I'm in a full panic over upcoming crown and dentist choice - opinions please

Z

Zach_H

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I'm in a full panic over upcoming crown and dentist choice - opinions please

I am in full dental meltdown mode (terribly anxious patient) over getting a crown with a new dentist. It turns out my old dentist of 20 years doesn't accept my new insurance and the savings is enough to make a switch.
I had a root canal retreated and need to get the crown. I don't want to wait too long since it is a temp filling (its only been 5 days) and I want this to have the best chance at success.
When I called my old dentist for a recommendation of who to go see (After 20 years I figured he would understand) he was out of town and his machine referred patients to another practice - which is one of the two that I went to see for an opinion about what to do.
The young guy has only been in practice 18 months solo and a year with someone else and had a tiny staff (no hygienist, etc...) just an assistant and secretary and is not very busy with a new practice. His office doesn't have all the bells and whistles but he did correctly diagnose that I should be seeing the endo for an opinion. I don't know anyone at this practice but all the online reviews are great and the dentist was personable. For non general dentistry he uses specialists - which I am a fan of.
The other choice is a much larger practice with every bell and whistle that I know several happy patients from. The dentist is only a couple years older but his father is in the practice as well as another dentist. When I went for an opinion, the dental assistant did some of the diagnosing which was odd and they tried to push the one day crown instead of gold, which my endo recommended for the back upper 2nd molar. They seem much more commercial, but that might be an appearance. They also advertise doing it all - root canals, braces, implants, etc...They have over 1700 reviews online - that seems bizarre and suspicious.
I made an appointment for Monday with the solo young guy, but worry that I might have made a bad choice since he isn't that busy (I could do the appointment almost any day) and I don't have a reference other then he was correct in identifying the problem and my old dentist trusts him enough to send his patients there while he was out of town.
So - in full dental freakout mode - is this a non issue and anyone can do the crown? Should I do more research and try to figure this out or does it really not matter? The solo guy was personable and seemed to care 0 his website pushes treating patients like family, etc..
I know that if I am unhappy, I can always switch to the other one and go from there - although I will feel awkward switching with a new crown and want to see the same person for a while until at least things have settled down and I know that they worked or not.
Anxiety sucks.
 
Enarete

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

I can fully understand your worry and that you would like to avoid a bad decision. You seem not to want to do any experiments this is very understandable.

If the choice is only between this two places, then I think you have made a good decision. From your post is clear that the big practice with 1700 reviews online makes you feel sceptical. I personally would also find a dental assistent doing a diagnosis very unapropriate and it would give me the feeling that the dentist himself doesn't really care about the quality and about my happiness. This is even more important since you are an anxious patient and therefore need even more attention and reassurance than a normal patient.
By the way, I myself don't trust young dentists whose parents are also dentists and work in the same practice. Such dentists probably never experienced dental fear of any kind themselves because they recieved a good care from parents and probably never got complex treatments done. So maybe they would have less patience with such patients, just because their universe is too far away from the universe of a phobic.

The 'solo guy' may still find himself in the stage of building the practice and this may be a good reason for having a tiny stuff and a lot of appointments. This also will be a reason for him to really make sure you will be satisfied and feel taken good care of - he for sure would like you to stay as a happy patient. The other place won't be much interested in keeping you. Another important point is that he would refere you to an specialist for some treatments: this shows that he minds ethics and acts responsible and wouldn't push you to something he feels is more complex than he can handle.

However, what I feel is really happening with you: you already have made a decision and has chosen a place you feel good about (sometimes such decisions base on gut feeling which ist often more right than logic). Now your anxiety starts to paralyze you because your appointment comes, your mind is trying to play tricks on you and find reasons for you to worry or to even cancel / change the appointment. If you would book an another place, be sure that you would start to worry again few days in advance, wondering if it was a good idea.

I have the best practice ever and a dentist who is kind and experienced beyond my wildest dreams and I still want to cancel sometimes because I feel it was not the right decision and there may be someone even better. Your mind will always find a reason for you to worry but remember that your initial decision was very reasonable and not out of fear which means it was a good one.

Dentistry is very complex and maybe there are no straight right or wrong choices. Every treatment has pros and cons and there will be some more recomended procedures or materials and some less recomended. You need a dentist who you feel looks for solutions that are in your best interests and is on the way willing to accomodate your preferences.

That was quite long.. sorry for that
 
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Zach_H

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

That was quite long.. sorry for that


No need to apologize for that, I appreciate all of your comments.

I suspect you are correct with what is going on. I do have a few reoccurring thoughts that I can't seem to shake.

It seems borderline nuts not to go to the larger practice when there are several people that I know that are happy and a ton of online reviews (even though it seems crazy to have that many reviews). My wife went there and was happy, but she has no anxiety and said she will go anywhere and switch to my place if it makes me feel better. They always say personal recommendations are best and I feel like I'm ignoring them. I know that I can always switch, but I'd rather get it correct the first time. The assistant did all of the diagnostic tests and then the dentist came in and did them again, so while the dentist diagnosed, it was odd to sit through what felt like a practice exam that drew no real conclusion until the dentist arrived. I do like that they give out a cell phone number if an off hours emergency occurs. I've never needed it, but I like knowing one is there.

Probably irrational - but with the small, new practice - I worry about what happens if my allotted time is up and the next patient is there. Without a hygienist to start the next cleaning, etc... is he rushing to get me done or cutting corners to make extra money to build the practice? That's probably just the anxiety talking, but those are the feelings I cannot shake. Finally - the young, new practice uses my old dentist as his emergency contact if he is away....which I know is only relevant 1-2 weeks per year - but that would be quite awkward for me and I wouldn't go. I also wish he had a hygienist. I don't know why, but it would make me feel better...strange, I know.

There is a distinct part of me that likes the idea of a smaller practice with personal attention, etc... At the end of the day, I suspect either will be adequate. I'm so terrible at this stuff.
 
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Zach_H

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

Now that the appointment is tomorrow - I don't think I can go through with it and am scared to death I made the wrong choice. Scared is an understatement.

There is something that bothers me about the dentist doing his own cleanings instead of a hygienist. I know that is crazy, but it bothers me and I fear that it will limit my ability to do a long term relationship with him. It doesn't seem to be like a traditional office in that sense. How does he handle emergencies if he is doing cleanings? He isn't busy and is a new practice (2 years). Maybe his skills aren't up to par because he doesn't use tools that often? I'm losing it. Seriously - breakdown central.

I don't have any references with the (younger guy's) office except my old dentist sent patients there when he was away. I know 5-6 people that are happy at the big office.

The small office uses my old dentist for emergencies if he is away - I can't go back there and won't know what to do.

The flip side is the big office typically makes there own crowns and I have been advised to do gold. They are willing - Maybe they don't do traditional impressions for gold often enough to be good at it. They like to do stuff in house and I prefer specialists. My wife recently went here for her first cleaning and she is happy enough - of course she doesn't have anxiety. I sort of want my wife, kids and I to go to the same place.

I feel like a fool having a breakdown with my family at home.

I don't know what to do. Scared doesn't touch how I am feeling.

I had the same dentist for 20 years and don't want change to occur on a crown - it's such a big thing to me. I don't know who is competent and who to form a relationship with.
 
Enarete

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

Zach,

you seem to be really worried and none of the two options seem to really feel right for you at the moment. That might just be the anxiety or maybe you need some more time to make the final decision.

Would it be an idea to use this appointment to talk to your dentist today and ask him about the points that are concerning you? You then can still decide if you let him do the work today or make an another appointment or go to the other clinic or find a new one.

Don't put yourself under pressure, the anxiety is enough pressure. Ask whatever you want to know and get all infos you need to feel ok with your decision. Sometimes a good chat with the dentist is the best thing to do.
 
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Zach_H

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

I don't feel like I have time to put it off. I had the retreatment of the root canal and only have a temporary filling. I've made it this far I feel like I need to get the crown done. I don't want to lose the tooth now. I'm terrified that this is the wrong guy and something will go wrong....but I'm not 100% confident that the other practice is right either. Honestly, I'm falling apart and barely trust myself at this point.

My gut feeling is that this guy got the diagnosis correct, sent me to a specialist to verify and that even if he is young and a new practice - that should be enough to trust him. If I went to the other practice, I already know that they never mentioned the infection that I had and they prefer to use the milling machine, not a lab crown, which is not what my endo suggested. It strikes me as odd that they have so many happy patients, including a few that I know, yet I don't know if I trust them. Maybe it's the anxiety talking, I don't know. I'm not sure I trust anyone yet.

Another main problem is that my old dentist is the emergency contact if this young guy is out of town. There's a chance that this never becomes an issue, but it freaks me out. The idea of having a problem and having my dentist be away scares me and triggers anxiety.

I almost feel feel like this guy should do the crown since we are on the same page, then I should change to the other practice and have a fresh start....but that seems incredibly illogical.

I also have a heck of a head cold...which isn't helping.

Definitely losing it.
 
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krlovesherkids777

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

Zach,

Just wanted to let you know althought I haven't had a chance to respond, I've read your post and am thinking ofyou today and hope things go well ! no matter how far you get.. you already got up the courage to talk about it, make an appt, visit them and get consults and even though there are lots of questins and anxiety.. I'm extremely anxious ...... myself.. you are on your way.. no matter how far you get.. it seems like you will make a good careful deicsion.. trust yourself.. the dentist will earn their trust if deserved but you are giving yourself a chance to get taken care of.

Please let us know how it goes today.
 
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Zach_H

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

Zach,

Just wanted to let you know althought I haven't had a chance to respond, I've read your post and am thinking ofyou today and hope things go well ! no matter how far you get.. you already got up the courage to talk about it, make an appt, visit them and get consults and even though there are lots of questins and anxiety.. I'm extremely anxious ...... myself.. you are on your way.. no matter how far you get.. it seems like you will make a good careful deicsion.. trust yourself.. the dentist will earn their trust if deserved but you are giving yourself a chance to get taken care of.

Please let us know how it goes today.

thanks - I am sitting here freaking out and driving my wife crazy. She banned me to the upstairs so I could pace without making her dizzy :o

I don't know that I will make a decision that will please me....seriously.

It seems my main fears are -

1. Why am I not going to the practice that has several happy patients that I know and instead going to a relative newcomer? Granted he got the diagnosis correct and I was comfortable with him, but it seems like an odd choice to make. I know it isn't 1 size fits all.

2. How will I know that at the end of the ordeal - in a couple weeks with the final crown - that he did a good job? I'm definitely not a dentist, but will probably spend hours in the mirror looking for problems that might not exist.

3. This might be the anxiety speaking - but part of me cannot shake the feeling that this isn't the long term practice for me. If the other practice is a better choice - why am I not starting with this procedure there? I still fear that he doesn't have a hygienist and does the cleanings himself - although that seems to be more normal then I thought. If my appointment was at the other practice - I would probably be wondering why I am not going to the guy that knew the problem immediately and got me on the proper course. It's really a nightmare situation for me.

I was so happy with my dentist of 20 years, but he doesn't accept our new insurance and it turns out he messed up the care on this tooth - although i think he was trying to be ultra conservative - which I appreciate.

I wish I knew some people that went to this practice and were happy.


I am terrified.
 
krlovesherkids777

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

Zach,

I also want to say.. yeah the worst moments of anxiety are the ones right before you leave the house , driving there and walking in the door.. I'm betting this newcomber will put you to ease.. the BEST dentist I've went to were all younger and newer.

The one I have now is the youngest of the bunch and the newest to the practice. I absolutely am so happy with him, he is the most considerate, kind and gentle dentist and very competant so far seemingly. its still in the early stages, though I've seen him maybe 6 times, I think going on 7th or somewhere around there. I couldn't be happier I picked him! I hope the same for you.. maybe since he has more appts available he will have the time to not be rushed like the other bigger practice.

I also went to a gal 20 years ago , she was my first good dentist. and she was only a year into practice , i did it because she was one of the only who took medical assistance. she ended up being so compassionate and actually changed my life and view of dentistry. so theres another younger , newer dentist that was really compentant.

I hope this one really works for you and things go well.. just go as far as you are comfortable. you are the boss all the way.
 
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Zach_H

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

Zach,

I also want to say.. yeah the worst moments of anxiety are the ones right before you leave the house , driving there and walking in the door.. I'm betting this newcomber will put you to ease.. the BEST dentist I've went to were all younger and newer.

The one I have now is the youngest of the bunch and the newest to the practice. I absolutely am so happy with him, he is the most considerate, kind and gentle dentist and very competant so far seemingly. its still in the early stages, though I've seen him maybe 6 times, I think going on 7th or somewhere around there. I couldn't be happier I picked him! I hope the same for you.. maybe since he has more appts available he will have the time to not be rushed like the other bigger practice.

I also went to a gal 20 years ago , she was my first good dentist. and she was only a year into practice , i did it because she was one of the only who took medical assistance. she ended up being so compassionate and actually changed my life and view of dentistry. so theres another younger , newer dentist that was really compentant.

I hope this one really works for you and things go well.. just go as far as you are comfortable. you are the boss all the way.


Thank you - I cannot begin to describe how much i appreciate your comments and support :)

I went back into my phone and found a few texts to a friend of mine that knows my dental ordeal - I wrote, after meeting the young guy - he is the first person to give me hope that my tooth could be normal. Then i wrote - he seemed like a great person until he hit my tooth with the instrument to test it, but that is what it needed I guess. Seems like a really nice guy.

I'm trying hard to focus on the positives here.

Worst case scenario is that the tooth goes to hell, I lose my back molar and get an implant. While I don't want to have those thoughts or procedures, etc....I know that that is the single worst thing that can happen to me and plenty of people have survived worse.

I also know that I can switch dentists next month, and the month after, and even after that if I want to. This isn't marriage.

I don't know if that is real, or relevant, but I am trying to think about those things to stay positive.

Seriously - I cannot thank you enough for hanging with me through this appointment.
 
krlovesherkids777

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

I'll look forward to hear how this goes for you!!! please let us know! hoping all is smooth saling and that you even have fun.. I actually ,, sounds really strange..... have fun at the dentist,, he's a funny guy and that REALLY helps ease the anxiety!! Last time he practiccally had to kick me out lol.. hope it goes that well for you!
 
Enarete

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

Zach, you WILL be all right. It doesn't matter to which dentist you will go, you have to trust and you cannot controll if they did a good job.
In a clear happy moment you have chosen this young dentist so it must be right. Sometimes the right decisions happen through intuition because you subcoscious grasps more clues that your logic but it doesn't mean that the decision is wrong.

What would I do for my dentist doing cleaning by himself.. wow.. I am so scared of people I don't know and wouldn't appreciate to have to get a cleaning from somebody I never had a chat and appointments before.. so dentist who does cleanings by himself would for me be a good sigh.. you see, one size doesn't fit all.

Crossing my fingers for you, let us know how you are doing and you will for sure be all right. Don't let the panic get you:)
 
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Zach_H

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Re: I'm in a full panic over upcoming crown and dentist choice - opinions please

Update to the experience -

My wife got me into the car and I agreed to go talk and feel him out, see if I was comfortable, make sure we were on the same page, etc... We arrive a couple minutes early and the secretary greets us and asks how I am feeling. I tell her I'm a mess and she tries to make me feel better - it failed. Talking with my wife made me feel better. He's late - definitely not the start that we needed. When I went for the consultation he was prompt, and I can hear him giving instructions to someone and being patient answering questions, etc... I'm growing more and more agitated as time goes on and they finally bring me into the room - 30 minutes late. I seriously wanted to leave but my wife wouldn't let me.

We get into the exam room (my wife goes into the room with me) and he asks how the tooth is feeling. I tell him it is still pretty sore, but some of it might be my congestion, but it hasn't completely settled down yet. He then tells me that he things doing the crown could be a waste of a lot of money and he would hate to see me waste that money and for him to do good work just to throw it away if the root canal retreatment isn't successful. I get stressed out and tell him that I will gladly spend the money on the crown, but not having a crown after the initial root canal got me into this situation and i couldn't see myself walking away with more instructions to just wait. I've been waiting for 5 years, got the nerve to get the retreatment and didn't want to risk breaking the tooth or having it fail due to leakage, etc...

We start to talk back and forth about options. He thinks I should give it a couple weeks, I tell him i can't just leave the temp filling in, my anxiety is too high, etc... He offers to put a permanent filling in and I tell him that won't solve the breaking of the tooth, etc... We talk about it in an honest dialogue for 45 minutes...yeah, 45 minutes. Finally - he suggests taking the temp filling out, putting a permanent filling in, doing a crown fitting and using a temp crown. With this approach, he tells me that the root canal portion will be sealed by the permanent filling, the temp crown will prevent the tooth breaking and if it settles down and we do the crown, the prep is done. It saves me the lab fees and fitting and we can push that to january when the insurance resets and I won't have to pay out of my pocket.

We've taken so much time to reach this conclusion that we can't do the work at the moment. He tells me he had a cancellation that afternoon (I think he was just not booked) and we could come back in an hour and do it. He leaves the room and asks y wife and I to talk it over. We agree to just get it done at this point and it seems a reasonable approach.

We go, my wife eats lunch, and we come back.

The procedure starts and he does his best to answer all of my questions. Apparently my gums were too bloody to use the white composite filling material so he has to use the older silver amalgam. I'm kind of bummed about that, I'm not sure why, but it isn't what i wanted. He tells me that there is too much blood to dry the tooth out completely and get a good seal with the composite. He had to put the amalgam filling into the roots that were just treated a bit to get them set (I might be wrong about why, etc....) and he tells me everything looks good and is setup, etc... He then shapes the tooth, takes a few molds and fits a temp crown.

he tells me that my gums are going to be "angry" for a few days and to expect some discomfort, but everything looks good and he is happy with the fit, etc....

Assuming the discomfort goes away it will be time for the real crown in january. if not, he wants me to think about asking the endo for an evaluation/opinion and go from there. I still might lose the tooth, but I sure hope not.

I'm still a little bummed about having the silver filling under the crown, but don't know why. he told me that given the situation, every dentist he knows would have done the exact same thing. It does little to comfort me and I am fighting the urge to google results and read about why it isn't the best. I think, given the blood, there really was no choice. It saddens me that the endodontist put that gutta perra in all the way through the root and he had to remove some to put a filling in, but I guess that is what is necessary for a good seal. He told me the filling, under a crown, could last the rest of my life. I'll be 40 Monday. I hope it does.

All told, my wife was very comfortable with him and I appreciated that he took a ridiculous amount of time to discuss options and genuinely please me. As sick as my anxiety is about the dentist, I am already wondering if I made the right choice or if it could have been better, etc.... which seems absurd as I am sure there are very few dentist that will sit with you for 45 minutes or an hour debating possible solutions to the problem. I think he tried to do his best work, which i appreciated. I still wish he had a hygienist :)

I don't think he is busy yet at all with his practice - even after 18 months, which does freak me out a bit.

He also told me, when I questioned an option and apologized for being a pain, that it was ok and if you can't explain something fully to the patient maybe you are int eh wrong field. i thought that was nice and made me feel like less of a pain in the butt.

I'd love any feedback you might have :) You are the best for hanging through this with me.
 

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