Hi Tom,

Yes, it's been awhile since we chatted. Are you still playing golf?

The chances of your dentist seeing these posts is pretty slim as this isn't the type of site they would most likely visit. Even if they did, they would not be able to tell if you were their patient or not because they deal with the same issues with so many different people.

To make it a bit easier to follow, I am going to re post some of your post and reply in bold type.

<<I always got a checkup twice a year when I worked and had insurance. They told me last year being my teeth were in good shape they would see no reason if I wanted to wait a year so I of course I agreed. Bad move now I am thinking.>>

DENTAL CARE IS EXPENSIVE. HOWEVER, PUTTING OFF PREVENTIVE CARE IS NOT REALLY IN YOUR BEST INTEREST FOR MANY REASONS. SO INSTEAD OF HER SUGGESTING THAT YOU COME IN LESS FREQUENTLY, SHE SHOULD HAVE JUST OFFERED YOU A SENIOR DISCOUNT MAKING PREVENTIVE CARE A BIT MORE AFFORDABLE TO YOU. THEN THESE CAVITIES WOULD HAVE BEEN CAUGHT A BIT EARLIER BEFORE THEY BECAME A BIG PROBLEM.

<<I go in last week and was told I have cavities under two of my older crowns. I also have cavities# 4-9 -24-25-26 and 32. My Dentist asked me what had changed in my health for all these cavities to show up and I don't have a clue. She asked me if I eat sweets and I told her only once in a while>>

DOES YOUR DENTIST TAKE CHECK UP XRAYS ONCE A YEAR? THESE WOULD BE ABOUT 4 XRAYS EACH TIME. THE REASON THESE XRAYS ARE NECESSARY FOR MOST ADULTS TO HAVE IS BECAUSE THEY CATCH THE CAVITIES IN PLACES THAT WE CANNOT OTHERWISE SEE AND BEFORE THEY DEVELOP TO INTO SOMETHING BIG.

DECAY DEVELOPS UNDERNEATH CROWNS BECAUSE:

1) THE CEMENT HOLDING THE CROWN ON HAS AN ADHESIVE SHELF LIFE OF ABOUT 5-10 YEARS, DEPENDING ON THE TYPE OF CEMENT USED. ONCE IT'S WORN OUT, IF THAT CROWN LOOSENS OR THE TOOTH BECOMES COMPROMISED FOR ANY REASON, BACTERIA WILL GET IN AND UNDERNEATH THE CROWN CAUSING DECAY TO OCCUR.

2) IF THE ORIGINAL DECAY WAS NOT ENTIRELY REMOVED WHEN THE TOOTH WAS PREPARED FOR THE CROWN, IT WILL EVENTUALLY BECOME LARGER AND DEEPER. DEPENDING ON THE PERSON, THIS CAN TAKE YEARS TO PROGRESS OR IT CAN TAKE ONLY A FEW MONTHS.

SOME OF THE THINGS THAT CONTRIBUTE TO TOOTH DECAY ON TEETH THAT ARE NOT CROWNED ARE:
SUGARY, STARCHY AND STICKY FOODS.... POOR ORAL HYGIENE ... PLAQUE BUILDUP .... DRY MOUTH .... MANY MEDICATIONS .... DIGESTIVE ISSUES ..... DEHYDRATION ..... CERTAIN HEALTH CONDITIONS, ETC.

<<She asked if I was diabetic and I told her my last A1C in November was 5.6 and I have never been told I was diabetic. I do know my blood sugars have been easing up for the last 12 years but I do watch what I eat and test several times a week to make sure I am keeping good control and I do exercise almost everyday. Never had an A1C over 6.0 in the last 12 years but I still ask to have it done at least two times a year at the VA. I am now using the VA because I think they do blood work better and faster than my regular doctor and I have the results the same day. >>

REGARDING THE RESULTS OF THE A1C TESTING.... IN MY NON PROFESSIONAL OPINION, THE A1C TEST IS NOT THE IDEAL OR ONLY MARKER FOR DIABETES. IT IS BASICALLY ONE OF FOUR TESTS THAT SHOULD BE PERFORMED TO DETERMINE A TRUE SUGAR LEVEL IN THE BLOOD. THOSE 4 TESTS ARE:
FASTING BLOOD GLUCOSE, A1C, POST MEAL GLUCOSE AND FRUCTOSAMINE. EACH ONE OF THESE TESTS MEASURES THE BLOOD SUGAR CONCENTRATIONS DIFFERENTLY AND ACCORDING TO HOW LONG THE SUGAR HAS BEEN CIRCULATING IN THE BLOOD. SO HAVING ALL 4 OF THOSE TESTS WILL PROVIDE A MORE ACCURATE ACCOUNT OF YOUR BLOOD SUGAR.

<< I did have a medication added last year called Colistipol but they said nothing in that medicine should caused all this. I also changed blood pressure medicine form Lisinopril which I have found to have caused leg and ankle swelling.

REGARDING THE TOPIC OF DRY MOUTH. OUR TEETH REQUIRE LOTS OF SALIVA TO CONTINUOUSLY BATHE IN AS THIS HELPS TO PREVENT DEBRIS FROM BECOMING TOO STICKY TO OUR TEETH. SALIVA ALSO KEEPS THE ORAL TISSUE MOIST AND HEALTHY.

COLESTIPOL, LISINOPRIL, LOSARTAN AND FLOMAX ARE ALL MEDS THAT WILL REDUCE THE FLOW OF SALIVA AND CONTRIBUTE TO DRY MOUTH. SO GIVEN THE FACT THAT YOU ARE ON ALL OF THESE, THERE IS NO DOUBT THAT YOUR MEDICATIONS HAVE PLAYED A ROLE IN YOUR TOOTH DECAY. YOU CAN LOWER THE RISK OF TOOTH DECAY WITH IMPECCABLE ORAL HYGIENE AND A WHOLE FOODS NUTRITIOUS DIET.

<< One more thing they told me is I need a root canal under one of my older crowns and I know how you and me feel about those things.
I called Friday and asked just how they knew for sure if I indeed had infection under the crown because I never had any problems with this tooth ( number 14 ) number 15 and 16 have been out for over 30 years and was wondering why not just pull this one and been done with that problem. I think I can manage to eat without number 14 and I know what root canals can cause.>>

YOU DO NOT HAVE TO HAVE TOOTH PAIN TO HAVE AN INFECTED TOOTH. IF THE INFECTION IS DRAINING, THEN THERE MAY BE NO PAIN OR OTHER SYMPTOMS WITH THAT TOOTH. HOWEVER, A DRAINING INFECTION IS NOT HEALTHY. ALSO KEEP IN MIND THAT ALL ROOT CANALED TEETH ARE CHRONICALLY INFECTED AS THE ROOT CANAL PROCEDURE DOES NOT CURE THE ORIGINAL INFECTION IN THE TOOTH. SO EVENTUALLY THE TOOTH WILL SHOW CLINICAL OR RADIO GRAPHIC SIGNS OF THE INFECTION.

<< They also told me that it was possible that the two crowns they said had cavities under them might could not be saved. One had a root canal many years ago and the other never had one. They could not know until they removed the old crown to see how bad decayed it was. >>

THE DECAY IS MOST LIKELY BEEN PRESENT FOR YEARS AND IS TO THE POINT WHERE THE TEETH ARE NOT SALVAGEABLE. DOING A ROOT CANAL ON THESE TEETH (A SECOND TIME ON THE ONE) WOULD NOT FAVORABLY ALTER THE INFECTION STATUS IN EITHER TOOTH.

<< The cost was what shocked me if I did decide to have all this work done. More than $4000.00 and of course I never planned for this when I retired even though I can afford it.>>

DENTISTRY IS EXPENSIVE AND IT WOULD BE WISE TO THINK ABOUT WHETHER OR NOT THE PROPOSED DENTISTRY WOULD HAVE ANY LONG TERM BENEFIT FOR YOU. REMOVING THE DECAY FROM THE UNCROWNED TEETH AND RESTORING THEM WOULD BE WISE, IF THE DECAY HAS INFILTRATED THE PULP, THEN YOU WOULD HAVE TO DECIDE ON A ROOT CANAL OR EXTRACTION. SO IT IS BEST TO ADDRESS THOSE CAVITIES ASAP.

REGARDING THE ROOT CANALED TEETH AND THE DECAYED TEETH WITH CROWNS ON THEM... THE LONGEVITY IS QUESTIONABLE. PERHAPS YOU COULD DISCUSS WITH YOUR DENTIST REMOVING THOSE TEETH AND FITTING YOU FOR A PARTIAL DENTURE.

<< You think I might need a 2nd opinion on all this work ??... I have been using this dentist for at least 12 years now and so far she has been good but now I am wondering ??>>

A SECOND OPINION IS MOST LIKELY GOING TO RESULT WITH SIMILAR ISSUES. THE CONCERN THAT I HAVE, AND IF I RECALL CORRECTLY I HAD VOICED THIS CONCERN AWHILE BACK, IS THAT YOUR DENTIST SEEMS TO LET THINGS GO UNTIL THEY BECOME REALLY BAD. SOME DENTISTS DO THIS BECAUSE THEY DON'T THINK THE PATIENT WOULD COMPLY WITH THEIR RECOMMENDATIONS EARLY ON... SOME DO THIS BECAUSE THEY DON'T TAKE THE NECESSARY XRAYS OR READ THEM VERY WELL. DO YOU REMEMBER US CHATTING ABOUT THAT?

<< How would I know for sure just how bad #14 is because like I mentioned it has never give me any problems and never any pain when eating. I am a little confused after calling them Friday and they told me I could wait on it for a while ??>>

THE TOOTH IS ROOT CANALED, THEREFORE IT IS INFECTED. FOR THEM TO INFORM YOU OF THE INFECTION INDICATES THAT THE INFECTION HAS SPREAD BEYOND THE TOOTH AND INTO THE BONE. FOR THE OFFICE TO TELL YOU THAT YOU CAN WAIT ON THIS.... CLEARLY TELLS ME THAT THEY LET THINGS SLIDE FOR TOO LONG AND MAYBE BECAUSE THEY FEEL YOU WON'T COMPLY WITH THEIR RECOMMENDATIONS UNLESS YOU FEEL SYMPTOMS.

I JUST WISH TO ADD THIS...... your health conditions given the medications that you are taking are all correlated with inflammation, if not infection as well. Our teeth very much affect our overall health. Root canaled teeth and decayed teeth are infected and inflamed. The longer the infections and inflammation are present the more your health will be affected. It appears that your medications are lowering your blood pressure, maybe even your cholesterol and the inflammation of your prostate. However, medications are basically bandades that suppress the symptoms. None of them are "curing" those issues, they cause side effects and your teeth may be a huge part of why you have those health problems in the first place. So you may want to consider this correlation as you think about how to address your tooth problems.

I've given you a lot to chew on here Tom. I would suggest that you print out what we've shared here and read it a few times. Then let me know your thoughts.