Hi Cyberphonics,

I am in the dental field (for many years) and will offer you what ever help I can. First I just want to say that it is not ideal to see so many different dentists. It sounds like you are being passed off from one to another at their convenience similar to how you would be treated as a patient at many dental schools. These dental type clinics usually employ sub par dentists and/or brand new dentists which means the quality of the care could be lacking in ways that you would not be aware of. The dentists will also disagree with each other and treat the same tooth differently... which means if one does not finish something, it will just get over looked or turn into something different. Frequently the patient ends up with one problem after another because nothing ever really gets definitively diagnosed properly and treatment is often incomplete or just not that good. Would you be able to seek dentistry from a private practice rather than this type of office?

I will repost your questions and reply in bold type.

Here are my questions...

1) All they told me about the lower left at the desk is that they're waiting for insurance authorization for a crown for it. That's fine but is there nothing that can be put in there temporarily in the mean time? My golden age dentists would never have just left a gaping hole in my tooth let alone not explained why they weren't treating it. Even if the reason is that it might come back out like the other guy suggested, that's better than nothing. I'm afraid that it's going to fracture the tooth due to being exposed since the hole is so big that everything I eat goes in there, gets compacted, then starts putting pressure on the gum and walls of the tooth as I chew, which I told them. What should I ask to be done to fill this gap?

I CAN ONLY ANSWER BASED ON YOUR DESCRIPTION SINCE YOU HAVE NOT POSTED AN XRAY. IT SOUNDS LIKE THIS TOOTH MAY NOT BE SALVAGEABLE SO THEY ARE NOT IN ANY HURRY TO PUT A CROWN ON IT. ALTHOUGH THIS TOOTH SEEMS URGENT TO YOU, THE REASON IT BROKE OFF THE WAY IT DID WAS BECAUSE IT HAD TO BE FRACTURED TO BEGIN WITH WHICH MEANS BACTERIA HAS BEEN GETTING IN UNDERNEATH THE FILLING FOR WHO KNOWS HOW LONG. AGAIN I HAVE NOTHING GO GO BY BUT YOUR DESCRIPTION BUT THERE MAY NOT BE ENOUGH TOOTH STRUCTURE TO HOLD A CROWN.

2) What should I insist be done with the root canal? Should I insist on being referred to an endodontist? I'm not interested in getting it extracted unless the pain won't go away no matter what. I've read here that root canals always have infections in them even if you're not in pain so you should just get your teeth removed. Being that I've had root canals where it's now 10 years later without issue, I hesitate to think teeth should be ripped out just because they've had a root canal under the assumption that every root canal tooth is full of infection.

TEETH SHOULD NEVER BE "RIPPED OUT". TO HELP YOU UNDERSTAND BETTER..... THERE IS NO "ASSUMPTION" ABOUT ALL ROOT CANALED TEETH BEING INFECTED. IT IS A FACT THAT THEY ARE INFECTED AND ALL DENTISTS KNOW THIS. THE TOOTH CAN NEVER BEEN CLEANED OUT COMPLETELY WHICH MEANS INFECTED NERVE TISSUE WILL ALWAYS BE PRESENT INSIDE OF THE TOOTH. IRRELEVANT OF WHETHER THERE IS PAIN OR NOT, THE INFECTION SPREADS FROM THE TOOTH INTO THE LIGAMENT AND ON TO THE BONE. UNFORTUNATELY NO ONE IS IMMUNE TO THIS HAPPENING IRRELEVANT OF WHAT IS DONE TO THE TOOTH. THE QUESTION SHOULD BE... WHAT IS MOST IMPORTANT TO YOU? YOUR OVERALL HEALTH OR RETAINING INFECTED TEETH? ONLY YOU CAN ANSWER THAT.

<<THIS tooth, however, definitely has problems so I want to know what I should ask to have looked at and checked before even considering extraction or retreatment. My main fear is that it wasn't necessary. Can someone explain why a big deep filling = root canal? I came in because the filling cracked. I had no problem with the tooth before that. Why would replacing the filling not be an option? Even if it cracked again in 5 years I'd rather that than have been told I HAD to have a root canal if that wasn't true.>>

FIRST TO CLARIFY WHAT DECAY ACTUALLY IS... IT IS WHEN THE TOOTH ROTS FORM BACTERIA. DECAY IS INFECTION.
MERCURY (SILVER COLORED) FILLINGS EXPAND AND CONTRACT WITH HOT AND COLD TEMPERATURES SO THE MATERIAL PULLS AWAY FROM THE TOOTH RESULTING IN OPENINGS ALONG THE MARGINS OF THE FILLING. THERE IS ALWAYS DECAY UNDERNEATH THESE FILLINGS WHICH IS NOT PICKED UP ON AN XRAY UNTIL IT IS DEEP. ONCE DECAY HAS GOTTEN CLOSE TO OR REACHED THE PULP OF THE TOOTH, THERE IS NO WAY TO UNDUE, MEND OR REVERSE THAT OCCURRENCE AS THE TOOTH WILL REMAIN INFECTED IRRELEVANT OF WHAT IS DONE TO IT. ONCE THE TOOTH HAS BROKEN DOWN TO THE POINT WHERE IT CAN NO LONGER HOLD A FILLING, THEN A CROWN OR ONLAY NEEDS TO BE DONE.

3) I've read that fillings in back teeth are more concave than the front but the filling that guy did on the upper left feels abnormally concave. It feels noticeably deep and the surroundig tooth feels noticeably sharp as if there's a hole rather than a filling and I've never had an upper filling feel like that. Can they just pack more of something on top of it to fill it in a bit or would they have to redo the filling?

NO POSTERIOR (BACK) FILLINGS ARE NOT NECESSARILY CONCAVE. THEY ARE CARVED DOWN TO FIT INTO THE EXISTING BITE. ONE OF TWO THINGS MAY BE HAPPENING HERE. ONE THE DENTIST LACKS IN HIS SKILLS. TWO YOUR BITE IS WAY OFF AND IN ORDER TO FIT THE FILLING INTO YOUR EXISTING BITE THE OCCLUSION (BITING SURFACE) PORTION OF THE FILLING HAD TO BE GROUND DOWN SEVERELY.

4) What could be going on with my front crown and how can I protect it? I know they think I'm nuts but I've had that crown in for a while and that movement is new and obvious and even if it does't make sense, it DOES seem to tighten back up on its own. I'd rather not just wait until it falls off because I fear that by then, my tooth underneath will have suffered decay. I agree that I don't want them to try to rip it off if it won't come off on its own but is there some way they could seal around it or check to make sure the seal has no space?

FREQUENTLY WHEN A CROWNED TOOTH FEELS LOSE AND THEN TIGHTENS UP THIS INDICATES A PROBLEM WITH THE TOOTH. IT CAN BE RELATED TO DECAY IN THAT TOOTH, PERIODONTAL DISEASE AND/OR INFECTION IN THE JAW BONE. FIRST THE PROBLEM NEEDS TO BE DIAGNOSED. SECONDLY THERE IS NO WAY TO "SEAL" AROUND THIS CROWN.

5) How long can a tooth be dying before anything shows up on xray? My front tooth that gets the weird inner pain from touch every once in a while, I know they said they see nothing but I read on some boards where no one would do anything to help because they didn't see anything until it was too late and the person lost the tooth. Is there anything I can do to be preemptive if the xrays show nothing?

MANY DENTAL PROBLEMS DO NOT SHOW UP ON XRAYS UNTIL THEY ARE SEVERE. THERE ARE RADIOGRAPHIC AND CLINICAL SIGNS THAT MAY INDICATE SOMETHING IS GOING ON EARLY ON, BUT NOT ALWAYS. YOUR DESCRIPTION OF SYMPTOMS WITH THIS TOOTH INDICATE A PROBLEM IS BREWING.

6) This is just curiosity, is it normal to always put a crown on both front teeth? Back when I had a root canal in my front tooth, when he shaved it down to get ready to fit it for a temporary crown, when he let me look at it I saw that he shaved down the root canal tooth and the healthy tooth next to it. I freaked out because no one said they were touching the other tooth but it was too late after the fact, it was already shaved down to a nub. He said he HAD to put a crown on that one too because it's next to it. Is that a cosmetic standard? For the record, I don't recall which of the front ones had the canal so I'm most scared about the moving crown because I'm afraid it's on the one that was the healthy tooth.

YOUR "HEALTHY" FRONT TOOTH COULD BE INFECTED SINCE IT IS NEXT TO THE INFECTED ROOT CANALED TOOTH. AS I MENTIONED EARLIER, THE INFECTION SPREADS AND IT IS COMMON TO SEE SEVERAL ROOT CANALED TEETH IN A ROW.... WHEN ORIGINALLY THERE AT ONLY BEEN ONE.
I CANNOT TELL YOU WHY YOUR DENTIST CROWNED BOTH OF THOSE TEETH AS HE MAY HAVE DONE IT FOR COSMETIC PURPOSES SINCE HE KNEW THE RC TOOTH WOULD TURN BLACK DUE TO ISCHEMIA. IT IS TYPICAL TO CROWN BOTH FRONT TEETH AT ONE TIME BECAUSE IT IS DIFFICULT TO MATCH A CROWNED TOOTH TO A NATURAL ONE.

7) I read that it's illegal for a dentist to refuse you a copy of your records. Is that true? Months ago I asked the staffer for a copy of my treatment history there and she gave me an attitude and said no, unless you're moving to a new dentist, you don't need to see your records. I've had so much work done and I want proof of it all since I've also read about dentist's tossing stuff out or modifying things to cover their asses. Do I have the right to demand a copy of my entire folder including xrays and if they refuse again (that staffer is no longer there), what's my recourse? Who can I report it to? Should I start with my union since that's who my dental plan is from?

YES YOU HAVE THE RIGHT TO OBTAIN ALL OF YOUR DENTAL RECORDS. THEY MAY CHARGE YOU FOR EACH PAGE AND XRAYS. IF THEY DO NOT COMPLY THEN CALL THE UNION REP AND/OR CALL THE DENTAL BOARD AND COMPLAIN.

8) Last question, most importantly, I want to be able to get second opinions on things but no one ever details HOW they got a second opinion. From what I see, you can't just walk into an office you're not a patient of and ask them to look at something and give you an opinion to take back to your actual dentist. So for people saying "I just went and got a second opinion", what did you do exactly?

IF YOU ARE INSURANCE DEPENDENT, THEN GETTING A SECOND OPINION MAY HAVE TO BE APPROVED BY YOUR INSURANCE CARRIER. IF YOU ARE WILLING TO GO OUT OF YOUR NETWORK, THEN YOU CAN CALL ANY DENTIST FOR A SECOND OPINION. HOWEVER, YOU WOULD NEED TO BRING ALL OF YOUR XRAYS WITH YOU OR THEY WOULD TAKE NEW ONES BECAUSE THEY CANNOT ACCURATELY DIAGNOSE YOUR DENTAL ISSUES WITHOUT BEING ABLE TO SEE WHAT IS OCCURING BELOW THE GUM LINE.

Did you make an appointment somewhere and bring a copy of your records and they gave you a free consultation? Did you have to sign up as if you were a new patient with your insurance and pay a copay for being seen or pay out of pocket? I want to find a new permanent practice but until then, how do I go about just getting advice from another dentist/endodontist?

NOT ALL DENTISTS WILL OFFER A FREE CONSULTATION. IF YOU HAVE A RESTRICTED PLAN AND YOU ONLY WANT TO STAY WITHIN THAT PLAN THEN YOU WILL HAVE TO CALL YOUR INSURANCE CARRIER ABOUT SEEKING A SECOND OPINION.

Bryanna