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Old 09-13-2016, 08:18 PM
 
74 posts, read 123,349 times
Reputation: 29

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So I went in to the dentist once I finally got some insurance. For the last six years, all of my time and savings have gone into helping my mom, who had a stroke in 2010. She lost all her savings and none of her other children (I don't consider them siblings at this point) have helped out or even called to see if we're okay. I don't have any of my own savings really anymore, and I guess I kind of screwed myself from getting back into the work force by focusing on my mom. Not to mention I have no social life. I work every day in the family restaurant virtually by myself (server, manager, host) which struggles to turn a profit.

About a few years ago, I developed a cavity in my right lower second premolar(?). The cavity got bigger and bigger, but it's never really caused any pain. I cleaned it on my own as best as I can. It may have attributed to a few infections a few times as I've had a swollen neck lymph node on the right side, but it usually went away on its own or with antibiotics (which I sometimes took for strep throat infections). So I went in to the dentist, the only one in my area that accepts an HMO it seems. He assessed I had quite a few other cavities (due to improper brushing techniques... I always rinse after brushing with a fluoride toothpaste, which apparently is the wrong thing to do) and needed deep cleanings because of some calculus on my front teeth (the deep cleanings alone are $85 per 4 quads plus $50 anesthesia... I've only had 2 quads done so far).

Anyway, he did some fillings on a lot of teeth except for the big cavity in the premolar. I eventually asked him to work on that big one specifically. Today, he did that, but he said it needs a root canal after all, which is a procedure he does not perform. He advised me to go see an endodontologist for a root canal on the tooth in question, then come back to get the other fillings done. Me being poor and all, I have some reservations and asked if I could just have the tooth removed (which would be a lot cheaper with my HMO). He questioned my reasons, but I made an appointment next week for the rest of the fillings. He said to let him know ahead of then if I wanted the extraction in place of a root canal as well during that appointment.

He put a sedative filling in after cleaning the cavity, which he commented was full of dead tissue (probably why he says it needs a root canal). Honestly, the tooth has not caused any noticeable pain since the cavity developed or progressed. No abscesses either. I will say the area at the gum line has turned dark, maybe from being exposed? The tooth is not white and is kind of discolored (not black, more like off white) probably from demineralization/enamel loss. Is the tooth worth saving? It's not exactly sensitive to cold or heat either... which may not be a good thing.

I am not against pulling the tooth, but I heard that extractions can cause your teeth to shift, which leads to jaw issues (TMJ disorder). My jaw is already acting up with all these visits to the dentist (he breaks up the filling procedures in sessions to lessen chance of jaw fatigue). Has anyone with a similar situation noticed shifting without getting a (partial) denture after the extraction? Do premolars generally need crowns? Those are what really cost you the big bucks. When I was younger, one of my molars was extracted on the left side and my teeth did shift/collapse a bit to "close" the space. Yet I don't recall any TMJ pain.

Did I mention that all my wisdom teeth have fully come in? I may need to get those extracted as I notice my jaw seems more tired than lately (either the wisdom teeth or just all the dental visits). Of course the cost of that is the reason for my hesitation to do that. I've read those don't cause shifting as they're in the back of your mouth.

You know, I wish I had taken better care of my teeth, or gone in sooner. And I wish I could afford better dental coverage and health care. My HMO only allows for only one PCD at a time and you can only change it 1x a month, and the nearest endodontologist that accepts my plan is 40 miles away.

My own clinical depression from my personal life (being a caretaker) caused me to act foolishly so now I'm paying the price for it. I guess I got what I deserved. Yet any input would be great.
Attached Thumbnails
Do I really need a root canal? Or can I just extract it?-unnamed.jpg  
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Old 09-13-2016, 09:01 PM
 
9 posts, read 17,108 times
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I would definitely get a second opinion from another dentist! You might not even need a root canal or extraction. And try to do oil pulling in the mean time.
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Old 09-13-2016, 09:04 PM
 
Location: Texas
44,257 posts, read 56,896,314 times
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Huh?

I always rinse after brushing.

You're not supposed to swallow toothpaste.
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Old 09-13-2016, 09:24 PM
 
74 posts, read 123,349 times
Reputation: 29
Quote:
Originally Posted by stan4 View Post
Huh?

I always rinse after brushing.

You're not supposed to swallow toothpaste.
You spit the fluoride toothpaste out after brushing. I was told it's best not to rinse with water immediately after as you undo the work you just did.

Quote:
I would definitely get a second opinion from another dentist! You might not even need a root canal or extraction. And try to do oil pulling in the mean time.
I might have to, especially since my dentist doesn't do root canals to begin with.

Can anyone answer this? How common is it to have crowns for second premolars with large cavities?

Also: anyone have TMJ disorder that was caused directly by premolar extraction? I see conflicting reports online and am confused.
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Old 09-14-2016, 03:27 PM
 
3,094 posts, read 1,924,496 times
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Quote:
Originally Posted by pet1984 View Post

Can anyone answer this? How common is it to have crowns for second premolars with large cavities?

Also: anyone have TMJ disorder that was caused directly by premolar extraction? .
Yes, crowns are commonly placed on second premolars with large cavities.

When a tooth is extracted and not replaced with an implant or prosthesis, the remaining teeth will drift into that empty space. When that happens, your teeth will no longer align properly, which can cause TMJ problems and/or chewing difficulties and gum problems from not being able to clean around the misaligned teeth very well.

Teeth support each other when they're nice and straight like this.
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Old 09-14-2016, 07:14 PM
 
74 posts, read 123,349 times
Reputation: 29
Well, I went ahead and scheduled the root canal for Oct. 11 (soonest possible as this endo travels from branch to branch and is never at the same one for long per month). I'm nervous for several reasons: what if it fails, is it worth it (the premolar looks like it's shifted in its own socket or there's receding gums... the bottom of the tooth is exposed and has a dark line straight across), and how much it's gonna cost with my measly HMO. My mom went ahead and got a CareCredit account so maybe that'll help.

I keep reading horror stories about sub par root canals so I'm terrified. The endo that's doing my procedure will reportedly only need an hour or so to perform the RC? I assumed they need to take longer to thoroughly clean out the mess inside. I honestly would just get an extraction (initially cheaper, more straightforward), but don't want shifting teeth that'll cause TMJ disorder. My dad has had two molars removed and he doesn't have malocclusion issues. So I'm torn. I had a molar on the opposite side of the tooth in need of a RC removed when I was younger so the neighboring molar shifted (not the neighboring premolar, though).

I did hear back from a nearby endo (the one I settled with that is in-network with my HMO) that said I definitely need a RC. Of course, she's an endo so she'd say that. An implant specialist would likely say I need an extraction/implant, I imagine. The latter is the more expensive option, but then some say that's the better choice as a RC'd tooth could break anyway (thus wasting the time and money spent to preserve the tooth in the first place).

Finally, is a tooth with gum recession worth RC'ing and crowning?
Attached Thumbnails
Do I really need a root canal? Or can I just extract it?-p1000937.jpg   Do I really need a root canal? Or can I just extract it?-p1000947.jpg   Do I really need a root canal? Or can I just extract it?-p1000949.jpg   Do I really need a root canal? Or can I just extract it?-p1000951.jpg  

Last edited by pet1984; 09-14-2016 at 07:30 PM..
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Old 09-20-2016, 04:54 PM
 
1 posts, read 5,092 times
Reputation: 10
Default Root canal nightmares!

I hope you get this message. Well ive had root canal nightmares, nightmares because i have been miserable for the last 3 years, since i had root canal from dentist that did not do it right. went to different dentist and they just keep cleaning, deep cleaning but the pain keeps coming back, yet still no one is telling me that my root canal has gone bad. symptoms are burning sensation in your chest (heartburn), sometimes spreading to your throat, along with a sour taste in your mouth. Chest pain. Difficulty swallowing (dysphagia) Dry cough. Hoarseness or sore throat. Regurgitation of food or sour liquid (acid reflux) Sensation of a lump in your, stomach issues, headache, fatigue, vision and sinus infections. so i decided to change dentist, oh all the symptoms cause me a lot of money, going in and out of doctors and er because i feel i was loosing my mind what is wrong with me. So new dentist had panoramic xray, boom root canal infections, he said i had this for a while, the next day took it out, it was so gross, i had cysts in my root canal and can go to blood streams and more sypmtoms, god knows what. i feel so much better. now i need implant to replace that tooth, which cost a lot but im saving for it, flipper will do for now. So dont wait this is your body were talking about. take care.
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Old 09-20-2016, 06:12 PM
 
74 posts, read 123,349 times
Reputation: 29
Well, I went and got the root canal yesterday. Went to a place my mom went to for hers years ago before her stroke. My hometown dentist already did a pulpotomy so I don't know if that helped the new dentist or not. She numbed me up, drained the premolar, filled it, and then put a premanent amalgam filling on top. She gave me amoxicillin for the remaining infection that could be at the bottom of the pulp where her tool couldn't reach. And said to wait for the infection to go away till we decided if a crown was needed. As of today, I feel okay-ish. No big or even little pain, just jaw soreness on the side where the RC was performed. I didn't eat very much yesterday other than some 0% strained yogurt, mashed potatoes, and a personal cup of rice mac & cheese. So that could explain why my tummy was so weird today. I had a big lunch and took my daily acidophilus supplement to see if that'd help settle my stomach (antibiotics always do that to me) after my regular jog.

The sheer stress of all this was making me feel awful. I get why dental care is the way it is in the U.S. (for better or worse), but the people I spoke to at various practices about my situation did not seem to care about my well being until the young lady that did my root canal. Simply explaining things was welcome whereas my primary DDS is too aloof for my liking. A lot of patients have dental phobias so we can't always speak up for ourselves when we know we should. My primary dentist closed way before business hours ended last Thursday (and you can tell when someone's ignoring your calls or putting it towards voice mail), and they delete their answer machine messages before listening to them, it seems. So they were clueless when I called them in response to a message I left them last week. Sigh. Well, it's all done... for now. I still have some fillings to take care of as well as two quads worth of deep cleaning. None of which I'm looking forward to. My primary DDS isn't a great guy, but the deep cleaning hygienist was at least really very nice and thorough.

I really do need to get on to a better, more acceptable plan so I can freely go to more practices than the ones I'm limited to here.

Quote:
I hope you get this message. Well ive had root canal nightmares, nightmares because i have been miserable for the last 3 years, since i had root canal from dentist that did not do it right. went to different dentist and they just keep cleaning, deep cleaning but the pain keeps coming back, yet still no one is telling me that my root canal has gone bad. symptoms are burning sensation in your chest (heartburn), sometimes spreading to your throat, along with a sour taste in your mouth. Chest pain. Difficulty swallowing (dysphagia) Dry cough. Hoarseness or sore throat. Regurgitation of food or sour liquid (acid reflux) Sensation of a lump in your, stomach issues, headache, fatigue, vision and sinus infections. so i decided to change dentist, oh all the symptoms cause me a lot of money, going in and out of doctors and er because i feel i was loosing my mind what is wrong with me. So new dentist had panoramic xray, boom root canal infections, he said i had this for a while, the next day took it out, it was so gross, i had cysts in my root canal and can go to blood streams and more sypmtoms, god knows what. i feel so much better. now i need implant to replace that tooth, which cost a lot but im saving for it, flipper will do for now. So dont wait this is your body were talking about. take care.
I'm sorry to hear that and that you had to endure all that. Sounds like a nightmare. The dentist that did my RC said flat out I was too young (32) to be losing a natural tooth, especially by choice. She told me to come in and get the RC done if I wanted (no waiting either, which I liked). I never felt pain directly from the tooth itself - as in a toothache. Well, not until my DDS cleaned out some pulp last week and then put in a sedative filling. And even then, it was more of a dull ache than a lingering sharp pain. So that's why I let this go on for so long. The tooth probably was the reason why I had some mysterious sore throats and swollen glands (sometimes it was strep, other times my family doc didn't know).

I honestly hope this improves my overall health as I need to stay strong so I can continue to be my mother's caregiver.
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Old 09-22-2016, 01:45 AM
 
Location: Somewhere between chaos and confusion
396 posts, read 228,218 times
Reputation: 814
I am glad you decided to go for the root canal....anytime you can save a tooth, that is good. I lost my first tooth due to not having it looked at sooner, the cavity ended up deep into the root part, so nothing could help that. Luckily, I was a candidate for a permanent bridge, so I now have a fake tooth holding the others from shifting too much...so I feel your pain.

You should also think about using a flouride rinse. You can use the Act brand from any cvs, Walmart, etc. you can get stronger from your dentists. It has really helped my teeth, I have had many many fillings over the year, my teeth are pre-disposed for issues.

Good luck!
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Old 09-23-2016, 05:26 PM
 
74 posts, read 123,349 times
Reputation: 29
Well, my dentist adjusted those fillings again yesterday morning. But there is no difference in pain. The kind of pain that makes my head hurt and I'm having trouble focusing. It's been a month since the procedure and I've been in pain more or less since then. I chew lightly on the fillings and the pain returns. My headache is throbbing. I scheduled my next fillings appointment this coming Monday (you can see why I'm apprehensive), but the receptionist didn't bother to book it for me in the schedule after I told her to earlier this week. I wouldn't have even known unless I'd gone in on Wednesday morning for the walk-in fillings adjustment. I don't know what's going on - the fillings are deep and multi-surfaced (on the mesial, distal, and occhusal surfaces overall of three teeth on top). So this pain is either normal for the situation (I haven't had a filling in years so I don't recall the healing process) or the dentist botched the job. :/ I'm actually crying right now and I usually have a decent pain tolerance. But I have to suck it up because he's closed on Fridays (and apparently dentists can't be burdened with emergency issues), and I've already spent over $1000 in dental fees in one month. As a caregiver of a relative, I make no actual income so I have to save extra hard to have spending money for myself. I guess I'll go on Monday when he reopens and I'll ask for an x-ray to see if the nerves are damaged. I really can't bear this pain anymore (and yes, I realized I brought it upon myself, but it doesn't mean I should have to suffer either).

I added some pics of the fillings that hurt.
Attached Thumbnails
Do I really need a root canal? Or can I just extract it?-p1000956.jpg   Do I really need a root canal? Or can I just extract it?-p1000955.jpg  

Last edited by pet1984; 09-23-2016 at 06:42 PM..
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