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

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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

http://www.jettperio.com/

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!

this just in

climber

north fork

Nov 27, 2012 - 02:01pm PT

I heard this was how micro looked before he became a dentist :-)
Cool of you Micro.

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?

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

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

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.

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.

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

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.

[Click to View YouTube Video]

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

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

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

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

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

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. :)

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!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

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?

JOEY.F

Gym climber

It's not rocket surgery

Aug 21, 2014 - 09:34pm PT

Don't leave us Micro!!
Thanks again.

Reilly

Mountain climber

The Other Monrovia- CA

Aug 21, 2014 - 10:04pm PT

Micronut, my wife has about half a Grand Cherokee SRT in implants in her mouth.
Can I use her mouth as a down payment?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Aug 21, 2014 - 10:07pm PT

How many miles on it Reilly?

GDavis

Social climber

SOL CAL

Aug 21, 2014 - 10:17pm PT

at 3-4k an implant, for those of us on a time and dollar budget who maybe had wisdom teeth come in... thoughts? I've been needing to take care of those but considering my car cost 1/8th as much I'm wondering how the heck I can come up with that?

Any Mexican doppelgangers?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Aug 21, 2014 - 10:35pm PT

Greg are you missing a tooth or have a bad tooth? And where?

GDavis

Social climber

SOL CAL

Aug 21, 2014 - 10:42pm PT

A pair in the back, my wisdom teeth. Kinda falling apart : / too much... rock climbing?

JOEY.F

Gym climber

It's not rocket surgery

Jan 12, 2015 - 08:15pm PT

I'm only resurrecting this to say that the doc can't call in you pain meds to a pharmacy to be waiting for you after your procedure. In California, at least, you have to take the script in yourself to get it filled.
I was unpleasantly surprised at this after today's semi-epic day in the chair, but all is well.
Also, thanks again Micronut for all your good info.

wayne w

Trad climber

the nw

Jan 12, 2015 - 08:42pm PT

G Davis,

A friend recently had a lot of dental work done in Costa Rica, at a clinic with a very high standards. The total was a mere fraction of what the cost would have been here.

PM me if you want the info.

Gnome Ofthe Diabase

climber

Out Of Bed

Jan 12, 2015 - 09:08pm PT

Okay, I'll bite, my dentil hygiene went completely off the rails after spinal surgery.

In need of periodontal deep cleaning I sat in the chair of mid evil torturous invention five out of ten planned times at a cost that sent us into debt.

I was very embarrassed to take a year to pay off the debt. I had both side top back molars yanked then.

in hind sight a mistake not to have tried to use the tooth tops to create implants ?

and now the next in line are both very loose. the upper right is fully rotted below,
at the root/gum line juncture.

I live, run-out, on the edge of a dentil emergency with no pro in. Fully committed in the splatt zone.!

Insight and fear of the costs, have me in a holding pattern, while I wait for some sort of insurance or for death and salvation .

been told that they can use the old tooth that is good ?
except for the gum receding and loose ness I have little pain, some cold sensitivety.

Getting long in the tooth sucks , truth.

SC seagoat

Trad climber

Santa Cruz, or In What Time Zone Am I?

Mar 13, 2015 - 12:51pm PT

uh oh. Had crown prep a week ago and the last few days it's been hurting...not much...but more like I "feel" the tooth...slight pressure feeling. Called dentist...he thinks I may end up needing a root canal. I've never had one and almost faint at the thought of it but I also know this crown prep doesn't feel like any other crown prep I've had.
I'm scared shitless to tell you the truth. Crowns I can deal with...but root canal?????

Any words of wisdom since I don't have them either.

Scared in Santa Cruz

Susan

Ricky D

Trad climber

Sierra Westside

Mar 13, 2015 - 04:13pm PT

Root Canal - two words that strike fear in the hearts of men and women.

Followed closely by two more words that strike terror in the same - "Rubber Dam".

Start practicing now by shoving a Von's plastic grocery bag into your mouth while lying upside down for 3 hours as someone in a mask trickles water down your nostrils.

I cannot decide if the Rubber Dam was invented by the S&M crowd or has Dick Cheney been hired as a consultant for the ADA.

SC seagoat

Trad climber

Santa Cruz, or In What Time Zone Am I?

Mar 13, 2015 - 05:17pm PT

^^^ ha ha good one. Breath play I guess.
I did have experience with the "rubber damn" (sic)...as my dentist in the 70s used one (or I assume it was) for his general dentistry work. I recall this big rubber thingy over my face.

Susan

the Fet

climber

Tu-Tok-A-Nu-La

Mar 13, 2015 - 05:37pm PT

I just got a gold crown put in on a molar that was cracked. My only other crown from 25 years ago was initially porcelain and I hated it, it kept falling off, then chipped and was sharp. The gold one is nice and smooth and has never given me any trouble.

So for the new one I went gold again. My insurance covers 50% and the Dr. told me my portion would be about $500. AFTER getting it all done, they tell me they need over $750. I guess because the price of gold went up and I have to pay for 100% of the gold.

So its a total cost of $1,250 a reasonable cost for a gold crown?

Ricky D

Trad climber

Sierra Westside

Mar 13, 2015 - 05:59pm PT

1250 sounds about right. Check around your house for some old gold chains from the 90's - might be able to swing a trade.

bvb

Social climber

flagstaff arizona

Mar 13, 2015 - 07:03pm PT

Ballpark for sure, but my insurance (FEP BC/BS Blue Dental) picks up 50% of all crowns, including precious metals. Isn't a porcelain crown spendier than gold?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Mar 14, 2015 - 11:59am PT

Susan. Calm down....breathe......unlock your white knuckles from the keyboard. A root canal done by a specialist (an endodontist) is really, truly, honestly no big deal these days. Most people go right back to work and are wide-awake while they have it done and suffer very little discomfort after work. Doing the procedure, with good local anesthesia, you will feel absolutely nothing.

But I highly recommend spending the money and seeing a specialist. A good general dentist can do a good root canal but honestly they have a higher failure rate and hire postop complication rate and studies show they take considerably longer to finish the procedure.

The hardest part is the cost. It really can get expensive but is far cheaper than eventually losing the tooth and needing a dental implant. However, with that said, if the tooth has very very deep decay, by the time you add the cost of a root canal and the cost of a crown, you are a good bit of the way toward an implant which is often a lifelong fix. I would look your dentist in the eye and say "does this tooth have at least a 10-15 year prognosis with a good root canal and a good crown." If he fidgets at all and thinks the tooth may be on a downhill trend then I would highly recommend extraction and a dental implant which is also really not that big of a deal.

Good luck, and feel free to email me if you have any other questions.

Scott

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Mar 14, 2015 - 12:02pm PT

Fet,

Yes, gold has gone up significantly. It is a fantastic material for the mouth but has gotten very very pricey. The newer porcelains are way stronger than even the porcelains that were around 5-10 years ago. So I would definitely go all porcelain (Emax.....Lithium disilicate) these days, but gold is still a fantastic option for the back molars.

There is also an entire catalog of imprints you can put into gold molars. My favorite is the martini glass or the Yosemite Sam that is often seen on mudflaps.

Happy chewing.

Scott

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Mar 14, 2015 - 12:04pm PT

BVB,

Gold has become so pricey that these days a really good porcelain crown can actually be cheaper. And many offices are milling the porcelain crowns with CAD CAM machines from a solid "nugget block" right in the office, which reduces the lab bill over time and can be even more affordable.

It has nothing to do with cosmetic or not cosmetic, just the price of materials. As the time for the dentist to prep the tooth and cement it is the same.

Scott

John M

climber

Mar 14, 2015 - 12:17pm PT

Don't listen to him man.. He is just trying to get you into his chair and then he will give you drugs and then make you….

listen to climbing stories

oh the horror!!!!!

SC seagoat

Trad climber

Santa Cruz, or In What Time Zone Am I?

Mar 14, 2015 - 02:42pm PT

Thank you MicroNut. An endo I would be seeing as even my general said that.
I'm not jumping right in at the moment as it's calmed down and it's beginning to feel more like the tooth in front of the prepped one is maybe the culprit. When I tap on it, it "hurts" but when I tap on the prepped one, nothing. Wondering if it got traumatized during the prep from all the work getting the existing crown off its neighbor. He really struggled getting the crown off.

I have excellent dental insurance but blew over half of it on the new crown.
I'm headed out to Moab in a few days and saw there is an endo exclusive practice in Grand Junction and thought it might be more cost effective than a Santa Cruz endo.
I still get light headed even trying to say those two words....but I've been getting lots of encouragement so I gotta stand tall!
Thanks again!

Susan

Crimpergirl

Sport climber

Boulder, Colorado!

Mar 14, 2015 - 02:52pm PT

Do not put off a needed root canal either...doing so means you may end up with an abscess, then you may hit the dental lottery: removal of expensive dental work and tooth, bone graft, dental implant. Not fun!!! And very high dollar.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Mar 14, 2015 - 03:38pm PT

Listen to Crimpergirl Susan. She's right. Putting it off just means more work and more money later. Every single time.

I totally see why people procrastinate, but it never pays to hold off on the work when the pain goes away. People who come into the office in pain tend to have terrible experiences. If you do it when you're not in pain, the anesthetic works much better and the experience is far better overall. It's like a hamster on a wheel. People who don't like the dentist only come in to the office in pain so when they come into the office it's painful and they end up not liking the dentist.. And on and on and on. For the rest of their life. They never give it a chance to be a good experience.

I hope you find a good and caring and honest guy who gives you a great root canal and that it lasts for the long-haul. Let us know how it goes!

Scott

SC seagoat

Trad climber

Santa Cruz, or In What Time Zone Am I?

Mar 14, 2015 - 03:42pm PT

Ok. Got it. Oh boy.

Susan

Edit....I guess the frustrating part for me is I was having zero problems until I went for my cleaning. The X-rays showed some decay under the crown. So what I thought would be a standard drill and new crown has turned into transient discomfort beyond any other crown prep I've had which had my dentist bring up the potential need for RCT.

I've used up far more than my fair share of bandwidth. I'll step away now with the knowledge of where this year's tax refund is going. Thanks for everyone's input.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Mar 14, 2015 - 03:54pm PT

You can do it Susan. Tighten up your laces, cinch down your helmet, trust your feet and step off the belay.

Ricky D

Trad climber

Sierra Westside

Mar 14, 2015 - 06:07pm PT

Go with gold on molars - holds up so much better than composites.

On the other hand, have enough crowns and your Dentist will start mumbling about how you are worth more dead than alive. If you get to that stage - think about willing your teeth to your kids.

Off White

climber

Tenino, WA

Mar 14, 2015 - 06:42pm PT

Hi Susan, I'm going to chime in with an endorsement of the root canal too.

I was pretty darn terrified the first time I had one, they have a pretty scary reputation. I had a horrid toothache, and nothing calmed it down. Went through a stack of codeine in a single night with no effect, the only thing that helped was a sip of cold water, which lasted maybe 30 seconds.

I went to the endodontist on the ragged edge of trembling, sleep deprived and wide eyed. He set me up with some headphones, some nitrous, and from the moment of the first Novocaine injection it NEVER HURT AGAIN. The procedure itself was no big deal, it was the pre-event fear that did me in, coupled with the pain that just wouldn't go away.

I still suffer some dental anxiety, but I get a cleaning every six months like clockwork. I also tell the kids, "When you gets older you gonna wish you took betta care o' your teef!"

SC seagoat

Trad climber

Santa Cruz, or In What Time Zone Am I?

Mar 16, 2015 - 12:35pm PT

The fix is in. Endo appt on Friday.
They've scheduled me for a treatment length appt. in case "I need treatment".
I suspect I do.
Thanks everyone for your encouragement.
I'll manage. I've been though worse!

Susan

johntp

Trad climber

socal

Mar 16, 2015 - 12:42pm PT

Root canals are not that bad.

I've had two and still have the pain killers in my fridge from eight years ago.

the Fet

climber

Tu-Tok-A-Nu-La

Mar 16, 2015 - 01:24pm PT

Thanks Ricky, BVB, and Micronut!

skitch

climber

East of Heaven

Mar 16, 2015 - 02:52pm PT

Micronut: What percentage of dental work is actually necessary??? I just always wonder how much is going towards my dentist being able to only work 3 days a week and how much is because I eat too much sugar and never floss.

My dental office always tries to schedule me for a crown because they say that the old filling in that tooth is wearing away, and maybe the tooth will crack, or something like that. . .they also remind me that I have $950 I can use for the year, which I think they try to maximize. . .I do not trust anyone.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Mar 16, 2015 - 03:19pm PT

SKitch,

Dentistry is a total racket. We only exist to make money and buy new toys. You should see my new truck. Toyota Tundra, 3 inch lift, sick rims, winch and tow package. No lie. Its boss.

FACT: Dentists invented the Big Gulp, Jolly Ranchers and Lik-em-Aid. We rely on guys like you who rarely floss to fund our four day weekend road trips 950.00 at a time.

All kidding aside it is a really great industry and has tremendous job security because even though we pretty much figured out how to eradicate decay and gum disease a century ago for most people (Floss daily, brush with fluoride, city fluoridated water), people love to neglect their mouth and tend to put off dentistry till it hurts, which leads to more dentistry. Dental insurance is a bit of a scam, as it only covers a small fraction of most people's needs. Most people should plan for the cost of their dentistry based on their risk profile and plan financially accordingly, just like home repairs, auto repairs, vacations etc...but who really does that? I don't. I just roll with the punches when they come when it comes to dentistry. Find a good honest dentist (not easy) and do the work he recommends and it should last a long, long time. The sooner in life the better. By your 50's, dentistry can get out of hand if you put it off 20 years like so many people do. In your 20's and 30's, if you get some good dentistry and keep up with your homecare daily and get a cleaning every 6 months, your chompers should last you a lifetime with minimal work....providing the dentistry is good and you don't smoke or have diabetes or alcoholism or really bad genetics.

Good luck, and remember

"You don't have to floss all your teeth....just the ones you want to keep.)

And by the way, my new truck really is cherry. I'll post up pics later.

Scott

WBraun

climber

Mar 16, 2015 - 03:22pm PT

I hate dentists.

I don't hate the dentist man himself just all that mucking around in and on my teeth.

Because of that I haven't been to a dentist in 40 years ......

SC seagoat

Trad climber

Santa Cruz, or In What Time Zone Am I?

Mar 20, 2015 - 12:50pm PT

Root Canal done.
He said it was a "case study" tooth. Being a wisdom tooth he said they can be funky and he said it "fought him all the way" It had 3 roots and very curvy canals. It virtually was painless ... although I know it will be sore when the numbing wears off.
I told him how everything seemed to be fine for 5 days after the crown prep then I went to Yosemite and boom it started hurting. He said the altitude change can affect a bad tooth. Indeed he showed me monitor pictures of a bloody pulp and said it was not a happy tooth.
I'll get the crown on next week and hopefully be back on the road...literally...well in a car or on a bike.

Susan

guido

Trad climber

Santa Cruz/New Zealand/South Pacific

Mar 20, 2015 - 01:18pm PT

FredC

Gym climber

Santa Cruz, CA

Mar 20, 2015 - 01:34pm PT

I just got back from my dentist. He did two fillings and I got "Fuji". In both!

Apparently the materials guys in Japan have come up with all kinds of cool plastics, this one gives off flouride over time. It's like I have time release fertilizer in my mouth.

The shots worked today so it was all fun.

DanaB

climber

Mar 20, 2015 - 11:32pm PT

Scott,

If a crown is old and the gum has moved away exposing the tooth, should the crown be replaced?

Thanks.

Tobia

Social climber

Denial

Mar 21, 2015 - 05:03am PT

Micronut, I just had my teeth cleaned. I get the same evaluation as always, your teeth are in very good shape; however your gums have receded further for a person your age (58). It is more prevalent on my upper teeth, in particular around the canine and first molar.

I have my teeth cleaned at a Dental Hygiene Clinic at a local Technical College, as it is only $30 and they due a thorough job.

I am usually warned about brushing to hard; which if brush any softer using a sonicare, it would be called "airbrushing". I floss daily.

Now I am on a prescription toothpaste (Prevident 5000 Boost) to prevent cavities as my Dentine is exposed around above mentioned teeth.

Any ideas on how to retard further gum loss?

ECF

Big Wall climber

Ouray, CO.

Mar 21, 2015 - 05:12am PT

What's the fifth dentist problem with Dentyne gum?
Is he just a disagreeable prick?

You were out voted 4 to 1 dude, move on...

Gnome Ofthe Diabase

climber

Out Of Bed

Mar 21, 2015 - 06:04am PT

QUestion and a blind post no pre reading so sorry if I am not fitting in or repeat any thing.
My teeth are mostly sound but the back molars are loose and have big sharp cavities, one the right side that I used to sleep on is so loose that I can click it against the other.
I have no cash or dentil insur(I am signed up but have to wait a year to save up and be covered etc.)
Now the last day of a free clinic is in a college gym, I was going to go but
I have had two pulled no implants and no bridge,
Where's the question? Well it is this;

Is it better to have the remnants, loose and hollow, but solid crowns, to work with or yank the puppies at the free clinic and wait to get more done when all that needs to be in place is.?
Just hoping for a heads up about what to expect.

Never had the wisdom teeth pulled or give me any problems until now
The periodontist I saw a year ago and had to pay over time, said that he felt surgery to deep clean and remove the wisdom on the loose side might save the tooth but now?
He was great but the money thing was not good.

.And.. A dentist did invent Cotton Candy called Fairy Floss , in 1897 and introduced at the 1904 World's Fair. Dr W Morrison and confectioner, (candy man) John C wharton collaborated.

ECF!,! I'm not following you on purpose! A little creepy no? Great minds think alike!

SC seagoat

Trad climber

Santa Cruz, or In What Time Zone Am I?

Mar 24, 2015 - 03:00pm PT

OK Been there done that.
Root canal very successful....truly the anticipation was the absolute worst part.

Today the final crown was put on. Luckily the one they had made before I had the root canal fit fine.
I did start to freak when he said they were going to drill out the temp without numbing. He said there is no nerve so it shouldn't hurt. I got pretty shaky thinking maybe, maybe there's something left. Shades of Marathon Man went through my head.
I did ask him if he could change drill bits. I cannot handle that one that grinds and vibrates as if a jackhammer is in your mouth. He said "sure, no problem" and switched to one that just whines.

Temp filling out, crown on, perfect fit. Thanks everyone for virtually holding my hand.

And Dr. Micronut Scott, I OWE you! Don't you do charity dental work off shore or something? Please I'd love to make a donation to something you support.

Susan

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Mar 24, 2015 - 03:54pm PT

DanaB,

Not necessarily. A small amount of exposed dentin or cementum (as long as it is healthy and not decayed) is not really a big deal. The Brittish say your crown now "stands proud" above the gumline. Theoretically it is now a bit easier to clean the crow-tooth interface (margin) which can prevent more decay under the crown margin. You just want them to keep an eye on that area at your visits so that decay does not creep up on that tooth at the gumline.

Happy flossing,

Scott

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Mar 24, 2015 - 03:55pm PT

ECF,

I'm that guy. The fifth of the 4 outta 5 dentists who recommend anything. I chew Hubba Bubba. Sugar free gum is for lightweights who drink Zima and smoke e-cigarettes.

Tobia

Social climber

Denial

Mar 24, 2015 - 03:59pm PT

micronut, you skipped right over my question, is that a hint?

Kristen

climber

Jun 7, 2015 - 04:28pm PT

I appreciate this thread Micronut, but had to post this link for you to read:

https://www.womentowomen.com/thyroid-health/the-great-fluoride-myth/?utm_source=newsletter-6-06-15&utm_medium=email&utm_campaign=store&utm_content=thyroid-article-read-more

I'm one of the 'crazy' people who think that fluoride added to public drinking water is 'poison'!

SC seagoat

Trad climber

Santa Cruz, Moab or In What Time Zone Am I?

Jun 7, 2015 - 04:32pm PT

Oh! Seeing this pop up again. I gotta say that root canal I had was the best damn thing I ever did. I want to get more on some sensitive teeth. But at $1500 a pop my dental insurance evaporates fast.
I'm a believer.

Susan

Toker Villain

Big Wall climber

Toquerville, Utah

Jun 7, 2015 - 06:17pm PT

Just saw tooth's post from November 2012 on the first page.

I didn't know that you had to be jewish to be a dentist.

Gnome Ofthe Diabase

climber

Out Of Bed

Jun 7, 2015 - 06:20pm PT

Ricky D

Trad climber

Sierra Westside

Jun 7, 2015 - 06:23pm PT

I'm waiting for the Geneticist who can combine shark teeth with humans so that when one chomper goes bad another rotates into place.

And another thing - there should be a law restricting the finger size of Dentists so the dude with the Truck Driver digits gets cut on day one!

And once again - whoever invented the Rubber Dam should be burned at the stake!

Toker Villain

Big Wall climber

Toquerville, Utah

Jun 7, 2015 - 06:23pm PT

Yeah, I still have all my teeth.

Because I saved them.

cleo

Social climber

wherever you go, there you are

Oct 19, 2015 - 01:13pm PT

Ok, time to chime in!

My 2 front upper canines are baby teeth - no adult teeth ever existed. I had a 3rd baby tooth, but it got pulled when I was a teenager (and a bridge put in). After that, the dentist, being surprised at how solid the worst baby tooth was that he pulled, suggested I leave the others alone for a while. So I did.

It's now time to do something! Both teeth are dead, and one finally broke off, so I look like a hillbilly. Otherwise, they don't bother me.

So... implants....

How does one go about choosing a dentist or specialist to do such work in a new town (I'm moving to Sacramento)?

I've got TWO to do... should I do them both at the same time? Would it save any money to do so?

What do you think about the "Dental School" option - being a guinea pig for students under expert supervision, to save money?

Does it really take 6-12 months for the whole process?

Does it still cost $3-$4k, or have prices gone up :(?

steveA

Trad climber

Wolfeboro, NH

Oct 19, 2015 - 01:45pm PT

My wife and I are lucky.
My son's wife is a dentist, and I might add, she graduated top in her class at UPENN.

whitemeat

Trad climber

San Luis Obispo, CA

Oct 19, 2015 - 04:15pm PT

I got a couple words for this thread! F*#K WISDOM TEETH!!!!!!

My gosh that was the worst thing ever! Stupid teeth!

But a super funny experience to look back on, this thread makes me laugh when I look back on those bad days!

http://www.supertopo.com/climbers-forum/2438678/Whitemeat-real-scared-wisdom-teeth-HELP

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Oct 19, 2015 - 05:04pm PT

Cleo,

First off, I see from your photo that you are an alpine climber. Good news. Just leave the front teeth out, most alpine climbers don't have a full set.

In the event you eventually want to date or marry....or chew solid food, lets get you set up with some implants. They should end up looking beautiful and will last you a lifetime if done right.

#1. ONLY SEE A SPECIALIST! Not a general dentist who "likes to place implants." Stick with a Periodontist (what I do) or an oral surgeon and have a good general dentist do the pretty porcelain tooth part.
How does one go about choosing a dentist or specialist to do such work in a new town (I'm moving to Sacramento)?

How does one go about choosing a dentist or specialist to do such work in a new town (I'm moving to Sacramento)? Look at GOOGLE reviews and Angie's list reviews. Google "dental implants, Sacramento" or "Periodontists, Sacramento." They can be faked, but they give you a good idea. Go do a meet and greet....expect to pay a couple hundred bucks, but hear him out and get a feel for his bedside personality. Then ask him to help you find a general dentist. Specialists tend to work with dentists who know their craft. Remember, you need the surgery to go well, and the crown part to be pretty. That takes a team.

-I've got TWO to do... should I do them both at the same time? Would it save any money to do so? It will not save you money, and you might get a better "color match" by doing both since the porcelain is "baked" at the same time and processed at the same time. But if you can only do one at a time that is totally understandable. These things get expensive. Just have the general dentist make you a really good looking temporary clear retainer or something to have throughout the process. These only cost a couple hundred bucks.....you should never go toothless these days.

-What do you think about the "Dental School" option - being a guinea pig for students under expert supervision, to save money? This is a great option. UOP dental school dept of Periodontics. Or UCSan Fran. Both are great options. Much cheaper, and the resident program will turn out really nice work (they are doctors but still resident students by that point) but the process is much longer.

-Does it really take 6-12 months for the whole process? yes. But you should be able to wear a temp the entire time.

-Does it still cost $3-$4k, or have prices gone up :(? That is probably a fair estimate per tooth. Yucky, I know, but a lifelong investment and a true quality of life issue. Take your time, save up, finance a bit if you need to......but keep moving forward. Moving toward health is way better than moving toward decline. Even if it takes time. Think of it as a big wall.....this ain't a sport route.

Good luck, and let me know if I can be of any more help.

Scott

SC seagoat

Trad climber

Santa Cruz, Moab or In What Time Zone Am I?

Oct 19, 2015 - 05:11pm PT

Thank you again Scott, for the handholding you gave me last spring about the root canal I needed. Went to a specialist, so so worth it.
Having said that I highly recommend whatever advice you give (at least involving dentistry ;)

Susan

cleo

Social climber

wherever you go, there you are

Nov 7, 2015 - 11:14am PT

Thanks Scott, just checked back in. Need to get on this!

Cheers,
Val

christoph benells

Trad climber

Tahoma, Ca

Nov 7, 2015 - 06:45pm PT

micro nut-

hello, i was wondering if you know anyone who has done home dental work.

I have two cavities that seem like i could get my dremel out and grind them away.

what do you fill them in with?

this is not a joke, well kind of, but i am serious that i think i could do it myself.

p.s. i lived in clovis for many years of my young life, over on armstrong and nees.

guido

Trad climber

Santa Cruz/New Zealand/South Pacific

Nov 7, 2015 - 06:52pm PT

Guido and dremel tool and old friend on old Junk in good old Samoa, circa 1974.....................

cleo

Social climber

wherever you go, there you are

Nov 12, 2015 - 10:43pm PT

Huh, how do you tell if a dentist is a periodontist vs a regular dentist who like to do implants?

(Can any dentist say they are a periodontist, and if some, why would a regular dentist who likes to do implants not just add periodontist to their title or specialty?)

Karen

Trad climber

Casper, Wyoming

Nov 13, 2015 - 07:24am PT

Just had bad is sugar on one's teeth? I have a serious addiction to gummy worms! But I worry that the sugar is doing damage.

Please let me know. Thanks, Karen

The Chief

climber

Down the hill & across the Valley from......

Nov 13, 2015 - 07:29am PT

Hey Doc "Nut"... whatdaya think of my smile?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Nov 13, 2015 - 08:09am PT

Cleo. That's an easy one. A periodontist of oral surgeon has a sign saying "practice limited to _." Or just ask. Are you a board certified Periodontist, oral surgeon, etc....

Or just ask 'em "are you a dentist or a specialist?" Or use GOOGLE.

Karen. I like gummy bears too. Just brush and floss normally and you'll be fine!

Chief....That trut needs floss STAT!

G_Gnome

Trad climber

Cali

Nov 13, 2015 - 09:01am PT

Chief, must be a brookie, a brown would actually have some chompers showing.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Nov 13, 2015 - 09:07am PT

Those fangs are retractable! that thing looks like a cobra more than a trout!

The Chief

climber

Down the hill & across the Valley from......

Nov 13, 2015 - 10:05am PT

Jan... YUP!

From a very special lake at 12.2k and was around 15".

Sorry for the drift, Doc, but I have to admit that my teeth were chattering with excitement when I first came upon this gem.

jstan

climber

Jan 4, 2016 - 10:58am PT

Shameless plug:

Here in SB I got a quote of just under $30,000 for work not including implants, or tooth pulling, or bone
grafts. Got the whole works including 5 implants( no grinding of otherwise good teeth) done for
$7000 in Los Algodones by Gabriella Bastidas. Met two people in her waiting room referred to her to
have salvage work done to repair failures done by other dentists.

High Fructose Corn Spirit

Gym climber

Jan 4, 2016 - 11:30am PT

Micro, just want to compliment you on your 19oct post, so well written, thorough and informative.

Cleo, I hope all systems go and you're on your way!

Pennsylenvy

Gym climber

A dingy corner in your refrigerator

Jan 4, 2016 - 02:37pm PT

Micronut.......Thanks for this thread , it's a gift !

So, what is your opinion on some rumors I have heard about a connection between root canals, a bad pathogen (bacterial), and heart disease ?

Spiny Norman

Social climber

Boring, Oregon

Jan 4, 2016 - 03:02pm PT

Probably scare up more business on an ice climbing forum.

:P

Reilly

Mountain climber

The Other Monrovia- CA

Jan 4, 2016 - 03:06pm PT

Micronut, my cousins need some work done but can't afford to pay.
Could they work it off?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jan 4, 2016 - 03:39pm PT

Pennsylenvy,

You're welcome. Glad to help. Hard to get good medical beta out there these days.

So, what is your opinion on some rumors I have heard about a connection between root canals, a bad pathogen (bacterial), and heart disease ?

A few years ago a great deal of scientific endeavor went into looking at the relationship between oral health(or unhealthy/disease) and risk of cardiovascular events or strokes. There seems to be a risk/correlation between those that have gum disease/failing root canals/rampant decay and heart attacks/strokes, etc. Strange eh? Well, they looked and looked and looked for a "Floss or die" data set that showed a direct cause/correlation between the two, but it turns out the data ended up being vague and "relational" at best. Yes, if you have rampant gum disease and lots of decay and failing root canals and bacteria teeming in your mouth, you seem to fall into a category that says you are more likely than a healthy Joe to have a heart attack or stroke......but does the yuck mouth cause the heart attack/stroke? Not necessarily. I believe that if you are generally neglectful of your mouth to that extent, you may also generally neglect your systemic health and be overweight, smoke, have a fatty diet and drink alcohol......all of which increase your risk for cardiovascular events.

In a nutshell, though it has been reported that dental bacteria have indeed been found in the brain tissues of people who have died of bacteremia in the brain, this is like getting struck by lightning inside your house. It theoretically happens, but don't sweat it, the odds are with you. And the same goes for dental bacteria and heart disease/stroke. There is a correlation that is loose at best, but just take care of both your body and your teeth and you should be fine.

Lastly, don't put off a nasty, recurring mouth infection/root canal abscess/gum abscess. You are begging for all kinds of pain and suffering and it is generally not good for your localized immune system to be chronically fighting off an infection. Get it treated. Do what it takes and take care of yourself before you end up in a damp tent in Camp 4 with some unkempt Swede named Gustaf prying at your molar with a #2 Lost Arrow with you doped up on Wild Turkey six hours before the two of you head up on The Nose.

Dr. Micronut has spoken.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jan 4, 2016 - 03:40pm PT

Thanks Fructose. Swelly, I'll reach out to you when I have a few minutes. Remind me here if I forget.

Tobia

Social climber

Denial

Jan 4, 2016 - 04:09pm PT

Reminder:
Mar 21, 2015 - 05:03am PT

Micronut, I just had my teeth cleaned. I get the same evaluation as always, your teeth are in very good shape; however your gums have receded further for a person your age (58). It is more prevalent on my upper teeth, in particular around the canine and first molar.

I have my teeth cleaned at a Dental Hygiene Clinic at a local Technical College, as it is only $30 and they due a thorough job.

I am usually warned about brushing to hard; which if brush any softer using a sonicare, it would be called "airbrushing". I floss daily.

Now I am on a prescription toothpaste (Prevident 5000 Boost) to prevent cavities as my Dentine is exposed around above mentioned teeth.

Any ideas on how to retard further gum loss?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jan 4, 2016 - 04:42pm PT

Tobia,

A couple questions.

1. Did you have braces at some point? Childhood? Adulthood perchance?
2. Have you ever been told you are a clencher/grinder, and if so do you currently have a hard night guard?

I ask because the position of the teeth and the presence of clenching and/or grinding are two major players in people who are seeing significant recession despite their best gentle efforts. You should definitely be on a Sonicare brand toothbrush and use a very mild, mellow toothpaste. (All the Whiz-bang whitning brightnig toothpastes out there, including Colgate Total have all kinds of things in them that you don't want or need, including abrasives and "bleaches" to shine things up. Get a cheapo bland toothpaste, or stick with Sensodyne or the prescription Prevident 5000 given by your dentist.

And have him/her "Check your occlusion." Only a dentist can do this and it takes training to know what you are looking at, but maybe one of the supervising clinicians at the clinic can take a look. If you are seeing heavy enamel wear on the chewing surfaces (ie: the tips and edges) of the teeth that have recession, you are probably grinding. This causes a "flexure" of the tooth microscopically and that stress can sometimes translate into soft tissue loss or recession. In that case, I do a gum graft and equilibrate the bite and you are right as rain. But that can get costly, so make sure you first look into the Sonicare and consider a hard night spint if you are diagnosed as being a grinder. If its really a hardship to get your hands on a Sonicare, message me and I'll send you one at cost. Glad to help.

Scott

Tobia

Social climber

Denial

Jan 12, 2016 - 10:14am PT

Micronut,

Thanks for the detailed reply, it gives me a better understanding of my problem. I am a grinder! I never realized that I do in the night; but am aware of it when awake, I have anxiety issues. Sometimes my jaws seem to cramp from clenching my teeth.

I will have an occlusion check my next visit, to the clinic.

I rinse my mouth out with 50% hydrogen peroxide & 50% water before I brush. Is this a good idea?

I also have been dipping my brush in baking soda when using the Prevident. Is that to abrasive?

I have been using a Sonicare for 15+ years due to my dentist's recommendation long ago because of gum recession. At that time he said I was brushing too hard.

I thank you very much for Sonicare offer and the free advice. I learned more from this online appointment than a paying one at the clinic, very kind of you to provide this service.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jan 12, 2016 - 10:56am PT

Tobia,

Glad to help.

a couple things....

I rinse my mouth out with 50% hydrogen peroxide & 50% water before I brush. Is this a good idea?
I also have been dipping my brush in baking soda when using the Prevident. Is that to abrasive?

1. Stay away from the peroxide. You aren't trying to chemically "kill" bacteria. Just loosening the soft plaque mass with proper, light, brushing and flossing. Peroxide doesn't do a whole lot and can be an irritant if you have a thin "biotype" and are prone to recession. Just use a regular no frills toothpaste. The only time I use peroxide is if I have a bad mouth sore or a sore throat, then a little gargle and spit can be an effective disinfectant for a couple days.

2. Yes. Too abrasive. Stop NOW!. Find a regular mild no nonsense toothpaste and stick with it. That baking soda is like washing your hands with Ajax.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jan 12, 2016 - 10:58am PT

Swelly I totally forgot! Sorry man. I'll email you tonight!

Tobia

Social climber

Denial

Jan 12, 2016 - 05:11pm PT

Thanks again. And I have officially stopped. I floss daily, if not more.

rottingjohnny

Sport climber

Shetville , North of Los Angeles

Jan 12, 2016 - 07:18pm PT

Reilly... Maybe Dr. Micronut would do a trade for the Rolex you're wearing in that picture of you and your big brother...?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jan 18, 2016 - 08:49pm PT

Hey Swellymoon,

Sorry for the late reply! Hit me up here on an email via the supertopo email function. I'd like to help out with any questions about your daughter.

nature

climber

Boulder, CO

Mar 17, 2016 - 01:33pm PT

is $1400 for a crown and $1200 for a root canal above average or?

I just got a root canal. Had no idea they take 10 minutes now.

hey micronut, if you have a few minutes over the weekend perhaps we can chat on the phone? I've got an estimate of $9K to do all the work I need not including an implant.

Reilly

Mountain climber

The Other Monrovia- CA

Mar 17, 2016 - 02:12pm PT

10 minutes for a root canal? Where, Target?

nature

climber

Boulder, CO

Mar 18, 2016 - 03:21pm PT

calling micronut.

What I mean by them taking 10 minutes is they've got the process down as well as the technology. After you are all numbed up it's a matter of drilling to the root, either removing it or cleaning out the canal, irrigating it, adding an antiseptic which is left for a week and then putting in a temp filling. I'll go back in a week when they will open it up again, irrigate it one more time and then insert the final piece and then seal it up. I'm left with a temp filling so I still have the process of getting the crown.

This is how endodontists roll these days. My first dentist told me as much.

nature

climber

Boulder, CO

Mar 18, 2016 - 03:37pm PT

well for what it's worth it is tooth #20 which is a single canal. i'm sure some further back take a bit longer.

Reilly

Mountain climber

The Other Monrovia- CA

Mar 18, 2016 - 04:27pm PT

maybe the Dentists I've been using took their time

Locker, it was a big mistake to pay by the hour, trust me.

nita

Social climber

chica de chico, I don't claim to be a daisy.

Mar 18, 2016 - 04:38pm PT

*
Nature, ...Have you thought of taking a dental vacation ?...If so, Talk/email Delhi dog, i'm pretty sure he goes on vacation to Thailand for his dental needs..or is it home in India?..I can't remember, but he can direct you.

nature

climber

Boulder, CO

Mar 18, 2016 - 05:42pm PT

nita - i'm considering that. I'm wondering if i can spend some extra time while on my Papua New Guinea trip mid-summer.

At the same time considering some of the work and the fact I'm starting up a business it's tough to think about taking any time off. But I'd save a ton. Mexico was another option a friend clued me in to.

In fact you may recall on my India Trip I went to southern India because of the dental tourism. The dentist yesterday had mixed feelings on the work but mostly good. I should have done crown instead of in-lays but that was mostly my decision. Not sure I had the time for all the crowns, etc.

Karen

Trad climber

Prescott, AZ ~ God's country!!!!

Mar 18, 2016 - 05:51pm PT

Have a question how much should a crown be for a back molar. I was quoted 1,000 dollars, that just seems extremely expensive and I cannot afford it. The problem is however, the dentist showed me all the tiny cracks in that tooth and he said it is only a matter of time before a chuck breaks off and then I'll need a root canal and the damn crown !!! I don't have insurance and have been in a panic since the dentist gave me this news.
Recently, Due to not having insurance and couldn't afford a root canal and crown had a molar removed, fortunately you can't see it when I smile.
Appreciate your advice for my question.

John M

climber

Mar 18, 2016 - 05:59pm PT

a thousand dollars is the going rate. I paid 900 a couple of years ago. The last tooth that needed a crown I had it pulled. 250 bucks easy peasy.

Of course real men would pull it themselves. Hahaha.. Cue Werner.

Crimpergirl

Sport climber

Boulder, Colorado!

Mar 18, 2016 - 06:01pm PT

Not a dentist (clearly), but crowns usually cost me 1500 WITH insurance. I did let one tooth go once (no insurance). It then got infected. Agonizing pain. I got to pay for a root canal and a crown then. Cha ching.

Good luck and I hope you find relief. Teefers are expensive to care for. Better than no teefers though.

nature

climber

Boulder, CO

Mar 18, 2016 - 06:05pm PT

If you can afford it over time check out care credit. That was one option. I don't think $1000 for a crown is excessive (micronut, calling micronut ;) as mine was $1400 but then this is the peoples republic of boulder.

I'm thinking Bali for the work. It's probably where I'm flying in to before PNG. just a longer trip and it'll pay for my original trip. reviews are good so far.

Cue Werner.

And BURT BRONSON

Karen

Trad climber

Prescott, AZ ~ God's country!!!!

Mar 18, 2016 - 06:31pm PT

I have been told by many to go to Mexico to have dental work done. What do you think about that option?

High Fructose Corn Spirit

Gym climber

Apr 27, 2016 - 10:24am PT

Hey Micro,

So it looks like (feels like) I have four teeth that are growing increasingly super sensitive (painful) to hot and cold and pressure. They are 21, 28, 18, 31 on your standard dental chart...

Recent exam confirms (1) all four in the past were composite filled at their outside bases because of caries (?) or receding gums (?); (2) all roots look healthy under x-ray - so I'm told.

So I guess I'm just left wondering: (a) I'm 56, is this something an older person just has to get used to with his original teeth and it is a normal development with aging? (b) The teeth "look" fine but if I spent the money and had these implants installed would I get that super strong tooth feeling again? (c) This super sensitivity to pressure, hot and cold has increasingly advanced in the last six months, esp. Any chance it might just go away or is it here to stay till end-of-life? I switched toothpaste to the sensodyne types which may have helped, not totally sure though.

Your input most welcome! Thank you.

PS

If x-rays show healthy roots why the pain clamping down on a pencil, for eg, particularly for 28 and 21?

Karen

Trad climber

Prescott, AZ ~

Apr 27, 2016 - 01:12pm PT

High F. Have you tried the toothpaste called sensodyne? I had really sensitive teeth and this cured it.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Apr 27, 2016 - 02:35pm PT

High Fructose,

I don't have much time right now to answer your question....let me get back to you asap.

but for now I have some thoughts, don't do anything rash like have the teeth taken out or something like that until I can respond.

1. No, you don't have to "just live with it."

2. My guess is that something like wearing a hard night splint for a while might calm down the muscles of mastication and take some of the load off the teeth, which is probably a big factor unless you have a large amount of exposed root surface.

Give me a couple hours and I'll respond in full detail.

Until then, the fact that your screen name is "High Fructose Corn Syrup" could have something to do with it. The irony is not lost on me.

Scott

High Fructose Corn Spirit

Gym climber

Apr 27, 2016 - 03:57pm PT

thanks, micro.

SC seagoat

Trad climber

Santa Cruz, Moab, A sailboat, or some time zone

Jul 28, 2016 - 12:30pm PT

Oh boy...this thread helped me a lot about a year ago to get through my first root canal.
It went quite well.
Now, my second. Not so well.
This is a lower molar, next to the last 30? 31? Not sure.
I had "not too bad" discomfort that was managed by Ibu (just one OTC) tablet. It went on for two + weeks so I knew it was time.
Back to the endo who did the first one. He does the numbing, a lot, it was not bad but then starts the drilling and says "oh it's a 'hot tooth' and says I may need more numbing". Yup, I replied and the next numbing was not exactly pleasant as I think he had to go down through the pulp. He said it was bleeding and that it was a "ten out of ten tooth" didn't know how I had endured it especially since I had 3 long airplane flights since I had first had symptoms etc etc. Of course I'm starting to freak out thinking should I just have had it pulled. I kept asking him, after I could talk, does he feel confident it's saved. He said yes.

Ok, procedure done, I'm numb and feeling no pain except stiff jaw. Quick run for groceries before I expected post procedure "discomfort". They gave me an Ibu/Tylenol combo which I avoided until I knew what it was going to be like. Well, it's like VERY painful the night of, and today (day after) ... Much more than it ever did before Tx and much more than the first one (which was an upper and evidently not as "hot". I was also given antibiotics to take if swelling occurs.

How many days should I expect this before I call him back? I don't want to be a wuss but this is so different than the first one. There is no indication of swelling so I don't think I need to start the antibiotics but I sure didn't expect more pain during recovery than I did before Tx.

Whine whine poor me. I'm supposed to be out in the middle of the ocean and they're all waiting for me.

Susan

John M

climber

Jul 28, 2016 - 12:57pm PT

Hi Susan, I have no idea if this applies to your case, but I have heard about it from other people and other situations. I broke my nose playing rugby. It was a bad break. I had it surgically repaired. They gave me pain meds and told me to take them on time. Since it didn't really hurt when I broke it and I don't like taking pain meds, I waited until the pain started. The hydrocodone and ibuprofen that they gave me did not work. It was after hours and the doc sent me to the emergency room for a shot of demerol. After that the hydrocodone and ibuprofen worked fine. Doc said something like pain is cumulative. Some weaker pain meds can keep it down if it hasn't advanced too far, but once it goes past a certain threshold then a stronger pain med is needed to knock it back down.

Just some information. Hopefully micronut will chime in, but if he doesn't, I wouldn't hesitate to call the dentist. The nurse will know what to do or can ask the dentist.

G_Gnome

Trad climber

Cali

Jul 28, 2016 - 01:03pm PT

Susan, not a dentist, but it should hurt less every day and most teeth quit hurting in 3 or 4 days. I got a root canal on a lower molar long ago and it never did quit hurting and had to be pulled. So if it still hurts like hell after 4 or 5 days go back in. But it never hurts to call first to get their opinion, they are the experts.

fear

Ice climber

hartford, ct

Jul 28, 2016 - 01:12pm PT

they are the experts

Some of them are. Probably 50/50 around here..... And for the love of G_d if you find a good dentist/endodontist don't lose them!

Crimpergirl

Sport climber

Boulder, Colorado!

Oct 26, 2016 - 08:36pm PT

Checking in for the dental support group meeting.

Recovering on day two from #18 being extracted. It didn't want to go, but the periodontist was victorious. I flipped off the tooth parts as I left.

I am THRILLED! That mofo tooth has been jacking with me for years - and that was even after a root canal/crown. So I sit here drooling a bit with a mouth full of stitches dreaming of corn chips and peanuts. Happily margaritas don't have sharp edges. It's all good. Happy to have the resources needed for the upcoming implant (post healing from extraction and bone graft).

Corn chips. Mmmmm.

the Fet

climber

Tu-Tok-A-Nu-La

Oct 26, 2016 - 08:49pm PT

Plus the ice in the margarita is anti inflammatory. It's really medicinal at this point.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Oct 26, 2016 - 09:12pm PT

Hey there Crimper.....I hope you're healing well. I kind of forgot this thread existed. So glad you got that thing out. Keep 800mg of ibuprofen circulating in your system twice a day and slap an ice pack on that cheek of yours just along the jaw line a few times a day for the next two days. Between the ice and the ibuprofen you probably won't need much of the narcotic.
Feel free to put a bag of tortilla chips, one cup salsa, 1/2 cup margarita mix and three shots of Cuervo into a blender over ice. Blend until frothy, salt the rim of your favorite glass and enjoy. You can also finish the worm out of the bottom of the tequila bottle and place that between your cheek and gum for about 15 minutes twice daily. In the event the socket turns necrotic and gets infected, please make sure to post photos.

All kidding aside, heal fast and fully. The extraction is way more difficult than the implant placement. Reach out to me if you have any questions at any time.

Dr. Micro

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Oct 26, 2016 - 09:16pm PT

Also, my apologies to those of you up-thread that I never reached back out to. Sometimes I stay away from the Taco for a while and this thread must come and go without me noticing it. If you still have questions, feel free to repost or fire away with new ones.

Scott

Russ Walling

Social climber

from Poofters Froth, Wyoming

Oct 26, 2016 - 09:18pm PT

Micro... Still waiting on the sack of falsies you were trying to score for me. Update please.

Crimpergirl

Sport climber

Boulder, Colorado!

Nov 3, 2016 - 12:17pm PT

Thanks Micro...No narcotics used (except some margaritas). I have gnawed VERY CAREFULLY on some corn chips. Unlike normal, I grow tired of eating them long before I rifle the entire bowl of them.

Head back today to get the "dissove-able" stitches out. They have not dissolved a bit! Can't wait to be rid of them - especially the one that I swear is in my tonsil.

I do fear I have some dry socket going on. Boo. I will do my best to post any bloody nasty photos (I regret not grabbing a photo of the pieces of that mofo tooth when the procedure was done).

Be glad when it's all over. Happy to have dental insurance that pays but a fraction of this. It's not much, but I'll happily take it!

Reilly

Mountain climber

The Other Monrovia- CA

Nov 3, 2016 - 01:05pm PT

What a coinkidink! Just back from my quarterly cleaning with my favorite
dental hygienist - Madame Torquemada. Rest assured, I DIDN'T ADMIT TO NOTHIN'!

Crimpergirl

Sport climber

Boulder, Colorado!

Nov 3, 2016 - 06:53pm PT

Seven evil stitches gone! The throbbing has diminished greatly. Looks like I may be avoiding the dreaded dry socket. Yay!

SC seagoat

Trad climber

Santa Cruz, Moab, A sailboat, or some time zone

Nov 3, 2016 - 07:13pm PT

^^^^^. Oh thank gawd.
Had one a million years ago and oh boy....oh boy....

Heal fast!!!

Susan

Ben Harland

Gym climber

Kenora, ON

Nov 3, 2016 - 07:33pm PT

I have a question that you may know the answer to: I'm interested in synthetic tooth enamel. A japanese dental researcher has been doing tests for some years on one and I haven't heard anything for five years or so. Is it coming soon? Is it a white elephant?

In the early days, it made the news media and I'd love it to get developed as a guy with enamel wear issues. Any opinion welcome!

apogee

climber

Technically expert, safe belayer, can lead if easy

Nov 3, 2016 - 07:39pm PT

OK, micro...here's a question for you....

I've been toying around with having several front teeth crowned...I've got a chipped front tooth that I've had since I was a kid, and for the sake of visual consistency, crowning several teeth at the same time seems like the only option. (Veneers don't seem to be an option, given the chipped tooth.)

What do you think of the CEREC process of creating crowns? Is it reliable technology these days? Does it do a good job of matching colors? Are the materials as durable as any other option?

Fossil climber

Trad climber

Atlin, B. C.

Nov 3, 2016 - 08:05pm PT

Micro - really, really good of you to offer this service. There should be more like you.

jbaker

Trad climber

Redwood City, CA

Nov 3, 2016 - 08:44pm PT

Thanks for doing this, Micronut! My dentist told me I need a planing and descaling. My wife and son went in the next week and were told the same thing. Is this a new (or newly covered procedure) that is legit, or just a new way to monetize patients?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Nov 4, 2016 - 02:48am PT

Apogee the CEREC in-house milling system is the bomb. The machine alone is around $100,000 and there is significant training for a dentist to get on board with the technology. Most guys who purchased one and do all the training really know what they are doing. But there is a learning curve to it as a practitioner. I would ask the guy how "long have you been doing this?"

It's pretty high-tech CAD/CAM technology and the key is getting good aesthetics. It's a total no-brainer on back teeth but they mill those things out of solid blocks that don't have a lot of color variance. To do a front tooth and make it look nice and translucent and natural takes real skill and some baking time in the kiln/oven after they hand paint the final product usually. So for back teeth they just mail it out of a white this block that is pretty close to a natural tooth. Front teeth are a different animal altogether and often a laboratory technician who stacks the porcelain and bakes it and does the creative process of colorization can get you a better long-term cosmetic crown that you will be happy with.

Look your dentist in the eye and ask him if he would put the ceric crowns on his front teeth or have a lab do it. If you have a lab do it it will take an extra week or so but you might end up with a better smile. If they can do the custom colorization in house then I would probably go for it. Bottom line, do not let them cement those crowns unless you absolutely love them. Even if they have to remake it and eat the cost after the try-in. Tell them that ahead of time. You need to see those crowns in your mouth without cement Tatian before committing to saying yes I'll buy them. Once they cement/glue them and they are yours to keep. I would probably even asked to walk outside and see them under different lighting then in the dental chair. It's a huge investment and you need to love them or you'll kick yourself.

And to answer your question, yes. The material (eMax usually ) is just as durable if not more durable than your typical porcelain restorations.
Good luck. And remember, you can always go gold up front. Lasts forever.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Nov 4, 2016 - 02:55am PT

Jbaker,

Scaling and root planing is a valid procedure if you have the beginnings of gum disease. There is normally a 2-3 mm pocket around the tooth but if bacteria get down inside that pocket and start to breakdown of the soft tissues you get tartar buildup and bleeding and eventually bone loss from gum disease.

If that pocket is in the four-five millimeter range then deep scaling and root planing is required as a simple cleaning will not be able to get deep enough to get rid of the inflamed tissue and subgimgival build up.

If the pocketing becomes 6-9 mm we do gum surgery to repair the damage.

Scaling and root planing is not indicated for pockets less than 4 mm deep. Ask to see your periodontal charting and have them show you in your mouth where the deep sites are. Also, ask them if you should be seeing a periodontist.

Many general dentist offices use it as a money earner. I see it all the time and they often talk patients into it who do not need it.. Many are just good and diligent and use it on their patients when they need it or refer them to a periodontist like me. A Periodontal office does the deep scaling over four visits. One hour each visit for each of the quadrants. You will get anesthetic and they will numb you good and thoroughly. You should not need any pain medication after the work other than motrin. Pretty mild procedure. And our office it is $240 per quadrant. That's in a moderate sized town in California. That should give you some idea of what you're looking at.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Nov 4, 2016 - 02:57am PT

Thanks Fossil. This thread is actually kind of rewarding believe it or not.

And as far as the Dremel tool is concerned. You would be surprise what I see.

Reilly

Mountain climber

The Other Monrovia- CA

Nov 4, 2016 - 07:14am PT

A Dremel? I wish! Madame Torquemada just uses her Swiss Army knife!

High Fructose Corn Spirit

Gym climber

Nov 30, 2016 - 07:49pm PT

Crimpergirl, if you're still around, could you share what your molar symptoms were before you elected to get your tooth pulled and implanted.

What was your pain history with this particular tooth. Did it start making noises weeks, months or years before you made the decision to get it pulled?

Knowing what you know now, is there anything you would've done differently at any point along this process? re root canal, etc?

Very curious here.

My #31 (right bottom furthest rear molar) has been presenting once again with enough discomfort that I've shifted to left-side chewing all the time now. I'm ready to defer 100% to my dentist who thinks we need to drill out an old composite, see if there's any infection under it and proceed from there. This is to happen next week.

In the interim I'm wondering if it might be a case of just grinding my teeth as that possibility was raised as well.

So I remembered this thread and your posts and was wondering what your history profile regarding said tooth was. Maybe anything you can describe in this regard might be helpful? Any feedback welcome. Thanks.

Did your tooth x-rays show anything pathological? My x-ray on this tooth continues to show healthy roots.

For the next few days I'm going to be sleeping with a plastic tooth guard that once upon a time I had casted for bleaching - just to see if this could prevent any suspect grinding and aid healing. Wouldn't that be something if that was all it was. Fingers crossed.

If it turns out I in fact need a root canal, which I hear can be problematic, I might just bypass this altogether and go straight for an implant, which the dentist says is strong as anything. I'd love to have that capability and feeling of max strength back.

Jaybro

Social climber

Wolf City, Wyoming

Dec 1, 2016 - 07:10am PT

60 yr old with minimal ACA policy, a mouth full of holes, dropped fillings,cracked crowns, broken teeth, no money.

Where should I start?

G_Gnome

Trad climber

Cali

Dec 1, 2016 - 10:10am PT

In Thailand!

skcreidc

Social climber

SD, CA

Dec 1, 2016 - 10:14am PT

I bought a Dremel tool a while back. There was a warning on it: "Not for use in dental applications". Why do they need that warning?

This is one litigious society we live in. On the other hand do the RPM go high enough on those suckers?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Dec 1, 2016 - 10:17am PT

My #31 (right bottom furthest rear molar) has been presenting once again with enough discomfort that I've shifted to left-side chewing all the time now. I'm ready to defer 100% to my dentist who thinks we need to drill out an old composite, see if there's any infection under it and proceed from there. This is to happen next week.

In the interim I'm wondering if it might be a case of just grinding my teeth as that possibility was raised as well.

So I remembered this thread and your posts and was wondering what your history profile regarding said tooth was. Maybe anything you can describe in this regard might be helpful? Any feedback welcome. Thanks.

Did your tooth x-rays show anything pathological? My x-ray on this tooth continues to show healthy roots.

For the next few days I'm going to be sleeping with a plastic tooth guard that once upon a time I had casted for bleaching - just to see if this could prevent any suspect grinding and aid healing. Wouldn't that be something if that was all it was. Fingers crossed.

If it turns out I in fact need a root canal, which I hear can be problematic, I might just bypass this altogether and go straight for an implant, which the dentist says is strong as anything. I'd love to have that capability and feeling of max strength back.

Fructose,

Heres a couple thoughts.....

1. Yeah, let the dentist go in there and excavate first. Once he gets in there a few things will dictate the next step. He will either

a) remove the decay ad do a filling. Done. All better.

b) if the decay is extensive (ie. more that 1/3 the tooth) you might need a crown over the top to keep it from fracturing down the road.

c) if the decay is REALLY deep and into the pulp you will need a root canal and a crown. This gets expensive but if the endodontist gives it a good prognosis and the dentist thinks he can make you a great crown, then that's still better most of the time than extraction. My wife just had this done and we decided to do the root canal and the crown becauyse she still had lots of good tooth and root down there and I personally know the endodontist and the dentist and they do impeccable work.

d) he will keep excavating and find that there just isn't enough sound tooth structure (or a fracture is seen or suspected) and the tooth will be deemed hopeless.

In which case you would move toward extraction, a bone graft (minor deal...just involves putting some freeze dried cadaver bone into the hole like potting soil to help grow new bone and provide for a nice solid base for the implant) and a dental implant. This is a fantastic option and one that will most likely last you the rest of your life. I do a few hundred of these a year and patients love them once its all done.

A big filling, root canal and a crown can run you a few thousand dollars and if the tooth is still a bit dodgy then sometimes its prudent just to go with the implant and pay a bit more.....rather than end up with an implant in a few years anyway.

Hope that helps!

Scott

fear

Ice climber

hartford, ct

Dec 1, 2016 - 10:18am PT

Plenty high enough. Problem is not the speed but that having an actual 120v electric motor in your mouth is generally regarded as poor form.

High Fructose Corn Spirit

Gym climber

Dec 1, 2016 - 12:12pm PT

Micro, thanks!!

I intend to follow every bit of your beta. Your expertise is much appreciated.

I'll see how it goes and report back.

...

That you do about 300 implants a year is... simply... AMAZING. I'm sure this translates to MUCH pain and suffering reduction for hundreds of people. Amazing science and art form you do. Kudos.

ms55401

Trad climber

minneapolis, mn

Dec 1, 2016 - 04:06pm PT

thanks for the info

what's your take on the importance (or not) of flossing? have seen at least a couple pieces in reputable newspapers saying it may not be necessary and that its impact has not been rigorously assessed

I floss -- most but not all nights -- but would be just as happy to have 2 minutes returned to me

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - May 9, 2017 - 05:29pm PT

ms55,

That "Anti-Flossing" ad/rhetoric/article has been making the rounds lately. Its kinda funny. How do you feel about showering in general. Or changing your socks?

Don't shower for a week....smelly. A month, possible skin sores and serious flaky funk. Three months? Rash, inflammation, scabies?

The thing with flossing is this. Yes, its a hassle. But Brushing alone only removes about 70% of the plaque mass. Leave enough plaque in between the teeth for long enough and you'll get inflammation, cavities and eventually gum disease if you are at all susceptible.

Some people use toothpicks or little skinny floss picker thingies. But those are usually a bit too chubby to fit under the contact point. If they happen to fit for you, then that's kosher. Its not that floss is something magical in itself. Its just recommended to get all the plaque off your teeth every 48 hrs or so in some way shape or form.

Mouthwashes won't do it. They can't penetrate under that ticght contact point. Waterpik is a maybe and works in some cases if the teeth and spaces are just the right size (More spaces is better for Water-Piks).

Bottom line, whoever wrote that article got some media time and some click-bait. But overall the point is that in order to avoid gum disease, you need to do something in your daily routine to get between the teeth. Hope that helps!

Here's a quick public service photo for what I fix every day. Come see me if you don't like to floss and end up looking like this guy! As a Periodontist I see about a case like this every three days or so. Love it!!!

Reilly

Mountain climber

The Other Monrovia- CA

May 9, 2017 - 05:53pm PT

Aaaargh! Now I'm motivated to go to my hygienist, Madame Torquemada, this Thursday:

rottingjohnny

Sport climber

Sands Motel , Las Vegas

May 9, 2017 - 07:47pm PT

Micronut....Wouldn't it be cheaper to have all your teeth pulled and replaced with dentures...all those dental procedures seem too expensive...? rj

Fossil climber

Trad climber

Atlin, B. C.

May 9, 2017 - 07:51pm PT

Thanks Micronut --

I was once a medic/dental tech in the Navy (Korean War) and appreciate what you do. Thanks for offering free advise!

Jaybro

Social climber

Wolf City, Wyoming

May 10, 2017 - 06:35am PT

What if you get a phaser, I mean laser, beam to the brain?

Ps I found some implants I can afford....

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - May 10, 2017 - 09:27am PT

Del Cross,

I was kind of kidding about the shower analogy. I've gone 28 days without it in the backcountry with no scabies! But spend some time in hospitals with indigent folks who don't/cant bathe and you'll see it ain't so fresh and clean.....gnarly skin diseases can come from bacteria left undisturbed on the surface.

The bottom line with the flossing points I made (and this IS steeped in years of clinical trials and induced pathogenesis models ad nauseum) is that if you leave a "periodontopathogenic" plaque mass between the teeth long enough you get breakdown of the periodontal ligament, chronic inflammation, eventually bone loss and gum disease. Let alone decay if you are susceptible. Whatever you chose to use break up that plaque film use is fine. Floss is just one of the most effective in most mouths with normal spacing and contacts.

REMEMBER: You don't have to floss ALL your teeth........JUST THE ONES YOU WANT TO KEEP!

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - May 10, 2017 - 09:43am PT

SomebodyAnybody,

Sounds like you are on the right track in general. Here's a couple thoughts from my own practice and I'm a periodontist.

1. For early gum disease (4-6mm pocketing), Scaling and Root Planing (deep cleanings) is the first line defense. We don't use a laser at this stage but some offices do. It may have some small benefits at that level, but I don't tend to see much improvement in doing it with a laser or just doing it by hand alone. The laser is a bit of an adjunct if anything at that setting. The laser at the low levels allowed for a hygienist, kills some bacteria and stimulates circulation at a micro level. Its not the surgical setting I use that has a cutting/coagulating function. But I can't justify charging patients for it since I have a rock-star hygienist who is amazing and gets great results without the laser. If she does her two visit tango and gets all the tartar off from below the gumline, removes some inflammatory tissue in the process with her tools, and motivates/shows you how to take care of it at home, that early gum disease GOES AWAY. She's a wizard with early periodontitis cases.

2. As the gum disease gets more severe (5-8 mm pocketing, bone loss and mobile teeth) we then bring out the big guns and do LASER Gum Surgery. I use the LANAP protocol and its invasive but conservative and does an amazing job at stopping the disease. Its about 5-6k and is really thorough, but it saves teeth and is really a fantastic option vs. losing your teeth.

3. Lastly. Periodontitis (gum disease) is a disease PROCESS. Think of it like diabetes or high blood pressure. Susceptibility, genetics and your behavior all play major roles. You can be stable and "cured" for a while and the disease can stay away or surprise you and come back. Sometimes its the patient's fault.....no cleanings for a while, they stop flossing, eat like crap and neglect their mouth and the disease returns. Sometimes the patient does everything we ask them. They do the deep cleanings. They improve their homecare and diet. They do the surgery.....and they still decline. Its tough. That's what makes working on the human body so challenging.

My goal is to always do my best to keep them healthy with the most conservative treatment possible and to watch them closely for relapse and stomp on it if it rears its ugly head.

Just know that if you have dealt with some gum disease in the past, you need to keep a close eye on it (3-4 month cleanings is standard for maintenance) and be willing to re-treat if things start to come back a bit.

Hope that helps!

Scott

Russ Walling

Social climber

from Poofters Froth, Wyoming

May 10, 2017 - 04:58pm PT

Micro! You got a bag of falsies for me yet?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - May 10, 2017 - 05:50pm PT

They did suggest I either quit coffee or brush right afterwards, saying the staining was harboring the bacteria

Dude thats terrible and totally false!! Seriously!

Do not stop drinking coffee.....I drink three cups a day. It's one of the joys of life. Do not give it up. There is no research to support that nor have I ever seen it and I do this all day long.

Just be a good thorough brush and floss or when you do it. And maybe consider drinking if you sips of water after your last cup of coffee if stain is a real issue for you. It really has nothing to do with gum disease so don't worry about it.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - May 10, 2017 - 05:52pm PT

Russ I got nothing man. I just do gum surgery. You need to find a dental lab!

Jan

Mountain climber

Colorado & Nepal

May 10, 2017 - 07:33pm PT

I have questions regarding bone growth in the mouth. I have a cauliflower shaped bony lump on the roof of my mouth which shrinks or grows depending on the amount of supplemental calcium I take. The other is that I have prominent bony phlanges running the sides of my upper jaws. My Japanese dentist in Okinawa when I lived there told me he had never seen those before (the lump in the roof of the mouth he had). He also said in his dental book that they mentioned it was typical of Eskimos. Since I am about 10% Native American and have mildly shovel shaped front teeth, I attributed it to that.

Now my American dentist (trained in Cleveland) says that he thinks they are the result of me grinding my teeth. Since I have never had any indication of that and I have slept in rooms full of people in Asia who probably would have noticed, I was doubtful, but he was adamant. He also said I could never be fitted with dentures on my upper jaw because of the bony protrusions and would need implants instead.

I know that Eskimos particularly the women, used to soften leather by chewing it so maybe that was equivalent to grinding teeth??

I'm wondering then what you make of all this?

zBrown

Ice climber

May 16, 2017 - 02:13pm PT

Your thoughts on the going rate for sinus lift bone graft plus implant and crown (in Southern Cal) would be appreciated.

I didn't even know such a thing existed and, luckily for me at least, it's not my jaw.

40,000 year old human mandible, believed to be Romanian

High Fructose Corn Spirit

Gym climber

May 16, 2017 - 02:40pm PT

Micronut's advice in my case was right on.

My dentist excavated an old filling, then refilled it with new composite. The investigation showed not only new caries under the old filling but also the depth of the caries approached very near the root; indeed he said he could see through the remaining layer after cleaning out all the decay (a trained eye, I guess) right to it, i.e., the root, and dared not go any deeper. I asked about a future root canal probability. Pressing him, he told me 70-30 odds. I asked 70-30 against or 70-30 for. He said 70-30 for... root canal. So I've started preparing for one, expectations-wise.

All that was many months ago. So far so good. In other words, no pain. At tooth #31. In the meantime I've shifted my chewing (esp hard stuff, like ice cubes, no just kidding), 90 per cent of it, say, from my right side to my left. This was awkward at first but now it feels "second nature". So harray for all that.

Thanks, Scott, for your advice. It helped in the decision-making.

Spider Savage

Mountain climber

The shaggy fringe of Los Angeles

May 17, 2017 - 07:53am PT

I've got a decent dentist. Year after year, never finds anything. Just cleans and sends me on my way.

So this kid I know is diagnosed with six cavities to fill. He doesn't have the money and puts it off for 3 or 4 years. I send him to my dentist and nothing! No cavities. Cleans his teeth and sends him on his way.

So, what is the deal? Are fillings optional?

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jun 28, 2017 - 04:34pm PT

Jan, ZBrown and Spider....gimme a few minutes to come up with some replies....starting a surgery in a few minutes. I'll get back to you asap.

HFCS glad to hear I was some help in your situation!

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jun 28, 2017 - 04:43pm PT

Jan you have what is called a Palatal Tori or Torus Palatini. VERY common. I see two or three a week. I often point them out to the patients who have no idea they have them...even big ones. They can range from fairly small...

to big old honkers....

Here is some cut and paste from the interwebs that seems spot on.

Palatal tori are more common in Asian, Native American and Inuit populations, and twice more common in females. In the United States, the prevalence is 20% - 35% of the population with similar findings between black and white people.

Although some research suggest palatal tori to be an autosomal dominant trait, it is generally believed that palatal tori are caused by several factors.[1] They are more common in early adult life and can increase in size. In some older people, the size of the tori may decrease due to bone resorption. It is believed that tori of the lower jaw are the result of local stresses (like clenching and grinding) and not solely on genetic influences

If they don't bother you, we don't typically remove them. Its a bit of a hassle surgery and can be pretty painful for a few days afterwards. If a person does end up needing a full upper denture then we do remove them so the denture can fit nicely up against the roof of the mouth. Good luck and let me know if you have any more questions!

Scott

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jun 28, 2017 - 04:49pm PT

ZBrown my fees up in Fresno are as follows:

Surgical placement of implant $2700.00
Bone graft or Sinus lift about $1500.00

This does not include the price of the tooth/crown that goes on top of the implant once it heals up and is ready for "restoration."

Hope that helps give you a framework for what you might end up needing. Cheers.

Scott

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jun 28, 2017 - 04:52pm PT

Spider Savage let me break this down for you....

Either:

A: Your dentist isn't properly diagnosing the decay in your friend (and possibly you) and the new guy is right and its time your dentist hangs up his hat.

or

B: Your dentist is right, neither of you have any decay/cavities and the other guy is a snake oil salesman and is illegally over-diagnosing and is just tring to make money.

Diagnosing cavities is SIMPLE. Current x-rays and a visual/tactile exam are all that is needed. This is THE MOST BASIC skill a dentist or hygienist has and utilizes on a daily basis. It ain't rocket science. Get another opinion STAT. What town are you in....maybe I know somebody you can trust.

NO. Fillings are not optional. If you have decay, you need to remove it, patch it up and fix it or it typically spreads, going deeper into the tooth, undermining healthy enamel as it goes. Leave it untreated long enough it can lead to pain, big expensive fillings, root canals, big expensive crowns or eventual tooth loss. Fix it while its small and its usually a couple hundred dollar patch job at most.

zBrown

Ice climber

Jun 28, 2017 - 09:01pm PT

Thanks Scott. The implant # tracks pretty well with San Diego.

I had one not too long ago. The graft like I said, I'd never even heard of,

Have you heard of (or seen a paper on) "anatomical extraction"?

I was having an old bridge "deconstructed" and whole process was smooth as silk.

The surgeon was an ex-engineer and is now retired do I don't know if he ever finished the paper.

Thanks again.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jun 29, 2017 - 09:42am PT

Glad to help zBrown. My pleasure.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Dec 4, 2017 - 08:45am PT

Spider Savage.....just checking in. What ever came of that visit? Did things turn out ok?

Mighty Hiker

climber

Outside the Asylum

Dec 29, 2018 - 07:58pm PT

Look! Another ST dental resource. Scott may have competition!

Breaking news: you, too, can now own a long out-of-print copy of the famous book by Dr. Joe McKeown, "Everybody's Tooth Book" (published 1973, Happy Valley Apple Press) for ONLY $83.24 plus shipping. Warning: the listing on Abe Books doesn't do the actual cover justice. Many of the interior illustrations were done by Joel Beck, phenomenal (underground) cartoonist who had to be plied by the author with drinks at The Spot bar in Pt. Richmond to finish the drawings (those were the daze!)—maybe alone worth this steal of a price?! (Full disclosure: a less expensive version, at $5.30, can also be found on eBay—neither are sold by Dr. Quack himself).

Autographs will be available at the next Facelift, for a modest donation to the YCA.

Ricky D

Trad climber

Sierra Westside

Dec 29, 2018 - 09:10pm PT

Why aren't teeth a single ridge of enameled bone shaped with the same cutting and grinding surfaces?

Seems it would greatly reduce the incidence of cavities if there were no nooks and crannies between individual structures.

hooblie

climber

from out where the anecdotes roam

Dec 29, 2018 - 09:34pm PT

^^^ mess with the flossdaddy and you get da drill

briham89

Big Wall climber

santa cruz, ca

Jan 17, 2019 - 01:16pm PT

Scott you rule! Question about minor to moderate gum recession...how long can you wait before getting a gum graft? Will waiting 6 months or a year cause adverse effects / complications? Mainly wanting to wait for dental insurance to kick in.

tradmanclimbs

Ice climber

Pomfert VT

Jan 17, 2019 - 03:45pm PT

cracked a tooth on a frozen Hershey bar (see what happens when you go with cheap chocolate) after a big solo ice day almost 3 years ago now. My dentist wants to do a crown before the root dies. it will be about 2k?? toying with the thought of starting a go fund me. heck I contribute to lots of these for medical expenses but I am still having a hard time pulling the trigger....

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jan 17, 2019 - 04:08pm PT

Brian,

No....nothing to get too stressed out about. Gumline recession usually takes years to develop and doesn't usually move too fast. I wouldn't put it off for two years...but waiting several months shouldn't be a problem. The main thing you want to find out before getting it fixed is "Why do I have it?" It's not always just from brushing too hard. Usually it has to do with a clenching grinding habit, acid reflux, aggressive ortho movement as a kid, ect....many factors. Try to have your periodontist get to the bottom of why you have it, that way if they fix it you can protect your investment (wearing a night guard, using a Sonicare, etc....)

BTW, Ask him if he does the Pinhole Surgical Technique. It state of the art and the way to go if you're a candidate. Its how I roll and it is pretty much painless and I don't have to harvest gum tissue off your palate to do the graft. No blade or stitches either. Look into it. Google me or the Pinhole Surgical Technique.

Scott

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Jan 17, 2019 - 04:25pm PT

Tradman, go get that thing crowned (As long as you have a great dentist, a well done crown can last 15-20 years or more). If there are little micro-fractures and that thing isn't covered and you split it eating a taco, you're probably gonna need the tooth pulled and an implant which is great long term but is gonna put you in the poor house at 4 grand. Do the crown now. Its like having one bald tire and putting it off too long.....one bald tire change vs a whole new set if you dilly dally. Just my two cents. Good luck!

Scott

Reilly

Mountain climber

The Other Monrovia- CA

Jan 17, 2019 - 04:33pm PT

micro, BITD my dentist hooked me up with nitrous oxide and some nice headphones.
Heck, I almost looked forward to getting drilled on! How come no more nitrous?

johntp

Trad climber

Little Rock and Loving It

Jan 17, 2019 - 06:04pm PT

Good on ya nut for keeping this going.

Reilly, lately kidz have been abusing nitro.

Jon Beck

Trad climber

Oceanside

Jan 17, 2019 - 06:08pm PT

My dentist wants to do a crown before the root dies. it will be about 2k?? toying with the thought of starting a go fund me.

Plan a trip to San Diego and get it done in TJ, I can get you a referral to a great dentist. the money you save will more than pay for your trip.

https://www.whatclinic.com/dentists/mexico/tijuana/dental-crowns?adwords=true&gclid=Cj0KCQiA7IDiBRCLARIsABIPohgy_mwYbryGej02EAV230FhlVTPtB1WaAwTDhKjMeSfroBniLUCDiwaAoqfEALw_wcB

tooth

Trad climber

B.C.

Jan 17, 2019 - 09:00pm PT

But just please don’t ever come complaining to me after you have been to Mexico for dental work. This walked into my office from MX this week.

Scott wouldn’t put implants in this environment but someone did since they knew they would never see this patient again once they flew home after paying cash.

Ricky D

Trad climber

Sierra Westside

Jan 17, 2019 - 09:58pm PT

Someone needs a wax job on that upper lip.

D Murph

climber

May 22, 2019 - 01:20pm PT

Scott, tooth,

Went to dentist today and they asked me at the end if I wanted a fluoride foam treatment for $40. I've had a couple cavities in the past so I took it.

What are your thoughts on this? Worth it or not so much? Price reasonable?

Thanks!

Dennis

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