Question:
Went to dentist for routine checkup with no apparent problems. Was told
I had 2 bad teeth, one needed a crown, one a filling. I said go ahead
with the crown. After drilling for temporary crown, was in intense pain
so went back. Now he said I need a root canel. Got root canel. (The
place they sent me wouldn't accept my insurance) Went back for build up
as they called it with amalgan. Now tooth is sensitive. Will this go
away after gold crown is installed? Don't suppose so. Also he used an
instrument I'm not familiar with. It was thin black plastic wand with a
cord & a pad that went under my shoulder. Is this a laser tool? Should I
let this guy do the filling or move on?
Answer:
I had 2 bad teeth, one needed a crown, one a filling. I said go ahead
with the crown.
This may have been what is needed. It is usually a communication problem.
It depends on what condition the tooth was in in the first place. If it was
badly decayed I will usually tell the patient and try to show him as much as
he can understand what is going on and what the risks of further
complications are. He (your dentist) may have done the right thing, but it
was too late and the work he did was the final blow on an already unhealthy
tooth. On the other side of the arguement, the temporary could have been
left high thus causing the pain. If the tooth had a deep crack, it often
can hurt afterward and even the root canal won't help. Again, the problem is
the dentist not taking the time to inform an interested person such as
yourself what the options are. Usually BTW, the reason this is happening
more and more is that insurances are controlling more and more how we
practice and what they will pay for. Now you might not like hearing this,
but you could have been part of the problem trying to save money. He did
send you to a specialist and you chose not to go due to them not accepting
the insurance. YOu may want to go there first as originally suggested by
your dentist and pay for an evaluation (probably $50 or so) and ask for the
details he see or find a time you can have a discussion with your current
dentist and tell him you would like a detailed explanation so you can
understand. He may be defensive at first depending on how you present
yourself. Give him a little leeway at first, but after you see how he
reacts, you will know if it was an attitude or he was just too busy to
explain. I hope this helps a little. If you have any questions, feel free
to ask me directly by e-mail.
After drilling for temporary crown, was in intense pain
so went back. Now he said I need a root canel. Got root canel. (The
place they sent me wouldn't accept my insurance) Went back for build up
as they called it with amalgan. Now tooth is sensitive. Will this go
away after gold crown is installed?
If the tooth is only slightly fractured, the pain could go away with the
crown. You will know when they place the temporary crown (if it isn't left
high)
Don't suppose so. Also he used an
instrument I'm not familiar with. It was thin black plastic wand with a
cord & a pad that went under my shoulder. Is this a laser tool?
could be electrosurgery to remove excess tissue. More evidence to me that
this guy may know what he is doing, but you have a badly broken down tooth
that is difficult to repair and he is not communicating well with you. Give
him the benefit of the doubt.
Should I let this guy do the filling or move on?
What will you move on to? If it is another provider on your plan, you may
run into similar problems: no time to effectively communicate. I am not a
provider for these plans because I feel I need to treat each patient
individually and cannot if overwhelmed with too many patients at a time. I
realize this is a big delemma for both of us. My solution is I allow my
patients to make payments and set up a master plan to gradually get there
mouth in its best shape at the rate they can afford.
DON'T let him put a gold cap over the amalgam!! First all amalgam
should be replaced, then the gold placed.
I have heard of and experienced the
galvanic response of dissimilar metals next to each other in the mouth
causing a plating phenomenon that plates the gold with silver and the silver
with gold. Arie, I am curious what is the phenomenon when the gold is on
top of the amalgam.
first, I want to let you know that I always take out the amalgam and build
the tooth up with glass ionomer or composite if necessary. I do this mainly
to make sure there is sound tooth structure under the filling. Often, on
teeth that need crowns, I find fractures, soft lining materials (dycal), and
even old decay under the amalgam filling.
