Dental Woes...

[runnerchic71]

Hey All,

I suffered an injury to my upper large middle tooth (quite obvious by now I am not a dentist, nor do I work in the field...). Long story short it turned black within two weeks and became quite painful. I was started on a course of antibiotics and scheduled for a root canal.

Following the root canal, things got A LOT worse. I can tolerate pain, but this was unbearable. I was started on a new course of anitibotics, and given pain medication. Within a couple of days it settled down, but was still not 100% painfree. I finished my course of anitibiotics on Sunday morning, and since then the pain has started to amp back up and return.

I spoke to the dentist today - and they do not think that the infection is back...but it really feels like it is. They are wanting me to see the primary dentist in there office, and potentially a specialist to determine if there is a root fracture, and to see if the tooth can be saved. (Won't be able to see the primary dentist for 2 weeks!!) My feeling from the way they were talking to me today is that the root canal was a waste of $ and I am going to need to pull this tooth and do something with the resultant hole in my mouth. I work with the public, and a huge gap in my smile is probably not going to be good for my business.

My question is - dental implant? Or bridge? The teeth beside it are in there original condition, no fillings... I also have a trip scheduled to Bonaire (and paid for) leaving December 22nd. I am concerned about being able to dive on the trip we have been looking forward to. Any thoughts at all would be appreciated.... thank you so much,

 

[Mark Derail]

I'd like to know where, in the Caribbeans, where good dental work can be done for cheaper than in Canada.

I vaguely remember reading there's one on Cozumel, and seeing a TV show about Belize.
Anyone ever do it?


I feel your pain Runner. I'm due for a bridge in a molar - for over 5 years.
I'd go with an implant - they last longer than anything else. Gold tooth?

Also not all dentists are great, a 2nd opinion...might just cost you a set of xrays.

 

[runnerchic71]

I'd like to know where, in the Caribbeans, where good dental work can be done for cheaper than in Canada.

I vaguely remember reading there's one on Cozumel, and seeing a TV show about Belize.
Anyone ever do it?


I feel your pain Runner. I'm due for a bridge in a molar - for over 5 years.
I'd go with an implant - they last longer than anything else. Gold tooth?

Also not all dentists are great, a 2nd opinion...might just cost you a set of xrays.

Hey - thanks for the response I've heard dental work is a lot cheaper down south too...but again, not sure exactly where. I am hoping to see a specialist, just worried if it does need an implant that I won't be able to use the tooth to hold my regulator on my dive trip.....long healing time I think?

Gold, lol...not sure thats the look I'm going for right in the front of my mouth !

Thanks!

 

[CajunDiva]

I feel your pain runnerchick71. I was involved in a head-on collision years ago and took a steering wheel to the mouth...no fun dealing with the aftermath! I have dealt with both possibilities you mention, and I have dealt with healing from an implant in time to go diving.

There's no way I would elect to damage two perfectly sound natural teeth to get a bridge with today's implant technology available. I have two implants and they are very stable...really no different from my natural teeth except for the lack of nerves. The difference is that mine are not in front - they are molars. I think you could expect the healing time to be about six to eight weeks. (Of course that varies by individual)

The most important thing is to have a qualified individual do the work. Talk to them about your expectations and what to expect in terms of healing time and be sure to discuss the diving aspect with them. It's definitely a process to go through, but I don't think you would have any problem being ready for your Bonaire trip unless you delay treatment for some reason.

 

[t4e]

personal opinion go for the implant, having worked in a dental office for 5 years with an awesome dentist that was all for saving teeth rather than pulling them

a bridge would require the adjacent teeth to be filed down pretty much in half to accommodate the bridge support, unless they have come up with other solutions lately that will require less removal of the adjacent teeth, no matter what though they will have to be filed down to a certain extent
a brige is two crowns with a full tooth in between to replace the gap
other things to consider with a bridge is that its harder to keep the area clean plus over time the bone will recede and you will need a new one

implants first of all are way more expensive and success depends highly on the state of the bone although this days they can fix that to a certain extent
also there is the possibility that your body will reject the implant
and yes the whole process takes quite a bit of time to complete and find out if its a success or not

overall you will not have problems holding on to your regulator, if the implant took it will be as strong as any other healthy tooth in your head
i am not sure how long will be before you can dive though

hope this helps a bit, a specialist will be more qualified to recommend the best course of action

and do get different opinions please before you decide, after all its your mouth and your money


edit: what worries me is the fact that you still have pain after the root canal, that is not normal unless they punctured the apex, i.e. went beyond the bottom of the tooth

 

[Mark Derail]

Edit: This is a personal rant: I think [some] dentists try to preserve natural as long as possible just to ensure future repeat customers.

Some take on operations that they shouldn't! My case, for bad wisdom teeth needed pulling. Local dentist assured me that he could do it...ended up with a sinus puncture above, and a major infection below. Did one side at a time.
Was off work sick for a whole month - at age 25!

Also when you have young kids, you can have their baby teeth strengthened with a clear enamel that prevents cavities - repairing baby teeth is ridiculous. Local dentist said, after my second kid, oh you have to ask for it.

Found out about it from a parent.

Edit: comic relief:
Bionic teeth - think about it - no more need for a can opener. Embedded BluTooth. Tongue activated calling.

 

[Laurence Stein DDS]

Hi runnerchick71,

It sounds like your are referring to your maxillary central incisor. My first question would be WHY did your tooth darken. Were you ever struck in the front of the mouth...auto accident, sports injury, assault, stupidly opening beer bottles? Did this tooth have a previously placed filling...especially a deep filling.

Typically, a tooth darkens when the nerve dies. The blood trapped within the nerve chamber and canal decomposes and releases pigments into the tooth. This can happen rapidly in some cases... especially trauma. A tooth that is discolored may be that way for years without symptoms or in other instances, may darken soon after some insult.

If there is a history of trauma, then the odds are better that the tooth may indeed have a fracture somewhere within. Often such fractures are not visible.

Even with a fracture, some teeth should first be treated with a root canal and then capped to hold the pieces together. Occasionally, this approach does not work... this doesn't mean it shouldn't have been treated this way or that the tooth won't fail at some unspecified time in the future. From what you describe, root canal therapy would have been indicated even if it didn't succeed.

So what do you do now?

From what you have said here, the adjacent teeth are virgin... nothing wrong and no fillings. This is ideal for a single tooth implant. You could also choose to make a 3 tooth fixed bridge (cemented onto teeth). But, this would involve the "preparation" of one tooth on either side of the missing tooth. From a cost standpoint, a single tooth implant with a crown is not much different in cost to the 3 unit bridge. The advantages are that the implant only replaces the tooth you lost, it is easier to clean and it can never decay.

OK, where do you do the work?

I admit I'm biased. All implants are NOT created equal. Don't get cheap when doing implants. It will cost you in the long run. You want a brand name, well researched, FDA approved implant placed by a well trained dentist with a great deal of experience and who uses a great dental lab.

I would recommend a board certified oral surgeon or periodontist with experience placing implants and a restorative dentist with lots of experience restoring FRONT teeth. Front teeth and implants are much more difficult to perform and get good results. When done will, you won't be able to tell that a tooth was every lost. Done badly, and everyone will see it. There are some GP dentists who can do a good job... ask to see examples of their work.

The restoration should also be fabricated by a good dental lab. Cheap won't do. Labs in the Philippines or China, while offering the dentist low lab costs, can be of very poor quality and worse esthetics.

Be careful.

Regards,

Laurence Stein, DDS

MARK. Your comments reflect your ignorance about dentists, the care of the oral cavity or what is actually needed to create and maintain a healthy mouth. I'm sorry that you had a bad experience but churning treatment for repeat patients is not what any ethical dentist is supposed to do. When kids teeth break down, they experience real infections and side effects due to the premature loss of those teeth.

Your comments were uncalled for. What exactly did you contribute to this original poster's situation.

 

[Mark Derail]

Laurence Stein - I applaud your reply to the OP and the great advice. Based on your reply alone I'd seek you out for work, but I fear as a Canadian would cost me too much money - the stay & getting an molar implant.

I'll PM you - perhaps it's not as bad as I think it is. I'd rather suffer a few weeks in Miami than here in Montreal, for the weather.

But you have to admit - the allure of getting expensive dental work done in Cozumel or Belize is tempting.


In response to: "I think dentists try to preserve natural as long as possible just to ensure future repeat customers."
Yes, an uncalled-for rant. I edited my 2nd post to reflect that.
I apoligize for that.

(The First Post at the top was asking for info to support the OP)

I did mention that not dentists are equal, as in there are specialties that the general public might not know about, and 2nd opinions are important for big jobs. Then related personal experience, that would have been avoided with a 2nd opinion. I got it very rough removing 4 wisdom teeth the grew below existing molars.
The dentist was quite reassuring he could do the work.

A byproduct of this - instead of referring a difficult job to a specialist - like those that do facial reconstructions. I got sinus piercing, infection in lower jaw that ran down past my throat over my lungs. Multiple antibiotics, frequent trips to the hospital - where I caught the infamous C. Difficile that 18 years ago it wasn't very well understood.

The dentist was from Europe working with a Canadian license. The specialist I saw after to fix things up, did a follow up and the guy lost his license in Canada, and fled back to France before I could sue him, for lost wages & such.

Another comment:
I was also pissed at another dentist for not telling me about the enamel protection for my two kids when they were 4 yrs old. When confronted he said that he does it on demand only from the parents.
Then having no choice to pay for cavity repair on teeth that will fall out soon.

I did get both my kids braces - something they are happy for when they smile today.

Hi runnerchick71,

MARK. Your comments reflect your ignorance about dentists, the care of the oral cavity or what is actually needed to create and maintain a healthy mouth. I'm sorry that you had a bad experience but churning treatment for repeat patients. When kids teeth break down, they experience real infections and side effects due to the premature loss of those teeth.

Your comments were uncalled for. What exactly did you contribute to this original poster's situation.

 

[runnerchic71]

Hey,

Thank you for such a thorough response to my posting. The tooth was traumatized two weeks prior to it going grey on me. My border collie and I collided, and it ended up knocking just the one tooth. When I went in for the emergency visit, they told me that it was mobile and would settle down with some ibuprofen and making sure I stuck to soft foods.

Two weeks later it started to go grey, and began to throb, and really hurt up high in the gumline (right below my right nostril really). I saw the dentist first thing Monday, and they prescribed Clindamycin - 300 mg, 4x/day and scheduled me for a root canal. Following the canal, things got seriously worse like I said, and they ended up giving me stronger antibiotics (amoxicillin 500mg, and metronidazole 500mg - 3x/day) as they believed it was just a persistent infection.

After 10 days of the new antibiotics, and 2 days of no antibiotics that spot below my nostril was still tender, the tooth still mobile - and it began to throb. They have since put me on the same antibiotics again, and I am scheduled to see a dental surgeon tomorrow morning.

I am in Canada - how do I know if I am seeing someone who is good at what they do? I am only 28, I do not want a horrible looking fake tooth in the front of my mouth... The person I am scheduled to see is a member of the following organizations: the Canadian Dental Association, the Ontario Dental Association, the American Academy of Periodontology, the International Team for Implantology, the Oxford County Dental Society, and the London District Dental Society. Are those acceptable credentials? I am willing to pay to have this done, I do not want a cheap tooth thats going to end up failing down the road.

Any other tips would be great - thank you so much

 

[Laurence Stein DDS]

runnerchic,

They sound like great credentials. You appear to be going to a Periodontist. They do not typically restore the implants they place. If your regular GP cannot do it, ask the periodontist who he would recommend.

Good luck.