Dental

FallenAngel2612

I’m going to try and keep this as concise as possible. I was with the same dentist for over 20 years. Attended check ups twice yearly and hygeine visits etc (this is a private dentist). I had a filling in a molar a few years ago that gave me pain and sensitivity for a few months and was told to let it settle, it did and then kept flaring up on and off. I mentioned it at nearly all my checkups to be told it’s probably because you clench at night. Eventually he did an xray and said it didn’t show any decay of infection but he would do a root canal. I was a bit wary of this given he was essentially saying xray showed nothing. 

Bearing in mind this dentist has not done any routine X-rays/bite wings in at least 10 years or more. My understanding now is its best practice to at least do bite wings every 2-3 years?

Anyway although I like my dentist something felt off and I decided to get a second opinion. X-rays were taken and I was shown them, there was decay under the original filling snd it was quite clear to my untrained eye. 

He thought he could try refilling instead of root canal, unfortunately although he said he couldn’t see the nerve, I had pain for two weeks afterwards and a further xray showed it was sat right on the nerve. He said he didn’t think root canal had a good chance of success and because I was in so much pain extraction was best option. 

The extraction was extremely difficult and painful despite around 7-8 local injections but it did eventually come out intact, with some buccal bone broke. (I didn’t find this out till afterwards and I am still not healed 6 weeks later). 

His X-rays also showed a couple of other areas of decay that need fillings. As my other dentist had not done routine X-rays in years these have not and would not have been picked up. 

I guess what I’m asking is, is it bad practice to not do any routine X-rays during check ups for years? Surely doing this helps pick up problems when they are easier to deal with. He also missed the decay on the extracted tooth which could possibly have been saved,

I am now struggling with constant pain, a non healing extraction site and other work that needs doing. All my teeth are sensitive now and my bite is totally off making eating really difficult. I am taking meal replacement drinks.

i feel this could have all been picked up on earlier, not sure where to go from here and whether my original dentist had been negligent in not doing any X-rays for such a long time? 

Thanks for reading. 

sammyjammy

Was this a private dentist?  What do you hope to achieve?  Have you made a formal complaint to the dentist? I won't comment on the treatment as your post risks going down a route of medical advice so you are unlikely to get help with that side of things and if you do your thread will likely be deleted.

elsien

I don’t think it’s medical advice to give information about what the guidelines say, If anyone here is familiar with those.

my understanding, which could be wrong, is that there is no set timescale it depends on the age of the client they oral health , various other factors So basically, a clinical judgement within certain recommendation parameters. , I would suggest however that no x-rays in 10 years probably falls outside of that guidance. 

That is a query to take up with the Dentist in the first instance.

FallenAngel2612

Thanks for replies, yes I’m not asking for specific medical advice. Just wondered sbout the xray issue, obviously the practice/dentist takes a very conservative approach to treatment rather than preventative and waits before he sees or feels enough of a hole/cavity before treating. I obviously have no confidence anymore and have moved practices but I am going to submit a request for my dental records. If I’m now having to look at expensive restorations for things that could/ should have been picked up earlier and treated at an earlier stage, and therefore less invasive, that is not right and not good patient care. As I say, I’ve never missed an appointment. Have good oral hygiene, don’t smoke, and have a good diet. I know sometimes you can just be unlucky or there’s a genetic element. I am thinking I will write a complaint letter in first instance. 

FallenAngel2612

And yes sorry, private dentist

Toothsmith

X-rays should be done every 2-3 years in someone with a stable mouth, more frequently in someone with a more unstable mouth (ones showing more signs of decay, smokers, people with poor oral hygine or bad diet) So if old dentist really hasn't done any for many years - then yes - this isn't ideal. 

Decay isn't always obvious on an x-ray. You may have seen a darker area which second dentist said was decay - but I'm assuming this x-ray was taken not that long after first dentist had taken an x-ray too - which they were happy with? Now obviously I don't know what was decay and what wasn't - but it's possible first dentist saw the x-ray and wasn't worried about the dark area, as they knew what it had been filled with, and possibly lined with - and some filling/lining materials don't show up so well on x-ray and can look a bit darker like decay would look. 

So whilst my feeling is that if the first dentist really hasn't been taking regular, risk-justified x-rays of you, then all sorts could have been going on unspotted, I can also see that there are possible situations when the second dentist might have misinterpreted something too. 

A bit of buccal bone breaking on an extraction isn't an unusual thing to happen at all, and this usually heals up fine. It may well be an infected socket that is delaying the healing of that area - but these too do heal up eventually. They are just a bit more sore for a bit longer - but you need to go and get this reviewed if you are worried about it. Also - your bite won't be totally off - it just feels different now that tooth is missing. It'll start feeling normal again soon enough, but again, you need the dentist to check and reassure you there. 


So from what you've written, I wouldn't be prepared to condem original dentist just yet. I do think you have to ask some more questions though. Be sure x-rays haven't been taken more often than you remember (memory can be unreliable). If they haven't then you possibly do have some grounds to complain. If you ask for a copy of your notes and xrays, you should be able to see when they had been taken.