Hi Cyberphonics,

Your personal issues with this dental office are fairly typical for many people who go to clinic type dental practices. They are also not something anyone here can advise you on or do anything about. If you are not happy there and feel that you are not being taken care of properly (and it sounds like both of those things are occurring) then find some place else to go. If money is your "main" concern over the quality of care then there really isn't reason for you to leave there. Dentistry is very expensive especially when you have a variety of dental problems... some of these problems are self inflicted from lack of proper oral hygiene, poor diet, medications, illness... and some are from poor quality dentistry.

I will post your questions and answer them to the best of my ability in bold type.
<<<My questions at this point until I get some second opinions is that while I was googling stuff about decay under crowns and such, I saw some people mentioning two things...

1) That dental hygienists are better at detecting decay going on under crowns than the dentists/x-rays because of how they're digging around the gum line. Is this true?>>>

NO, THAT IS NOT EXACTLY TRUE. DURING A CLINICAL EXAMINATION DENTISTS ARE SUPPOSE TO USE A SPECIAL PROBE THAT SLIDES ALL AROUND THE CIRCUMFERENCE OF THE CROWN MARGIN. OUT OF LAZINESS, THIS IS RARELY DONE. THEREFORE, A GOOD HYGIENIST WILL USE THIS PROBE DURING THE CLEANING TO CHECK THE MARGINS. IF THIS PROBE IN NOT USED BY THE HYGIENIST THEN THE ONLY TIME SHE WILL PICK UP DECAY ALONG THE MARGIN OR UNDERNEATH THE CROWN IS EITHER 1) SHE FALLS INTO IT WITH HER SCALING INSTRUMENT OR 2) IT IS EVIDENT ON THE XRAY.

<<<2) That people should look into dental offices that are up on more contemporary treatments, specifically lasers that they use for a variety of things from repairs to killing bacteria and fighting decay. I've never heard of anything to do with lasers and dental work. Does it have a name so I can research this?>>>

DENTAL LASERS HAVE BEEN I USE FOR MANY YEARS. THEY ARE EXPENSIVE AND REQUIRE HANDS ON EDUCATION. SOME ARE CALLED ERBIUM OR DIODE. PERIODONTAL LASER SURGERY IS CALLED LANAP.

<<<3) There was talk of a new type of crown that's more opaque/transparent on an x-ray allowing your tooth to be seen underneath it which aids in being able to see problems going on underneath the crown that can't be seen with the regular porcelain/metal crowns. Anyone heard of this?>>>

IT IS CALLED PORCELAIN AND IT IS NOT NEW. YOU MAY BE REFERRING TO ZIRCOMIUM CROWNS? ALSO NOT NEW AS THEY HAVE BEEN USED IN COSMETIC AND HIGHER QUALITY DENTAL PRACTICES FOR SEVERAL YEARS. CROWNS THAT ARE PORCELAIN FUSED TO METAL SUBSTRUCTURES OR ANY METAL CROWN WILL BLOCK THE XRAY BEAM FROM PENETRATING THE CROWN.

<<<4) I heard there's dental puddy I can purchased over the counter that I may be able to use just to stick in that hole where the filling is for now. Would that be advisable or should I just leave it be?>>>

YOU CAN BUY TEMPORARY DENTAL ADHESIVE OR A DENTURE ADHESIVE IN A DRUG STORE. BOTH HAVE A PUTTY CONSISTENCY THAT CAN BE PLACED IN A VOID IN A TOOTH. IF THE TOOTH IS DECAYED AND YOU PLUG UP THAT HOLE WITH THE ADHESIVE, THE PRESSURE FROM THE DECAY CAN BUILD UP AND CAUSE A TOOTHACHE.

Bryanna

Great! Thanks so much, I'm not sure what the "clearer" crown is called, I saw an article about it from a few months ago stating that it was just now starting to be used which is why I said "new" but I couldn't find the article again and didn't remember what I was searching for initially when I found it. It may just be a new version of something already out like you said, I don't know. I'll keep looking.

My concern is finding a better dentist, not the cost. I have good insurance as I'm government, I just don't want to make decisions based on the assumption that everything I could get will be covered since anything that isn't I'll have to pay for myself and I'm aware of how pricey that can get because I had to do that for years. I don't recommend it lol

I'm glad to hear that these kind of issues are common to that kind of office. I never realized until recently that this kind of set up is called a clinic rather than just being an office where more than one dentist works out of. The service wasn't like this years ago when I first started going. It seems like everyone except then head dentist has been replaced. I checked reviews out of curiosity to see if anyone else feels like it's declined since then and the few I found stated exactly that even naming some of the good dentists who used to be there by name so I'm glad I'm not the only one who noticed.

I appreciate the help and I know a lot of people who don't take care of their teeth. Even came across someone on a board who said they only brush twice a week. Yikes! I couldn't imagine. But I take care of my teeth and I'm as healthy as an ox since I've been an athlete since my early teens and maintain the same regimens even though I don't play anymore. My annual check ups and tests always show what good shape I'm in inside and out which makes my primary physician happy lol

I did have one brief problem with a drop in vitamin D when I had to spend a few months working out of sunlight which I thought could have weakened my teeth but doc cleared that it's back to normal and that happened long after these problems started anyhow.

I don't drink or smoke, I don't eat sweets or chew gum, I drink soda maybe once a week and when I do it's only a can of all natural caffeine free ginger ale that I follow up with water, I brush two to three times a day depending on how often I've eaten and use my mouthwash each time, I floss daily with string floss and a few times a week will end the night with my waterpik, my diet is mainly fish vegetables and fruit with the occasional barbecued meats (mmm lol).

So I feel like there's only so much I can do on my end. I didn't have all these dental problems before seeing this new set of dentists so I'm inclined to believe it's more their fault than mine. Which I wouldn't think as easily if not for all the things they've done wrong with my dental work (and however you slice it, wrong isn't an opinion, when something that's supposed to lasts years falls out the next day etc and the head dentist has to bring you back in to have them do it properly, that's not me just imagining that someone messed up lol).

So even though I'm doing my final follow up with the head dentist who's the only one I trust at this point, believe me that my priority has been tracking down a new dentist who will look after my teeth the way my old ones used to. I hope everyone dealing with this is able to find and hold on to great dentists for as long as they can, it really makes a difference and can affect your quality of life.

Thanks everyone for all of your advice and concern. I wish everyone here the best of luck with their teeth and their health in general. Like the Trekkies say live long and prosper haha

Hi Cyberphonics,

Regarding the "clearer" crown... are you referring to a CEREC crown? They go by various names depending on the material.... LAVA, VitaCAD, Empress, etc. These are often fabricated right in the dental office. They are made of high strength dental ceramic, composite material or a mixture of composite and zirconia. These, like all porcelain (non metal) and zirconium crowns, can be seen through on a dental xray.

The head dentist in your dental office is the "director" of the franchise. He will remain there unless he sells the business. When dentists buy these franchises, the purpose is to temporarily employ "cheap and inexperienced" help of which he can make money off of each procedure. These places often employ dentists who either just moved in to the area, or just got out of dental school, or those who have a shady background and may be trying to get back on their feet. The hired help often leave as soon as they can acquire some experience and a better paying job. It is run very differently than a private practice. What draws people to this type of office is... their fees may be a bit lower (you get what you pay for), they usually offer lots of hours and they are conveniently located.

You mentioned using mouthwash. Check the ingredients in the one that you are using. Any mouthwash that contains alcohol, preservatives, chemicals, and dyes actually will do more harm than good to the teeth and gums. These products cannot differentiate between the good and bad bacteria so they kill off everything which causes an unhealthy balance.They also dry out the oral tissue, reduce the flow of saliva and predispose the user to decay and gum disease. Mouthwash is not necessary to use as there is no hygiene benefit to using it. Those that contain fluoride are actually toxic to the digestive system and even the label will warn... not to be swallowed.

The best oral hygiene regimen is simply.... thorough tooth brushing with a soft bristle or electric tooth brush twice a day with a non harsh tooth paste, floss thoroughly once a day at night, and use a tongue scraper at night. Combined with a nutritious diet and healthy lifestyle are the keys to good oral health!

Bryanna

Ha! I forgot I can't leave before giving you guys the final update from my head dentist. Oh but first Cerec sounds familiar, I think it was saying it was some improved kind of that, thank you so much!

Also thanks for explaining how that place works! I never had a clue. When I first started going there years ago, it was a handful of dentists who were experienced and had such great feedback from the community, really cared about their patients and would have dialogues with you and knew you and your families, etc. So it felt like when I went to a private practice. I had one dentist who cared for my teeth every time I went and it was great.

But once that set was out of there, it was exactly like what you said, they were getting replaced with people who were clearly new and didn't know their left from their right and more got added and now it's like a totally different place all together, like people are just being herded in and out, people just seem like they want to be done with you, it's a mess.

My head dentist is the only one still there like you said and he's the only one that still treats me like the "old days" consistently. I've known him for years and trust his judgment and experience so he was my last hope there in my eyes. It's a shame how things turn out and how money is made off other people's grief.

Mouthwash, thank you! I started experimenting with them because I felt like I didn't want a bunch of nonsense in something I was swishing in my mouth. The three that I feel like my teeth did the best with and that I could always get my hands on were Act, Listerine Zero, and Sensodyne pronamel fluoride rinse.

I prefer the Sensodyne of all because it felt "gentler". I liked it for morning because it feels like it coats my teeth a bit and I've seen a huge reduction in feeling and seeing the effects of acids like if I have orange juice for breakfast with it. The Listerine Zero I use for the rest of the day.

I tried using none and my teeth didn't like that at all because I'd read like you said some saying that you don't really need it but whatever problem I had at the time seemed to get worse so I added mouthwash back to my regimen. Maybe I'll try to only cut back on the Listerine and see what happens.

I try to stick to the salt water gargles for when I'd have aches. Water a clove was soaked in for a while helps tremendously so I had no more need for things like orajel if one of my bad teeth was giving me problems.

I also tried a bunch of different toothpastes. I went through the shelf and looked for the one that had the least extra stuff in it with the max over the counter fluoride that made my mouth feel clean and also didn't make them hurt. Of all the ones I tried, I ended up with plain arm and hammer total care and have seen a definite improvement. I don't know how bad or good it is but it's a definite keeper.

All of crest toothpastes felt like I was brushing with sugar, they'd actually give me more toothaches in my bad teeth, and all the colgate ones felt like I was brushing with nothing. My mouth wouldn't taste clean, my teeth never felt clean, and I seemed to have more build up. There were other ones but for the price none of them worked or felt better than the arm and hammer and many had more dyes etc.

I'm definitely going to be mindful of that and also making sure my brush isn't too harsh on my teeth so I don't increase damage, thank you Bryanna!!!

Final Update

I saw my head dentist to nip this in the bud since everyone else was a bust and he's the only one I can trust to have a dialogue with and who really seems to care and/or know what he's doing. He addressed everything he saw in my mouth and in the x-rays before I even had to ask him. Then answered everything I asked him lol

The root canal He checked it all out with the x-rays and looking inside, testing my bite, tapping to find any sensitivities. He agreed with the other dentist that the quality of the root canal was great and there were no signs of an infection that migrated anywhere or anything but disagreed that my wisdom tooth was the source of my pain biting down on it.

He said it was the height of the filling done on it that was causing excess pressure at its highest point when I bit down on anything that could slow the healing process in addition to just being uncomfortable so he shaved the excess filling down and smoothed it out and said he'll monitor it from this point to see if I have any further problems.

So for now, the test will be what happens the next time I eat. He did say though that he wants me to be more informed about my options with the wisdom tooth and get some guidance since that one is a bit crooked even if I'm not feeling any pressure from it pushing against my other teeth so he referred me to an oral surgeon.

The moving crown He said it was definitely moving (finally someone there not acting like I'm making it up! ). He said that while it has mobility, it isn't loose enough to take it off and the forward/back motion as opposed to an up and down motion would be more indicative of a gum problem than failing cement so he referred me to a periodontist to look at and the health of my gums in general, especially since I get some bleeding when I floss.

And that we'll talk more about how to tackle the crown once I've been assessed. He also suspected from his examination that the gums could be the issue for the back upper left I had the filling in that's been bothering me a bit which I can believe because the pain is more near the gums than "in" the tooth if that makes sense.

The lower left hole He confirmed the bit that I said broke off and that they really were just waiting to get a crown though it should have been better discussed with me and that they'd be fixing and prepping it properly before that but they were holding off on it to take care of some of the other things that were more pressing first.

I asked if it was possible to get it out of the way because it's just really uncomfortable having that gap with stuff going down in it all the time getting compacted and plus it actually makes it harder to floss it because there's no narrow area to guide the floss, it just slides all over the place lol

He said no problem, since we're going to monitor the root canal, we'll delay putting the crown on it and use that appointment for getting started on the lower left instead. And all of the above without me even needing to beg to be informed (this is why I like him lol). So he said he's going to stay on top of this and meanwhile, I made the appointments to see the oral surgeon and perio.

I feel much better now. I won't say that I no longer need to find a new (private) practice because I can't guarantee that he'll always be there to look after my teeth on the days I need them tended to but I at least have a course of action. P.S. The sweet but poorly skilled dentist who was ruining my mouth was finally sacked.

P.P.S. I asked him about this other root canal on my upper right behind the other one the girl said I had to have out of nowhere. He confirmed for me that somebody made a mistake, he saw nothing in my x-rays, chart, or in my mouth indicating that I need another one, someone just jotted a note saying I needed one for some reason so he said forget about that and got rid of it. Good thing I said no to scheduling it haha