One dentist found a ton wrong that another one didn't?

[Tdbo]

That's why the concept of "Second Opinions" was developed to deal with such situations as this.

 

[dkryan]

The thing to remember about dentists is that not all of them graduated at the top of the class. I had the same dentist for 40 years (he started his practice when I was 2 years old and retired when I was 42) and he was great! He knew about my car accident in 1988 and that it caused me to have a dead tooth up front, but he would check it every once in a while to make sure I didn’t need a root canal. After he retired the new dentist did all of these tests and came to the conclusion that I needed one. But I got a second opinion from my ex wife’s dentist (who is an amazing dentist!) and he confirmed that I didn’t need a root canal. I immediately switched to him. He drives a 2022 Porsche GT3 so that helped my decision

Slightly off topic……

Well?

It’s BITOG. Surely you asked him what oil he’s using in that Porsche….!?

 

[Vil_Riker]

I'm very confused. About a year ago one of my pre molars broke in half. They said I could get a root canal and a crown put on or pull it. Fast forward to just a few days ago, I go get a second opinion on what I should do as I don't want it to get infected and cause more problems. Anyways, this particular dentist which was more thorough than the other finds all kinds of stuff wrong. He says the broken tooth, needs to be pulled as there isn't enough to attach a crown to. He says I need a root canal on the same exact tooth on the other side, and about 3 fillings done. He referred me to an oral surgeon and an endodontic for the root canal. What I don't understand is why didn't the first dentist mention all this? They took xrays. We're probably talking about $6-$7k once the surgeon and orthodontist gets paid. The dentist alone wants $3500 The only thing I can think of is maybe the first dentist thought that's all I was worried about?

I guess I could always just have both pre molars pulled out and then keep an eye out and make sure they don't start shifting around. Tooth number 13 and 4

Opinions? I almost think I need a third opinion now. All I wanted was a simple tooth pulled, and everytime you go to a dentist they want to do a whole exam, then tell you they don't pull teeth. This second dentist lied to me as I asked if they did tooth extractions before I even set up the appointment.

One dentist practices defensively (wants to do many things to your teeth), the other one doesn't.

I would be a little bit suspicious of the one that wants to make more money off of you. You might have a train wreck in your mouth but I would seek a second opinion to be sure.

 

[Patman]

Slightly off topic……

Well?

It’s BITOG. Surely you asked him what oil he’s using in that Porsche….!?

I’m sure that he gets his oil changed at the dealership. Sadly he only has 7000 km on it so he doesn’t drive it that much

 

[Fitter30]

40 years ago went to a dentist for about 4 years twice a year for cleaning every visit one to three cavities. Moving to a new house wife lost a filling. New dentist moved in wife walked in and he filled it. So a made a appointment for a cleaning old dentist said i had two cavities. Cleaned my teeth ,xrays and no cavities. Found a new dentist that day. Twenty years later new wife had the same problem with her dentist and now goes to mine.

 

[ARCOgraphite]

True, but I don't think a year is long enough to need 3 fillings and a root canal in addition to the original broken tooth removed. I think the first dentist was either careless or the second dentist is trying to scam me. So in one year I have 4 more teeth that are messed up?

I have had a second molar broken in half down to the gum line for many years. I just keep the area well brushed once a day.

Almost ALL my past root canal on molars failed after a few years. My gold crowned molar lasted the longest. Metal crowns are easy to keep clean and they don't crack.

You need these molars to chew. Implants are very pricey and pretty severe.

If they are seeing an infection under the whole tooth, get an endo to look at that pronto, you can get bone loss.

And infected whole tooth is absolutely a priority over the broken pre-molar. I assume they are seeing infection "cloud" on the xray along the jaw.

Was that broken pre molar filled decades ago? Amalgam fillings weaken the tooth and actually act to cleave the tooth. Can't argue with the long service life after the filling, I suppose.

You triggerd me since I have been having a lot of dental stuff done the past 4 years. Next Need to get a denture on #28 on the mandible. The implant post is done. That was a failed (incomplete) root canal from around 2008.

I now have a more trusted endo guy.

 

[PWMDMD]

True, but I don't think a year is long enough to need 3 fillings and a root canal in addition to the original broken tooth removed. I think the first dentist was either careless or the second dentist is trying to scam me. So in one year I have 4 more teeth that are messed up?

Dentist here with 20 years of experience.

No one here can give you any answers. In general and this is not dental advice:

I have seen teeth go from restorable to non-restorable in a year.

I have seen small "incipient" cavities go from not needing treatment to root canals in a year.

I have seen obvious pathology get missed.

I have seen dentists over diagnose.

I have seen two very reasonable minds with good intentions see the same case very differently.

The only direct advice I can give you is go get a second opinion if you are questioning what you've been told.

 

[Bottom_Feeder]

Dentists can be like mechanics. Depending on who looks at your issue, they could either be looking out for you or looking out for themselves.

/broad brush

 

[The Critic]

Dentists can be like mechanics. Depending on who looks at your issue, they could either be looking out for you or looking out for themselves.

/broad brush

Most associate dentists also have a compensation structure that is similar to mechanics.

 

[spasm3]

Don't put off getting your teeth in healthy shape. Bad gums, bad teeth can lead to cardiac issues.

 

[The motor guy]

Most associate dentists also have a compensation structure that is similar to mechanics.

Yeah. I kind of wish I didn't get mad at the first dentist.

Dentist here with 20 years of experience.

No one here can give you any answers. In general and this is not dental advice:

I have seen teeth go from restorable to non-restorable in a year.

I have seen small "incipient" cavities go from not needing treatment to root canals in a year.

I have seen obvious pathology get missed.

I have seen dentists over diagnose.

I have seen two very reasonable minds with good intentions see the same case very differently.

The only direct advice I can give you is go get a second opinion if you are questioning what you've been told.

The one tooth he wants a root canal done I can't even see a cavity. I need to go to the surgeon I guess and atleast get the one broken tooth pulled and then go from there. I just get tired that things seem to get so complicated so quickly. I hear about people who pull their own teeth out with a pair of pliers in the garage and move on with life.

 

[PWMDMD]

Most associate dentists also have a compensation structure that is similar to mechanics.

True! There's usually as daily minimum plus a percentage of collections for the work they complete. We do not pay our associates this way, we give a nice per diem, and everyone is happy. This gives the incentive to want to do a good job and be productive without the added temptation of over treating to bump up their % collections. It takes the right kind of associate to accept this compensation agreement but it usually leads to a long term and happy relationship. Two of our associates have been here for 10 and 8 years and they are happy and have no plans to leave. I'd be happy to retire in 15 years with this crew!

 

[ecotourist]

Almost ALL my past root canal on molars failed after a few years. My gold crowned molar lasted the longest. Metal crowns are easy to keep clean and they don't crack.

I've had this discussion with my dentist. I have an MSc in Materials Science and he's a conservative dentist who thinks a lot about what he's doing. We both think gold crowns are the only way to go for molars. A previous dentist came from Britain (we've moved a lot). She was about 50 and had a number of gold crowns put on as a young woman by her dentist father. All but one were still original.

Gold is relatively soft and doesn't fracture. If anything it presses on better with use.

So I insist on gold crowns for all my "back teeth". But yes, there are white crowns at the front.

 

[loneryder]

I'm very confused. About a year ago one of my pre molars broke in half. They said I could get a root canal and a crown put on or pull it. Fast forward to just a few days ago, I go get a second opinion on what I should do as I don't want it to get infected and cause more problems. Anyways, this particular dentist which was more thorough than the other finds all kinds of stuff wrong. He says the broken tooth, needs to be pulled as there isn't enough to attach a crown to. He says I need a root canal on the same exact tooth on the other side, and about 3 fillings done. He referred me to an oral surgeon and an endodontic for the root canal. What I don't understand is why didn't the first dentist mention all this? They took xrays. We're probably talking about $6-$7k once the surgeon and orthodontist gets paid. The dentist alone wants $3500 The only thing I can think of is maybe the first dentist thought that's all I was worried about?

I guess I could always just have both pre molars pulled out and then keep an eye out and make sure they don't start shifting around. Tooth number 13 and 4

Opinions? I almost think I need a third opinion now. All I wanted was a simple tooth pulled, and everytime you go to a dentist they want to do a whole exam, then tell you they don't pull teeth. This second dentist lied to me as I asked if they did tooth extractions before I even set up the appointment.

Dentists like to push implants these days because they are very profitable. I had a crown come off intact. My local dentist said I needed an implant. Went to another dentist who glued it back on. I don't go to the local convenient anymore.

 

[ecotourist]

Readers Digest had an article a number of years ago about dental care in Canada. They had a "new patient" with a dental anomaly that didn't need treatment but otherwise perfect teeth see a number of dentists across Canada. Most (including my friend and colleague) said "that's interesting but leave it alone". A small number suggested treatment.

So getting a second opinion might be a good idea,

 

[PWMDMD]

I've had this discussion with my dentist. I have an MSc in Materials Science and he's a conservative dentist who thinks a lot about what he's doing. We both think gold crowns are the only way to go for molars. A previous dentist came from Britain (we've moved a lot). She was about 50 and had a number of gold crowns put on as a young woman by her dentist father. All but one were still original.

Gold is relatively soft and doesn't fracture. If anything it presses on better with use.

So I insist on gold crowns for all my "back teeth". But yes, there are white crowns at the front.

Gold crowns were (and still are in my mind) the "gold standard" (pun intended) but they fell out of favor as the price go gold increased and newer materials came onto the market that were more esthetic. If I ever need a crown, I'd seriously consider an all gold crown.

 

[4WD]

Gold crowns were (and still are in my mind) the "gold standard" (pun intended) but they fell out of favor as the price go gold increased and newer materials came onto the market that were more esthetic. If I ever need a crown, I'd seriously consider an all gold crown.

I have gold, silver, and white - and they all chew the same

 

[PWMDMD]

Dentists like to push implants these days because they are very profitable. I had a crown come off intact. My local dentist said I needed an implant. Went to another dentist who glued it back on. I don't go to the local convenient anymore.

Several comments in this thread have been from people who have had root canals followed by crowns that failed in one way or another. Root canals fail if the root canal system remains contaminated (failures shortly after completing procedure) or if the root canal system gets recontaminated due to leaky crowns and buildups. Crowns fail because cavities start adjacent to the crown and eventually undermine the crown.

Implants do not fail for either of these reasons because there is no root canal system to get infected or natural tooth to decay. So in this respect, they are superior. Implants fail due to failure to integrate into the bone (short-time after placement) or if there is a physical failure of the implant, abutment, or crown. All of these can be remedied even if it means removing the implant and starting over and they are much more rare than failed root canals and or recurrent cavities.

At least 20 years ago (I'm peds), the approximate cost of a root canal + build up + crown is the same as an implant + abutment + crown. It only gets really expensive when you had a root canal + build up + crown that fails and now need an extraction + implant + abutment + crown, all to replace the same tooth.

So you can see why someone might jump to recommend the implant right away assuming medically it's appropriate and the implant site is appropriate.

 

[SC Maintenance]

I had a gold crown - very back, for years. Doc then said it was too shallow for a white crown so it was gold.

Years later It fell out. Doc said the tooth was too shallow for a crown period - so had to go to a specialist - forget what there called, to do something or other to build up the root and put a pin in. Now it has a white crown.

I saved the gold crown (hey, its my gold). I should melt it down. I think its still around.

 

[PWMDMD]

I have gold, silver, and white - and they all chew the same

Gold lasts longer on average/fails less on average and it's kinder to the opposing dentition as far as wear. It also requires "less space/less tooth reduction" compared to white crowns.