If anyone is following this, please refer back to the last thread.

At my Monday, May5,appointment, the pros intern spent much time putting in, reshaping, etc, my temporary denture for my lower teeth. I don't believe I've ever seen worse proportions. The curve from the front teeth to the back is almost out of sight on one side. Looks normal on the other. My original teeth were bad but didn't look as bad as these do. Okay, they're temporary, but I hate to see his work on the permanent ones.

Also, the tops of the front 6 teeth roll back toward my throat. The teeth are not straight teeth. There's a ledge I feel with my tongue. That's vague, but does anyone understand what I mean? Are temps supposed to look unbalanced like that and curve backwards instead of being straight?

When I looked at them and asked why, he said it was just temporary - not to worry about it - that I couldn't expect them to look any differently.

Pros intern doesn't want me to have my upper bridge on implants. Says there's just a cavity on one of the canine teeth that are the anchors. My feelings about not doing that much work on a decayed tooth are not valid according to him. Wants to use my teeth whether I want implants as insurance against future work or not.

He sent me down to surgery for an opinion. Another totally new intern who looks 16 said that in his opinion, I should use my canine teeth again as anchors for the front bridge. That they're strongest teeth in my head, and one little cavity isn't going to make any difference. I asked him when he'd spoken to pros intern. He eered and ahhed and said a little while ago, but that it didn't influence him.

Then he started saying that because I'd had this present bridge as my front teeth for so long (over 40 years ) that the gum had narrowed toomuch to put inplants in, so that was that. That if I got anyone to do it, they'd have to graft bone in front and wait for that to heal - like 6-9 months. My sentence has been decided by a new grad who is with the other class coming into all the departments this week.

The patient advocate said she was only supposed to work as advocate between students and patients - not interns and up. Therefore, there is no patient advocate in the dental clinic.

I went to the dean's office. She was too busy to see me for several weeks or months. Doesn't matter, she's been briefed and the word has been put out that I'm a trouble maker.

Bryanna, if you read this, I have acted the way you suggested from the beginning. I haven't threatened, been ugly, blamed anyone. I've just told them what had happened to me. No one has given me answers to anything.

They're playing dirty.

One thing I would urge anyone to think about: like eyes, teeth, once pulled, are not renewable. Therefore, if you do not feel good about your dentist, find another one. And another one. And another one. Until you do feel good.

There is a new fad around dentists, around here, that says you do not need anything more than the small molars right behind your canines to chew your food with. And that people who smoke do not deserve teeth. And that people who do not brush with a specific speed electrical toothbrush twice a day do not deserve teeth. And that all this dental care is too costly for your insurance, even if you pay very high premiums "through your teeth".

I made an appointment with a new dentist and asked him whether he is old-fashioned in believing that dentists are there to prevent pulling teeth as opposed to modern science telling him to pull teeth "preventatively". (I do not see, frankly, what is exactly being prevented except costs for the insurance company. When there is a choice between doing a nerve and cleanout job on a tooth, obviously there is a risk that in five to ten years, you loose the tooth anyway. Is this a good reason to not do the clean-out job and see what gives? In my opinion, as the owner of the teeth, obviously the answer is no. Besides, if my insurer doesn't like it, they can tell me no. I do not need my dentist to "preventatively" tell me no, it feels like the dentist is trying to be the nicest kid in the class at my expense.)

Do not take any crap. If you are unhappy, change dentist.

My cuz the dentist told me that until they use a certain technique involving tevlon before the actual implant, they will not be able to do opposing implants that last, i.e.: if you have implants for let's say your upper canines and your lower canines as well, you will have problems quickly because of rigidity that is not present in natural teeth which will cause the implants to cause irritation-induced infections in the jawbone. In other words: you can have implants, but not if the opposing tooth is an implant as well. They might give it to you, but it won't work.

Oh Jon!!

You are not being treated properly. They are flipping you from one "gem" to another and they are not suppose to do that. Temporary teeth in most cases, should resemble what the permanent teeth are going to look like. When doing dentures, the temporaries will look somewhat different than the permanent but it is imperative that the temporaries fit perfectly into your bite or they will alter your bite and the permanent teeth won't fit properly.

There is no reason for your temporary teeth or new permanent teeth to look differently than your natural teeth did when they were healthy. Do you know what I mean? Nothing should be noticably out of balance from one side to the other and your upper teeth should be straight without any ledge anywhere. The only reasons why you would see a noticable difference are:

1) Your jaw is not lined up properly and your bite is crooked. But this would have been noticable to you with your natural teeth.
2) The implants are not placed properly and to accomodate them, the shape of your teeth had to be changed.
3) The idiot does not know what he is doing!!

I hate to say this but, your case is typical of what I have seen done in dental school clinics. It amazes me how this nonsense gets past those in charge...... but it does, all the time!

I think it would behoove you to get an opinion from a "real" dentist outside of the clinic before you proceeded any further. I know you are concerned about the finances, but at what expense are you putting yourself through this? An opinion outside of the school may help you to sort through all of the nonsense.

I am so sorry you are enduring such a difficult time. This is truly so unfair to you. There has got to be a patient advocate for the patients at the clinic.... if not, then the state dental board may be the place to talk to someone about all of this.

Bryanna

Hi minymo,

Comparing eyes to teeth may not hold the exact same comparison since teeth can be replaced with implants or by other less invasive options. Also, one could live without teeth with alot less difficulty than living without their eyes.

I agree that people should stay with a dentist that they are comfortable with but many people don't have the finances to keep switching dentists. But it would be nice to find someone you like more easily than it seems to be!

I am concerned by this quote as I have never (in 30+ years) heard of such a thing. Where in the world is this being told to patients??
<<There is a new fad around dentists, around here, that says you do not need anything more than the small molars right behind your canines to chew your food with. And that people who smoke do not deserve teeth. And that people who do not brush with a specific speed electrical toothbrush twice a day do not deserve teeth. And that all this dental care is too costly for your insurance, even if you pay very high premiums "through your teeth".>>

I am also cncerned by this quote.
<<When there is a choice between doing a nerve and cleanout job on a tooth, obviously there is a risk that in five to ten years, you loose the tooth anyway. Is this a good reason to not do the clean-out job and see what gives?>>
What is a nerve and cleanout job on a tooth? Are you referring to a root canal procedure or an apicoectomy? Either procedure does pose certain health risks especially to anyone who has a compromised immune system because it is impossible to remove all of the necrotic tissue from inside of a tooth. Losing the tooth in 5 or so years is less of an issue than what this type of chronic infection and inflammation could be doing to a persons immune system during that time.

There is some concern about placing opposing implants because there is no periodontal ligament around the implant like natural teeth have. So yes the implants are more rigid to bite against. But if done properly, it usually is not a problem.

Bryanna

Hi Bryanna,

I am sorry I startled you by the way I expressed myself. I will be more careful from here on.

Yes, I meant a root canal. There is no problem with my immune system or anything similar, and the only reason stated for pulling instead of trying to cure was, as I said, that I don't need it anyway. Also she said it would be needlessly expensive if the cleaning up did not work and I had to have it pulled anyway. I only need the small molars right behind the canines, is what they told me. I am not used to these holes in the back, now I chew in front a lot and sometimes I embarras myself because the food nearly sticks out.

I have a cousin who is a dentist, I spoke with him because I felt deeply shocked that the dentist coerced me into having the tooth pulled. I had been in a lot of pain for five days with the jawbone infection and her assistant told me that if it did not work and the pain became unbearable and I decided to have the tooth out anyway, she would make me wait at least another five days, she would not make an appointment with me quickly. The first two molars they urged and urged me to have pulled before I went for plaque removal around all my teeth. So this was the third tooth pulled I did not want.

Anyway, my cousin also told me that this is the prevalent point of view among dentists in The Netherlands. I do have a total coverage health-and-teeth insurance that I pay a lot for. I feel I am entitled to the best I can get and to make my own choices. This dentist did other things I disagreed with, I was real fragile at the time, and I have been in shock for weeks, very unsure whether I was in the wrong, and crying a lot, feeling betrayed and threatened. She had done painful things to my other teeth for 45 minutes before she bullied me into having this one pulled. And the pulling only took 2 minutes. If it had become an emergency, it also would have taken only two minutes. I could have waited for the anesthetic to work outside.

Hi minymo,

My goodness, you too have had an awful dental experience and no doubt it has left you feeling unsure about alot of things!!

I am not familiar with dental treatment in the Netherlands, but it sounds to me like there may have been some miscommunication or misunderstanding between you and the dentist. Or at least I'm hoping that's what it was and the dentists really don't practice with that type of mentality!

It is so hard for people to understand dentistry because the dental profession has kept SO much of it secretive (for lack of a better word) and for the most part has not encouraged people to ask questions. SO the average person has really no clue what to ask and has difficulty understanding what they are bein told. I am just guessing, based on my experience, this is somewhat your situation based on what you have written here.

It is true that people can live without their 2nd and 3rd molars because the majority of food is actually chewed up to the first molar in each quadrant. However, it is always easiest to have a full set of teeth! Perhaps that is what the lady dentist was trying to explain to you?

I'm assuming that the teeth she suggested to remove were badly decayed? She may have felt that it was not in your best interest to try to retain these teeth in your mouth by doing root canals since the long term prognosis was not in your favor. It's important to understand that root canals do not "cure" an infected tooth even though that is the term used most often by conventional dentists. Root canal procedures are done in an attempt to "retain" a tooth for an uncertain amount of time. The tooth never becomes healthy again and new strains of infectious bacteria build up inside of the tooth due to the lack of blood supply that has been permanently cut off during the root canal procedure. This new bacteria eventually makes it's way out of the tooth into the surrounding jawbone......... thus causing a jaw bone infection. It is the same principal as when a tooth becomes abcessed. The infection starts from inside the tooth and proliferates to the jawbone.

When a person has periodontal disease, an infection can begin in the deep pocket around the tooth below the gumline and work it's way into the tooth through the small blood vessels and nerves that intimately attach the tooth to the jawbone. In this situation, both the tooth and jawbone become infected.

Our bodies are amazing things because we have the capability to fight chronic infection for such a long time before our immune system becomes over worked and we develop signs or symptoms that something is wrong. The problem with this is that while we are fighting the infection, our organs are working overtime and who knows what the long term affects of all that fighting will be....??

I am truly sorry that you had such a horrible experience. I hope that you are eventually able to accept the loss of any teeth that were unhealthy by realizing that you really did your body a favor by not trying to retain them. I know this loss is difficult to accept, but in the long run, your immune system will be healthier for it!!

I wish you much more pleasant dental experiences in the future~!!~

Bryanna

Minymo - I absolutely agree with getting a dentist - or doctor - that you like. I live in a small town and have to travel more than an hour to get to any surrounding town which has an implant specialist. I asked as many people as possible about their implant experiences and costs. None of them were really satisfied and the costs were sky high! I decided on the state dental school clinic for a number of reasons. Cost was certainly one of the reasons because I am on medicare which does not cover ANY dental work. I have no dental insurance; therefore, no options.

Thanks for the information about the new material. I also appreciate the input about opposing upper and lower implants, but that's not the case here. Thank goodness!

Your experience sounds like a very bad one with an outcome you don't like. I've had root canals when I was much younger. It made sense to me then. I wish I'd known then what I've learned since. I've checked my dental root canal surgeries, and every one of them is gone because of bad infection. I'm convinced that the infection connected with them that was not cleared has had a great deal to do with the serious health problems I now have. If I'd had them pulled and started on implants back then, I probably wouldn't be having these problems now.

Having a hole in your mouth for a few years is awful. I hope you can get a better dentist to cover it in some way that is comfortable. Your dentist sounds terrible. Let me know when you find one and what is done. While you've got insurance to pay for it, please get it done. You don't want to be my age, without insurance and options.

Thanks so much for writing. Jon

Bryanna, is there any truth to what the newest surgeon told me? They don't want to do implants in my upper teeth, but the pros head said they could do that. Then the pros intern doesn't want to, then he talks to the new surgery intern and all these reasons come up that no one has referred to before.

Am I making a bad decision for myself when I insist I want implants for the anchor teeth in my uppers? Are my upper gums above the bridge too narrow for me to have implants on the canine teeth that are anchoring them. That sounds like bull to me. The bridge teeth don't touch the gum. They're anchored across the gum by canines which are original.

If I complain to the state dental board (=to ADA), they'll inspect the complaint, but only if I agree that their handling it rules out my rights to a legal action. There is no time limit to when they will begin or end looking into a complaint, and there is no guarantee that the work on me will continue.

Even now, I know there are nasty things that hurt - physically and mentally - when these people do not want to make this right. They've already started. The meeting that the advocate got for me with surgery was pleasant, everyone listened kindly, and no one answered even one question I asked about the subjects. They've let me have a hearing, but I'm probably never going to see them or hear from them again.

The advocate was pulled off, the dean won't see me. I am a dirty word at the dental school because I complained. And nicely, too. I am just a number to them - not a person. And I have reasons to believe - not paranoia - that the word has been passed all over the medical community - not just the school.



I told my daughter that I needed a 'second opinion" dentist but I doubt I can get one who'll not have some connection with the college. I've looked on the internet to find info about dentists in nearby communities. I can find where they received their degree, etc., but there's no way to find out all the zillions of other ways they might be connected there.

Bryanna, your help has been invaluable to me in understanding some of the problems I've had. I don't think there's any hope in trying to meet with any of them again. I'll just have to open my mouth only for surgery. I need some clout , and I don't have any or know anyone now who has some.

If you see a miracle walking around, grab it for me and send it quickly! I can't see anything else working. ANYBODY know ANYBODY who might be able to help?

Hi Jon,

I'm going to answer your post by taking one subject at a time.

With regard to the "uncertainty" about placing implants in your upper jaw:

1) It is not the gums that are too narrow, it is the bone. The width of the gums have nothing to do with placing implants unless there is severe gum recession. In the upper front area of the mouth, just like the lower front area, the cartlidge of bone is narrow to begin with. In your case, you also have bone loss because you have been missing teeth in the upper front for many years which has caused the bone to deteriorate even further. So placing implants in the front of your mouth would be very difficult and probably not successful without at least one or two previous bone grafting surgeries.

2) Extracting your upper canines and replacing them with implants would only be a wise option if you had extremely healthy bone in the canine area. If the bone in those areas is questionable at all, it may not be wise to place the implants there and expect them to anchor 4 other teeth (two centrals and two laterals) making the implant retained bridge 6 teeth or units wide. That's alot of pressure on 2 implants even in very healthy bone.

3) Dental school is students who may or may not have ever performed extensive reconstructive cases such as yours. There is going to be mixed opinions because none of them wants to be the one to attempt to do what they are unsure of unless they are someone who likes to take risks.

I have lots of experience in oral surgery, periodontics and prosthodontics. Without a doubt even in private practice, these specialists have difficulty agreeing with treatment options. The main reason is this........ oral surgeons look at the bone from a health stand point and they see all the failures that occur when dentists do things that they shouldn't. Periodontists think similarly as the oral surgeon and also see the failures of others but their main concern is the health of the gum tissue. Prosthodontists......... their first concern is the cosmetic part of the reconstruction, not the foundation of which it is built upon.

I have seen people who have had major dental reconstruction of their mouth done in different dental schools and I can only remember one case that was actually done well. They have no physically technical know how of how to put it together in the mouth because they don't do it enough. I'm truly concerned for the long term result of all that you are going through.

As for the second opinion......
MOST dentists are no longer affiliated with dental school after they graduate unless they specifially teach at one. Dentists can't wait to get out of the grips of these places and practice on their own. There is no communication amongst dentists in private practice and dental school interns, etc unless they are on the staff at the school. Dentists themselves never refer their patients to a dental school (unless a patient makes that request) nor do they ever seek their own treatment at one. Dentist actually sympathize with patients who have been tortured by a dental student! I truly think it would be wise to get an opinion from a dentist in private practice that someone could refer you to. It is imperative that you get a copy of your radiographs and records from the school to take with you.

Jon at this point, the dental school is just shooting darts and seeing which one lands where. Unfortunately, your treatment plan is going to change every time you turn around and some of it will most likely be because of failure of treatment that has already been done. I see it all the time............ Please consider an outside opinion.

Bryanna ~'.'~

Hi Bryanna

Thanks for your explanation. This woman dentist had what I termed an "abrupt" personality, she had been off sick with cancer for three months after I was with her for six months, I always felt she had no time for explaining. I felt more and more ill at ease with her. She suggested I have the pocket-cleaning done, because she was going to redo all my fillings. They are 25 years old and, incidentally, have been put there by students, including a solid gold crown (chunck of gold screwed in on the inside, then a crown on top) and 3 normal gold crowns. I only had a minor filling and one root canal on one of the crowns since.

Anyway this dentist said the pockets around some were too deep, redoing the fillings wasn't going to be worth it. But they did not bother me! They did not need root canals. And I did not want them pulled. If she did not want to redo them, all she had to do was say so. She refilled three molars, including the small one, in one quadrant, right before pulling the sore one in the back after all this pressure. This small one was way too high. I went back and she took some off. It was still way too high. I was upset enough to go to a different dentist for a second opinion. I told him quite clearly in the beginning that I did not want him communicating with her. Okay, he said. Than during the questions he still wanted her name. He told me she had done everything correctly. Then at the end I told him once more I did not want him contacting her. He promised once more. A few days later I was called by the lady dentist, telling me she had received a phone call from him, but she had been too busy to talk to him at the time. She told me she encourages second opinions, to take away any doubts because it makes her work easier. I appreciated her honesty in letting me know he called as opposed to his sneakiness and downright violation of the code.

Nevertheless I searched for another dentist. I found one who makes me feel completely at ease, and like I understand all he says, and the why of things. I concluded that maybe she did right, maybe not, in any case she seems to have done what she believed to be right, but her and me = bad combination personality-wise at least. I think feeling at ease with your dentist and being able to communicate is just as valid a reason as whether the work itself is good or not. I have told her this in a way that was not attacking her and she appreciated me letting her know this.