2012: Get to grips with my teeth. Advice welcome!

coldstreamalways

Sophiej wrote: »

I had a much smaller tooth on the top row...turns out it was my baby tooth & the new one had never grown through. I can see the new one in xrays. Anyway the baby tooth fell off & I needed a bridge (crowns on the two teeth either side & a fake tooth thats not attached to the gum in the middle). Perhaps thats the case for you?
Re braces vs Invsalign, a girl I work with had two years of misery (pain, discomfort & constant dentist vists) with braces & STILL has to wear a retainer to make sure they dont move back!

Having braces is a bit like dying your hair, the ligaments that hold the teeth in are genetically programmed to put the teeth where they were before treatment, moving them doesn't change the programming. Lifetime retention is strongly advised for all sorts of tooth movement, some are much much more likely to relapse than others.

Sophiej, with all due respect for the particularly extensive treatment plan (of 23 crowns) you seem to have undergone, there are no two situations that are the same and no two dentists will go about a plan in the same way. The destination may be the same but the route used to get there can vary dramatically. Afterall, if you have a hammer, everything is a nail. If all you can do is crowns (rather than orthodontics) then well, crowns it it.

Finding a trustworthy dentist is exceptionally important OP. That way you can seamlessly progress through the "required" treatment of root canal etc to the cosmetic work without having to worry about explaining what your end goal is to lots of different people as once you and your dentist have it planned (don't forget the hygienist!) then you really will be working as a team to get the best result.

Good luck!

brook2jack

pegshapedlateralincisor wrote: »

Youre not a dentist by any chance are you? I don't want to be making a fool of myself here



About the x-rays: it is not the case that you need to have x-rays taken at regular intervals - a dentist needs a good reason to take an x-ray, if the tooth and the surrounding tissue appears healthy, then there is no reason to take an x-ray, alternatively if you have pain or swelling then obviously an x-ray may be needed.

Have you learned about periodontal disease yet? Occult caries (hidden decay), supernumaries (extra teeth), internal and external resorption ( root/tooth eaten away from inside under gum), neoplasias ( cancers), cysts, secondary decay (decay under fillings), traumatic fractures and about a hundred other things that cause no symptoms until it is too late but can be picked up on x ray screening?

I suggest you read your radiology rules and regs. FDGP does good guidance http://www.fgdp.org.uk/_assets/pdf/restorative%20dentistry/cohort%209/resources%20-%20study%20day%20one/selection%20criteria%20for%20dental%20radiography.pdf

Every patient has individual guidance on how often to x ray but if you wait until there is a problem before x raying you are negligent.

I can say I'm a dentist but there is no way to check anyones credentials on the internet. Anyone can post and read. That's why you have to be careful and sure of what you post as people can argue with their own dentist they see on the basis of "facts" on the internet.

jugglebug

pegshapedlateralincisor wrote: »

Youre not a dentist by any chance are you? I don't want to be making a fool of myself here

hehe
Lots of us dentists post here.
Welshdent, Coldstream, Brook, Toothsmith and myself (Although I am not as prolific as some).
Don't be shy though all are welcome.
Would echo brook though. It isn't always the material, more the method it is placed with so try not to paint with such a broad brush.
A properly placed Composite can last just as well as an amalgam when used in the right context. Similarly whilst amalgam can be a lot more forgiving it doesnt follow that it will always last decades.

pegshapedlateralincisor

LOL, i've been well and truly trumped! :T

brook2jack wrote: »

That's why you have to be careful and sure of what you post as people can argue with their own dentist they see on the basis of "facts" on the internet.

jugglebug wrote: »

try not to paint with such a broad brush.

I shall work on these points!

Also, perhaps I have attached too much significance to the missing out on brushing at night, but is this not an important point when taking a patient history? Or is this just basic stuff??

BlondeHeadOn

jugglebug wrote: »

hehe
Lots of us dentists post here.
Welshdent, Coldstream, Brook, Toothsmith and myself (Although I am not as prolific as some).
Don't be shy though all are welcome.
Would echo brook though. It isn't always the material, more the method it is placed with so try not to paint with such a broad brush.
A properly placed Composite can last just as well as an amalgam when used in the right context. Similarly whilst amalgam can be a lot more forgiving it doesnt follow that it will always last decades.

Is it still possible to request amalgam fillings, if the dentist is planning on replacing them with composites? My old (amalgam) fillings have lasted me for 35 years, so I'd be quite happy to have the same thing again. I think my dentist is planning to replace them with composites though, which don't sound to be as good?

I've just realised that maybe I should start a new thread on this - sorry to hijack this one OP!

brook2jack

Why are they bieing replaced?

The choice of material often depends on size and shape of the hole.

As with any dental treatment you should give and sign informed consent, with all treatment necessary listed. The dentist shouldn't assume you want white fillings so discuss with them the choice of material and when you are happy give consent. Likewise a patient shouldn't assume they will have a certain type of filling material.... ask and understand all your treatment before you go ahead.

jugglebug

BlondeHeadOn wrote: »

Is it still possible to request amalgam fillings, if the dentist is planning on replacing them with composites? My old (amalgam) fillings have lasted me for 35 years, so I'd be quite happy to have the same thing again. I think my dentist is planning to replace them with composites though, which don't sound to be as good?

I've just realised that maybe I should start a new thread on this - sorry to hijack this one OP!

It isn't a case of Amalgam good, Composite bad
If you use the wrong material in the wrong way it will fail.
Now I cannot see your teeth but in general the 2 materials have different strengths and weaknesses.
I see a lot of old Amalgams where time has developed crack lines within the remaining tooth. Replacing these Amalgams will not really do anything to prevent the crack lines from spreading. It just doesn't work that way. Tooth coloured fillings on the other hand (Composite) Bonds very strongly to the remaining tooth, and when done well, in the right situation, can reinforce the tooth, making it stronger and *may* prevent the crack lines progressing.
In my own mouth I have 3 Gold onlays, not Amalgam or composite as both (in my view) Amalgam and Composite wouldn't be the best material for the job.
Can you request Amalgam? Yes of course. It is your mouth after all.
On the other hand if the Dentist feels Amalgam would be the wrong choice he / she are well within accepted practising guidelines to refuse as we are responsible for what we do, and to knowingly do something badly, even if begged and pleaded with can get us into legal hot water.
Ideally discuss with your Dentist as only they know your own case.

welshdent

hello pegshaped

Hope you have faired well with that ridiculous new VT system! We dont bite on here (patients do that to us!)

BlondeHeadOn

jugglebug wrote: »

It isn't a case of Amalgam good, Composite bad
If you use the wrong material in the wrong way it will fail.
Now I cannot see your teeth but in general the 2 materials have different strengths and weaknesses.
I see a lot of old Amalgams where time has developed crack lines within the remaining tooth. Replacing these Amalgams will not really do anything to prevent the crack lines from spreading. It just doesn't work that way. Tooth coloured fillings on the other hand (Composite) Bonds very strongly to the remaining tooth, and when done well, in the right situation, can reinforce the tooth, making it stronger and *may* prevent the crack lines progressing.
In my own mouth I have 3 Gold onlays, not Amalgam or composite as both (in my view) Amalgam and Composite wouldn't be the best material for the job.
Can you request Amalgam? Yes of course. It is your mouth after all.
On the other hand if the Dentist feels Amalgam would be the wrong choice he / she are well within accepted practising guidelines to refuse as we are responsible for what we do, and to knowingly do something badly, even if begged and pleaded with can get us into legal hot water.
Ideally discuss with your Dentist as only they know your own case.

Okay, that makes a lot of sense - the teeth with the old amalgams have developed the 'crack lines' you mention, which is why they are due to be replaced.

I'm a total dentist-phobe, so I tend to nod...and panic... when he is talking to me, just waiting for the moment when I can run out of the door to safety! I don't really take in a lot of what is said..... It's only afterwards I think about the reasons for things. :o

I have just had an onlay done on a bottom molar, and I have to say that the result looks beautiful - my mouth has never looked so pretty! The fillings are due to be replaced next year, so hopefully they will be done to the same high standard and will look nice too.

Thnkn you for the replies, and aplogies again for hijacking this thread.

pegshapedlateralincisor

welshdent wrote: »

We dont bite on here

Haha, that's reassuring! I'm still a long way from my VT years - only second year