I have just come back from a very frustrating experience with a dentist. I had broken the corner (cusp) of my bottom molar a couple years ago but didn't to go to a dentist because I had no insurance. Also the broken tooth didn't cause me any pain and most of the tooth was still intact. So today I went to the dentist so they could take a look at it and she immediately tells me, after looking at my x-rays, that I need a root canal. I tell her that I think that might be a bit extreme. So then she takes out her scraper and starts stabbing the broken tooth while asking "Does this hurt?" to which I kept saying no. She then tries to convince me that the break is bigger than it really is. I reply to her that it is just the corner and 85% of the tooth is still intact. She then says that there is some decay at the break and it might have gone underneath my filling (My broken molar does have a silver filling) near the nerve of the tooth. She suggests that the only way to find out if there is decay in my tooth is to remove the filling and take a look around. She does add that if she takes out the filling that she won't put another filling in afterwards and that the tooth would need to have cap on it because it would be too weak otherwise. So I guess she is telling me that to check my broken tooth she will basically have to destroy it to the point it needs a crown. Also she said that she might hit a nerve while drilling out the the silver filling and if she did I would need a root canal. She said she would try not to though (I feel so much better now). I ask her if she could just put a filling in and she says she can't because of the decay and because she doesn't do "Patch Jobs." She also chides me for not going to the dentist earlier. Anyway I don't see any decay on the molar and I've known some people that have had broken teeth that were fixed with fillings, but every dentist I go to always wants to do a root canal.
Is this normal? Do dentists damage a tooth so much that I will need crown afterwards just to check on it? That sounds crazy to me.
I guess my question is is there a sane dentist out there or are they all this crazy?
I work for a dentist. What your dentist did was exactly what a good dentist does.
An x-ray can determine SOME things, like where decay is and approximately how close to a nerve it is. Your dentist is perfectly correct to say that the only real way to see what shape your tooth is in is to remove the old filling. There's absolutely no way of her knowing ahead of time whether or not you will definitely need root canal or a crown unless she does this. If your existing filling is already very large, it is certainly
possible that you would need a crown.
She should not have chided you for not going to the dentist, but what she is telling
you is 100% warranted and 100% professional. As a patient it is rather unwise of you to tell her to repair your tooth, if she is telling you that you have decay underneath. That would be totally unprofessional of her to do a repair of this sort just because it is your preference.
If you're unhappy I suggest two things. One is, get a copy of your x-ray and see another doctor. The other is, just wait and see. Your tooth will let you know eventually
what needs to be done. Either it will begin to chip more, or it will hurt more. Bottom line, she was not damaging your tooth so that she can get your business. She was examining your tooth the best she could, the best ANYONE could. You have a good dentist.
First off, thanks braveheart226 for responding to my post.
I have to say that I'm surprised that what my dentist is trying to do is normal procedure. Drilling out an old filling to see if there is any decay, thus destroying the tooth to the point where I will have to have a crown, seems a little reckless to me. I mean if she finds decay then it was worth it, but if she doesn't then she has messed up my tooth for nothing and I will have to pay big money to fix it.
As far as questioning my dentist's actions I think it it is my right to do so. At the end of the day it is my tooth and not hers. I think it is dangerous just to do whatever a dentist says as they are human just like the rest of us and like us can make mistakes and bad judgements.
I asked about a filling because I know some people who have had that done to fix a broken tooth and had great results. Unfortunately nowadays Dentists like to put on Crowns and do root canals at a drop of hat instead thinking outside the box to come up with a different solution. If Dentists are so devoted to helping you keep your real teeth for as long as possible then placing crowns and doing root canals should be a last resort because once those procedures are done most your real tooth is gone.
I am going to go to another Dentist for a second opinion and hopefully he can come up with some alternative options to deal with my problem.
Unfortunately, sometimes things like a cavity or exposed nerve under a filling do not show up in x rays. The filling must be drilled out. The nature of the beast is that the filling doesn't just pop out. Drilling it out means taking at least a small amount more of the tooth too. So at that point, replacing it may be out of the question and a crown is the only recourse. One can only drill out so much of the tooth. And while "most of your tooth is gone" is correct, it's better than not having the tooth. An implant or bridge is more costly than a crown and a root canal.
You know what? I know getting a root canal is a huge expense and a massive pain, but I'm a mega scaredy cat, and I had a similar problem - about 20% of my tooth was chipped, and I left it about a year before I visited the dentist. After an ex-ray, my dentist recommended a root canal - he told me pretty much the same thing as you've been told, he could drill it out and take a look, then if it's okay, I'd need a crown, or he could just do the root canal and sometime in the future I can choose to get a crown.
I got 2 second opinions (paying about NZ$100 a pop) and got the same advice.
I chose a RC, and I'm so glad of my choice.
It was done in 3 appointments, the first one they drilled out the nerve and put some antibiotic inside the tooth, then a temp filling on top. The second appt they filed down the canal and put more antibiotic in there, and a temp filling. I had the last appointment yesterday, and they filled it with this rubbery stuff and did the final filling.
It cost me NZ$1200, but I'm glad of my choice. There's little chance of future damage to the tooth, and the tiny bit of sensitivity I had is gone.
I think you're right to question your dentist, but I also think your dentist has recommended a good cause of action based on my experience.
I am a dental nurse and can offer a little advice I hope if the tooth is compromised in any way decay can get into the tooth quite fast. Sometimes a patient can have a small spot or hole on the outer surface but a large amount of decay underneath. Dentine is not as strong as enamel and once decay has gone through the enamel there is not much resistance from the dentine and the decay will spread. From your eye it looks like small part of the
tooth is gone but obviously the x-ray shows some decay under an old filling. Decay under old fillings or crowns is very common unfortunately. Your dentist wanting to open is up is simply the best way to go about it, its hard to always tell via x-ray the real situation of the tooth its only once the tooth is opened up can the dentist assess weather you need a root canal or not. If the decay has spread to the nerve you will need a root canal.
Once a tooth has then been root treated it usually needs to be capped or crowned reason being a root canal tooth become brittle since the nerve which is the blood supply to the tooth has been removed, and for extra support and strength a crown is then placed.
However with that being said...if your gut is telling you something is not right go for a second opnion, you are entilted to. But it all sounds okay to me. If you not sure..ask your dentist...ask her to show you the x-rays and show you the decay and explain it. I dont agree with the scolding the dentist should always have a compassionate approach.