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Old 04-18-2010, 11:50 PM #1
ellem8 ellem8 is offline
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Default Hi Bryanna!

Not sure if you remember me but if you look down a few posts you will see that we talked about my extraction and implant on tooth #20. I have my almost 6 week post op check up tomorrow and I think things are going very well. I am having another problem though.

#20 was just the tip of the iceberg. I didn't want to bother you with my crazy dental history but now some things are popping up and your expertise would be greatly appreciated. I will start by saying that I know how you feel about root canals. Having found out this info too late there is nothing I can do about it now aside from having all my RC teeth removed and implants placed and at 35 and being as healthy as I am I just cant imagine doing that. At least not at this point.

So, I have had RC on #2, #3, and #4. All at different times, the most recent being tooth #2 which was in Jan. I had varying symptoms and problems with each tooth that lead me to the root canals that I can get into if you need me to but I will otherwise spare you the details. Here is the problem. I seem to be having some heat sensitivity on tooth #3 all of a sudden. Not cold, or warm, just hot food. Here is some history on he tooth. I had to have my perm crowns on #3 and #4 replaced in March of 09 due to the margins being off and it was causing some issues with my gums so I found a prosthdodontist and we got to work on it. My perio at the time wanted the temps to remain on for six weeks to see if my gums would heal. They did, at least I thought so and I went back to see him for my check up and he said I needed to have gum flap surgery. I proceeded to get a second and third opinion and they both told me my gums had improved tremendously and would continue to improve once I had my perm crowns placed, so I decided not to have the surgery. I finally had the perm crowns placed in Feb of this year, almost a year after we started, so I spent a year in my temps. (due to getting the opinions and deciding on the gum surgery) Now, here we go with the heat sensitivity with #3. I have had no problems until about a month ago. It is a weird sensation, like the tooth is expanding when I feel the heat, then as it cools that feeling goes away and then it becomes pressure, not bite, sensitive and begins to ache.

My endo always tells me there is no way you can feel hot or cold after a RC treatment but I am, for sure. (hot only, no cold) Whether it is the tooth or not I have no clue but it is for sure coming from #3. I think I may get a second opinion from a diff endo this week, but what could it be? Fracture? Could the tooth of been reinfected by bacteria from having the temp on for so long? My gums? (which are really healthy at this point) I feel like I have to have some idea of what I am dealing with before I meet with these people to know if they are leading me down the right path.

Sorry for the long rambling post. I know it is better for you to have more info than less. Should I start with the endo? If so do you think its a good idea to get a different opinion from a new one?

Thanks so much!!

Elle
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Old 04-20-2010, 09:50 PM #2
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Hi ellem,

How did your post op check go?
I'll reply to your thread tomorrow when I have a little more time to write

Bryanna


Quote:
Originally Posted by ellem8 View Post
Not sure if you remember me but if you look down a few posts you will see that we talked about my extraction and implant on tooth #20. I have my almost 6 week post op check up tomorrow and I think things are going very well. I am having another problem though.

#20 was just the tip of the iceberg. I didn't want to bother you with my crazy dental history but now some things are popping up and your expertise would be greatly appreciated. I will start by saying that I know how you feel about root canals. Having found out this info too late there is nothing I can do about it now aside from having all my RC teeth removed and implants placed and at 35 and being as healthy as I am I just cant imagine doing that. At least not at this point.

So, I have had RC on #2, #3, and #4. All at different times, the most recent being tooth #2 which was in Jan. I had varying symptoms and problems with each tooth that lead me to the root canals that I can get into if you need me to but I will otherwise spare you the details. Here is the problem. I seem to be having some heat sensitivity on tooth #3 all of a sudden. Not cold, or warm, just hot food. Here is some history on he tooth. I had to have my perm crowns on #3 and #4 replaced in March of 09 due to the margins being off and it was causing some issues with my gums so I found a prosthdodontist and we got to work on it. My perio at the time wanted the temps to remain on for six weeks to see if my gums would heal. They did, at least I thought so and I went back to see him for my check up and he said I needed to have gum flap surgery. I proceeded to get a second and third opinion and they both told me my gums had improved tremendously and would continue to improve once I had my perm crowns placed, so I decided not to have the surgery. I finally had the perm crowns placed in Feb of this year, almost a year after we started, so I spent a year in my temps. (due to getting the opinions and deciding on the gum surgery) Now, here we go with the heat sensitivity with #3. I have had no problems until about a month ago. It is a weird sensation, like the tooth is expanding when I feel the heat, then as it cools that feeling goes away and then it becomes pressure, not bite, sensitive and begins to ache.

My endo always tells me there is no way you can feel hot or cold after a RC treatment but I am, for sure. (hot only, no cold) Whether it is the tooth or not I have no clue but it is for sure coming from #3. I think I may get a second opinion from a diff endo this week, but what could it be? Fracture? Could the tooth of been reinfected by bacteria from having the temp on for so long? My gums? (which are really healthy at this point) I feel like I have to have some idea of what I am dealing with before I meet with these people to know if they are leading me down the right path.

Sorry for the long rambling post. I know it is better for you to have more info than less. Should I start with the endo? If so do you think its a good idea to get a different opinion from a new one?

Thanks so much!!

Elle
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Old 04-23-2010, 09:06 PM #3
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Hi ellem,

Sorry it's taken me so long to reply....

I read your post and have no doubt that the hot temperature sensitivity on #3 is very real ... don't let anyone tell you that it's not. A few things could be happening and I'll give you a couple of ideas although you may not like what I'm going to say.......I'm going to tell you the truth.

One of the big myths with root canal therapy is that the root canaled tooth can no longer feel pain or sensitivity. Every day patients come in complaining of pain and/or hot temperature sensitivity in a root canaled tooth. Usually an xray will show pathology brewing in or near that tooth, but some dentists will tell the patient that it's only localized or it's scar tissue. Neither is accurate.

The first reason that myth is false is because, every tooth has millions of microscopic openings called dentin tubules or accessory canals. These curvy little crevaces have nerves in them which are not accessible. Many of these tiny nerves instantly become necrotic tissue once the blood supply is cut off during the RC procedure but some of them can remain partially alive. Any vitality within these canals will trigger a sensitivity to hot temperature. Secondly, if the tooth is fractured in an area that has some live nerve endings, this too would cause sensitivity to hot temperature.

The conventional remedy for this complaint .... an endodontist may suggest to retreat the tooth with another root canal..... but ironically there is no way to determine where the vitality is nor would there be a way to access it. Or he may suggest a surgery called an apicoectomy.....which will do nothing but cause more problems. Or he may think he knows where the problem is an suggest to amputate one of the roots..... again, only causes more problems.

Your quote: <<My endo always tells me there is no way you can feel hot or cold after a RC treatment but I am, for sure. (hot only, no cold) Whether it is the tooth or not I have no clue but it is for sure coming from #3. I think I may get a second opinion from a diff endo this week, but what could it be? Fracture?>> WHAT YOU ARE FEELING IS REAL. YOU WILL BE GIVEN THE OPTIONS OF WHAT I NOTED ABOVE. REMOVAL OF THE TOOTH IS THE ONLY TREATMENT THAT WILL CURE THE PROBLEM.

<< Could the tooth of been reinfected by bacteria from having the temp on for so long?>> THE ROOT CANALED TOOTH HAS A CHRONIC INFECTION IN IT TO BEGIN WITH. THE TEMP CROWN COULD HAVE CAUSED ADDITIONAL INFLAMMATION RESULTING IN DIFFERENT BACTERIA, BUT IT WASN'T HEALTHY TO BEGIN WITH.

<< My gums?>> SOUNDS TO ME LIKE YOU HAVE A PERIO/ENDO ISSUE GOING ON FOR A LONG TIME. THIS MEANS THAT BOTH THE TOOTH AND THE POCKET OF SURROUNDING BONE HAS A CHRONIC INFECTION GOING ON. THIS SORT OF THING SOMETIMES RESPONDS POSITIVELY (BUT ONLY TEMPORARILY) TO TREATMENT OF THE GUM AND TOOTH. THE CHRONIC PROBLEM LIES WITHIN THE TOOTH ITSELF AND THOSE ACCESSORY CANALS.

<< I feel like I have to have some idea of what I am dealing with before I meet with these people to know if they are leading me down the right path.>> THE ONLY RIGHT PATH IS WHAT YOU DECIDE IS IN YOUR BEST INTEREST. THERE ARE ONLY A FEW OPTIONS... RE-ROOT CANAL... APICOECTOMY... AMPUTATE A ROOT..... DO NOTHING UNTIL IT BECOMES WORSE.... REMOVE THE TOOTH. I KNOW YOU DO NOT WANT TO LOSE YOUR TEETH. TOTALLY UNDERSTANDABLE. HOWEVER, YOU HAVE AN ONGOING, CHRONIC INFECTION WITHIN THE TOOTH THAT CANNOT BE RESOLVED. TAKING THAT INFORMATION INTO CONSIDERATION, A BIG CONCERN ABOUT KEEPING THIS TOOTH IS THE POSSIBILITY THAT THE BONE IN THAT AREA MAY BE NOT STABLE ENOUGH TO HOLD A DENTAL IMPLANT IN THE FUTURE.

I know you are young and feel healthy. But chronic infection in the mouth causes or at minimum contributes to chronic systemic disease. Diabetes and heart disease just to name a couple....so dental infections are not something to take lightly. It's like the saying goes......... If I only knew then, what I know now, I would have done things differently.

I am here to inform you of the truth even though I know it's not at all what anyone wants to hear. The outlook on removing diseased teeth and replacing them with dental implants or removable appliances can be looked at from a positive or negative view but only you can make the best choice for you. No one can tell you what path to go down... only you can decide for yourself.

Please don't let fear of losing your teeth overwhelm you and cause you to close off the information ..... let knowledge and instinct be your guide. I know it's hard but that's really all anyone of us can do.

Please keep in touch here and know that you are definitely not alone....

Bryanna






Quote:
Originally Posted by ellem8 View Post
Not sure if you remember me but if you look down a few posts you will see that we talked about my extraction and implant on tooth #20. I have my almost 6 week post op check up tomorrow and I think things are going very well. I am having another problem though.

#20 was just the tip of the iceberg. I didn't want to bother you with my crazy dental history but now some things are popping up and your expertise would be greatly appreciated. I will start by saying that I know how you feel about root canals. Having found out this info too late there is nothing I can do about it now aside from having all my RC teeth removed and implants placed and at 35 and being as healthy as I am I just cant imagine doing that. At least not at this point.

So, I have had RC on #2, #3, and #4. All at different times, the most recent being tooth #2 which was in Jan. I had varying symptoms and problems with each tooth that lead me to the root canals that I can get into if you need me to but I will otherwise spare you the details. Here is the problem. I seem to be having some heat sensitivity on tooth #3 all of a sudden. Not cold, or warm, just hot food. Here is some history on he tooth. I had to have my perm crowns on #3 and #4 replaced in March of 09 due to the margins being off and it was causing some issues with my gums so I found a prosthdodontist and we got to work on it. My perio at the time wanted the temps to remain on for six weeks to see if my gums would heal. They did, at least I thought so and I went back to see him for my check up and he said I needed to have gum flap surgery. I proceeded to get a second and third opinion and they both told me my gums had improved tremendously and would continue to improve once I had my perm crowns placed, so I decided not to have the surgery. I finally had the perm crowns placed in Feb of this year, almost a year after we started, so I spent a year in my temps. (due to getting the opinions and deciding on the gum surgery) Now, here we go with the heat sensitivity with #3. I have had no problems until about a month ago. It is a weird sensation, like the tooth is expanding when I feel the heat, then as it cools that feeling goes away and then it becomes pressure, not bite, sensitive and begins to ache.

My endo always tells me there is no way you can feel hot or cold after a RC treatment but I am, for sure. (hot only, no cold) Whether it is the tooth or not I have no clue but it is for sure coming from #3. I think I may get a second opinion from a diff endo this week, but what could it be? Fracture? Could the tooth of been reinfected by bacteria from having the temp on for so long? My gums? (which are really healthy at this point) I feel like I have to have some idea of what I am dealing with before I meet with these people to know if they are leading me down the right path.

Sorry for the long rambling post. I know it is better for you to have more info than less. Should I start with the endo? If so do you think its a good idea to get a different opinion from a new one?

Thanks so much!!

Elle
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Old 04-23-2010, 10:58 PM #4
ellem8 ellem8 is offline
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Hi Bryanna,

Thanks for taking the time to answer my questions.

When I saw my perio on Mon she said the implant looks good. There has been a little blood around it when I clean it, near the gum's but she didn't seemed worried about it. I also had her check my gum's on that upper right quadrant and my pockets measured at 2's, 3's, and one area was a 4. She said it was only the one area and it didn't look too bad. It is an area in between tooth #2 and #3 where I still have a temp crown on.

I don't understand how the endo industry can continue to go on without people knowing the consequences of what they are really getting themselves into. I would think that there are thousands of RC done daily across the US and this issue would be more visible and talked about. Why don't more people warn against RC? Why do they say they are perfectly safe?

I saw my endo on Tuesday and he said there is nothing else he can do for me. He didn't advise to redo the RC or an apio. He thinks I have a nerve issue going on. He referred me to a neurologist. This doesn't feel like nerve pain to me. My Mother had TN so I am pretty familiar with what that can entail. I know it can come in all shapes and forms but this pain I am getting is very central to my teeth. I fear that he is reluctant to admit that something else could be wrong, like a fracture, or bacteria still remaining etc. I would like to see another dental specialist but I just don't know who I should see now.

If I go by what you suggest I would have to have my 5 RC teeth pulled and implants placed, making 6 total implants out of my 12 molars. This is just a very hard reality to face, and at $7000 an implant pretty pricey as well. How would I function and eat going through that process? We are trying to have a baby and I don't see how that will work! lol I just don't think I am ready to come to terms with all that yet. I don't doubt your right. Please don't misunderstand me, it all just makes me nervous and I am ready for this to end, not drag on.

Let me try and understand. Is the chronic infection you speak about coming from the smaller necrotic nerves that are left? They never see any sort of infection on the x-ray, much less anything else.

I will eventually post my entire history for you so you can advise me accordingly but I warn you it is long. A lot has happened to me in the last 3 years. Here is a summary. 5 RC, 1 implant (internal root resorption) diagnosed with TMJD, crown put on all those 5 teeth. I am also a clencher and I had braces 5 times from age 10 - 23. I seem to be a recipe for disaster! lol

Thanks for all your help and time. I am not sure what my next step will be. I am about to leave for vacation for 3 weeks so I will be working on this when I get back in May.
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Old 04-24-2010, 03:43 PM #5
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Hi ellem,

Glad to hear the implant looks good. The blood you see in that area when brushing may indicate that you have some plaque built up there. Just in case that's what it is... it would be best if you gently but thoroughly brushed everywhere, including that area with a very soft bristle toothbrush twice a day. Plaque can be hard to see but it's very destructive and we have to be diligent with removing it.

With regard to pocket measurements.... #'s 1-3 are normal. Anything above that indicates an area between the gum and tooth that bacteria can hide in. One thing to mention is that when there is gum recession around a tooth, the pocket depth can measure low because of the recession. This simply means that more of the tooth is exposed than should be. Sometimes these teeth are sensitive to cold temperatures, other times they're not.

Endodontics is regarded as the elite field in dentistry (moreso than oral surgery or cosmetics) because this is the group that makes the most $$$. Many thousands of root canals are performed every day in the US. To be fair, dental offices in general seldom properly educate their patients of the consequences of their dental treatment. With endodontics, the procedure is one of a few that allows a person to retain their teeth irrelevant of the inevitable outcome. Many people, would rather keep a diseased tooth than have it removed. This is evident when someone is told that they have a tooth infection but because it's not hurting, they ignore it until it hurts. So in spite of the lengthy research, the many thousands of pathological reports of rc teeth and the well known health risks associated with root canaled teeth, the procedure is still viewed as a viable option in dentistry. The industry itself is not yet prepared to tell the public otherwise. The information is not secret it is just not readily shared with the average consumer.

It's the same principal as smoking.... in spite of all the health warnings against it.. people still chose to smoke and many physicians/dentists do not inform their patients of the seriousness of this habit until they are sick. Phillip Morris who is the huge promoter of smokeless tobacco and various brands of cigarettes.... ironically also funds lung cancer research, various cancer treatment centers.... etc. There are alot of things in our society that people should be made more aware of, but not everyone necessarily wants to be informed or knows how to acquire the information because sometimes it's hard to dig when things are "covered up".

Your quote>> If I go by what you suggest I would have to have my 5 RC teeth pulled and implants placed, making 6 total implants out of my 12 molars.>> WE ONLY USE OUR FIRST MOLARS TO CHEW ON. THE SECOND MOLARS ARE SELDOM USED UNLESS THERE ARE OTHER TEETH MISSING. THE THIRD MOLARS ARE NEVER USED FOR CHEWING. SO DEPENDING ON WHAT MOLARS HAVE THE ROOTH CANALS, DEtermines HOW MANY WOULD ACTUALLY HAVE TO REPLACED WITH IMPLANTS.

>> This is just a very hard reality to face, and at $7000 an implant pretty pricey as well.>> $7000 FOR AN EXTRACTION, BONE GRAFT, IMPLANT AND CROWN IS VERY EXPENSIVE. THE AVERAGE FEE IN THE US FOR ALL OF THAT IS ABOUT HALF OF THAT COST UNLESS THERE ARE EXTENUATING CIRCUMSTANCES. WHY SO MUCH IN YOUR CASE?

>> How would I function and eat going through that process?<< YOU WOULD NOT NEED ANY TEMPORARY REPLACEMENTS DURING THE HEALING PHASE IF YOU ARE TALKING ABOUT THE MOLAR AREAS ONLY. ONLY ONE AREA OF YOUR MOUTH WOULD BE DONE AT A TIME.

>> We are trying to have a baby and I don't see how that will work! lol I just don't think I am ready to come to terms with all that yet.>> I THINK YOU FALL INTO THE CATEGORY LIKE MANY PEOPLE IN THAT THERE MAY BE OPTIONS THAT HAVE NOT BEEN DISCUSSED BY YOUR DENTIST. YOU JUST MAY HAVE AN EXAGGERATED IDEA OF WHAT WOULD BE NEEDED. THIS IS ALL BASED ON YOUR STATEMENT OF THE RC TEETH BEING MOLARS. THE IDEA OF GETTING PREGNANT IS A HUGE, HUGE UNDERTAKING AND IDEALLY, YOU SHOULD BE AS HEALTHY AS POSSIBLE. THAT IS MY POINT IN A NUTSHELL......

I know it's confusing and overwhelming and all you really want is to believe someone is telling you the truth. I understand completely. All I can say is take one step at a time and don't give up learning about what your options may be.

>>Let me try and understand. Is the chronic infection you speak about coming from the smaller necrotic nerves that are left? They never see any sort of infection on the x-ray, much less anything else.<< THE CHRONIC INFECTION IS FROM THE BACTERIA INSIDE THE CANALS OF THE TEETH. IT CAN BE FROM NECROTIC TISSUE (NERVES) THAT WERE LEFT BEHIND AND/OR BACTERIA THAT ENTERED DURING THE PROCEDURE. THE RC PROCEDURE ITSELF TRAUMATIZES AND INJURES THE INSIDE OF TOOTH.... YOU MAY RECALL THE DENTIST USING SMALL INSTRUMENTS THAT HE SCRAPED THE INSIDE OF THE TOOTH WITH REPETETIVELY? THE RC PROCEDURE ALSO SEVERS THE BLOOD VESSEL AT THE END OF THE ROOT THAT FEEDS THE TOOTH. SO THERE IS NO LONGER ANY NUTRITION ENTERING THE TOOTH. ALL TEETH ARE LIVING BODY PARTS AND THEY REQUIRE BLOOD TO BE HEALTHY. THERE ARE ALSO OTHER ISSUES THAT ARE NOT FAVORABLE THAT I WON'T GET INTO NOW. IF YOU TAKE ALL OF THIS INTO CONSIDERATION, THE ISSUE OF CHRONIC INFECTION/INFLAMATION BECOMES MORE BELIEVABLE. DENTAL XRAYS ARE ONLY 2 DIMENSIONAL... MANY RADIOGRAPHIC PATHOLOGIES ARE MISSED UNFORTUNATELY.

I don't like writing in capitals... seems like I'm yelling or something.... and I'm definitely not. For now... go on vacation..... put this stuff on hold and rethink it when you get back. I'm here if you want to bounce some thoughts back and forth with me.

Have a great vacation!!

Bryanna











Quote:
Originally Posted by ellem8 View Post
Hi Bryanna,

Thanks for taking the time to answer my questions.

When I saw my perio on Mon she said the implant looks good. There has been a little blood around it when I clean it, near the gum's but she didn't seemed worried about it. I also had her check my gum's on that upper right quadrant and my pockets measured at 2's, 3's, and one area was a 4. She said it was only the one area and it didn't look too bad. It is an area in between tooth #2 and #3 where I still have a temp crown on.

I don't understand how the endo industry can continue to go on without people knowing the consequences of what they are really getting themselves into. I would think that there are thousands of RC done daily across the US and this issue would be more visible and talked about. Why don't more people warn against RC? Why do they say they are perfectly safe?

I saw my endo on Tuesday and he said there is nothing else he can do for me. He didn't advise to redo the RC or an apio. He thinks I have a nerve issue going on. He referred me to a neurologist. This doesn't feel like nerve pain to me. My Mother had TN so I am pretty familiar with what that can entail. I know it can come in all shapes and forms but this pain I am getting is very central to my teeth. I fear that he is reluctant to admit that something else could be wrong, like a fracture, or bacteria still remaining etc. I would like to see another dental specialist but I just don't know who I should see now.

If I go by what you suggest I would have to have my 5 RC teeth pulled and implants placed, making 6 total implants out of my 12 molars. This is just a very hard reality to face, and at $7000 an implant pretty pricey as well. How would I function and eat going through that process? We are trying to have a baby and I don't see how that will work! lol I just don't think I am ready to come to terms with all that yet. I don't doubt your right. Please don't misunderstand me, it all just makes me nervous and I am ready for this to end, not drag on.

Let me try and understand. Is the chronic infection you speak about coming from the smaller necrotic nerves that are left? They never see any sort of infection on the x-ray, much less anything else.

I will eventually post my entire history for you so you can advise me accordingly but I warn you it is long. A lot has happened to me in the last 3 years. Here is a summary. 5 RC, 1 implant (internal root resorption) diagnosed with TMJD, crown put on all those 5 teeth. I am also a clencher and I had braces 5 times from age 10 - 23. I seem to be a recipe for disaster! lol

Thanks for all your help and time. I am not sure what my next step will be. I am about to leave for vacation for 3 weeks so I will be working on this when I get back in May.
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Old 04-25-2010, 12:41 AM #6
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Quote:
Originally Posted by Bryanna View Post
Hi ellem,

Glad to hear the implant looks good. The blood you see in that area when brushing may indicate that you have some plaque built up there. Just in case that's what it is... it would be best if you gently but thoroughly brushed everywhere, including that area with a very soft bristle toothbrush twice a day. Plaque can be hard to see but it's very destructive and we have to be diligent with removing it.

With regard to pocket measurements.... #'s 1-3 are normal. Anything above that indicates an area between the gum and tooth that bacteria can hide in. One thing to mention is that when there is gum recession around a tooth, the pocket depth can measure low because of the recession. This simply means that more of the tooth is exposed than should be. Sometimes these teeth are sensitive to cold temperatures, other times they're not.

Endodontics is regarded as the elite field in dentistry (moreso than oral surgery or cosmetics) because this is the group that makes the most $$$. Many thousands of root canals are performed every day in the US. To be fair, dental offices in general seldom properly educate their patients of the consequences of their dental treatment. With endodontics, the procedure is one of a few that allows a person to retain their teeth irrelevant of the inevitable outcome. Many people, would rather keep a diseased tooth than have it removed. This is evident when someone is told that they have a tooth infection but because it's not hurting, they ignore it until it hurts. So in spite of the lengthy research, the many thousands of pathological reports of rc teeth and the well known health risks associated with root canaled teeth, the procedure is still viewed as a viable option in dentistry. The industry itself is not yet prepared to tell the public otherwise. The information is not secret it is just not readily shared with the average consumer.

It's the same principal as smoking.... in spite of all the health warnings against it.. people still chose to smoke and many physicians/dentists do not inform their patients of the seriousness of this habit until they are sick. Phillip Morris who is the huge promoter of smokeless tobacco and various brands of cigarettes.... ironically also funds lung cancer research, various cancer treatment centers.... etc. There are alot of things in our society that people should be made more aware of, but not everyone necessarily wants to be informed or knows how to acquire the information because sometimes it's hard to dig when things are "covered up".

Your quote>> If I go by what you suggest I would have to have my 5 RC teeth pulled and implants placed, making 6 total implants out of my 12 molars.>> WE ONLY USE OUR FIRST MOLARS TO CHEW ON. THE SECOND MOLARS ARE SELDOM USED UNLESS THERE ARE OTHER TEETH MISSING. THE THIRD MOLARS ARE NEVER USED FOR CHEWING. SO DEPENDING ON WHAT MOLARS HAVE THE ROOTH CANALS, DEtermines HOW MANY WOULD ACTUALLY HAVE TO REPLACED WITH IMPLANTS.

>> This is just a very hard reality to face, and at $7000 an implant pretty pricey as well.>> $7000 FOR AN EXTRACTION, BONE GRAFT, IMPLANT AND CROWN IS VERY EXPENSIVE. THE AVERAGE FEE IN THE US FOR ALL OF THAT IS ABOUT HALF OF THAT COST UNLESS THERE ARE EXTENUATING CIRCUMSTANCES. WHY SO MUCH IN YOUR CASE?

>> How would I function and eat going through that process?<< YOU WOULD NOT NEED ANY TEMPORARY REPLACEMENTS DURING THE HEALING PHASE IF YOU ARE TALKING ABOUT THE MOLAR AREAS ONLY. ONLY ONE AREA OF YOUR MOUTH WOULD BE DONE AT A TIME.

>> We are trying to have a baby and I don't see how that will work! lol I just don't think I am ready to come to terms with all that yet.>> I THINK YOU FALL INTO THE CATEGORY LIKE MANY PEOPLE IN THAT THERE MAY BE OPTIONS THAT HAVE NOT BEEN DISCUSSED BY YOUR DENTIST. YOU JUST MAY HAVE AN EXAGGERATED IDEA OF WHAT WOULD BE NEEDED. THIS IS ALL BASED ON YOUR STATEMENT OF THE RC TEETH BEING MOLARS. THE IDEA OF GETTING PREGNANT IS A HUGE, HUGE UNDERTAKING AND IDEALLY, YOU SHOULD BE AS HEALTHY AS POSSIBLE. THAT IS MY POINT IN A NUTSHELL......

I know it's confusing and overwhelming and all you really want is to believe someone is telling you the truth. I understand completely. All I can say is take one step at a time and don't give up learning about what your options may be.

>>Let me try and understand. Is the chronic infection you speak about coming from the smaller necrotic nerves that are left? They never see any sort of infection on the x-ray, much less anything else.<< THE CHRONIC INFECTION IS FROM THE BACTERIA INSIDE THE CANALS OF THE TEETH. IT CAN BE FROM NECROTIC TISSUE (NERVES) THAT WERE LEFT BEHIND AND/OR BACTERIA THAT ENTERED DURING THE PROCEDURE. THE RC PROCEDURE ITSELF TRAUMATIZES AND INJURES THE INSIDE OF TOOTH.... YOU MAY RECALL THE DENTIST USING SMALL INSTRUMENTS THAT HE SCRAPED THE INSIDE OF THE TOOTH WITH REPETETIVELY? THE RC PROCEDURE ALSO SEVERS THE BLOOD VESSEL AT THE END OF THE ROOT THAT FEEDS THE TOOTH. SO THERE IS NO LONGER ANY NUTRITION ENTERING THE TOOTH. ALL TEETH ARE LIVING BODY PARTS AND THEY REQUIRE BLOOD TO BE HEALTHY. THERE ARE ALSO OTHER ISSUES THAT ARE NOT FAVORABLE THAT I WON'T GET INTO NOW. IF YOU TAKE ALL OF THIS INTO CONSIDERATION, THE ISSUE OF CHRONIC INFECTION/INFLAMATION BECOMES MORE BELIEVABLE. DENTAL XRAYS ARE ONLY 2 DIMENSIONAL... MANY RADIOGRAPHIC PATHOLOGIES ARE MISSED UNFORTUNATELY.

I don't like writing in capitals... seems like I'm yelling or something.... and I'm definitely not. For now... go on vacation..... put this stuff on hold and rethink it when you get back. I'm here if you want to bounce some thoughts back and forth with me.

Have a great vacation!!

Bryanna
Very informative as usual Bryanna. Thank you. I want to comment on all of it but I don't think I will get a chance until I get back from our vacation but I did want to comment on the price of the implant. Here is a list of what I paid for the one on #19. I know the people I use are little more expensive than most but DOUBLE!!! Geez! I had no clue! LOL I hope it's OK to list these prices here.

Prosthdodontist charges:

Implant crown with abutment: $2255.00
Custom Surgical Guide: $410.00

Periodontist charges:

Oral Sedation: $293.00
Surg place implant: $1990.00
Extraction Surgical: $370.00
Ridge Augmentation-Extraction: $973.00
Guided tiss regen-resorb-per: $649.00

Total is $6940.00

I saw 3 perios and all their quotes were right in line with this one. Actually this one was the cheapest by about $300. If I am getting taken to the cleaners I would like to know so I can look around for someone cheaper who will also do a great job. On the bright side it will be a tax write off! lol
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Old 04-25-2010, 12:11 PM #7
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Hi ellem,

The fees are a bit high (I'll show you a comparison), however, you had some extenuating circumstances. Less complicated implant cases include fees for the extraction, implant placement, bone grafting and implant crown with abutment.... and that's it. What did you take for the oral sedation? Was it nitrous oxide/laughing gas?

Your quote:
Prosthdodontist charges:

Implant crown with abutment: $2255.00..THIS IS AVERAGE
Custom Surgical Guide: $410.00..NO CHARGE OR LAB FEE OF $125-200

Periodontist charges:

Oral Sedation: $293.00...NO CHARGE FOR "ORAL" SEDATION
Surg place implant: $1990.00...$1600 TO 2000
Extraction Surgical: $370.00...THIS IS AVERAGE FOR A SPECIALIST
Ridge Augmentation-Extraction: $973.00...DEPENDS ON HOW EXTENSIVE THIS PROCEDURE IS...GENERALLY $350-500 (not always necessary)
Guided tiss regen-resorb-per: $649.00.... $350-450

It is important to see someone who you can trust, we've talked about that before. When you are doing mutiple sites, even if they are going to be done at various times, there is always a fee courtesy or reduction extended for some of these services,...... if they even need to be done in all of the areas we talked about.

Ok, so go on vacation already!! Tell us how is was when you get back!!

Bryanna





Quote:
Originally Posted by ellem8 View Post
Very informative as usual Bryanna. Thank you. I want to comment on all of it but I don't think I will get a chance until I get back from our vacation but I did want to comment on the price of the implant. Here is a list of what I paid for the one on #19. I know the people I use are little more expensive than most but DOUBLE!!! Geez! I had no clue! LOL I hope it's OK to list these prices here.

Prosthdodontist charges:

Implant crown with abutment: $2255.00
Custom Surgical Guide: $410.00

Periodontist charges:

Oral Sedation: $293.00
Surg place implant: $1990.00
Extraction Surgical: $370.00
Ridge Augmentation-Extraction: $973.00
Guided tiss regen-resorb-per: $649.00

Total is $6940.00

I saw 3 perios and all their quotes were right in line with this one. Actually this one was the cheapest by about $300. If I am getting taken to the cleaners I would like to know so I can look around for someone cheaper who will also do a great job. On the bright side it will be a tax write off! lol
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Old 04-25-2010, 04:05 PM #8
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I don't like writing in capitals... seems like I'm yelling or something.... and I'm definitely not.
Bryanna
I chuckled when I read that.....

You've got a wonderful approach, Bryanna, and I hope you know how much you are appreciated. You are not only very knowledged, but you are straight-forward, sincere, and genuine.

Why can't our dental offices have more people like YOU!
This forum is very blessed to have you and I hope you don't ever feel that your knowledge and advice are taken for granted.

Also, thank you for providing the breakdown of cost estimate on tooth #19!
Saved me from starting a new thread!

Good Day!
Rae
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Old 04-25-2010, 11:09 PM #9
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Was it nitrous oxide/laughing gas? It was Triazlam. (sp) When I took it with my endo he didn't charge me for it, just gave me a script so I felt that charge was not necessary. I asked them about it but they said it was for their monitoring equipment. I still don't buy it because my endo had the same equipment. It's nice to see where I may of over payed for future implants. Thanks for going over that Bryanna.



What exactly is the ridge augmentation extraction? I remember we compared that to the other quotes and they had it too but I never asked what it was. That is really unlike me because my hubby and I ask A LOT of questions.

OK, OK, I'm going!! We are leaving early Tuesday! I will enjoy my trip, laying on the beach in the sun and sand and not think about teeth for 3 weeks!

See you when I get back!

Elle
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Old 04-26-2010, 09:38 AM #10
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Hi elle,

The drug is called Triazolam, it is the generic for halcion which is in the benzodiazepines family of drugs like xanax, valium, etc. In dentistry it's used as oral sedation. I have never known any dentist to charge for this, your case is the first for me! The monitoring machine is called a pulse oximeter which registers your oxygen level and can also be timed to periodically take your blood pressure. I know oral surgeons who routinely use this machine on all of their patients, sedated or not, and never charge a fee for it. Perhaps you could question that at one of your visits with her.

The ridge augmentation is the surgical preparation of the socket for the bone graft and then placing the graft. The more severe the bone loss, the more preparation and the more bone graft material needs to be used. Every extraction has some degree of bone loss and in most cases some ridge augmetation is performed, but not every case is there a bone graft placed at the time of the extraction.

I am very glad that you and your hubby ask alot of questions!! I always encourage patients to bring them on......!!!!

Ok, so enjoy your vacation...... sounds wonderful!!!

Bryanna



Quote:
Originally Posted by ellem8 View Post
Was it nitrous oxide/laughing gas? It was Triazlam. (sp) When I took it with my endo he didn't charge me for it, just gave me a script so I felt that charge was not necessary. I asked them about it but they said it was for their monitoring equipment. I still don't buy it because my endo had the same equipment. It's nice to see where I may of over payed for future implants. Thanks for going over that Bryanna.



What exactly is the ridge augmentation extraction? I remember we compared that to the other quotes and they had it too but I never asked what it was. That is really unlike me because my hubby and I ask A LOT of questions.

OK, OK, I'm going!! We are leaving early Tuesday! I will enjoy my trip, laying on the beach in the sun and sand and not think about teeth for 3 weeks!

See you when I get back!

Elle
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