The Dental Topic Thread: I'd like to be a resource if needed

Search
Go

Discussion Topic

Return to Forum List
Post a Reply
Messages 1 - 112 of total 112 in this topic
micronut

Trad climber
Topic Author's Original Post - Nov 27, 2012 - 01:45pm PT
Ok. About once a year, a thread gets started by someone in need of dental advice. There are a couple dentists here on the taco who chime in but usually its usually full of personal accounts, which can be great but often full of incorrect information. I'm willing to go out on a limb here and post my professional information as a resource to climbers. Maybe a bad idea? But hey, if I can help out members of my tribe I'm willing to take a bit of risk. If you have dental questions, go ahead and post em here and I'll give you my two cents. I'm a periodontist, a guy who surgically treats gum disease and rebuilds the dentition with dental implants. My website and Facebook link can be a resource and you're welcome to contact me with reasonable questions.

So, feel free to post dental stuff, rants, complaints, questions, whatever, here on this thread. And feel free to visit my website and 'like" us on Facebook. We appreciate the web traffic. I've personally treated many Taco lurkers, so ask around and let me know if I can be of any help.

Scott

Credit: micronut
http://www.jettperio.com/

Credit: micronut
On Facebook: Scott R. Jett D.M.D., M.S.


and here's a link to a few of the many dental threads on Supertopo
http://www.supertopo.com/climbers-forum/1992712/Dental-Insurance-vs-Dental-Plan

http://www.supertopo.com/climbing/thread.php?topic_id=1879845&msg=1881666#msg1881666

http://www.supertopo.com/climbing/thread.php?topic_id=1723439&msg=1723751#msg1723751

http://www.supertopo.com/climbing/thread.php?topic_id=1484204&msg=1485510#msg1485510
phylp

Trad climber
Millbrae, CA
Nov 27, 2012 - 01:51pm PT
This is incredibly nice of you!
Cosmiccragsman

Trad climber
AKA Dwain, from Apple Valley, Ca. and Vegas!
Nov 27, 2012 - 01:51pm PT
How much do dental implants usually cost, Micronut?
I'm minus a few teeth in the back lowers.
I tried dentures but they were really irratating,
and I hate gumming my steaks.
eKat

Trad climber
BackInTheDitch BackInTheDirt BackInTheDay
Nov 27, 2012 - 01:55pm PT
How graciously generous!

Thank you!

But. . . ya know what? From what I've seen, here at TheTacoStand, I wouldn't expect anything less from you. . . you are a terrific man!

oxoxox
this just in

climber
north fork
Nov 27, 2012 - 02:01pm PT
photo not found
Missing photo ID#275861
I heard this was how micro looked before he became a dentist :-)
Cool of you Micro.
Cragman

Trad climber
June Lake, California....via the Damascus Road
Nov 27, 2012 - 02:05pm PT
Scott....I really need your help, man.....thanks for being willing....





























photo not found
Missing photo ID#251936
Mungeclimber

Trad climber
the crowd MUST BE MOCKED...Mocked I tell you.
Nov 27, 2012 - 02:28pm PT
Why is it that Insurance only covers two cleanings a year, even if a patient may need more?

Just curious.





And, do you drink soda? How much?

Is it true that Soda companies buy off dental researchers to not research how much soda can deteriorate teeth, or is that an old tale that soda will rot your teeth?
Cragman

Trad climber
June Lake, California....via the Damascus Road
Nov 27, 2012 - 02:28pm PT
By the way, I thought it was kinda cool when this thread appeared right next to the one titled..."Stance Drilling".

:D
Spanky

Social climber
boulder co
Nov 27, 2012 - 02:29pm PT
First of all thanks for the offer. Good professional advice can be hard to come by.

I have a question that sounds like it is right up your alley so here goes;

I had braces as a kid for about 2 1/2 years. After they came off I was a good boy and wore the retainer for as long as they told me and eventually they told me I didn't need it anymore. One of the struggles with braces was to get my back molars to touch on both sides. They used a palate expander to give me space and then pulled them down. After a few years though my molars in the back didn't touch anymore. So as you would guess I do most of my chewing with the front half of my teeth. This means that my front teeth are wearing down faster than the back teeth and 20 years later I can definitely tell that my front teeth are wearing away. My current dentist seems to think I need braces again but I'm skeptical. If they didn't work last time why would they work now? So the question is are braces a good idea? Or am I going to end up needing implants to replace my worn out front teeth at some point? are there other options? On a side note my dads teeth were also heavily worn and he ended up with a full set of veneres (spelling)

Once again thanks for the info and yes I'm gunna die
Cragman

Trad climber
June Lake, California....via the Damascus Road
Nov 27, 2012 - 02:31pm PT
^ <veneers>
Reilly

Mountain climber
The Other Monrovia- CA
Nov 27, 2012 - 02:52pm PT
Micronut, bless you, but you have no idea what you've brought upon yerself.
Cragman is just the tip of the iceberg. :-)
FTOR

Sport climber
CA
Nov 27, 2012 - 03:08pm PT
awesome, thanks. too bad the nutcases are already at it with the nonsense, but i'll take you up with your more than generous offer.

had a rear molar that could not have a full root canal performed due to calcification. i chose to to go ahead and have a "best you can do" with the endodontist with a partial canal and buildup. this also required a lowering as they called it due to a cavity at jawline. was this a bad idea (after the fact)? the other option was an implant but seemed like if this works for a while so much the better. though, the other way to look at this could be a lot of wasted $. any thoughts?

i too worked with a periodontist for an implant. costs a small fortune and takes a while but it's bomber. as others have weighed in, wouldn't go to just any dentist for one of these. in fact, have seen where someone suggested only working with oral surgeons, probably my last choice for this procedure given my admittedly limited knowledge. surgeons seem more adept at pulling as opposed to planting.

again thanks-
micronut

Trad climber
Topic Author's Reply - Nov 27, 2012 - 03:35pm PT
Whoa,
just got out of a surgery and stoked to see that folks might dig this thread. What have I gotten myself into? How do I delete a thread?

I'm on lunch, so here's a couple quick answers.

Comic: 2300-2700 for the surgical implant placement. A bit more if we need to do bone grafting to augment lost bone volume in the site. The general dentist then charges anywhere between about 800.00-1200.00 for the tooth/crown that goes on it. Expensive, I know, but its a life changer for a lot of people to avoid dentures, avoid a bridge, and buy something that should last a lifetime. Titanium does not decay. Very few things in life cost 3-4k that can last for the rest of your life.

Cragman: Awesome photo, can I use that on my website?

Munge: Great question. Most dental insurance companies are sharks. They exist for one reason, to make money for themselves. No other reason. They get "paid" a grand or so a year in premiums. They shell out 200 bucks for a couple cleanings, 200 for some x-rays and some flouride. Bam. they pocket 600.00 for the year. They cringe when they have to pay more and will lie cheat and steal and deny claims and ask us providers to re-submit over and over ad nauseum hoping we just give up. They have an annual maximum of around 1-2k. A good root canal and a single crown costs more than that. Delta Dental had an annual maximum of $1,000 back in the 1980s when a crown cost 300.00 and a cleaning cost 50.00. You used to be able to get a lot done for the insurance allowance. Now, it just aint the case. ANd that's with the big three or four companies that actually have ok coverage. The hundreds of other anklebiter companies are truly just scams. Buyer beware sadly. But if your employer offers it, take it and be grateful, its costly to him/her and you get some money toward your maintenance.

Spanky: Gimme time on this one, I'm a lousy typist.

T*R: Those things have research that shows they work at least as good as floss. They're a bit gimmicky but they really do work. Floss is cheap, so I don't push those things much. Studies show that if you do anything at all to disrupt the plaque every 24-36 hrs, you can avoid gum disease. But you gotta get in between the teeth, and a toothbrush alone won't cut it. If everybody starts flossing, I'm outta work.

FTOR: Let me get back to you on this.

And Munge, yeah, I drink too much Coke. It does and will rot your teeth. Stick a baby tooth or a tooth pulled from a dentist in a cup of diet or real coke. SHow your kids how long it takes to dissolve into nothing. its a fun science trick. I'm a good flosser and eat well otherwise though. The PH and the carbonic and the unreal sugar content have kept us dentists in business for the past 20 years. That and people who don't believe in flouride and think it's poison. We figued out how to keep gum disease and decay off the map 40 years ago. Brush twice daily. Floss once daily. Get flouride in your water. See a hygienist every six months. Done. Decay and gum disease should have been eradicated. But people love to not take care of themselves. Its in our nature. We also figured out how to cure/avoid type II diabetes. But its a 4 billion a year industry because people love to neglect themselves and their children. Sad.

ok kids. I gotta go. more later. gotta go pay off 300k of student loans.

Credit: micronut
limpingcrab

Trad climber
the middle of CA
Nov 27, 2012 - 03:35pm PT
Five questions in two hours. You might need to quit your day job to keep up with the taco.

I'm guessing you won't be the first.
Cosmiccragsman

Trad climber
AKA Dwain, from Apple Valley, Ca. and Vegas!
Nov 27, 2012 - 03:46pm PT
I can't afford a Dentist anymore so
I use her!

photo not found
Missing photo ID#148807
Spanky

Social climber
boulder co
Nov 27, 2012 - 03:46pm PT
Thanks micronut. If you would like you can PM your answer or put it on the board if you think it would be useful for someone else.

cheers,
Dan
tooth

Trad climber
B.C.
Nov 27, 2012 - 07:22pm PT
Not that Micronut doesn't have all the answers anyway, but if you have a general dentistry question and want a perspective from someone who has worked in the US, Canada and seen patients in Mexico, Venezuela, Guyana, India, Myanmar, Guam, Guatemala, Nicaragua, etc. I've answered a lot of PM questions over the years from the Taco.

I haven't ever seen Micronut give an answer to anything non-perio that isn't backed up by the latest research I know about which is amazing since the saying goes, 'put 4 dentists in a room and you'll have 5 opinions'.


http://www.okanagansmiles.com

http://www.facebook.com/dentistkelowna


 Jonathan
Mungeclimber

Trad climber
the crowd MUST BE MOCKED...Mocked I tell you.
Nov 27, 2012 - 07:28pm PT
Dig this thread

Thx!
micronut

Trad climber
Topic Author's Reply - Nov 27, 2012 - 07:53pm PT
Spanky,
Here goes. Orthodontics has come a long way in the past 20 years, even the past five honestly. They used to use heavy wires, heavy forces, and often "did the best the could" to level and align teeth into proper esthetics and function. They also didn't know about how sneaky teeth are in their propensity to "go back home" or rotate, twist and settle back into the place they started. Now, orthodontists basically tell kids and adults, "retention/retainers for life."

Now, amazingly, they use much lighter wires, much lighter forces and better technology and science (no doubt from learning from the past), to more precisely align teeth and place the chewing and functioning forces where they are most needed and evenly distributed. I often recommend adult orthodontics (DONE ONLY BY A SELECT FEW ORTHODONTISTS WHO KNOW THE CRAFT WELL) to people who had it done in the past either without great results or with significant relapse. In some cases, Invisalign is a great option, in others, its the full monty. But, if done well, I've seen adult ortho change peoples lives and or create stability, without which, they would have faced a real and debilitating decline in the coming years. I have had two of my own staff treated in the past few years. One 40 one 52. Both looked my orthodontist friend in the eye and said, "you jack me up and I'll kill you." I recommend that approach. If he squirms, walk. If not, you might be in the right place. Its a big investment, but it can be great and much needed for lots of folks.
Gene

climber
Nov 27, 2012 - 08:09pm PT
Both looked my orthodontist friend in the eye and said, "you jack me up and I'll kill you." I recommend that approach.


Not much ambiguity in that advice. LOL.

Nice thread, Micro.

g
khanom

Trad climber
Greeley Hill
Nov 27, 2012 - 08:58pm PT
Ok, you are a saint, but I think you are crazy for posting this thread.


I have a question:

If I have a molar extracted can an implant be done at a later time, say several months to 2+ years?
Gal

Trad climber
a semi lucid consciousness
Nov 27, 2012 - 10:18pm PT
Awesome, THANKS THANKS... I may have a question later... I will take it offline. You are a kind hearted person!
strangeday

Trad climber
Brea ca.
Nov 27, 2012 - 10:23pm PT
Thanks for this thread micro....

Regarding extractions and implants, I have had multiple extractions, and need to have another done soon. The last time I had one done, they recommended a bone graft, which was quite a bit more money than I could afford, but i paid for it anyway. Is the graft to make it easier to add an implant later? Or is it for another reason? I'd never been told I needed one before, and was curious as to why I would need one now.
tooth

Trad climber
B.C.
Nov 27, 2012 - 10:35pm PT
Khanom,

you can have an implant if there is bone to put it in. Adding bone to a fresh hole in your jaw is the best/easiest/cheapest way to ensure there will be.



Things have changed recently and now we always recommend a bone graft in a location where an implant or even a partial denture could be used later. People change their minds, I want them to have that option.

MisterE

Social climber
Nov 27, 2012 - 10:41pm PT
OK, Micro: bridge or implant?

I got a couple that need it, and the bridge looks like a quick solution, but the implant seems like a better long-term solution requiring some money and time sacrifice out of the gate...

Thoughts?

Thanks again for being a resource for something that is difficult for many of us.

Erik Wolfe
rottingjohnny

Sport climber
mammoth lakes ca
Nov 27, 2012 - 10:55pm PT
I always wanted to look like Freddy Mercury....RJ
tooth

Trad climber
B.C.
Nov 27, 2012 - 11:35pm PT
Implants are normal to floss/live with.

If you get a bridge, what do you do with it if one of the teeth gets a cavity? The whole bridge (3 teeth) is affected. It happens a lot because bridges are a pain to floss under and get neglected. Plus, every time you drill a tooth, you chance killing the nerve and needing a root canal.
Why increase that risk to adjacent teeth with a bridge?

If you have no bone to put an implant in, or smoke, or have gum disease, not many dentists will jump at the chance to lower their 95% success rate record by putting an implant in that environment.

So then you could get a bridge with a very thin replacement tooth hanging between the other two so that you can clean/access the space between a lot easier. Makes it airy, almost can clean it out with your tongue, but it also would look funny if it is in a visible location.

Just some things to think about before you commit.

S.Leeper

Social climber
somewhere that doesnt have anything over 90'
Nov 28, 2012 - 12:12am PT
Thanks for your offer! I just liked you on facebook.

I just had dental implants in Mexico and I heard that Mexicans are coming to the states now because implants are becoming more affordable here.
Is that true?
Ken M

Mountain climber
Los Angeles, Ca
Nov 28, 2012 - 01:46am PT
Thanks, docs!

I've wondered over the years about waterpics....useful, or gimmick?
They seem to have stayed around.
Mighty Hiker

climber
Vancouver, B.C.
Nov 28, 2012 - 01:50am PT
What about the various mechanized toothbrushes? Do they work well? Who should use them?
nature

climber
Boulder, CO
Nov 28, 2012 - 01:53am PT
Ok. About once a year, a thread gets started by someone in need of dental advice

...raises guilty hand....
tooth

Trad climber
B.C.
Nov 28, 2012 - 01:55am PT
I give waterpiks away to invisalign/ortho patients along with the newest sonicare toothbrushes when they start treatment.

Sonicare toothbrushes are amazing. You just hold it still over each tooth for 5 seconds per side (3) and angle it up into the gums a few degrees when you brush the front or back. I have seen big improvements with patients in 6-12 months when they start brushing - either they weren't brushing before, or that toothbrush is actually working better than not. I think that a lot of people act like they are sawing their teeth off with regular toothbrushes which isn't effective, so learning to use a new toothbrush that works properly - even if they don't brush more times per day - can actually make a difference.


Using waterpiks are better than doing nothing, but if I could only use that or floss, floss would be the best choice.



I just met a guy who has used a chewed up stick his whole life to clean his teeth. I gave removed 4 of his back teeth, then gave him a toothbrush.
micronut

Trad climber
Topic Author's Reply - Nov 30, 2012 - 11:41am PT
Mr E. I like this little video. It pretty much sums up my feelings.

There are RARE times a bridge is a better option. Usually when gum disease has undermined the bone and cosmetically an implant would be impossible. But with good bone and gum grafting, we can usually move people towrds implants.

Also, implants will not become prone to recurrent decay. If you do a bridge, and in five years one of those prepared/abutment teeth holding the bridge in gets decay, you have a real situation. This can mean re-making a new bridge, or losing a tooth and making an even longer, more expensive, weaker bridge.

micronut

Trad climber
Topic Author's Reply - Nov 30, 2012 - 11:47am PT
Good answers by Tooth on all the above questions.

The key is effectively removing the soft, filmy plaque (teeming with bacteria) every 18-36 hors. That's all you gotta do, you just have to do it gently and thoroughly and effectively. You can do it with a nice regular soft toothbrush........no need for all the expensive tentacles and curb feelers on some of these things these days............and some good old fashioned floss. Its what I do and I get all that stuff for free.

But, if you have kinda low motivation or sensitive gums or build up plaque quickly or just want the best thing with the least dexterity and skill needed, the Sonicare is awesome. Get one. Use it. You'll get good grades from your pretty hygienist at your next visit.

But with the Sonicare, just let it do the work. Just hold it gently with your fingers. Hold it with three fingers if you are an OCD scrubber and already dealing with recession.
micronut

Trad climber
Topic Author's Reply - Nov 30, 2012 - 11:56am PT
Strangeday,

If its at all possible, make sure you have the bone graft placed when the tooth comes out. Especially if the tooth is difficult to extract, resulting in some destruction or removal of the socket wall. It's expensive, I know (My surgical extraction fee is $195.00 and the bone graft is $500.00) but you maintain the integrity of the site for a nice implant or possibly a bridge down the road. If not, that "hole" will resorb a good bit, not always, but 90% of the time 20%-60% bone volume reduction is expected according to some studies.

If the bone "goes away", you may not be an implant candidate down the road. Or, you might, but will need the bone grafting before the implant, which can actually cost quite a bit more due to the complexity of grafting a skinny ridge vs. just filling the hole at the time of extraction. My "ridge graft fee" can creep up into the $1000.00 range for a one hour appointment, with graft material, collagen matrix/membrane and screws to hold the graft in place.

Talk to your dentist/surgeon and let him know you really want the graft. If its a financial burden, let him know you believe in the graft but just can't do it. I often give away/pay for people's grafting if they are really in need and are genuinely unable to pay for it since I believe in it so strongly.

PAUL SOUZA

Trad climber
Central Valley, CA
Nov 30, 2012 - 03:31pm PT
+2145154512151212510 for Micronut!

He's worked on my grill a couple times. Class act.
John M

climber
Nov 30, 2012 - 04:11pm PT
Just wanted to say.. Tooth and a few other dentists have answered questions for people for years now on the taco.

thanks Micronut and Tooth and all of you other dentists. This is way cool.
Mighty Hiker

climber
Vancouver, B.C.
Nov 30, 2012 - 04:22pm PT
Yes, thanks to both our toothy friends!

Are there alternatives to the soniccare device to consider? If there are sub-types, is any one preferable to others?

Despite diligent flossing and brushing, I have to get my teeth professionally cleaned three or four times a year, and my dentist has suggested the sonic care.
darkmagus

Mountain climber
San Diego, CA
Nov 30, 2012 - 05:09pm PT
Thanks for your willingness to share your wealth of knowledge! That is a really cool thing to do. I'm thinking about doing the same kind of thing on here for my profession!
micronut

Trad climber
Topic Author's Reply - Nov 30, 2012 - 08:49pm PT
Thanks Yall, glad to help out a bit. This stuff is fun and easy for me. Like showin a newbie at the gym how to tie in. Its kinda second nature and fun to help.

Mighty Hiker,

Yeah, the others are pretty comparable in their ability to clean plaque. Honestly, plaque clings so loosely to the teeth you can get it off with little more than a light whisk and a spray of air sometimes. You can't remove tatar/calculus anyway, which is just mineralized plaque. The whole point is to use something you like so you'll use it.

The Sonicare cleans "Beyond the Bristles"...meaning it actually vibrates the plaque off at a micrioscopic ie: sonic level. It moves in a somewhat elliptical pattern and whisks off the plaque with the sonic frequency. You just have to get the bristles close, where the tooth meets the gum.

The others are just rotary. Meaning they spin or oscillate nicely, but the brsitles need to contact the plaque mass. I like the Braun and the Oral B as well. But if you're gonna shell out the coin for something with batteries, go with the sonic care. But ALWAYS GO SOFT or you'll be gettin gum grafts faster than Mark Hudon can jug a fixed line.
dirtbag

climber
Nov 30, 2012 - 08:57pm PT
"The tooth will set you free."
MisterE

Social climber
Nov 30, 2012 - 09:23pm PT
Thanks for the informative responses and video!

Umm, you guys do Grills?



J/K LOL!
Big Mike

Trad climber
BC
Nov 30, 2012 - 09:35pm PT
Thanks for this thread micronut! Do either of you guys deal with snoring or sleep apnea? My girlfriend has been bugging me to go to the local dentist and look into one of those mouth guard type deals..
tooth

Trad climber
B.C.
Nov 30, 2012 - 10:39pm PT
Yes, I treat sleep apnea patients. CPAP machine is the gold standard. In BC you have to get a physician to diagnose the disease first, then prescribe a sleep appliance which the dentist will make. We have to make sure it won't make TMD issues worse and do a lot of other things, but then it can be places and adjusted over a few weeks. People do love them and they can be used in conjunction with the CPAP machine.


Micronut, have you ever done rapid root extrusion on teeth that were barely in bone (with say 5mm of buccal bone loss) before extracting (over 6 weeks) and then done an immediate implant? Pulling down all that new bone until the gingival margins are in the right spot works great.


MisterE, my wife did gold veneers for a guy when she was in SoCal.
bluering

Trad climber
Santa Clara, CA
Nov 30, 2012 - 11:19pm PT
Wow! Nice gesture, Scott!

I have always had horrendous teeth since I was a boy. Gotten worse since. I think I have a good guy working on me now. We're doing a 5 year plan to get me back in shape.

Essentially, I need crowns across the rims. Almost all of them. Had 5 extractions too! Just too much decay and that f*#ks with bacteria getting into your heart, from what I hear.

I trust these guys. Fellow Italians. Paesanos. 'Infantino' is the practice.

One thing I hate about dentists is extractions!!! Madonna! I can handle drills and shots in the face, but yarding on a tooth is killer!
bob

climber
Dec 1, 2012 - 09:37am PT
" If everybody starts flossing, I'm outta work"

Well the dentist said it!

Flossing really changed my mouth. (that battery powered brush stepped it up a notch too!) Now I just have to deal with that old damage.......

Thank you Micronut and all you dental folk. I know where I'll make my next appointment.

Bob Jensen
Silver

Gym climber
Dec 1, 2012 - 09:59am PT
I just broke number 30 in half and had to have it pulled and grafted for the implant. Good news is you get the thing pulled and you have 9 months before you need to shell out the big bucks for the post and then you get another three months to save for the crown.

All in know is every time I open my mouth at the dentist it's a grand so micro yer 300 patients away from paying of that loan.

Thanks for the help thread.
rottingjohnny

Sport climber
mammoth lakes ca
Dec 1, 2012 - 10:54am PT
Tooth...A retired , old fart dentist mentioned that using baking soda was a good way to clean teeth..? What's your take on that...? Old wives tale..? RJ
locker

Social climber
Douchebag Central
Dec 1, 2012 - 10:56am PT


The baking soda idea isn't an "Old wives tale" that I am aware of...

Even my own Dentist has suggested it...

rottingjohnny

Sport climber
mammoth lakes ca
Dec 1, 2012 - 11:02am PT
Thanks locker...I'll get that credit card number to your secretary as soon as i dig it out of my wallet...RJ
locker

Social climber
Douchebag Central
Dec 1, 2012 - 11:24am PT

That'll be $165.00 total...

Giving you a discount for knowing the "Two finger salute"...



EDITED:

PS...

they even make toothpaste with Baking Soda already in it...
tooth

Trad climber
B.C.
Dec 1, 2012 - 11:28am PT
Baking soda is the additive in some toothpaste that is equivalent to the sand in sandpaper.

You need it on your toothbrush as badly as you need it on your floss.


In reality, just the physical disturbance of smooth floss between your teeth, or nylon bristles massaging between your teeth and just under your gums will do the trick.


Toothpaste helps with all sorts of things (it's big business - bigger than actual dentistry itself) but those things aren't needed if you just brush and floss.





I can recommend it just for the simple reason that it won't cause problems other than excessive abrasion on your enamel if you go overboard with it.
rottingjohnny

Sport climber
mammoth lakes ca
Dec 1, 2012 - 11:38am PT
Locker...You get the one finger salute for that excessive charge of 165...Thanks tooth ...that makes sense with the baking soda...less is better..RJ
locker

Social climber
Douchebag Central
Dec 1, 2012 - 11:45am PT


I am only following the medical pricing guidelines, Rotting...

The $165.00 for NOTHING, is standard...

Crimpergirl

Sport climber
Boulder, Colorado!
Dec 1, 2012 - 01:51pm PT
I think it's been implied, but I want to make sure I understand something about flossing.

Like so many products, there are now a zillion types of floss to chose from. Are they equivalent? Or are certain kinds better? Some of friggin' ropes...who can get those between their teeth? Or worse, how do they get the stuck rope out?
Crimpergirl

Sport climber
Boulder, Colorado!
Dec 1, 2012 - 01:51pm PT
Oh, and by reading this thread, I was prompted to get up and floss right now.

(wipes floss projectiles off screen)
Crimpergirl

Sport climber
Boulder, Colorado!
Dec 1, 2012 - 01:58pm PT
Okay, one more question...

I have a fizzy water problem (e.g., club soda). I have a penguin (love it!). So is this as bad as coke? Less bad? Benign?

Thanks for this thread. It's terrific!
micronut

Trad climber
Topic Author's Reply - Dec 1, 2012 - 02:11pm PT
Hi Crimper,

SO HERE GOES........THE DEFINITIVE FLOSSING POST.

Floss is floss really from a "does it work" perspective.

I like waxed because it feels a little more "grabby" in my mouth, and it tends not to shred. Un-waxed is totally fine too.

The thickness just depends on your contacts. If you have really tight contacts between the teeth, Glide (brand) is awesome. Gore tex if I'm not mistaken. Or some NASA type teflon, that stuff is super strong and absolutely will not shred.

If you have larger spaces, like pretty big, I like the "waxed dental tape". I use it in a couple spots, or I double up a regular strand to get in between where I have some slightly open contacts.

Day to day, I use floss picks. My wife buys the cheapo 100 pack and I floss while in my car. Theyre nice 'cause you don't have to get your fingers dirty and the dexterity required is far less than with fingers.

Lastly, there's a bit of an art to flossing that many people don't do. YOU GOTTA WRAP THE FLOSS BACK AND FORTH A BIT ON EACH SIDE OF THE CONTACT SO YOU COVER THE WHOLE SURFACE OF THE TOOTH. Ie: you need to think of it like you towel off your back. Teeth are convex. if you just snap it up and down, you aren't covering enough surface area to remove all he plaque. It doesn't take any longer. Just gotta do it with a little "wrapping" side to side. NO SAWING.

Remember...............

"You don't have to floss every tooth. Just the one's you want to keep."

micronut

Trad climber
Topic Author's Reply - Dec 1, 2012 - 02:26pm PT
Big Mike,

Sleep apnea is a real kiler and it messes with your other systems on a cellular level. Oxygen is your friend in a big way and the cumulative effect of hypoxia are a real issue for folks long term. See a sleep apnea specialist and start conservative. Then work toward more and more aggressive means. On the left side of the spectrum would be a dental appliance that oens/holds the lower jaw open and thus opens the airway a bit while you sleep. A major improvement for many people. The next step is a CPAP machine, then perhaps some combination of the two. On the far opposite end is surgery to open the airway and remove excess tissue that collapses on itself whle at rest. All of these can be great options.....BUT YOU NEED A GOOD DIAGNOSIS! A dentist is a great start......but somebdy who has training in sleep apnea and has been making appliances for quite a while and can tell you about his extra training and his success failures in treating apnic patients. Dental students do not learn enough about the art of treating sleep apnea in school.

A sleep study is the definitive way to get a diagnosis. You need to be measured for o2 intake and CO2 blow off. Over time. The numbers tell your story. How many episodes of "holding" breath....how long each episode, etc. Your skeleton and soft tissues of he airway also play a big role. So does neck diameter. Actually, there are great studies that show a direct correlation between neck diameter, weight, sleep apnea and sudden/premative death. Scary.


There's a great guy who is doing great things for people here in Fresno actually. If you really are BIG, Mike, PM me and I'll get you in to see him.

Lastly, sleep apnea stuff/treatment is often covered by medical, not dental. Cool eh?

Chinchen

climber
Way out there....
Dec 1, 2012 - 10:35pm PT
Where Can I find a great, FREE dintist? I need help.
MisterE

Social climber
Dec 1, 2012 - 11:01pm PT
Nobody's said "diastema" yet.

Tee Hee.
Ken M

Mountain climber
Los Angeles, Ca
Dec 4, 2012 - 12:32am PT
On the issue of Sleep Apnea:

I've treated many people with this, and have struggled with it as an issue when I was medical director of a group. Seemed like most everything was a waste of money.

It was accurately said that CPAP is the gold standard of treatment. It is also accurate that >90% that people who start on CPAP stop using it within 9 months.

It's as bad as flossing!

I think there are no great answers. When Niteguards help, that's great and simple.

I'm actually trying to put together a study on a novel approach: Use of Diamox. There is some evidence that it does change the numbers in studies, but not enough evidence to make recommendations. Wouldn't that be ironic?
JOEY.F

Gym climber
It's not rocket surgery
Dec 6, 2012 - 10:35pm PT
How's it going Tarbuster?
I am having all 4 quadrants surgically cleaned, on #2 now.
Effen painful, long overdue.
Question to the Docs.
Do you prescribe/advise a stool softener with the viks?
I know it's kinda gross, but, no one told me....
I have appreciated this thread Micronut and Tooth and your advice since you started it. Thank you.
Crimpergirl

Sport climber
Boulder, Colorado!
Dec 6, 2012 - 11:17pm PT
Okay, a question.

About 1.5 years ago, at the suggestion of my dentist, I had a crown put on my back, lower left molar. It didn't bother me at all, but she said it had a big crack. I thought I'd be a responsible adult and get it fixed before it became trouble.

(I won't do that again!)

After the temp crown was put on, it started hurting. I've had a cracked tooth before that needed a root canal and I know what that feels like. That is what this felt like. So I had to go off to the must surly dentist in Boulder to get the root canal.

After it's done, my tooth still hurts. I get the permanent crown. I tell my main dentist at that time it still hurts. And every time I've been to the dentist since, I tell her that my tooth still hurts. Every time she tells me it can't hurt because it's had a root canal. Frustrating.

Finally, on my own after the pain had worsened greatly, I went to a new guy to get him to look at it and redo the root canal (or what ever needed to be done). The tooth had become increasingly painful. I had to go out of town for 3 weeks in a row and didn't want to get caught on the road suffering. This is about 4-5 weeks ago.

He pokes, he squirts water, pushes air - all that good stuff and announces I have a "complex" case. The tooth I'd had a root canal on was pressure sensitive ("duh" I'm thinking! - I'd pay someone to pull it for the instant relief!). And he says the sensitively (I call it slobber sensitivity since everything makes it hurt) is the tooth in front.

He does a root canal on the tooth in front (he was good!). I think that is tooth 19.

Since them, the very back tooth still hurts and I still feel like it'd be great relief to have it pulled. And the tooth in front of #19 now hurts like a mo-fo: it is now slobber sensitive. Sigh.

Is there such a thing as a chain-reaction tooth sensitivity. I suppose I can go back and get yet another root canal on the tooth in front of #19, but will that make the next one hurt too? I feel the sensitivity all the way into my front left teeth. It is primarily cold sensitively, though wind hurts a lot too.

Would love your thoughts on this. Hope it makes sense.


Tarbuster

climber
right here, right now
Dec 6, 2012 - 11:57pm PT
Joey. F,
I'm following Tooth's lead on Dr. Jim Beck in Pueblo for a detailed workup on bruxism. This means more than sleep studies for apnea. Dr. Beck's wife told me they are no longer taking new patients and furthermore wouldn't do the workup on me without also doing the rest of the work I have slated. Interestingly, she said their 2 visit $1500 sleep and postural studies workup would produce records which may not be readable by another dentist and they're not interested in "teaching" my dentist how to follow suit with implementation according to the findings. Understood. I didn't ascertain the extent of said implementation beyond my need for multiple onlays and an implant. My dentist is a prosthodontist and farms out sleep studies to a lab but doesn't do any postural observance.

I asked Dr. Beck's office (his wife, who was quite helpful) for a referral in the Boulder Denver area for a dentist who does a similar postural workup (you may remember there was some mention by Tooth that a link to my long-term arm problems may be uncovered or elucidated somewhat by these postural studies: i.e. the Holy Grail of my musculoskeletal health issues). Meanwhile, it was suggested I look up dentists who belong to the American Academy of Craniofacial Pain (AACP) in my own area, which I have done and I'm meeting with one next Tuesday, who does some postural workup. Whether or not he'll do the level of detail on the postural side of things which Dr. Beck would do is something I have yet to determine.

Tooth: you following this?
I'll have some feedback next week.

(Good luck with that Callie)
micronut

Trad climber
Topic Author's Reply - Dec 7, 2012 - 12:24am PT
Callie,

Oh man, what a bummer. Nobody should have to go through that kind of scenario. It really sounds like you probably have a vertical root fracture on that tooth that is still hurting. We often cannot see these on radiographs but most of the teeth that I extract with suspicion of a vertical fracture end up having a visible crack I can see once the thing is out.

AND YOU BY ALL MEANS CAN HAVE PAIN associated with a root canal'd tooth. The microscopic ligaments that hold the tooth in place, the PDL, can transmit pain as the broken root "pumps" up and down. Even a hairline crack, like a crack in a windshield can do this. Happens all the time. No dentist should give up on somebody who says "this thing still hurts!".

The problem is, we don't have a fix for a tooth with a vertical root fracture. They usually need to be extracted, grafted, and restored with an implant, which if done right should be a smooth and fairly painless process that ends up in a tooth that lasts a lifetime.
micronut

Trad climber
Topic Author's Reply - Dec 7, 2012 - 12:31am PT
JOEY F.

"Vitamin V" can really beat up the stomach. If he Vicodin is really jamming you up, can you get by with just 800 ibuprofen/motrin/advil twice daily? If so that's your best bet. And rinsing with warm salt water thrice daily. The warmer the better. And some moist hot compress a few times a day if you are past the first 24 hrs, wherein I usually like ice on the jaw.

Tylenol III could be a better alternative for you if the Vico tears you up. Or Ultram. Its not quite as strong but really cuts the breakthrough pain down.

For the next quadrant. Take 800 ibuprofen 45 minute pre op. And hit the ice packs hard for the first 12 hrs post op. I rarely, rarely have patients need the heavy stuff if they follow the post op recommendations to the T.

Also, no real talkin or yappin or working out or jogging or nothin' for the first four hours. Moving the jaw and the surgical site around tends to get it all inflammed. Sleep elevated on a few pillows to let gravity help, and stick to really soft foods. Its a drag, I know, but saving them teeth is a major lifesaver for quality of life down the road. You'll be really glad you did it if you do your daily chores and brush and floss well from now on out.

Hope you feel better soon,

Dr. J
JOEY.F

Gym climber
It's not rocket surgery
Dec 7, 2012 - 01:20am PT
Yikes, The first round of meds wore off ouch....Thanks for the ice advice...Throb throb...Good luck tarbuster and crimpie...
tooth

Trad climber
B.C.
Dec 7, 2012 - 08:39am PT
Yes I'm following Tarbuster. I spent many trips learning from Dr. Beck, what he does won't be followed by just anyone. I've continued to study more about this area, but it isn't just drilling a hole and filling it in!



Crimpergirl, I can think of many reasons why that tooth started to hurt after... perhaps a 3D x-ray would show 1. if all 5(?) of the canals were filled 2. cracks 3. IA nerves/proximity to extruded sealer from the RCT which may hurt for a couple weeks 4.....etc Your local endodontists should be able to help you out.
Crimpergirl

Sport climber
Boulder, Colorado!
Dec 7, 2012 - 09:40am PT
Thanks to both of you.

The most frustrating part is being told repeatedly by many people that the tooth can't still hurt. Pisses me off as it's my tooth, in my head, and it hurts!

The information is very helpful!
jopay

climber
so.il
Dec 7, 2012 - 09:46am PT
Alright I have a few questions and just let me say I appreciate you dental professionals doing this. I'm 66 and still have all my wisdom teeth, over the years dentists have mentioned it being a good thing to have them removed, but I'm kinda of a "if it ain't broke don't fix it " kind of guy, and they were never any trouble.That is until about a year ago thatI began biting my cheek and of course once bitten the cycle starts, so my dentist says that I'm squeezing my cheek tissue between my lower wisdom tooth and the tooth above. The lower wisdom tooth is visible and actually used for chewing. So I made an appointment with an Oral Surgeon and he concurred with my dentist but wants to take the upper wisdom tooth on that side out as well and an extraction appointment is set, however after perusing the vast data on the Inter web it seems that older folks have more concern with this procedure as the roots are fully formed and some bone might have to be removed, yikes. Is it ever a possibility that they can't be removed due to attachment to the bone or jaw? There is even mention of harming ones jaw bone or some type of sinus area, is any of this an issue or am I just being too well read.
Tarbuster

climber
right here, right now
Dec 7, 2012 - 10:32am PT
Side note/question about anti-inflammatory and pain meds:

Last year I was being treated by a spine Dr. for herniated disc at C6 (clinically determined not the root cause of my particular long-term forearm issues) and was taking Gabapentin/Neurontin for nerve compression pain and also Diclofenac (said to be much stronger than ibuprofen) and their protocol was to include an antacid along with the Diclofenac. They are saying some micro-bleeding always occurs in the stomach with ANSAID use so they are recommending Ranitidine/Zantac as a prophylactic for that insult (reducing stomach acid in the presence of micro-bleeding).

Also had both hips resurfaced this year and the surgeon/hospital instituted the same program, prescribing Ranitidine along with OxyContin and Oxycodone/Vicodin. (And of course with those painkillers also laxatives, SENNA is a good one (sennosides 8.6 mg, simple vegetable extract).

Tooth, Micronut: are you perhaps familiar with the prophylactic use of acid reflux drugs for mid/longer-term use of anti-inflammatories and painkillers? I'm suspecting this has something to do with the longer-term use (i.e. 5 to 6 weeks following joint replacement), as distinct from dentistry wherein it's usually short-term use following the work, (i.e. acute pain).

Perhaps of interest, acute dental pain is just about the ONLY pain in which ibuprofen has been effective for me. It never does anything for chronic musculoskeletal issues in my case.

Thank you.

BTW & off-topic:
Here's a heads up dissuading the use of ibuprofen in a ROUTINE prophylactic capacity for sports related pain, these studies have been coming out for some time:
http://well.blogs.nytimes.com/2012/12/05/for-athletes-risks-from-ibuprofen-use/
tradmanclimbs

Ice climber
Pomfert VT
Dec 7, 2012 - 10:54am PT
50yrs old. Currently under employed carpenters helper. tooth in the back lower right sometimes but not always very heat/cold sensitive. how long can I put off dealing with this?
Spanky

Social climber
boulder co
Dec 7, 2012 - 01:13pm PT
Hey Micro,

Just wanted to say thanks for the advice.

cheers
TwistedCrank

climber
Dingleberry Gulch, Ideeho
Dec 7, 2012 - 02:26pm PT
My teeth are ok but I need to know why it hurts when I pee.
micronut

Trad climber
Topic Author's Reply - Dec 7, 2012 - 11:36pm PT
Tarbuster,
Thanks for the Ibuprofen article. Pretty good read. I'm not a big fan of chronic use of anything, including NSAIDS, especialy for athletes (I swam on the US team in the 90s) but if you are really suffering as an athlete for a season/phase of tear down, I've always told folks to mix it up with Aleve, Tylenol, Ibu..etc. Not sure this helps, but they are metabolized slightly differently and that might help a bit in my humble opinion. But yeah, long term anything is gonna get you somehow.

And your thoughts on antacid use with long term NSAIDS, interesting. I don't have much experience with that concept, because, as you alluded prior, my surgeries are usually pretty intense for only 3-5 days, and 800 ibu twice daily does wonders. Rarely do my patients take narcotics for more than a couple doses, if any. I believe this has to do with the fact that I tend to try and be really gentle with the tissues and a maniac about micro-suturing to "perfection". My assistants hate me because I dink around closing things up, making em look like stitching on an ArcTeryx Gamma SV.

I really wish you had a way to see my guy in Fresno who is really good with cases like yours. It's over my head and not in my specialty to deal with the dental scenario you're dealing with, but keep your chin up and let me know if you are ever in central California. I can get you in to see a real genius when it comes to dentitions like yours.
micronut

Trad climber
Topic Author's Reply - Dec 7, 2012 - 11:38pm PT
Spanky, you're welcome.

Twisted Crank, send Tooth a urine sample.
micronut

Trad climber
Topic Author's Reply - Dec 7, 2012 - 11:46pm PT
Tradman,

It depends on a lot of things. The most important is WHY are you having the sensitivity. If its a little bit of gum recession, and it isn't moving quickly, you may be fine for quite a while. Put it off too long and you might need an expensive gum graft.

If its decay, and it's moving toward your pulp, it can become a big dela quickly and you don't want to put it off unless you want to risk an expensive root canal, and crown, etc...

If its a microfracture in the tooth, same thing.

If its a bigger fracture (though you still won't be able to tell yourself, I'm not talking about a crack you can feel), it can be a real time bomb and you can end up with a costly extraction.

YOU NEED A GOOD DIAGNOSIS TO ANSWER THIS ONE CORRECTLY.

The bottom line is that all of dentistry is easy to fix when its a small deal (and costs accordingly, and that things almost always progress to bigger procedures and more expense. Its just the way it goes. Just like a car. That sensitivity is your "check engine" light. Ignore it, and the consequences tend to grow with time. I hope its a small fix, you just gotta get in there now and have it looked at. Its worth the couple hundred $ to have it looked at, diagnosed, and cost estimated. If you end up there on a Saturday with a jaw swollen up or a cracked tooth you'll kick yourself and your wallet will get dinged even harder.

Hope it works out,

Scott

Tarbuster

climber
right here, right now
Dec 7, 2012 - 11:51pm PT
Tooth, Micro!
You guys rock. This thread needs to be a "sticky", one that sits always at the top like on other forums.
...(OK, maybe on the side, but handy).

Floss the ones you want to keep.
JOEY.F

Gym climber
It's not rocket surgery
Dec 8, 2012 - 12:16am PT
Micro, your advice for ice was the bomb. Did that and pain/swelling went down and finally slept. Also, today did IB and rinse. Just a sore jaw now, nbd.
You and Tooth are the best and can't thank you enough.
A long time ago a dentist told me,"I'll trade you 2 flossings for 1 brushing"...
Thanks again.
tooth

Trad climber
B.C.
Dec 8, 2012 - 12:19am PT
Jopay,

I wouldn't worry much at all about an oral surgeon removing that top wisdom tooth. They will go over risks with you, but even if the roots of the tooth entered the sinus, (I've seen that a lot) you are at an oral surgeon's, they can more than handle that. They place 50mm implants through the sinus into the cheekbone (zygoma) and do other things to it more invasive than simply removing a couple root tips from under it.

So often what you see on the internet about anything is similar to two blind guys describing an elephant while one is hanging onto it's tail, and the other it's tusk.

Most of the wisdom teeth I remove are fully-formed teeth. Very rarely is it stuck to the bone, this week I did one that was, I cut up the tooth into pieces, removed the pieces from within the bone, and today the patient told me that the needle was the most he felt with the procedure.


Those things you mention are issues that can arise, but I haven't seen it with an errupted max wisdom tooth.


Tarbuster, I haven't had any experience with the drugs you are talking about - I was kinda surprised to find out that they don't have Vicodin in Canada - T3's is the strongest I have prescribed while up here, and most people don't even fill it out.



Tradman,

50 year old stick frame house. Sagging roof. You can't look in the attic or behind the drywall. How long can I leave it?

I guess I would have to know what your "leave it" means to you. "Leave it" before you lose the tooth? Before you need a filling? Before you need a root canal/crown? Before you need crown lengthening as well? Before you need an implant/denture? Before you need SuperSeal treatment or gingival grafting to cover the exposed cementum or dentin? Before it blows up with an abscess? Before the abscess rots the nerves in your bone and causes nerve damage?

Even if we knew any of the problems that could be causing these symptoms, we can't predict how fast the problem will progress with you -- everyone is so different. When my patient has a problem I can only recommend treatment, I can't recommend waiting at all because I see too many problems blow up overnight.

If your roof is sagging how do I know that it won't fall in tomorrow, or that it won't snow heavy tonight and then thaw tomorrow and start dripping inside?



TwistedCrank, if it hurts when you pee, urine trouble.




edit: this took me 6 hours before i posted, so I didn't see the last 6 posts or replies from Micronut. Best save the sample for him -- postage to Canada is too expensive and it would arrive as a solid right now.
Crimpergirl

Sport climber
Boulder, Colorado!
Dec 8, 2012 - 12:22am PT
Thanks again to both of you. Left message with excellent endodontist (did I spell that correctly? Spell check says no) today. We'll see what he says. Of course I called after hours. Doh!

Good luck to the others of you. Happily, I have insurance (marginal as it is - everything still costs a danged fortune) mine is in no way an emergency. Just a pain. Literally. :)
treez

Trad climber
99827
Dec 8, 2012 - 01:00am PT
Despite being otherwise incredibly attractive, I have 4 holes in my grill due to not enough baking soda in my diet.

My local clinic quoted me 43,000 dollars up front.

So my question is.....WTF!?!?!?!?!?

I get the part about owing money for college and being smarter than me and all.......but COME ON!
jopay

climber
so.il
Dec 8, 2012 - 07:09am PT
Thanks for the reply Tooth, so by your answer I'm assuming age at time of removal is not that big a deal,I did mention I'm 66, but I understand it's better to remove them when one is younger.
steveA

Trad climber
bedford,massachusetts
Dec 8, 2012 - 07:49am PT
Micronut,

It was very kind of you to start this thread.

I'm very lucky that my daughter-in-law is a skilled dentist, (graduated top in her class at UPENN).

I won't be bothering you with any questions.
tradmanclimbs

Ice climber
Pomfert VT
Dec 8, 2012 - 08:27am PT
thank you.
JOEY.F

Gym climber
It's not rocket surgery
Dec 28, 2012 - 07:14pm PT
Quadrant 3 done today, 1 more to go. The ice and IB work well. Thanks again Tooth and Micronut.
JOEY.F

Gym climber
It's not rocket surgery
Jan 14, 2013 - 08:30pm PT
#4 done! The doc was half way into it when he said I needed a bone graft. I wiggled my fingers (how much), he put it in gratis as he had leftover from a pt before me. How cool.
I guess it says something about being a long term patient with the same doc. Very lucky indeed to have the insurance too, very lucky.
(lots of great info up thread thanks to our resident dentists btw...)
mouse from merced

Trad climber
The finger of fate, my friends, is fickle.
Jan 14, 2013 - 09:31pm PT
Joey F, good show!
Credit: mouse from merced
Will all this improve your belay responses?

Massive :)!!!!

Phil_B

Social climber
Hercules, CA
Jan 29, 2013 - 10:35pm PT
Here's a question I haven't seen asked yet. I got a scaling and root planing last year. The dentist tried to talk me into a set of injected antibiotics too. I balked when I saw that they wanted me to pay about $100/tooth. Gah, I was getting two crowns at the same time so I told her no.

I researched it on the Net and it seemed that there is a little bit of controversy on it. Not all folks are convinced that it works.

Besides, I'm not really a fan of using antibiotics if I don't already have a bacterial infection.

After the procedures, I didn't notice anything and have concluded that it's another way for the office to make money. The dentist I was going to seemed to part of a larger corporation and not in her own office. Didn't know that going in.

So anyway, what do you guys think of antibiotic prophylaxis for root planing and scraping?
splitter

Trad climber
Cali Hodad, surfing the galactic plane ~:~
Mar 23, 2013 - 04:31pm PT
I probably should have followed the advice, "Pull them all out and be done with it, you'll save yourself a lot of money and pain." which was the opinion that prevailed among the old timer's during my youth in Cape Breton. Well, I got off to a good start in that direction, regardless.

My first toothache, and therefor dental visit, presented itself shortly before my 9th birthday. I woke up one morning and the first molar my on my lower left side was aching.

I had to wait for my father to get home from work, at which time he arranged an after hours appointment with a dentist. It was early evening when we arrived at his office. I recall him being an older guy, and he was extremely drunk. I climbed into the dental chair at which time he attempted to stand up from his office chair but almost hit the floor, but managed to sit back down. He never left that seat...thank God!

Long story short, he told my father where the pliers (what they looked like to me). He then told me to point to which tooth it was. Then he simply told my father to, "Yank the sum'bitch out", plain and simple. No novocaine, no nothing. My father made quick work of it. But all it really needed was a simple filling. It is still the only tooth missing on my lower jaw.

Okay, here is the real doosie! We lived in SLC, Utah when I was 13 through 15. I woke up one morning (when I was 14) with this ache in my gum just below the bottom of my nose. I immediately went into the bathroom and looked into the mirror. I didn't recognize myself. My face was swollen to the size of a volley ball. I was immediately taken to a dentist.

The dentist said that it was an abscess, and that he would have to do a root canal on one of my front teeth to release all of the fluid. I remember sitting in the chair and the dentist telling the nurse not to bother to prepare a novacaine injection because he feared that it would mix with the infection fluids causing the swelling and might go to my brain. She looked shocked. His response, "Don't worry, the pain will knock him out within the first minute." It didn't, never did.

It took him around 45-50 minutes to drill up through the whole length my right front tooth (follow the nerve root) to the gum/jawbone. I will never forget what the three (3) main drill bits looked like. of which he rotated back and forth with. There was a tiny one that had a high pitched whining noise. A medium sized one, and a particularly dreadful one that was the largest, was round, and had these little rectangular nobs protruding from it.

There is absolutely no words that can describe the hideous pain that I endured. Believe me, it was pure torture. I have, over the years, described the experience in more detail to doctors, dentist, etc, and they all responded the same way. One, it was malpractice, two it was torture. Well, if that (drilling through my right front tooth) wasn't torture, what he did next was.

After the drill bit, the big one with the bumps, popped through the end of my tooth into my gum/jaw bone and nothing happened (he was expecting all the fluid and puss to drain out, he instructed me to suck as hard as I could to help initiate it. As painful as it was to do so, I gave it all I had, but nothing happened. Man was he pissed.

He began pacing back and forth, telling me that I wasn't trying hard enough, etc! Finally, he told the nurse to bring back the drill bits, and he laid them back out on the tray in front of me. He said that he was going to take a 15 minute break and if I hadn't managed to get the fluid draining by sucking on that tooth as hard as I could, that he was going to drill through my left front tooth. Believe me, as painful as it was to do so with those three instruments of torture staring me in the face, I gave it all I had but nothing happened.

It took him another 45-50 minutes of constant drilling to, once again, drill all the way up through the center of that tooth to the gum/jaw. Pure torture. No pain medicine, not even an aspirin. The nurse and my mother put cold wash cloths on my head and looked like they were about to weep. At first, the dentist instructed them to hold me down, but they didn't need to because I was holding onto the chair with all of my strength and every muscle in my body was contracted, that's about all I could do.

When he finished the second tooth, and nothing happened, once again he paced back and forth, looking very frustrated. Suddenly he stopped, looked as if a light had come on/something had dawned on him and he walks over and lifts up my top lip. I wonder what he thought, felt like when he saw the dark blue abscess that was at the top of my inner lip/gum just below the nose. All I could see in his face was a slight trace of disgust.

He then took out a small scapal and simply lanced/poked it and everything came gushing out. That's all he had to do in the first place, simply lance it, a relatively painless procedure which would have also saved me from later losing my two front teeth.

He then, once again without any novacaine or pain meds, inserted and sutured into place a 6 inch section of surgical tubing so any of the remaining fluid would continue to drain. He didn't bather to fill the two front teeth for the same reason. He sent me home with zero pain med's, not even any antibiotics/prescriptions. I thought that was rather odd, since it was an infection.

I remember being curled up on the living room couch in a fetal position for two days and two nights, in horrible pain and not being to sleep. I couldn't breath through my nostrils because they were swollen shut. And I couldn't close my mouth because of the tube protruding from it. With each breath this searing pain shot through my head.

On the third day my aunt and uncle arrived from California on there summer vacation. Just a few minutes after they arrived I heard her exclaim, "Poor boy." and she dug through her purse and gave me a pill. Not sure what it was, but it knocked me out and I awoke a day or so later and the pain seemed to be only half as bad.

To be continued (you won't believe what happened to me about 15 years later)...
tooth

Trad climber
B.C.
Mar 23, 2013 - 08:11pm PT
Phil B.

Micronut is a periodontist so this area is his specialty.



I provide my hygienists the tool Arrestin, the antibiotic at $100/ tooth. Works wonders on stubborn areas that won't heal up to 2-3mm pockets. We also use lasers, scaling, root planing, and all other tools that we can find. I've seen many patients who we have helped stop perio dz and get to a stable, healthy state using a lot of tools. I also read research a lot and have read research showing that almost every single procedure I do is ineffective. Yet people's bodies heal when they start taking care of themselves after we help educate and then treat them.




If all you have is a hammer, every problem looks like a nail.


When you get 4 dentists in a room, you will have 5 strong opinions on what to do.




What I tell my patients is that there are lots of options. Let's educate you on what is going on in your mouth, then choose the best solution/plan. Next, we find the guys who do those procedures the best. Everything can work to a degree, but some guys try ortho (braces) and don't succeed at first, then never do it. Others keep doing it and study it, figure it out, and then excel at it. I refer my patients to the best guy for their best treatment option.


I can do a study here that shows that mini implants suck. They fall out. Our oral surgeons hate them because all they do is remove them. They have this opinion because only one guy around does them. And doesn't do them well. I know another who does do them excellently and has followed up on everything and hasn't lost more than 1% over 14 years.


So pick the treatment you want, and get the right guy for the job. No dentist can specialize in even a tenth of the stuff that is out there now, it's just too much.



Oh, and antibiotics before prophy, etc? If it is 2g Amoxicillin, research is showing more and more that the systemic pill therapy isn't doing much for people. Doctors just do it to cover their butts because as we all know, medicine is primarily driven by legal precedent in the US, not by research. Dentistry is beginning to get there thanks to lawyers. To your detriment.
tooth

Trad climber
B.C.
Mar 29, 2013 - 12:29am PT
So what's the rest of the story Splitter?
splitter

Trad climber
Cali Hodad, surfing the galactic plane ~:~
Mar 29, 2013 - 11:57am PT
So what's the rest of the story Splitter?
I've been kind of regretting even posting the first one, and I didn't want to trash this positive & well meaning thread with another one of my epic downer, this kind of sh#t only happens to dirtbags, stories. But, since ya requested it...

I was pounding nails on the South Shore (Tahoe) one summer ('79) and managed to f'up my lower back up pretty good. I ended up in the Truckee Hospital. The doc put me in traction, etc. and I was in there for 18 days and counting (they didn't seem to know how much longer i was gonna need to stay). But that was about as long as I could handle it, so I just up and split one day.

I was still in pretty bad shape, with very little money, so when I finally arrived at my brothers place in San Diego (he let me recoup there) I was broke. The hospital bill was waiting for me, since I had gave his address as a 'permanent address'. You can imagine what that looked like (don't recall the exact amount) so I applied for Medical, and received it, which covered the cost.

Medical, at the time, also covered dental and I had one small cavity that I had detected so I decided to get that taken care of (i was okay'ed for around 3 months of Medical). So I randomly pick this dentist out of the San Diego phone book. And I went in. To save time I will inform you now, it took six (6) different visits too 6 different dentists to get that one small cavity fixed.

They all followed the exact same system/procedure. I would go in, be placed in a dental chair and a full set of x-rays would be taken by a tech/nurse (or whomever) then they would pack my mouth/gums with gauze and the dentist would come in and administer the shots. Probably fairly standard.

I recall, a couple of times trying to explain what tooth I was in there for, but was usually cut short by the nurse/tech and reassured that the dentist would see what needed to be fixed. And by then, my whole mouth was so numb, I could only mumble anyway.

Every one of them pretty much followed the same procedure once they began work also. Long story short, they would remove every filling in my mouth, drill the underlying surface (supposedly cleaning away any new decay) and then refill or cap (when necessary) each tooth. My mouth was so numb, I couldn't tell if he had fixed the one I had initially went in for or not. The first five (5) didn't. I finally got the 6th dentists attention, after he had supposedly finished.

I told him that he missed one, and tried to show him by running my tongue over my lower left teeth. He didn't even look (my tongue and lips were so numb, I couldn't really tell where I was sticking my tongue, but it was in the general direction of the cavity). All he said was, "How did you know there was a cavity there?" HE obviously knew there was a small cavity there! And therefore, imo, all of the dentist I had visited probably new there was a cavity there also. I have NO clue why they didn't fix it...'nip it in the bud' (so to speak). So he fixes it without even looking at the x-ray, he knew it was there. The point is, I would have only gone to one dentist, the first one, had that one fixed it.

They were ignoring the x-rays they took. Because I had just had every one of them fixed. I kid you not, they were drilling teeth that had NO decay, and refilling them. And, for some reason that I have no clue of, they were skipping this small cavity that was on my lower left side.

I mean, I picked six random dentist. I don't recall why I never went back to any of first five to get that one fixed that they missed, I guess I figured if they had missed it, the weren't worth going back too. I had no idea that they were drilling down my teeth and getting closer and closer to the nerve root each time. I just figured that the prior dentist had missed something, and they were getting or fixing it.

I know that when a significant amount of time goes by (5-10 years, perhaps) decay could often build up under one or more of my fillings and they would remove them and clean them up (remove the decay) and refill them, particularly if it was a capped tooth. But, I had gone to each of these dentist within this three month period that I had the MediCal, not enough time for decay to build. I simply figured that the prior dentist had perhaps missed or skipped something and they were getting what they missed.

I'm not sure what else they did, perhaps drilled teeth that had no decay or fillings to begin with, I don't really know. But, about 1-2 years later, the sh#t really hit the fan.

I recall seeing headlines announcing a, "Big crackdown on MediCal fraud." I thought, since I had gone to six dentist, that perhaps I was guilty of abusing the system. I was ready to fight it, because I had only wanted to get that one tooth fixed.

I left my brothers house and had returned to the eastside for the winter of '81/'82. And my brother sent me this 800 # with a woman/caseworker's name. He said that she was trying to contact me. She called a bunch of times over a 1-2 year period. I never called back because I figured that they wanted to prosecute me for fraud or whatever, I never called her back. So, eventually she stops calling (but I kept her name and # in my wallet).

Then, one morning around '85/'86 I see this breaking news story; "Judge decides to award the full amount of $250K to each patient." (from each doctor/dentist that the medical fraud had been brought against).

Those who had been awarded the malpractice in connection with the fraud were going to be awarded somewhere between 25K-250K for each one (doctor, dentist who had been guilty of fraud / malpractice). The Judge decided to award the claimants (which I would have been one had I called her back) the full $250,000.00 each per fraud case.

I couldn't believe it. I dug the 800# out and managed to get a hold of her. She said I would have been one of their star witnesses, and would have collected 250K from each of the doctors! BTW, I eventually ended up either loosing, or needing root canals on all of those teeth (sooner than later).

I would have been a millionaire and then some, $1,500,000.00! I would have bought property. My damn goal was to buy a, "two story log cabin with a view of the White Mountains in one direction, and Mt Tom in the other" that I mentioned on another thread recently.

Oh well.

EDIT: I left out one part that was particularly abusive or at least negligent (in my opinion). One of those dentist left me on laughing gas (the only dentist that put me on it) and sitting in the chair waiting for him, from 2:30 (when i began my visit) to 6:30 (when he finally finished). I sat there, (under anesthesia/laughing gas) until 5:30 (3 hours) waiting for him.

I recall requesting (before i was put under) Fleetwood Macs album Rumors to listen too on the headset, when they gave me a choice of music. I new that album by heart, since my roommate had it and I listened to it all the time. I counted all the times I listened to each side as it played over and over as I sat there that 3 hours high on the gas waiting for the dentist. I new something wasn't right, but you are powerless to respond.

After he finished the majority of the work, he took me off the gas but I was still as high as when I was on it. I could hear him yelling at me, "WHAT IS THE MATTER WITH YOU? I TOOK YOU OFF THE GAS (that was a BIG surprise to me, i was feeling exactly the same as when i was on it) YOU BIT DOWN TO DAMN HARD AGAIN AND YOU CRUMBLED ALL OF THE FILLING. NOW I'M GOING TO HAVE TO DO IT AGAIN (rebuild it)." I could tell he was really pissed, but I had zero control. I was supposed to gently bite down on the carbon paper that would leave a mark of the high points on the filling. I was still so f*#ked up that I couldn't tell if I was biting or not.

He finally let me go, and I had to sit out in the parking lot until after 10:30 PM (over 4 hours) before I got the nerve to drive home. It was like I was drunk. I am amazed that I didn't crash or something. I took all side streets so I wouldn't get ticketed. It was around 5-6 miles to my house. I recall being kind of dingy for at least a week. And felt some effects of it for months afterwards.
splitter

Trad climber
Cali Hodad, surfing the galactic plane ~:~
Mar 30, 2013 - 11:10am PT
Tooth -- What's up, no comment?

I didn't get any feedback on my 1st post, and like I said, had some reservations in regards to following it up with a 2nd post. You requested it, so I complied. So, I was hoping for the same courtesy from you, but it's not necessary (particularly, if you don't feel compelled to do so). i was mainly sharing (and perhaps venting a little).

I haven't read any of this thread, just the OP. It probably would have been more appropriate for me to post on the other medical thread "What's wrong with Medicare?" (or whatever it's called). I posted my opinion & experiences there in regards to Medicare since I worked in the field for close to 20 years as an OTR, hence I treated & billed Medicare patients, many who were Medi/Medi (MediCare/MediCal) and I'm very familiar with that system and why, imo, it has been shot to hell (simply put).

And, I had actually "randomly picked" seven (7) dentist (not just 6). I left out the first dentist in my story, because I think they let him slide because he did the initial treatment, in which the teeth probably did need the work done.

I am not certain what the whole picture was, what exactly they had defrauded the government on and precisely how they victimized me since I only had a brief conversation with her on the telephone.

I didn't mean to malign your profession, and certainly not you guys in particular, but just wanted to say that I feel the system was defrauded, raped and abused for many years by the people (doctors/md's & dentist) who should have respected it most...and now it is no longer there for those who are in desperate need of it (disabled/elderly, etc).

I am well aware of the need for such services as MediCal (dental) and it is no longer available (at least not in Cali). And I am all for taking trips to faraway places and offering your services (KUDOS), I did the same at one time with mine (as an OTR, upper extremity wound care, burn care, splinting, therapy, neuro, blah, blah, etc in conjunction with Orthopods, Neurologist, MD's in general, etc) and perhaps I will again, God willing. In other words, I'm all for it, because its a big and hurting world we live in.

But there are people here in America that have teeth that are aching just as much, a toothache is a toothache, eh? And poverty is poverty. Maybe you excepted Medical patients when it was available. Not sure, but I would have looked at it as a service to the needy (with at least partial reimbursment/nominal coverage), much like a trip to Tim-buk-too (or wherever) minus the photo op, albeit. ;)

Well ... rant over!

BTW, a friend/acquaintance of mine is a dentist and is a great guy (haven't seen him in years, though). He did the FA of the Chinese Water Torture Route on El Cap Route, while a student at Loma Linda University Dental School, Darrel Teske, perhaps you know of him!

And, thanks for this thread Micronut, although I haven't read any of it, I suspect it has been & will be a beneficial addition to ST.

edit: Like I have said elsewhere, I worked & had health coverage for many years (up till '03) including dental. So, I've seen both sides of the coin (fwiw). ...wudevah!
tooth

Trad climber
B.C.
Mar 31, 2013 - 06:47pm PT
Sorry. I was climbing. Back from the weekend. I'll read your rant. But I did read and your stories already. Sorry to hear, but entertaining. I'm always interested in stories of people who end up with dental treatment that they later question. I hear a lot of patients tell stories like this, and usually they have complex situations that they don't understand. I don't want to be the next bad guy on their list, so I really slow down and do the most urgent treatment first and spend as much time as possible educating them. Sometimes they still don't get it. I can't figure out why you went to a third dentist... and on to a 7th! (this happens quite a bit) - and have t heard or even seen (in the books of practices I bought) fraud like you described. Incredible. How did you hit 6 of them in a row like that? Were they advertising to MediCal patients in the yellow pages?

Oh, and for the mission dentistry, I know of over $100,000 of free dentistry given to people in town last year. People who not only need it, but value it. I have a hard time with people who don't want to pay their $8 co-pay but have two Starbucks in their hands at the front desk. There are those who alternate cleanings with their family who get a little help every other visit once I find out. Or the guys who walk 1.5 hrs across town and make it on time , no car or bus money, and do one filling a year( which essentially accomplishes nothing when you have 15 cavities). They get everything done so that what they can pay for will keep them from needing anything but a cleaning every 6 months.
I do stuff overseas because I get requests from there. It also helps locally by bringing other health care professionals and inspiring them to do more than sit on a beach in Mexico on their days off. I can't do half a million of free work a year, but a group of us can. Sometimes it just takes a new experience to get others into it as well.

We don't have the same mediCal system that I used to work with In SoCal. Makes it better for both parties.
mark miller

Social climber
Reno
Mar 31, 2013 - 08:02pm PT
Yo micronut,
being as you are the only one in this area of the country that has knott operated on me in the last 36 years, maybe we should get together and write a history of procedures and practices over the years. I was involved in a construction accident where the elevator crushed through my jaw half way through my skull and the rebuilding technologies of the 70's on ward, it's been a slice of life.
I can only hope that no one else gets to experience. Fortunately now they keep me on PTSD medications and I get through it day by day.
Maybe we can even climb and have a brew....
micronut

Trad climber
Topic Author's Reply - Apr 11, 2013 - 11:11am PT
Sorry everyone, haven't tended to this thread lately. I'll look upthread and try to answer the recent questions as soon as I have time.

Phil B.
Good question. Things like Arestin and other antibiotics that are "shoved/injected" under the gumline have a place in dentistry, but honestly I don't use them much at all, and I'm a gum specialist. The reason is this.

1. Even if you "kill" all the bacteria in the mouth lets say, on a monday, several days later the majority of them are back within 40 days. The body tends to re-populate, just like in the gut. There is a natural "flora" that is established and maintained. You take an antibiotic to reduce specific types of bacteria, and those "under the gum" antibiotics are good in killing some of the more potent "bad" players, but there are limitations to how long and how thorough.

2. The dose of Doxycycline is often really low, and the ability of the medication to stay below the gumline for very long is an issue.

3. There is a positive hydrostatic pressure under the gumline that "percolates" fluid called gingival crevicular fluid, up from down inside the pocket. when you inject down into the pocket, there is a tendency for the medication to just "float" back up to the top and out.

4. If there is something down deep under the gumline trapping bacteria...a big old filling, a crack, a furcation.....or tartar/calculus, you have to go get it and fix it. Putting antibiotics down there is just putting lipstick on a pig.

So, in isolated cases, where the deep scaling and root planing hasn't worked all that well, but the patient cannot afford surgery or the disease isn't deep enough to warrant surgery, I use it sparingly in the deeper sites. I charge about 40$per site, just to cover my costs. And I see pretty nice tissue results.

But many dentists use it as a sales pitch and to make money. You have to look out for those guys.

Good luck. AND FLOSS EVERY DAY!

Scott
Crimpergirl

Sport climber
Boulder, Colorado!
Apr 16, 2013 - 01:36pm PT
Micronut:

Thought I'd follow up regarding my earlier tooth questions in case you were interested.

Recap: Tooth 20 (lower, left all the way back molar) was cracked so the dentist recommended a crown.

I started the procedure for a crown. A couple days later, the tooth is killing in a way I know means it needs a root canal. I get the root canal.

Dang thing never quit hurting though everyone kept telling me I couldn't feel it (which angered me).

Whined about it for almost two years. Finally, days before I left for a 3 week out of town trip, my lower left jaw really started hurting like I need a root canal. I went to a new endodontist and he thought the problem could be #19. I got a root canal on it.

That was Nov. A few days into my trip, a good part of the partial filling comes out. Boo.

Get back to town, get the crown. Nothing much had changed. Oddly though #20 was feeling better. But #19? Felt like I want to pull #19. Throbbed. Woke me up at night.

I didn't make another trip to the dentist as I was tired of all the trips and being told all was well and that I couldn't feel the tooth since I'd had a root canal.

Hit the dentist a few weeks ago for a standard cleaning. They ask how all is. I tell them the same thing that I'd been saying for three years: my lower left jaw hurts and I want to pull my tooth. Also inform that I can no longer close my mouth properly and that #19 feels like it's lifting out of my jaw during the night. Thought I sounded like a crazy person.

They take a new x-ray and comment on such change in less that four months. Infection. Bone loss. Tooth Reabsorption. (I thought only cats got tooth reabsorption!)

So I'm in bed right now with a seriously swollen face after #19 had to be cut out yesterday. Got a bone graft and stitches and other fun stuff that accompanies all that.

While my mouth is throbbing a bit, I can say that the feeling that I want my tooth pulled has gone away which I'm very thankful for. I am a hillbilly now and will remain that way until I get the implant in 6 months or so.

I brought the tooth pieces home. They are gruesome! There are three pieces: crown, and each root. Figure I'll mount them as jewelry as the little devil cost me 5k total.

micronut

Trad climber
Topic Author's Reply - Apr 16, 2013 - 02:17pm PT
Callie,

WHat a drag. I'm so sorry you had to go through all that. Not just the dentistry, but the feeling that you were hurting and nobody was listening. In my opinion, without x-rays or other diagnostics, this is what happened.

1. The tooth was indeed cracked, not just up around the crown, but down deep, vertically along the root.

2. The dentist could not see the fracture because they are often hairline and not in the visible plane of the x-ray beam, being a 2D image of a 3D situation.

3. Though you had a root canal, it never felt right, and even hurt, because the periodontal ligament still has pain and "feeling" fibers, and bacteria can re-infect the site slowly along the fracture line, like a mini highway for bacteria.

4. I ALWAYS suspect a vertical root fracture if somebody has lingering, persistent pain after dental treatment that does not go away and "feels just not quite right."

5. The x-ray finally showed some darkness after the thing finally "blew up" and bacteria and abscess and resorption caused significant bone loss.

6. I may have recommended extraction of that thing long ago, right off the bat, and replacement with an implant, since they are so predictable, good looking, and definitive, but no need for me to Monday morning quarterback here. The thing is, they should have listenedwhen you siad it wasn't right.

7. You might be a hillbilly for a while while the bone graft repairs and an implant integrates, so I'd recommend some Daisy Dukes, pigtails and paint on freckles. Go for the Farmer's Daughter look, you could pull it off.

Say hi to Dave and I hope your episode with this tooth is soon over. E-mail me if you ever have any other issues, and maybe consider another dentist if you have lost some trust with him. Or talk to him and tell him how you feel. Maybe this one was just one of those tough to diagnose situations.

Scott
Don Paul

Big Wall climber
Colombia, South America
Apr 16, 2013 - 02:18pm PT
I just had a molar pulled out last Thursday. (in Colombia) Cost nothing at all, just like medical care. Dentist gave me something called diclofenaco, to reduce inflamation and pain. Three 3 ml doses. In Colombia they just give you the syringe and you have to find someone to inject it. Do you have any friends who can inject this? he asks. Not sure if they really want to, can I inject myself? He looks at me funny then agrees, so I get a handful of syringes and ampules, but pretty quickly find a friend who's injected lots of cows on the family farm. Problem solved. That drug worked great, by the way. No narcotic effects and really did eliminate the pain.
Crimpergirl

Sport climber
Boulder, Colorado!
Apr 16, 2013 - 03:11pm PT
Thanks Scott - you did indeed call the vertical fracture and need to extract a while back. BTW, I mentioned this possibility to my dentist after you mentioned it but she did not flinch.

Weird thing is that she didn't even recognize the infection/bone loss/reabsorption from the x-ray. Rather she had someone else look at it. I find that a bit scary. I would think even and "ordinary" dentist would know what that looks like. Maybe time for a new regular dentist.

So happy to have that pest out of my head!

The swelling is absolutely spectacular! I look like elephant man. Hope that goes away soon. I have to teach tonight so I'll be scaring people on public transportation and in the classroom. :)
micronut

Trad climber
Topic Author's Reply - Apr 16, 2013 - 03:16pm PT
Don Paul,
That stuff is made for getting rid of Tapeworms! Stop it now!

Just joking. Its Diclofenac, a fairly effective NSAID, like Motrin, Ibuprofen or Aleve. I think you might get better pain relief from 800 mg of Advil, Motrin or Ibuprofen in tablet form....and you don't have to have a buddy inject you. Which is probably kind of fun for your friends though. I don't want to rob them of the experience, but you may not even need it if you do some warm salt water rinses and keep ice on it for a couple days. Good luck.

Vaya Con Dios!

Scott
dirt claud

Social climber
san diego,ca
Apr 16, 2013 - 03:17pm PT
Hope you get better Crimpie. Thanks for this thread Scott, just noticed it. Very cool of you too offer this to the taco tribe. Now, if we could get a lawyer and physician on here who gives free advice we would be set,lol :-)
Crimpergirl

Sport climber
Boulder, Colorado!
Apr 16, 2013 - 03:22pm PT
Haha! I totally took the tapeworm hook. Good one!
Don Paul

Big Wall climber
Colombia, South America
Apr 16, 2013 - 03:36pm PT
Thanks Scott - Im fine but its cool you're helping people out like that. If I had a tapeworm I would probably leave it alone since its always so hard to lose weight.

All that's left now is to cut out the sutures after a week, scissors will probably work fine and I wont need a cattle rancher, just a paper pusher of which there are many around here.
skywalker

climber
May 9, 2013 - 05:58pm PT
Hi Micronut/ Scott

I just went to the dentist for a tooth I broke a couple days ago. Let me premise that it had a root canal 20 yrs ago and has been slowly ground to a pulp (no pun intended). Its the far back lower molar. The dentist gave me several options two of which require bone removal to make room to fix. The other was simply removing it and that its not that bad because its the 1st molar.

It was interesting that he noticed my bite was not correct and there was some discussion about me breaking and dislocating my jaw (break at the joint) 20 years ago. He didn't tell me what decision to make but hinted that due to lack of space in the back and an incorrect bite that it maybe better to correct the bite and cut my losses.

I had it pulled (not pretty for me) today. Afterward he said I was better off without it. I'm scheduled for a full evaluation in a month. Its the first time I saw this guy but he was super confident in his abilities and seemed like my super hero in this problem.

So....might I be better to call it good and rather than an implant in that small space and the bone restructuring required, use the effort to correct the bite and move on. I'm 40 by the way with a full set of teeth otherwise.

Thanks for offering! I felt he wanted to give me my options but wanted me to decide and I would like advice as a non patient. I know it all depends but any thoughts would help moving forward.

S.../Dan
Sewellymon

climber
.....in a single wide......
Jun 12, 2013 - 11:51pm PT
Hi Scott,

Having crowns put on 6-12. Sleep grinding when younger = my 56 year old teeth are ready. Plus me a businessman professional so need a nice smile.

My dentist went for the “rapid treatment” timeline. 2 sessions a week for 3 weeks = molds are now made so now just awaiting the permanent crowns.

So here is my Q's? Was this too aggressive? 2 – 3 hours in the chair for 6 sessions in 3 weeks? Lot of Novocaine, too. Am asking because I also have come down with a raging ear infection that likely is no correlation to the treatment other than maybe my immune system beat up from the shots and drilling?

And for that matter, are placements of the cords used in making mold supposed to hurt like a mutherf*kr?
climbski2

Mountain climber
Anchorage AK, Reno NV
Jun 13, 2013 - 12:29am PT
I think Micronut is on ElCap at the moment. Or perhaps just getting down.
micronut

Trad climber
Fresno/Clovis, ca
Topic Author's Reply - Apr 18, 2014 - 02:30pm PT
Skywalker and Swellymoon. I just checked this thread for the first time in almost a year. It kinda fell off my radar.
micronut

Trad climber
Fresno/Clovis, ca
Topic Author's Reply - Apr 18, 2014 - 02:37pm PT
Skywalker. How you doing with that molar gone? If it really is a "first molar", which means it is the closest molar to the front...2nd molars are behind that and 3rd are your wisdom teeth.....you should look into a replacement.

If it is indeed your first molar you probably really want to look into replacement with a dental implant. The first molars are somewhat the cornerstone of the back teeth and it really helps long term to avoid other issues with your bite down the road if you have a good first molar. Especially if you have a history of issues with your occlusion, you may want to consider a consultation for an implant. They are wonderful and very predictable and typically less painful than the extraction. Have a surgeon do it, not a general dentist who also "does implants."

Let me know if I can help in any other way.

Scott

micronut

Trad climber
Fresno/Clovis, ca
Topic Author's Reply - Apr 18, 2014 - 02:39pm PT
Swellymoon. How is that work in the upper front teeth holding up?
Messages 1 - 112 of total 112 in this topic
Return to Forum List
Post a Reply
 
Our Guidebooks
Check 'em out!
SuperTopo Guidebooks


Try a free sample topo!

 
SuperTopo on the Web

Review Categories
Recent Route Beta
Recent Gear Reviews