New teeth desperately needed, where do i go?

[TwinMum]

Hi, im hoping someone out there can help me.

Im wanting to get my teeth sorted out. I have a huge problem with my teeth where they are decaying from the inside and unfortunately the enamel is breaking off and i am left with horrible stumps which eventually fall out and leave me with nothing.

It is really affecting my confidence and im always covering my mouth when i talk. I even had a young child comment asking me whether i ate too many sweets!

I currently have 6 teeth missing, two of which are near the front of my mouth, and every other tooth, apart from 4 have atleast 1 fillng in them.

I have a healthy diet which hardly includes any sugar and am careful with my dental hygiene but my teeth are still decaying.

I saw a specialist a few months ago about the problem with my teeth and he told me that the chances of me having any teeth left in 5 years is unlikely. No matter how many fillings i have, the problem isnt being solved.

I am wanting to finally be able to smile with confidence but have no idea who to see or where to go.

Please help!!

 

[brit]

I've moved this to the Dentistry Section.
It may help to know what kind of specialist did you see? Are you taking prescription drugs which could adversely affect your dental health? Any other medical conditions which could be a problem?

Do you think the problem is with your teeth, your gums or both?
What options were you given by the specialist?

 

[Zzzdentist]

I've encountered very challenging cases like yours where decay doesn't seem to be able to be stopped. Usually it can be related to a dry mouth either related to a medication or mouth breathing tendency. Aggressive treatment with high fluoride toothpaste, fluoride rinses, fluoride trays, changing medications, along with frequent cleanings and excellent homecare can help somewhat.

In some cases, dentures or dental implants might be an option to consider if the problem is chronic and the situation severe enough.

 

[TwinMum]

Im not sure what sort of specialist he was but he said that there was nothing that could be done to stop the decaying. It looks like the problem may be genetic. My gums are perfectly healthy apart from having two absesses.

The problem started when i was 12 when a small part of my tooth broke off from the gum line. From then on my teeth became worse and worse. I have had 4 teeth removed, 5 have only the root left and all of my other teeth, apart from 4 have atleast 1 filling in them.

I have tried Fluoride and calcium suppliments, clean and floss my teeth atleast twice a day and have regular visits to the dentist. I have spoken to my dentist about the problem but she doesnt really say much. I have asked on a variety of times for her to sort my front teeth out, but as i have teeth which are in a worse state towards the back of my mouth, they are the priority to be treated!

 

[Zzzdentist]

I wonder if you have some sort of enamelogenesis imperfecta where the enamel doesn't form well enough to protect the decay susceptible dentin deeper inside. That might explain the recurring cavities and difficulties you have been having. Sometimes full coverage restorations like crowns might be an option. You could always get a second opinion about your situation as cases like yours can be challenging and not all dental professionals may be experienced enough to be able to deal with it.

 

[TwinMum]

That does sound like a good explaination to why my teeth are in such a state. I have heard that the NHS has strict guidelines for dentists and am wondering if this is why my front teeth havent been sorted out when i have asked. It seems to be the worst teeth which are being sorted out first and not the teeth which i ask for. I understand that my teeth towards the back of my mouth are in a bad way but my front teeth are in such a state that my confidence is so low.
If i went to another dentist would that be the same: priority teeth first, or would i be able to have a say in which teeth are to be sorted out?

I am thinking about going Private but the cost of the treatment is worrying me.

Which should i do? I just want to be able to smile with confidence!

 

[Zzzdentist]

Sorry one of the other dentists or members will have to comment there as I don't know how the NHS system works. It is common though for dentists to prioritize urgent treatment, but if you do let them know what your primary concerns and wishes are, usually they should be able to alter their treatment plans to accomodate you. Again, maybe the NHS only allows dentists to do the most urgent work first? I'm not sure.

 

[annie778]

Twinmum if you can get a proper diagnosis of a condition like the one above you should be able to get specialist treatment via the NHS. It might be worth your while paying for a private consultation with a specialist if that means you get free treatment. You probably have to go to a dental hospital to get a confirmation of any private diagnosis. Your best bet would be to convince your current nhs dentist to refer you to a specialist for a consultation.

You need to be a bit assertive with the dentist and tell him you have been looking after your teeth but they are congenitally weak and tell him your dad had a problem too so mention a genetic link. If a specific medical condition that has affected your teeth is diagnosed then they have to treat you as a special case and sort your teeth out for free. This does not mean you will get the sort of wonderful materials you would get if you go private, but it does mean that they do most of it for free. The difficulty is getting a diagnosis.

 

[annie778]

Graham might be able to help, but as he is in Scotland (where the nhs has different rules) he may not know the system in your area.

 

[brit]

I think Annie means Gordon not Graham???
The problem is OP says she has already seen a specialist but she's not sure what kind she saw.
OP - given that your current dentist doesn't have much to say on the matter, I'd definitely be looking for a second opinion if I were you.

I'd like to think Annie's right about the NHS covering advanced hospital care if genetically you were a special case or sth similar - Gordon probably is the best one to ask but people don't get free implants on the NHS after car crashes do they? Or do they? Maybe they do. (they would get NHS dentures though!)

If you have a dry mouth condition Gordon has said before that this needs ongoing treatment with artificial saliva as well as fluoride etc etc ...you say you have tried fluoride but it should be an on-going thing in your case not a try it once approach...it sounds a bit like your dentist is inexperienced and does not know what you should do to keep your teeth as long as possible.

 

[annie778]

Sorry I meant gordon.

Couple of years old but sheffield pct states on their website that dental implants are funded in cases of congenital conditions where other restorative therapies are not appropriate. Looks like you can also have them if you have had mouth or facial cancer or a major accident (appendix D). From the looks of it, you'd have to be referred by an nhs dentist. Go to NHS choices website to find an alternative nhs dentist if you're not happy with the one you have or contact the PCT. I guess the challenge is to prove the condition is abnormal and congenital and you need an nhs dentist to refer you to a specialist to be diagnosed.

 

[annie778]

By the way Sheffield pct's policy may not apply to the whole of the UK. Different areas may have different approaches/criteria. It's best to contact the local PCT to ask what their policy is.

 

[Gordon]

Trying to catch up on this one, sorry if I miss something...

1) The NHS doesn't have strict guidelines on the order which teeth are restored. However, most dentists will prioritise things themselves, usually back teeth first.
2) The NHS won't fund implants to replace your missing teeth. Mostly these days implants are reserved for cancer patients and even then they aren't commonly provided.
3) It doesn't matter if you're referred in by a private or NHS practitioner, but it might be worth asking for a referral to your local dental hospital to see a specialist in Restorative Dentistry