Can you trust your dentist?

[Protimenow]

Yes, I think this is the right forum for this.

I'm saying this because for all the years since I got my St. Jude aortic valve, the dentists wanted me to pre-medicate with 2 Grams of Amoxicillin before I visited them. This was to reduce the risk of endocarditis that is possible when the gums are compromised.

I have a tooth that was filled years ago. Apparently, I had a root canal done. There was still 'tooth' where the canal was done, but still a hole that went into my mouth - and maybe into my jaw.

The thing was covered with amalgam (silver/mercury) to cover the hole and build the tooth back up. Every few years, some of it breaks. My last dentist put more amalgam on it, and I was good for another year or two. He mentioned a crown but didn't push it.

The last time the amalgam split off, I decided just to leave it alone. Eventually, more parts of the filling split off, more parts of the amalgam cracked, and it eventually felt like there was a small piece covering the remaining hole from the root canal. I figured that the area of the canal was healed up, but I didn't want to take my chances. I figured that it was time to get a dentist to look at it.

My original dentist didn't take insurance. I chose one that was supposedly well rated and took my insurance.

It was then that things seemed to go a bit south.

They x-rayed the tooth. He told me that I had to get it extracted.

I told him that the last time I had an extraction, it bled for hours and was a problem to get the bleeding to stop. He told me that 'nobody leaves my office bleeding' - which I took to mean that he may try electrocautery to stop the bleeding. I told him that I had an oral surgeon to do an extraction if I need one.

I asked what I'd be putting up with with TWO missing teeth, one next to the other. He said I may need a bridge - an appliance that I wouldn't do well with and wouldn't want to mess with. I told him that I just wanted the tooth packed.

His assistant packed the tooth and built it up with some stuff designed for this purpose.

So - here are my thoughts:

This dentist didn't care that I could leave the office with a functional tooth.

He didn't care about INR or pre-medication (maybe guidelines have changed?)

He seemed more interested in making money on an extraction and a dental appliance than he was in providing actual care.

I won't be seeing this guy again. It seems to be more about money than care.


How have YOUR experiences been? Do you trust your dentist?

 

[Lisa from LJ]

I trust my dentist. I've had an extraction of a "6-year" molar with very little bleeding, so it's weird that yours bled so much. I've also had a root canal (endodontist did it), implant (oral surgeon did it), and several crowns without a problem. I do always take antibiotics before all dental visits, and after the root canal and implant I took a typical course of oral antibiotics. Did the dentist tell you that you didn't need antibiotics? If so, that would worry me more than the rest. It sounds like he had a plan of action and you chose to take another route. Why do you think you wouldn't do well with a bridge?

 

[Gloria Mundi]

I love mine- and my oral surgeon, too. I joke that I hope they never retire; both are in their late 50s/early 60s.

I've had bad teeth since I was a kid. We got regular dental care and I ALWAYS had at least one cavity, usually more. My sister, by contrast, never had one till she was an adult and a brother never had one till he was in HS and started buying himself bags of candy on the way home from basketball practice.

So- at 71 I've dealt with my share of crumbling fillings, decay under a tooth holding up each of my 2 bridges, a couple of root canals...and 8 implants over about 20 years. Thank heaven, when the option is some repair that MIGHT hold or an implant, I can choose the implant. I don't like bridges because they require grinding down perfectly good teeth on either side- and the grinding is not pleasant. Implants are expensive but they're like your own teeth, only better.

Never had a problem with post-extraction/implant bleeding. (I am not on anti-coagulants.) Since the mitral valve prolapse diagnosis. I take antibiotics before the implant surgery. Apparently the thinking has changed and some sources say it's unnecessary but I figure it's cheap, easy prevention. Ordinarily I'm careful about not using antibiotics but for an implant, I will.

I hope you find a dentist you can trust. I know there are a lot of profit-driven ones out there- the chain operations seem to be particularly bad.

 

[Standardvelocity]

when I left the hospital after surgery I was given a card that outlined dental procedures requiring antibiotics and dosage, the first dentist appointment I mentioned antibiotics and the front desk person figured it was just a cleaning and not required. B S, l had my family doc write a script for antibiotics and took them 1hr beforehand, the hygienist agreed with the antibiotics. Look out for your own best interests!

 

[Protimenow]

If the bridge requires ANY maintenance, I am a bad candidate for that. I won't want to remove it, brush it (or whatever), or do ANY care for it. I'd be even worse with dentures. At my age and current condition, it doesn't make sense to me to get an implant -- I may not live long enough to get enough use out of it. Or, perhaps, I just undervalue myself - for the last many years, I've been doing this.

I've had root canals. I've gotten fillings. I've had no problems with those procedures. There was one extraction - a large tooth - and it bled a lot.

I'm not alone here - others have reported the same experience. Biting on gauze is a great idea - the blood coagulates on the gauze - then when you remove the gauze, it opens the clots that formed on the gauze, and you're back where you started. Fun.

This dentist wasn't part of a commercial network of dentists. He was an in network dentist for Blue Shield (maybe they pay so poorly that he HAD to do something, like an extraction, that would pay for the visit - patient be damned.

So - I'll keep looking. I have some more stuff to be done -- but not by THIS guy.

I had a prescription for Amoxicillin that I got from my PCP. It expired. I'll have a new one written. I'd rather be safe than sorry.

 

[Gloria Mundi]

At my age and current condition, it doesn't make sense to me to get an implant -- I may not live long enough to get enough use out of it. Or, perhaps, I just undervalue myself - for the last many years, I've been doing this.

I get that. I just figure that healthy teeth in sufficient quantity allow me to enjoy all the crunchy stuff like vegetables and nuts that make up a large part of my diet and keep me health overall. Not willing to switch to a diet of mashed potatoes and soft, overcooked foods. I know I'm fortunate, though. I can pay for the occasional implant and still afford plane tickets to interesting places.

 

[AZ Don]

OUr family went through countless dentists years ago. Aggressive recommendations, questionable billing practices, etc. We thought we found a good practice until they recommended extracting wisdom teeth from my 14 yo son. There is an argument that they are easier to remove early on but the ADA doesn't recommend removing before 18 years old. We found a highly rated dentist 45 minutes away and he has been great for the whole family for 8 years now. My son still has his wisdom teeth but may need one out soon.

I think it's like anything else. Just keep looking around until you find one you like, then hope insurance changes don't force you to look for a new one, or they don't move away.

 

[pellicle]

Do you trust your dentist?

I do, I've been seeing the same guy since about 2004. I did work close to where he is, but since then have driven to Brisbane to appointments.

There are ones in Warwick but despite that being only 40km away I'd rather do the nearly 400km round trip and see the guy I trust ... I went through a few dentists in the process of finding him. I won't go back to places that treat me as you've identified they treat you.

I can get abused for free ... why pay for it?

 

[Gloria Mundi]

This dentist wasn't part of a commercial network of dentists. He was an in network dentist for Blue Shield (maybe they pay so poorly that he HAD to do something, like an extraction, that would pay for the visit - patient be damned.

I dropped dental insurance when I retired. I had my first implant when I was working and was happy to find that they covered 40%. Then I found that the max they'd pay for ALL work done in a year was $2,000 and that was apparently a high limit compared to the average. So, it paid something but not much. Plans I looked at after retirement were similar. I pay as I go and like not having to choose from a network for work where precision counts.

 

[oo0My_Valve0oo]

I live in a desirable coastal location. The demographic has changed in recent decades but it has been unfolding and foreseen. Lots of people have 2nd homes. Don't live anywhere year round. Seems to be higher percentage of dentists pushing procedures just to increase income. Some scammers. Many practices have sold business and you are seeing their history and reputation but get some unknown undeclared new owner/dentist so you cannot trust anything or anyone. I was with a guy with a strong reputation but my experience of him revealed some flaws. He stopped taking my insurance so I was looking for a replacement. First appt is in Sept. fingers crossed.

 

[V__]

If the bridge requires ANY maintenance, I am a bad candidate for that. I won't want to remove it, brush it (or whatever), or do ANY care for it.

The only bridge type I'm aware of is a permanent structure, similar to a crown [1]. You should NOT be able to remove it. You do want to floss under the bridge as a part of the regular teeth cleaning [2]. However, you may want to floss your "regular" teeth anyway, and it's basically the same process.

Regarding your question of the experience with dentists, I have been generally happy with them. Usually was getting recommendations from my co-workers and getting no-nonsense people who were not eager to do too much work. There were exceptions. As an anecdotal example, in one case a practice was sold, and I didn't like the new guy. At the new place people kept asking if I came with Briana [3], who I've never heard of. Turned out she was a hygienist at the old practice. She came over and a bunch of patients followed her.

[1] I have 2 of them. Have had one of them for the last 30 years.
[2] There are simple "hooks"/loops you can get in a pharmacy for getting the floss thread under the bridge. There are also other versions, but I'm not using them.
[3] Name changed.

 

[3mm]

you may want to floss your "regular" teeth anyway,

I recently got a water flosser per my dentist's recommendation and information I see from various dentists online. I water floss first, then use string floss, then brush my teeth. It takes more time, but I see a lot of debris in the sink when I'm done. I really, really do not want to get endocarditis again!

The water flosser feels good, and when I finish using it my mouth feels clean.

 

[V__]

I recently got a water flosser per my dentist's recommendation and information I see from various dentists online.

Much appreciate sharing the experience! I did water-floss in hospital (since they didn't want me to use the regular floss at the time), but got un-used to it since. Maybe I should re-start

I see a lot of debris in the sink when I'm done.

This reminds me of a study published a few years ago, about the effect of the flossing. Apparently it wasn't formally confirmed until then. However, I'd say this is the the case when the benefit is quite obvious even without running a dedicated study.

I really, really do not want to get endocarditis again!

I never had it, however, from the stories shared in this community, it looks pretty bad. Certainly seems worth the extra step to avoid it.