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Puzzled about dental treatment options
Options
LammieJames
Posts: 6 Forumite
About three months ago I was mugged coming out of a tube station in London. Apart from the inevitable bruises, cut lip and so on, my two front teeth were pushed back into my mouth about 1/4 of an inch. Although they were loose-ish at the time, I was told there would probably be no need to splint them and they would be OK - although the doctor also said that if in any doubt I should consult a dentist.
As it happens, I don't have a dentist. I tend to go as and when - and probably not often enough, given that I wear partial dentures top and bottom...:embarasse
Anyway, they did eventually stop being loose and ultra-painful in the intervening weeks. The problem started after about three or four weeks, when I noticed that both teeth kept hurting, not when I push them out slightly with my lower teeth but as they settle back in. They only need to go out a fraction and I get a sharp pain when they settle back in their normal place. I can feel it happening to both teeth individually, not just one of them.
So I went to a dentist and he took loads of X-rays and told me that he could see nothing, but that he thought I had something called "vertical root fracture", which is often not detectable on an X-ray. The dentist proposed a root canal treatment and a crown to both teeth, for which he wanted £2,350. The other option, he said, would be implants, which might cost even more. I walked out of there smartish, mainly 'cos I don't have that kind of money.
I then managed to find an NHS dentist and went in to see him. He took X-rays, which were inconclusive but he also thought might be a vertical root fracture. But instead of a root canal and crowning he proposes to extract my two front teeth and add new ones to the partial I already wear. His reasoning seems to be that you can't treat vertical root fractures with a root canal and that extractions are the only realistic treatment. If I do that, the total cost of the extraction and a new partial three months down the line is just shy of £200 on the NHS.
Now, I'm totally confused.
On the one hand, the cheapest option would be handy as I've just had a 50% cut in my income and we're struggling. I could borrow some money if I really had to, but I don't want to waste it if another six or 12 months down the line it all ends up par-shaped. I'm not sure if I can afford implants. But on the other I don't want to lose my own front teeth if I don't have to. I'm being told two different things and don't know what to believe any more.
My wife, meanwhile, is taking the kickey out of me a bit. Right now, I can't manage crusty bread, apples, corn on the cob, anything that involves biting into something with my front teeth. She, on the other hand, has worn full upper and lower partial dentures for several years and compared with me can eat almost anything. I generally get on well with my own partials, which I've had for a few years. They fit and work well and I can eat anything with them.
Does any of this make sense? And what would people here do? Should I pay top whack or go for the more drastic but much cheaper NHS option?
As it happens, I don't have a dentist. I tend to go as and when - and probably not often enough, given that I wear partial dentures top and bottom...:embarasse
Anyway, they did eventually stop being loose and ultra-painful in the intervening weeks. The problem started after about three or four weeks, when I noticed that both teeth kept hurting, not when I push them out slightly with my lower teeth but as they settle back in. They only need to go out a fraction and I get a sharp pain when they settle back in their normal place. I can feel it happening to both teeth individually, not just one of them.
So I went to a dentist and he took loads of X-rays and told me that he could see nothing, but that he thought I had something called "vertical root fracture", which is often not detectable on an X-ray. The dentist proposed a root canal treatment and a crown to both teeth, for which he wanted £2,350. The other option, he said, would be implants, which might cost even more. I walked out of there smartish, mainly 'cos I don't have that kind of money.
I then managed to find an NHS dentist and went in to see him. He took X-rays, which were inconclusive but he also thought might be a vertical root fracture. But instead of a root canal and crowning he proposes to extract my two front teeth and add new ones to the partial I already wear. His reasoning seems to be that you can't treat vertical root fractures with a root canal and that extractions are the only realistic treatment. If I do that, the total cost of the extraction and a new partial three months down the line is just shy of £200 on the NHS.
Now, I'm totally confused.
On the one hand, the cheapest option would be handy as I've just had a 50% cut in my income and we're struggling. I could borrow some money if I really had to, but I don't want to waste it if another six or 12 months down the line it all ends up par-shaped. I'm not sure if I can afford implants. But on the other I don't want to lose my own front teeth if I don't have to. I'm being told two different things and don't know what to believe any more.
My wife, meanwhile, is taking the kickey out of me a bit. Right now, I can't manage crusty bread, apples, corn on the cob, anything that involves biting into something with my front teeth. She, on the other hand, has worn full upper and lower partial dentures for several years and compared with me can eat almost anything. I generally get on well with my own partials, which I've had for a few years. They fit and work well and I can eat anything with them.
Does any of this make sense? And what would people here do? Should I pay top whack or go for the more drastic but much cheaper NHS option?
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Comments
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Are you planning to change your lifestyle and dental habits?
Crowns or implants even if they work require meticulous maintainance on your part and regular maintainance at the dentists. You would need to revamp the way you clean and maintain your teeth and make regular dental visits a priority.
If however you are happy to continue as you are now then have the teeth out. Bear in mind though you will need a new denture after your gums have finished healing at additional cost.0 -
If you're someone who hardly ever goes to the dentist and don't really place any value on your teeth then go for the cheap simple option.
Complex expensive stuff takes time, care and money to maintain, and unless you're going to change habits of a lifetime, you're not going to do that.
Keep it simple.How to find a dentist.
1. Get recommendations from friends/family/neighbours/etc.
2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
3. Assess the helpfulness of the staff and the level of the facilities.
4. Only book initial appointment when you find a place you are happy with.0 -
Ha - there's something you don't get every day!!!!
Two dentists agreeing on a treatment plan!!!
How to find a dentist.
1. Get recommendations from friends/family/neighbours/etc.
2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
3. Assess the helpfulness of the staff and the level of the facilities.
4. Only book initial appointment when you find a place you are happy with.0 -
Thanks guys. I'm discounting implants as they are a) too expensive right now and b) I've been told if I opted for extractions, implants can be added at some future stage, albeit I might have to have bone transplants if I wait more than a year or two.
Can I just ask: assuming it is a vertical root fracture, is the RCT plus crown treatment one that could work? Or is the NHS dentist's opinion that it wouldn't work correct? And is it sometimes impossible to tell that it is a vertical root fracture? That completely threw me, TBH, the idea that it's not visible even by X-ray....
BTW, I wouldn't want it to be thought that my attitude to looking after my teeth is not to care at all. I mean, it isn't brilliant but I brush my teeth regularly, albeit I'm not a big flosser. I don't eat sugar or sugary foods, or drink fizzy drinks and gave up smoking a few years back, largely at my dentist's urging.
The only reason for going to dentists less often in the past 3-4 years is out of a sense of weariness: after the usual teenage carelessness followed by almost 20 years of twice-yearly check-ups, scalings, deep cleansings and many thousands of pounds spent on fillings, RCTs, bridges etc, I found myself with regular abcesses and broken teeth, for which the most effective, or the ultimate treatment turned out to be an extraction on several occasions. After a few extractions I chose to have partials to improve my eating and looks.
It's fair to say I don't obsess about teeth and that might count against me at a time when it would almost certainly be required, but I'm not a total slacker...
Still, back on-topic I guess what I'm trying to say is, if it is a vertical root fracture (big if) a RCT and crown might work for five or six years or longer I'd be tempted. If it all goes pear-shaped in a year's time, I wouldn't. Does that help?0 -
LammieJames wrote: »Thanks guys. I'm discounting implants as they are a) too expensive right now and b) I've been told if I opted for extractions, implants can be added at some future stage, albeit I might have to have bone transplants if I wait more than a year or two.
Can I just ask: assuming it is a vertical root fracture, is the RCT plus crown treatment one that could work? Or is the NHS dentist's opinion that it wouldn't work correct? And is it sometimes impossible to tell that it is a vertical root fracture? That completely threw me, TBH, the idea that it's not visible even by X-ray....
BTW, I wouldn't want it to be thought that my attitude to looking after my teeth is not to care at all. I mean, it isn't brilliant but I brush my teeth regularly, albeit I'm not a big flosser. I don't eat sugar or sugary foods, or drink fizzy drinks and gave up smoking a few years back, largely at my dentist's urging.
The only reason for going to dentists less often in the past 3-4 years is out of a sense of weariness: after the usual teenage carelessness followed by almost 20 years of twice-yearly check-ups, scalings, deep cleansings and many thousands of pounds spent on fillings, RCTs, bridges etc, I found myself with regular abcesses and broken teeth, for which the most effective, or the ultimate treatment turned out to be an extraction on several occasions. After a few extractions I chose to have partials to improve my eating and looks.
It's fair to say I don't obsess about teeth and that might count against me at a time when it would almost certainly be required, but I'm not a total slacker...
Still, back on-topic I guess what I'm trying to say is, if it is a vertical root fracture (big if) a RCT and crown might work for five or six years or longer I'd be tempted. If it all goes pear-shaped in a year's time, I wouldn't. Does that help?
If it is a vertical fracture then the tooth is best in the bin to be honest. Any treatment is doomed to failure in my experience but I am unsure how you would get a vertical fracture with the trauma you describe (and yes you cant necessarily see them on a radiograph)0 -
Hiya, thanks for that Jugglebug. What do you mean by that statement? Is it not something that one might expect if your teeth have been knocked about?0
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Vertical root fractures are more a problem of long term stress and strain on a tooth rather than an impact - which is usually associated with horizontal fractures. These do show up better on X-rays.
Trauma can kill teeth, which would be sorted out by root filling.
I think what the dentist is saying is that he thinks that root filling the teeth will save them, but there might be unforseeable and unnoticed effects of the trauma that might mean the treatment will fail.
Basically - he's saying "I'll give it my best shot, but I can't offer any guarentees".
It's up to you to decide if you're willing to 'bet' that much money on him being able to save them.
Obviously, I haven't seen the x-rays, or you, so I'm in no position to call it for you.How to find a dentist.
1. Get recommendations from friends/family/neighbours/etc.
2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
3. Assess the helpfulness of the staff and the level of the facilities.
4. Only book initial appointment when you find a place you are happy with.0 -
Can't understand why dental treatment costs so much !! -- thats why you're scared to go -- and the pain !!0
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Can't understand why dental treatment costs so much !! -- thats why you're scared to go -- and the pain !!
I'm not scared of dental treatment or pain. I've put up with quite a lot of both with my teeth in the past six or seven years
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The money side isn't nice, you're right: the recession doesn't do any of us any favours and the fear of borrowing several grand and then losing my job altogether is quite worrying, especially if it didn't work out in the end....0 -
Can't understand why dental treatment costs so much !!
Can you really not??
Next time you go, look at the building, the staff and the equipment. Imagine the cost of all that, and keeping it up to date and maintained. (Including the staff with training sessions!) Imagine the regulations that have to be complied with.
Add all that cost up, and divide it by the number of working hours in a day.
All that has to be paid for by the patient fees, and one dentist can only see one person at a time. So - If you're in the chair for anything from 5 mins to an hour, you have to pay for that bit of the running cost of the practice. Plus the 'dead time' in between patients when cross infection protocols are done to ready the surgery for the next person.
Does that help? Or do you still think the 'cost' of a filling should just be a little bit more than the cost of the capsule of filling material?How to find a dentist.
1. Get recommendations from friends/family/neighbours/etc.
2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
3. Assess the helpfulness of the staff and the level of the facilities.
4. Only book initial appointment when you find a place you are happy with.0
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