Dentist advice needed

Cloudane

Background: fell off my bike when I was a kid and smashed my two front teeth (with no replacements for Christmas).   Had root canals done and left them alone after that until my 30s when I decided I should probably stop going around smiling at people with ugly broken teeth so got them crowned at about £600 each.  

Today (5 years or so later) I've had a full check up and x-ray due to my gums going a bit red between the crowns and was told it's because one of them had too much of a margin and bacteria were getting to the underlying tooth and eating it away.  Crown will have to be removed and the one next to it isn't looking great either so the dentist (new) would ask for advice.  

At this point I would also observe that I noticed the "margin" with my tongue ages ago and asked the dentist (now retired) who fitted them about it and he dismissed it as normal. Bit annoying as I suspect improper fitment is what got me into this mess over crowns he said should last 30 years or so but not sure how I could prove that and take action even if I wasn't a useless beta male. Anyway that rant or legal advice isn't what I came here for. 

Newbie dentist says bare minimum cost in the best case and the tooth can be saved and re-crowned (unlikely) is £600. A bridge £1.5k or so may be possible if the other front tooth is okay but she's unsure so in a few years I could be back there with worse problems and money wasted.  Realistically  she recommends an implant at £2500. (!!!!!)
If the other front tooth is bad (she's asking someone with more experience to look at the x-rays) then there's no other tooth big enough to support a bridge so it'd be 2 implants at £5k (could get up to 6k depending on other work to redo root canals etc) (!!!!!!!!!!!!!!)

Put simply, £6k would just about blow away my entire savings (yes, I know I should save more. At least I'm paying into a pension) which I don't want to do.  

What I've done so far is get on the 3 month waiting list at an NHS dentist... it's an hour drive but fine.  The plan is to decline this  private one when she calls back and wait out the 3 months and go NHS route. 

Question is.... how bad are they?  I know they don't do implants or bridges on the NHS.  Are dentures particularly bad?  Bearing in mind as she points out there's also the visual aspect with them being "smile teeth". 

I'm not quite 40 yet and the dentist recommended "investing" for this reason but she's bound to as it pays for her next holiday

What do MSE'ers think?

brook2jack2

No one can comment on what's best for your teeth without seeing you, your x rays and your medical history. 

The important thing is no dentistry lasts forever ,everything needs maintainance and you need a dentist who you trust for your long term care , be that NHS or private , and you keep regular check ups. Even a really badly fitting crown should not get decay under it so quickly and so badly . There may be some changes you need to your diet etc. 

Cloudane

Odd that it shouldn't decay so badly.  I've always brushed twice a day and don't go near sugary drinks, take coffee without sugar, have a healthy diet, the only less than ideal thing is a couple of beers (2 pints a day generally) but compared to most around here that's not a lot.  Never got into the habit of flossing though, I'm trying to get into it now.  Only other thing I can think of is with that margin at the back of the tooth between the crown and the gum, I can't help constantly messing with it with my tongue.  Never been able to train myself out of it.  Don't know if that would affect anything

The dentist I saw today is new as the one I had retired, I don't know if the new one is very experienced but that may be an unfair thing to be judging given all the qualifications and training they go through.  Maybe I'm just hoping that and that another opinion would be more optimistic... but basically I have no particular relationship to hang on to.

Hoping that things will hang together for a few months until I can get on the NHS, that way the options will range from the relatively "cheap" tier 3 to going private and emptying my savings.  At the moment there's no pain and the only reason I went was there was a tiny bit of blood once or twice when I brushed and now the gum between the two front teeth is turning a darker shade of pink (this is apparently due to the shadowy area shown on the x-ray around the tooth).  She was going to follow up around a hygienist appointment in about a month with a few options so I'm thinking it won't have been super urgent.

The other thing I'm hoping is maybe say the NHS dentist says yeah it needs to be pulled and I go with the cheapo NHS denture that I can see it as like a "trial" for say a year while I scrape some more pound coins together and potentially switch to implant(s) later if I don't like the denture.  But I hear the bone regresses?  So not sure that'd be an option or not.

Lorian

Crowns with poor margins need a lot of cleaning to keep them healthy. I have a shelf full of Tape, Floss, interdental brushes, and Chlorhexedine. If you don't have these thengo shopping as  whatever you do next it will need regular thorough cleaning or you'll spend a fortune and end up with the same problems again.

brook2jack2

You need to start using either floss or tepe brush every day , between all teeth, but more particularly the two crowns as if you are not cleaning between teeth then you are missing 40% of the tooth. Bleeding is a sign of gum inflammation. 

If you eat eat or drink anything with sugar more than three times a day you will get decay. Dont worry about what you eat or drink at a meal , look at what happens in between meal times . Even is it is just a nibble or a sip of something , people who graze tend to have a lot of decay. 

Many things in a "healthy diet " can be just as bad for teeth as sweets eg raisins, smoothies , flavoured yogurts , protein shakes, fruit teas , honey etc 

Cloudane

Thanks for the continued feedback, since getting worried I'm into a flossing habit with the easily accessible teeth.... the back ones I still struggle with but after seeing some of these costs I'll do whatever it takes to preserve every tooth!

I put weight on if I so much as sniff food (low metabolism and heart rate) so don't tend to snack.  Been obese,  now healthy weight (for the past 5 or 6 years) and intend to stay there.  By healthy I mean sandwich and fruit for lunch and usually a decent mix of lean protein, reasonable on the carbs (often things like brown pasta rather than white) and veg, for dinner.  I don't touch smoothies they're loaded with calories.  Sometimes have a flavoured greek yogurt or protein shake in all honesty though, I didn't know they were a problem.

Is sugar-free gum a problem?  Particularly in the last few months I've been chewing that rather than snacking.  I know the ads about it being good for your teeth were probably a load of BS, but figured it probably wasn't bad.   Doubting myself now though!

Cloudane

Current dentist's receptionist has called me wanting me to go in and discuss options.  I said I don't have the kind of money they're talking and that I've joined the 3 month waiting list for an NHS dentist but she was adamant that the lead dentist there "wants to see if she can help" so I agreed to hear her out.  Better not try and charge me a consultation fee afterwards as I'm not paying to be pressured to go and listen to a sales pitch.  

I'm expecting to be told "you can't be waiting for 3 months, you have to get this sorted privately as it has to be done sooner rather than later or else you'll get an infection and sepsis and die" and that the only 'help' will be a credit proposal so currently thinking of how to respond.  Ideas include "if it hurts I'll go to hospital or if they still won't see me then try getting my face smashed in and if that doesn't work there's always the life of crime and free dentistry in prison..."

In brighter news, I'm well into the flossing habit now.

Cloudane

Got called back in by the lead dentist and at least owe the previous one who fitted my crowns an apology as it turns out everything is fine!  Poked and wiggled at every angle and couldn't see anything wrong. New  x-ray was taken and the same shadow that "any dentist would think your tooth is about to fall out" wasn't present, it looked absolutely fine. She looked through my history of radiographs all the way back from before the crowns were even fitted - sometimes there's a shadowy area sometimes there isn't.   It baffled her and she's been there for decades but says there must just be something odd with the (dentine?) that sometimes looks odd but recommended course of action: leave well alone. 

Massive relief!

Sorry for the rants. It really weighed on my mind.