Vexing Dental Health Questions

[SunnyOne]

I was in the middle of some restorative dental work when the pandemic hit. I did not schedule follow up appointments with my oral surgeon & dentist - for some time after, their offices were closed and I had the fear of the unknown (having heard that dental work was particularly risky). I am not in pain or discomfort.

In the meantime, I retired and moved to FLA.

Neighbors here recommended a dental practice affiliated with the university - not the university free clinic, this is a regular paid dental practice, they just happen to be located at the university.

I scheduled an appointment with them to see about getting the work finished.
I met with a dental team there and yes, they can finish the work, but it did not stop there.

I have several 20 - 30 year old crowns, some of the teeth have root canals. I think due to time and aging, some of teeth have larger margins (spaces where bacteria can collect).

Nevertheless, I am not experiencing any pain or sensitivity with these teeth and I am a scrupulous brusher & flosser.

The dental team is recommending that not only will they finish the work in progress, that they also want to remove all of my other crowns to inspect my teeth to see if they have any "life" left to them or whether they should be extracted and replaced with implants.

Setting the expense aside for a moment, I am just having trouble wrapping my head around the idea of removing teeth that are not currently giving me any problems.

I recognize that with age comes older teeth and new issues - but I am thinking I'd rather address them when they become problematic - but I guess to the dentists - they are already problematic because they are older.

I would really, really appreciate hearing from anyone here who has faced this issue and how they ended up dealing with it?

FWIW, I grew up on a rural farm with well water - no fluoride. My family members have lost teeth and tend not to replace them .

It's been my goal to hold onto and take care of my teeth as much as I can. I even use remineralizing solution to try to strengthen them.

Appreciate all comments. Thank you.

 

[Aerides]

Go to another dentist. Or 3. I would not want a dentist that wants to go looking for problems. Presumably they did a xray? That should be all they need, no silly "inspection".

And yeah, crowns go, but you don't need to rush it.

 

[Gumby]

I have replaced crowns, but only as and when they have cracked.

 

[braumeister]

Definitely find another dentist.

I have 40 year old crowns in my mouth and they're just fine.

The dental office doesn't happen to have an Edward Jones office next door, does it?

 

[CindyBlue]

I have a family history of bad teeth, and I and my siblings are the present part of that history...sigh... I have a lot of the same dental circumstances as you. If I were you, I would find another dentist. I would not be looking for trouble until trouble finds me in this case.

 

[athena53]

Yeah that's scary. I got a few crowns, bridges, etc., over the years. They don't last forever and it's VERY hard to tell when the tooth under them is going bad, even on an X-ray, till the pain hits. Still, my dentist has never wanted to rip them off and explore- that's just asking for trouble. And, yes, mine are failing- just got 2 implants last week to replace a tooth under a bridge that decayed and fill in the adjacent space- but we don't mess with them till they fail.

On the pockets- did they tell you how wide they are? I forget what's considered serious but it's important to monitor the change over time and see if they're widening.

I don't even know if I'd trust them to do the restorative work.

 

[finnski1]

Definitely find another dentist.

I have 40 year old crowns in my mouth and they're just fine.

The dental office doesn't happen to have an Edward Jones office next door, does it?

This!

 

[Yoheadden]

I agree with the above. X-rays and a thorough exam should tell them everything they need to know. No need to replace what’s not bothering you. Find 2 other dentists to compare. Look into a water pik flosser from CVS or other major drug store in your area. You’ll be surprised how well they work.

 

[Gumby]

I agree with the above. X-rays and a thorough exam should tell them everything they need to know. No need to replace what’s not bothering you. Find 2 other dentists to compare. Look into a water pik flosser from CVS or other major drug store in your area. You’ll be surprised how well they work.

You can get a waterpik at Walmart, too. I bought one there last month.

 

[MRG]

Definitely find another dentist.



I have 40 year old crowns in my mouth and they're just fine.



The dental office doesn't happen to have an Edward Jones office next door, does it?

+1

 

[aja8888]

Just think....if the dentist "removes" an existing glued on crown, he will have to replace it with a new one...at your expense.

 

[Retiired]

Remember dentists are “For Profit” organizations. Their first loyalty is to the US dollar. Default advice is often based on that fact, not an imminent dental need.

 

[razztazz]

When I moved to my current city I lined up a new dentist. Saw her twice 6 months apart for the regular cleaning. On the third visit all of a sudden I have five (5) cavities that need to be filled. $800.00. I go to a different dentist. Declares my teeth perfect, which is their usual state of being. I probe. "Hey, you don't see anything, say, on the upper left starting to wear? Nothing. Nine years later I'm still waiting for one of those five imaginary cavities to become something.

 

[Amethyst]

I had two crowns replaced this year after X-rays showed the possibility of a crack under one, and decay under the other. Three dentists at the same practice agreed that the Xrays were suspicious. Naturally they cannot be sure how bad it is, until they remove the old crown. That is how it was explained to me.

You have to decide whether this is always a ploy to get you to pay for new crowns, or could be a genuine concern for your teeth. In your case, the pressure to get you to go directly to extraction/implant suggests two things: Either they saw really bad stuff on the Xrays and didn't explain it well enough to you, or they are seeing dollar signs.

As for "my teeth aren't bothering me," by the time your teeth actually hurt, you have big problems. That was my parents' attitude, and they both lost almost all their teeth. In your place, I would be asking about the health of my gums, not just my teeth. If you don't have any signs of gum disease, I would definitely seek the opinion of a second practice.

 

[brett]

No idea.

As others have said....get a second opinion.

 

[RetiredAndLovingIt]

I would run out of that office as fast as I could.

Just like the mechanic at the auto shop they are making a RECOMMENDATION. It sounds like they are not saying that there is anything actually wrong with your crowns, they just need to line their pockets.

 

[Bryan Barnfellow]

To save me money, my dentist has perfected techniques for working on small problems underneath existing crowns, when feasible.

 

[athena53]

Just think....if the dentist "removes" an existing glued on crown, he will have to replace it with a new one...at your expense.

And... grind down more of the tooth. I've had a crown fall off on occasion and the solution is NEVER to just make a new one and cement it on- I guess they need a fresh surface. I'm a white-knuckle patient and for me, even with enough anaesthetic, it's a nasty process.

 

[aja8888]

And... grind down more of the tooth. I've had a crown fall off on occasion and the solution is NEVER to just make a new one and cement it on- I guess they need a fresh surface. I'm a white-knuckle patient and for me, even with enough anaesthetic, it's a nasty process.

Yes, all traces of the old adhesive have to be removed and a new surface prepared for the new glue job.

 

[Bamaman]

I had a crown snap the tooth off at the gum. Oral surgeon suggested a $850 extraction and preparation for a $2250 implant. Then 9 months later, he'd put a $875 abutment in and send me to my regular dentist for a $850 crown on the abutment.

My dentist told me the oral surgeon has a $450K full head MRI to pay for--and that's why he's so expensive.

I went to another dentist that did the implant in 6 minutes--less work and stress than a filling even. And I saved $2K too.

If a tooth has a serious problem, the pain will tell you. Otherwise, don't have anything done. A second opinion is welcome in your case.

 

[pacergal]

Second opinion needed, thats for sure.
I also have several very old crowns and an implant. I replace the crowns if there is pain or they crack or the dentist sees something on the X-ray.
I would never expect a crown to be removed to see what's going on with the tooth beneath it! that is just asking for trouble, at your great expense.

 

[badatmath]

Not only the expense but the stress of the work would put me to getting another opinion ASAP.

 

[OldShooter]

I don't see any "vexing" question here at all. These people are crooks. Don't willingly do business with crooks or suspected crooks.

We have solved this type of problem by switching all of our business to the local university's dental school clinic. We are tended to by students nearing graduatioin, with professors reviewing their plans and inspecting every step of the work. This is the first advantage -- quality control far beyond anything that exists in a standalone dentist office.

The second advantage is that no one will ever try to sell us something we don't need. DW's prior dentist had recommended a crown, so when DW made the switch to the "U" she asked her student dentist and the professor about the crown. The result of this was a long discussion and some poking around at the tooth, at the end of which the professor determined that no crown was necessary.

The third advantage, which is the least of the three for us, is that fees are around half of street prices, sometimes less.

So, @SunnyOne, you mention a university "free clinic." If you can somehow get access to that I don't think you'll regret it.

 

[Alectoris]

As someone who may or not be part of the dental community, I would highly recommend you seek a second opinion.

I think that the suggestions as far as a dental school goes makes fine sense.

Unfortunately, there are plenty of scam artists in the molar mechanic world and it's saddening.

 

[RobbieB]

Remove crown to inspect tooth makes no sense other than dough for the dentist.