[threeputt]

I decided to edit the post and wait until I see another Dentist

[Bryanna]

Hi Tom,

I didn't see your original post. I'll check in later or tomorrow and see if you've re posted it.

Bryanna

Originally Posted by threeputt

I decided to edit the post and wait until I see another Dentist

[threeputt]

Hi Bryanna. Long time since I last chatted with you. I had posted but removed the post because I thought maybe my Dentist might see it but now I really don't care. Let me give you a little update. 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.

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.

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.

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.

I now am on just one B/P Med called Losartan/HCT 50-12.5 and now all is good. B/P is perfect and no more leg and ankle swelling. Only been on this one for three months but I would not think it could have cause all this in this short time ? The Lisinopril has been the cause of this problem for years and I even mentioned it to my Doctor and he said they didn't look that bad but I know better because at night they would get heavy. The problem is now gone since the different medicine.

The only other medicine I take is Flomax and I did not see anything that would cause a dry mouth and maybe cause teeth cavities. I also take an acid blocker for reflux.

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.

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 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.

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 ??

I will be age 69 in August and when I was very young I didn't take good care of my teeth plus probably bad genes as both my parents had dentures at an early age.

I have taken great care in the last 20 years and I floss everyday and brush after each meal if I am home. She did say teeth are like old cars,, they sometimes just wear out and give more problems as we age. I have even thought about having them all pulled because I have many crowns and several root canals over the years.

She also asked me if I have dry mouth and I do believe I wake up in the morning with this and really don't know why all of sudden. Maybe one of the meds is indeed causing this or just sign of aging ?



I am not going to spend the $1800 for the root canal on number 14 plus new crown, I do know that but will an oral surgeon pull it just by me asking ?

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 ??

Sorry for the long post but I guess you could say I am not happy about all this and as always I appreciate your advice. Tom

[Bryanna]

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.

[threeputt]

Bryanna, I am for sure still playing golf. Didn't get out this winter because my body don't work very good when its cold but I am back playing two days a week now. I have been retired for over four years and life is good other than the news on my teeth.

I will make a decision soon on what to do next and with your help it sure make me feel better.

I want to thank you for your nice reply. Yes my Dentist does take x-rays each year. Last year everything was great and I was upset that so much has changed since. Maybe it was me who suggested I come in only once a year. Knowing how I do things it probably was. I do tend to be hard headed

Tooth # 14, the one they suggested I need a root canal on was crowned in 2005 but never had a root canal before. The referred me to Endodontist but I have not called them yet. I am undecided on what I will do.

I know the Dentist I have been using for the last 11 years has put 8 crowns on my teeth since 2005. We got into an argument a last year on how many she had put on. I checked my records on the insurance site and it was 8 she has put on.

I am not sure how many root canals I have had. I know of four and that is pretty close. I have had three teeth removed in the last 30 years. Number 5 tooth was extracted three years ago after many years of giving me problems. The oral surgeon tried to talk me into saving it after I was already in the chair. I told him no and after he removed it he told me I made the right choice because he could not have saved it. Way to many years of infection had eat away at the gum. I should have had it repaired with something because I am sure my top teeth have now moved. Stupid me but I just was not going to pay for any expensive work. Now it is probably to late .

Tooth number 18 was removed several years ago also. I don't even remember why other than a bad toothache. Number 16 and 15 was also removed years ago and so far no problem eating.

That brings me to the decision on tooth number 14. It has never had a root canal and if I said it had I made a mistake. I called today and asked if it had ever had root canal but forgot to ask just how many total root canals have been done over the years. I will find out just to know though.

You mentioned that I would need to start getting these cavity problem under the crowns ASAP but the office seems so busy they cannot see me until late May and that appointment was to do the front teeth first, not the ones under the crowns. Maybe I should think about finding another Dentist because they don't seem concerned about my health as much as I am. I hope you understand my worry about all this. I trusted this person and now I am a little worried about things.

The blood sugar thing I understand. I just posted the A1C result and didn't mean it to show that I was not diabetic but under control. I know really I am diabetic but I keep in under control with diet and exercise. The longer I stay off B/S medicine the better I am. I will mention the higher than normal after meals I have seen in the last few months when I go to the VA week after next. I just like using them because they have all my blood work except the PSA back the same day and I know the results before I leave the hospital. My PSA results have always been very low. Last one was 0.6 which I was told at my age was great. Just the enlarged issue and the flomax has helped in that great


I will post more after I read your post several times. Just wanted to update you and thank you for your reply. Tom

[threeputt]

I talked the dentist into getting me early. Got all the cavities done in one trip instead of three.
They asked if I wanted the nitrous oxide which I had never had before. Being I was going to be in the chair for at least two hours I went for it.

Seemed like only 10 minutes instead of the two hours. I never even felt the shots I told her all I needed was Iron Butterfly playing in a gadda da vida in the background and it would have been just like back in the 60's again
The gas is the only way to go from now on if I have to had lots of work. Best choice I have ever made. They did not charge me for it because I told them I needed a trial . I did have to sweet talk them though which was not hard to do.

Now to make up my mind on the rest. Part one is over and I am glad. Down $600 and some change so I am getting there.

[threeputt]

Bryanna, I might have said that #14 had a root canal done in the past, not sure how you took it but in fact no root canal has ever been done on #14 tooth. I still got 2 weeks to make up my mind to spend the $2000 to have a root canal and then next day have it crowned or just remove this tooth.

The two teeth next to it has been removed years ago. One being the #16 wisdom tooth and then #15. I am thinking it has been at least 35 years since these teeth were removed. Now the question is this old crown on #14 and the dentist telling me it needs a root canal.

I am thinking there is not much tooth left under this old crown on #14 so they would need to build up I assume.

I know most dentists will tell me to keep it but really is it worth all this money and then have to remove it later if the root canal fails ?

I think I could eat food without it. When I called they told me I could wait but yet they claim it needs a root canal so is it infected and needs something done now?
I am confused on what to do. I also don't have that kind on money laying around but I can get it from my saving.

I understand if you don't want to answer me but I thought I would ask being I do think you thought #14 already had a root canal . Tom

[Bryanna]

Hi Tom,

Sorry that I've been MIA. Been dealing with a lot of things lately.

Regarding tooth #14 ... root canaling the tooth does not cure the infection it actually adds to the spread of the bacterial infection and inflammation. Based on everything you have shared about this tooth and from my extensive experience I would say that in all probability your assumption about nothing being left to this crowned tooth is correct. The decay is most likely very extensive leaving not much, if any, actual tooth structure remaining past the gum line. So there will be nothing to build a core base upon to place a crown over. Root canaling it is her last ditch effort to give you some very limited, but unhealthy, borrowed time with it. Inevitably the tooth will need to be removed. However, what is the chronic infection doing and going to continue to do to your systemic health? That is the real concern, in my opinion.

It will not be easy to chew food on that side of your mouth without any upper posterior teeth. However, that lone and sick tooth #14 is not aiding you in chewing and it is infected. Perhaps she can remove that tooth and fit you for a removable partial denture?

The choice to retain it or not is yours. But just know that what you are retaining is an infected tooth with a very limited life span.

I hope that helps.
Bryanna

Originally Posted by threeputt

Bryanna, I might have said that #14 had a root canal done in the past, not sure how you took it but in fact no root canal has ever been done on #14 tooth. I still got 2 weeks to make up my mind to spend the $2000 to have a root canal and then next day have it crowned or just remove this tooth.

The two teeth next to it has been removed years ago. One being the #16 wisdom tooth and then #15. I am thinking it has been at least 35 years since these teeth were removed. Now the question is this old crown on #14 and the dentist telling me it needs a root canal.

I am thinking there is not much tooth left under this old crown on #14 so they would need to build up I assume.

I know most dentists will tell me to keep it but really is it worth all this money and then have to remove it later if the root canal fails ?

I think I could eat food without it. When I called they told me I could wait but yet they claim it needs a root canal so is it infected and needs something done now?
I am confused on what to do. I also don't have that kind on money laying around but I can get it from my saving.

I understand if you don't want to answer me but I thought I would ask being I do think you thought #14 already had a root canal . Tom

[threeputt]

Thanks Bryanna, I went to another dentist. One that I have known for years. I used to use his dad years ago. Him and his wife work as a team. My son and his wife have been using him for years and they both love them both. He sit down with me and explained about the same thing you told me. I have having him remove three teeth on the 6th of June. He said I needed three root canals instead of one and one of those had a root canal already done years ago. #14 #19 and 31 are coming out. ` He told me they were ticking time bombs and it was wonder they have not already started hurting.

The other dentist would not email my xrays , saying I would have to sign something so I told them to just do new ones. The new dentist was nice about it all and said it was my choice but something needed to be done ASAP. I told him I have 9 crowns and I sure didn't want to face this every year. I can manage to chew on the right side for now. I am glad I am got this 2nd opinion. I trust this dentist and not sure why I never went to him to begin with. I did use him about 6 years ago when the dentist I use told me I need my other three wisdom teeth removed. He checked them and said nothing was wrong with them so leave them in and so far no problem. I will update you are I have them pulled. I was just not going to pay $6000 to repair something that would probably fail in a few years anyway. Part of getting old and the price I pay for not taking care of my teeth when I was young. Maybe bad genes also because my wife is two years younger than me and never had a cavity . Her Mom and Dad both had good teeth but mine didn't. Tom

[Bryanna]

Hi Tom,

I am glad that you went to a different dentist. I think I had mentioned to you awhile ago and again recently that I had some reservations about the one you were seeing. I know you were uncertain about her as well for a variety of reasons.

Regarding the retrieval of your xrays from your previous dentist ... she legally has to give them to you. The release form is a HIPAA requirement. It would behoove you to sign the waiver and get those xrays so that your new dentist has them as a radio graphic history. They are helpful in that he can then see what your oral health and dental restorative history has been over the last year or so. They would give him a comparison view of how well or how poorly her dental work has been between the time her xrays were done and the most recent ones taken by him. I highly recommend that you obtain them.

This newer dentist seems to be more preventive oriented and pro active at the same time. That is a good thing. I'm sorry to say but I think the other dentist was just patching you up here and there.

Please keep us posted.

Bryanna

Originally Posted by threeputt

Thanks Bryanna, I went to another dentist. One that I have known for years. I used to use his dad years ago. Him and his wife work as a team. My son and his wife have been using him for years and they both love them both. He sit down with me and explained about the same thing you told me. I have having him remove three teeth on the 6th of June. He said I needed three root canals instead of one and one of those had a root canal already done years ago. #14 #19 and 31 are coming out. ` He told me they were ticking time bombs and it was wonder they have not already started hurting.

The other dentist would not email my xrays , saying I would have to sign something so I told them to just do new ones. The new dentist was nice about it all and said it was my choice but something needed to be done ASAP. I told him I have 9 crowns and I sure didn't want to face this every year. I can manage to chew on the right side for now. I am glad I am got this 2nd opinion. I trust this dentist and not sure why I never went to him to begin with. I did use him about 6 years ago when the dentist I use told me I need my other three wisdom teeth removed. He checked them and said nothing was wrong with them so leave them in and so far no problem. I will update you are I have them pulled. I was just not going to pay $6000 to repair something that would probably fail in a few years anyway. Part of getting old and the price I pay for not taking care of my teeth when I was young. Maybe bad genes also because my wife is two years younger than me and never had a cavity . Her Mom and Dad both had good teeth but mine didn't. Tom