i went to get a second opinion today from the place where the xrays originated from (i took these to the second dentist, who gave me the opinion in the OP)

they suggested:

removal: wisdom teeth (1, 16, 32)
3: L
4: MOD
5: OD
12: OD
13: OD
14: L
15: OL
16: MOL
18: O
19: MODB
20: OD
21: OD
28: OD
29: MOD
30: OB

She did say after cleaning, it would be possible I'd need an additional surface as it's hard to see on xrays sometimes with plaque buildup, but she would try to do a large filling in 29 (the broken tooth) as long as the pulp isn't exposed. If it's exposed, they would give me an option of RCT or removal, however none of the other teeth appear to need RCT/crowns.

Now I have about 20 hours to decide which dentist to go with as I have part 1 of the cleaning scheduled at the inital dentist (in OP) on Wed at 3pm.

The biggest difference is this one actually did a full mouth exam with the icky dental tool, the first one primarily went off xrays with a few pokes. She also recommended to go to an ortho for my bite but I can chew fine and it isn't bothering me (one tooth, i believe 17, appears slightly raised up which causes the bite to be off). She also caught the B in 19 which is already existing (and first one missed somehow) as well as a B in 30.

Mike,

Go with the one who seems the most thorough. The surfaces noted by both dentists are similar and the reason for that is because they don't know what is going to be uncovered until they remove the decay.

I like the fact that this second dentist offered you the option of rct or removal if there is an exposed nerve. However, she is talking about doing some very large fillings which may or may not hold up very well. Whereas a crown on some of these teeth with large cavities may support the tooth better than the large filling. Obviously, this dentist is trying to save you money.... initially. Which can end up costing more in the long run.

There is no right answer here... go with your instincts.

Keep us posted...ok...
Bryanna

I missed 31 as MOD. She thought a crown wasn't needed on any other teeth as I made sure to ask, even mentioning 30, 31 as the first dentist said those would possibly need crowns but something along the lines of most of the tooth structure being there so it wasn't needed.

The second one was a clinic so it would likely just be one appointment per month, I have #29 scheduled for Feb 20th and cleaning for March 3rd as that's the soonest they had, but I can get the work done faster if I went with the initial dentist. I like the second one better, but I'm not sure about waiting so long?

Would you think a sedative filling would work on #29, or is RCT still likely? The biggest difference is #2, which she didn't mention at all, as well as #11. And they both appear to disagree with #3, MO vs L.

Really unsure what to do, I wish I could combine the thoroughness of the one today with the fast appointments of the first one.

edit: Also the first one is a chain dental place, which is what scared me to begin with, as I've heard bad things about chain dentist offices (Bright Now Dental). The second is a clinic, hence the long waits on their appointments.

edit2: Also at the chain dentist, I believe it was the hygienist that went over the fillings, rather than an actual dentist. I'm not sure if he'd be better at it, though? At the clinic, it was the dentist.

Hi Mike,

You are stressing over the number of surfaces and what you need to realize is that the surfaces are somewhat irrelevant in that the true size of the cavity will be known once the dentist removes all of the decay. I can also tell you that teeth that have cavities larger than 3 surfaces will not have much tooth structure left above the gum line once the decay is removed. So depending on the situation, very large fillings are not always the best way to go. Very large fillings tend to fracture because there is so little tooth structure above the gum line to bond the filling to. That's why onlays or crowns which are cemented to the remaining tooth structure are better at protecting teeth in that condition.

Unfortunately, every dentist will come away with their own opinion because of their individual preference and skill level. There is no way for you to know ahead of time who will be the best dentist for you. You have to go with your gut instinct and/or positive referrals to someone in particular.

The cavities that you have cannot be definitively determined by your x-rays or a clinical examination because they may or may not be deeper than anticipated. Meaning when someone has extensive and multiple cavities there may (or may not) be other areas/surfaces of early decay that are not evident until the tooth is cleaned out. I am telling you this not to make you worry more. I'm telling you this so that you stop stressing over the specific surfaces. It could also be that some of the areas are not as deep as they appear on the x-rays. Now wouldn't that be wonderful!!

I personally think you will end up with more problems if you have one visit per month unless multiple teeth were done at each appointment. Can they do quadrant dentistry? Meaning there are 4 quadrants in your mouth... at each appointment have all of the caivites done in one quadrant. At the second appt do all the cavities in that quadrant and so on. Not only will you get the dentistry done quicker, but it will be less anesthetic injections as opposed to doing a tooth here and there and different appointments. The entire quadrant gets numbed up every time you have a filling done. SO why not do as many as possible in that quadrant at the same time? If you had some crowns done, it would take more than 4 appointments but not too many more. Of course you would have to have long appointments and you would have to pay more per visit as well. But you need to know that the longer you wait to have the cavities done, the deeper they will become. So the quadrant option is an important thing for you to consider.

Regarding tooth #29... a sedative filling can be tried only if there is no nerve exposed during the removal of the decay. Though I think you better prepare yourself for the choice of root canal or extraction. This way you won't be making a last minute decision if it comes to that.

Is there any way you could go to a private dental practice rather than a chain or clinic? I'm not a big fan of either of those because it's been my experience (from a dental viewpoint as a chair side assistant) they both tend to be more focused on quantity than quality. But if that is what you need to do, then go with your instinct. You can always change if you are not happy.

Bryanna






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Unfortunately my insurance is mostly just chain dental places, and the clinic is by income so there's really no other options. The one four-surface is actually not that bad, there's a small circular hole that was already filled in the middle that makes up the fourth surface, with say 85% of that side still there, if not more.

Is it bad if I mention what the clinic said to the chain dental place, since there's a differing opinion regarding cavities in #2, #11? And #3 since MO vs L seems quite different?

I think the clinic place is pretty honest though, and they seem to match almost what the chain dental place said, although less "aggressive" about it. The clinic seemed pretty sure I wouldn't need a crown on #31, #32 but the chain said it wouldn't know until it was cleaned out. I know #32 is a deep filling but not sure about #31 as the clinic said it would just be a two surface, including the side whre I previously had filling placed so most of the tooth itself is still there.

Mike,

Deep cavities often involve more than just one surface. The number of surfaces can only be determined when the tooth is drilled into and the decay is removed. Not just because of the depth of the decay but because any weak areas will also need to be removed. Dental x-rays are only two dimensional and therefore can not show multiple dimensions to determine the exact size of the cavity. Clinical examination can only see what is visible. Does this information help make things clearer for you?

There is no reason to tell one office what the other one has said as neither of them are really going to care. They have their own ways of restoring teeth and that is how they are going to proceed. No one wants to intentionally miss a cavity. So you may want to say something like this .... I am concerned about the number of cavities that I have so please be sure not to over look any. That is the best way to let the dentist know to take a second, third look.

What you need to be prepared for is making the decision of whether or not to go forward with root canal(s) or extraction(s) because it may come down to that at some point or another. Again, this is not to scare you but to inform you that you may be faced with this decision.

It is a shame that you have to be so insurance dependent. But I totally understand how expensive dentistry is and it can be unaffordable for many people. I wish it wasn't that way... but it's not going to change unfortunately.

Bryanna