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Scared about dental diagnosis and treatment plan

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wangmo

Junior member
Joined
Sep 13, 2019
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5
Location
Vancouver, Canada
I had some bad experiences previously:

All my wisdom teeth were extracted while in my late teens (impacted) and my 1st molars are all removed for braces. All my silver fillings have been replaced over the years with white composite fillings. I am 54 yr old.

This all relates to the upper jaw.

Two 2nd molars received crowns, each about 1 year apart. There were high spots on both crowns and the dentist worked a little bit to alleviate the high spots but didn't really believe me... consequently my lower jaw bite is shifted "back" (like it would be if my jaw were resting while lying back on the dentist chair). I'm also a bit of tooth grinder (apparently).

During this period, gaps between my 2nd and 3rd upper molars got wider and immense food traps formed. The dentist filled the cavity on the inside edge of the 3rd molars (facing the crowns) and created a little overhang to "bridge" the gap (so to speak) This did prevent everything I ate from getting wedge in there but I now have a nice little cave/tunnel food trap under the composite overhang. This was 2 years ago. One of those fillings was at my last appointment at that office, a dental student did the filling (3rd upper molar) and it has been painful on and off ever since, food trap not resolved etc.... I nearly fainted when I stood up. I haven't been back there and I've been depressed about my teeth...

A few weeks ago, I was eating a "power cube" (a little 1" cube of peanut butter, coconut oil? etc.. soft but a bit chewy). They were good so I chewed a bunch of them only to experience extreme dental pain a few hours later in the quadrant last worked on by the dental student! Wow! Hot and cold sensitivity in 3 places in my mouth.... Time to face it. My teeth/gums are in rough shape.

I went to a new dentist last week after agonizing over who to go. I would really like a holistic or naturalpathic dentist but don't think they really exist in Vancouver, BC. Anyway, The dentist I went to seems very nice. Really conscientious about making you feel at ease and has a gentle hand. She did a cleaning and my gums felt immediately better. Now comes the scary part!

The diagnosis and treatment plan (the scary parts):
The two upper molar with crowns: Both have 'pits' that measure 10, 8 and 5. Both have a cavity down under the gum line. Both have bone loss but one side has severe bone loss and an apparent abscess (this is the side that pained me after eating the power cube). This Bone loss may be below where the second root branches off. Xray was unclear and she referred me for a Cone Beam Computed Tomography which will be almost $300 and is not covered by dental plan. (This is to determine if she can do a root canal on both molars and replace the crown or do an extraction.)
She also wants to do a root canal/crown on the 3rd molars (both of them). They both have cavities. One has an open cavity at the gum line and you can see it in a digital photo this it has cleared out some of the pulp from under the edge of the dentine and looks "riddled" with holes (like a meally apple) on the inside back corner and would need to be referred to a specialist to do the root canal because the tooth is almost laying sideways (it has started to travel to where the wisdom tooth would be) and has a twisted bent root.
Alternative to Root canal: Extract the molar with crown (if bone loss is so much that a root canal isn't feasable) and do 2 root canals/crowns on 3rd molars to support a bridge.

She also said that the third molar on my lower jaw needs a filling at the gum line. She said that she could do a beautifil filling there but given that she dosen't think I will take care of that tooth she wants to do a root canal/crown instead.

If there is no problem with the root (no pain, no infection) then why does she want to do so many root canals!

I just read somewhere that if the hot/cold pain sensitivity resolves relatively quickly (within a few minutes) then the tooth isn't dead. For me, hot/cold sensitivity resolves quickly and dose NOT linger for hours.

Am I right to question this? I have a big decision and not a lot of money! I am feeling more toward extracting the 4 upper molars and going for a partial but I'm scared and I don't want to make an irreversible decision that is reactive (no more drilling please!!!!) and maybe not the best treatment?

Please help me.
 
W

wangmo

Junior member
Joined
Sep 13, 2019
Messages
5
Location
Vancouver, Canada
Some of my other previous dental traumas:
~ 14 teeth pulled for braces. On one occassion the freezing had almost completely worn off and it was really painful... not super awsome for a 10 yr old to deal with. He loaded me up with more freezing and by the time mom drove me home I couldn't see because my eyes were frozen (both of them - becuase he pulled teeth on both sides)! Happened a few times with fillings too.

~ One hygenist in particular has terrified me of getting my teeth cleaned. She left my gums feeling like hamburger... it took quite some time before my gums healed. Went to that office for a few years.

~ My daughters first dentist put a filling in the wrong tooth. He drilled and filled for a filling between two baby molars and guess what! He did the wrong side and drilled and filled a perfectly healthy tooth.
 
Sol

Sol

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Mar 26, 2010
Messages
264
Location
USA
Wangmo,
Sorry to hear you are in pain, having to deal with an extensive treatment plan and the bad past experiences. Trying to follow along with your description (I'm not a dentist). Slightly lost because 3rd molars are the same thing as wisdom teeth but those were impacted and removed a long time ago?

The tooth with the abscess will most likely need a root canal assuming you want to keep it. That decision will come down to how much you want to keep the tooth and the long term out look for how well the restoration will last. The same thing will probably also apply to the other molar where the decay has reached the pulp of the tooth.

This comment sounds odd to me, "She said that she could do a beautiful filling there but given that she doesn't think I will take care of that tooth she wants to do a root canal/crown instead." Did the dentist explain or give some kind of reason why they didn't think a filling would do well (besides saying they didn't think you would care for it)? I could understand this more if the comment was made about the tooth laying sideways since that could make it harder to maintain but that doesn't seem to be the case and sounds a bit rude. From what I understood, your lower molar is asymptomatic (not sensitive or painful in someway)? Usual rule of thumb is to start with less invasive treatment when possible.

Sorry I'm not leaving you with a clear answer about what to do but I think you have every right to question this. Since the dentist recommended a lot of root canals would it be possible to get another opinion for peace of mind (maybe from an endodontist)?
 
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wangmo

Junior member
Joined
Sep 13, 2019
Messages
5
Location
Vancouver, Canada
I've been wondering about a second opinion...
I'm confused about the numbering. I have 2 molars and 1 premolar. The ones removed prior to braces were between the molars and premolar?

I was able to get a couple of the xray images sent to me.

Both crowned molars have deep pockets measurings of 10 and 8mm for each . The absessed molar also has bone loss that looks to extend across the other molar. Would this affect the success of a root canal?
Would that outside molar support a bridge? She said I would need to go to a specialist for a root canal on it.

I'm fairly certain that the abscessed tooth was lifted slightly from the chewy power cubes. After, when there was pain I kind of pressed down on the top with my tongue and felt.... ! .... Did my tooth just squish back down?!!

The tooth that looks like a wormy apple is the outsode molar in the other photo.
 

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Aurora10

Aurora10

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Feb 9, 2017
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Canada
I've been wondering about a second opinion...
I'm confused about the numbering. I have 2 molars and 1 premolar. The ones removed prior to braces were between the molars and premolar?

I was able to get a couple of the xray images sent to me.

Both crowned molars have deep pockets measurings of 10 and 8mm for each . The absessed molar also has bone loss that looks to extend across the other molar. Would this affect the success of a root canal?
Would that outside molar support a bridge? She said I would need to go to a specialist for a root canal on it.

I'm fairly certain that the abscessed tooth was lifted slightly from the chewy power cubes. After, when there was pain I kind of pressed down on the top with my tongue and felt.... ! .... Did my tooth just squish back down?!!

The tooth that looks like a wormy apple is the outsode molar in the other photo.
It is perfectly reasonable to want to get a second opinion, it's your money and your dental health. I have done so myself and just recently. If you really feel more comfortable asking for another opinion then why not? Good luck!
 
krlovesherkids777

krlovesherkids777

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"Am I right to question this? I have a big decision and not a lot of money! I am feeling more toward extracting the 4 upper molars and going for a partial but I'm scared and I don't want to make an irreversible decision that is reactive (no more drilling please!!!!) and maybe not the best treatment?"

Wangmo,

I would go for a second opinion too. It doesn't seem you have a peace at all about what she is suggesting. like something in your gut is questioning. If it were me personally I would get one.. Dental is a big decision and it costs time , money and its about your health. so you have every right to feel at peace about it. Do you have an idea where you might go for a second opinion. Sounds like a lot to decide on. and you really want to feel comfortable with where/who you go to.
 
krlovesherkids777

krlovesherkids777

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Wangmo,

Also.. did your dentist check for "vitality".. my current dentist did a test on me to check for Vitality using this probe thing. I guess this is one avenue to check for possible needing of root canals. might be a way to help validate , ask next dental opinion?
 
letsconnect

letsconnect

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If there is a lot of bone loss, then removing the teeth may well be the best option (no point in building a house on shaky foundations etc.)... I'm not a dentist so I can't comment on the x-rays! As the others have suggested, it might be an idea to get a second opinion if you're unsure?
 
B

blackhound

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I'd go for a second opinion. It sounds like you are conflicted and don't have full faith in this dentist's treatment plan. For this much work I'd rather be completely sure I was going in the right direction.

Flashing red light for me would be her telling you that you wouldn't take care of the 'beautiful filling' she would do. I'd be looking for the exit, frankly.
 
krlovesherkids777

krlovesherkids777

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Yeah..

"Flashing red light for me would be her telling you that you wouldn't take care of the 'beautiful filling' she would do. I'd be looking for the exit, frankly. "

I agree with Sol, that it was rude and Blackhound exactly
 
W

wangmo

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Joined
Sep 13, 2019
Messages
5
Location
Vancouver, Canada
Wangmo,

Also.. did your dentist check for "vitality".. my current dentist did a test on me to check for Vitality using this probe thing. I guess this is one avenue to check for possible needing of root canals. might be a way to help validate , ask next dental opinion?
I have not heard of this? They did check the 'pockets' which used a probe?
 
W

wangmo

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Joined
Sep 13, 2019
Messages
5
Location
Vancouver, Canada
Thanks everyone! I am going for a second opinion! (I have never done that before!)

I have an appointment with a dental office that has specialized for seeing patients with dental fears/past dental traumas and dental phobias. They offer financing plans and three levels of dental sedation. They can also use the xrays already taken.

I'm still scared about having the actual work done but feel a bit more at ease.

One thing that I realized in all of this, I might not know dentistry but I do know how I want to be treated as a patient and how I would like to see the support staff treated! I had lost sight of this! (I work as a booking clerk for an outpatient clinic at a hospital so have lots of good and bad examples of doctor/patient and doctor/staff relationships.) I was so scared about the actual procedures that I forgot ... I have control in this area!

If there is a lot of bone loss, then removing the teeth may well be the best option (no point in building a house on shaky foundations etc.)... I'm not a dentist so I can't comment on the x-rays! As the others have suggested, it might be an idea to get a second opinion if you're unsure?
My thoughts exactly. But I'm not a dentist either!
 
letsconnect

letsconnect

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That sounds like a great plan!

One thing that I realized in all of this, I might not know dentistry but I do know how I want to be treated as a patient and how I would like to see the support staff treated! I had lost sight of this! (I work as a booking clerk for an outpatient clinic at a hospital so have lots of good and bad examples of doctor/patient and doctor/staff relationships.) I was so scared about the actual procedures that I forgot ... I have control in this area!
So true...

Best of luck with the appointment and please keep us updated :) !
 
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