anyway.

Other clinics really don't accept my dental plan so I'd be paying out of pocket (minimum $1000 USD for the root canal alone). Our family business barely makes $1000 USD a month after bills and mortgage payment for the house. So I don't know if can shop around too much. U.S. dental care is HORRIBLE as it's not considered part of your health plan most of the time. My primary dentist is the only one in the immediate area that accepts my plan, and he's a private practice, not a chain. Yet I feel like he only cares maybe 50/50?

It's a tough situation, but thank you for responding. The extraction would benefit us now and that's all we can ask for as my family's future is undetermined. Once my mother and father pass away (they're in their late 60s and 70s), I... well, I don't know. I want to help them as they're all I have left. And if I can afford it one day, I can try an implant. That's as optimistic as I can be right now.
 
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