Getting to the root of a dental conundrum
November 8, 2012 3:46 PM Subscribe
Is there an urgent, specific time frame when (if?) getting a dental implant after a tooth extraction? And is my new dentist being too helicopter-y and otherwise...not quite on-the-level? (Warning: looong backstory inside)
posted by Oriole Adams to health & fitness (7 answers total) 2 users marked this as a favorite
Yes, I've been a baaad dental patient and avoided seeing one regularly for a little over 10 years - partly because the dentist I'd seen since I was six years old retired in the meantime, and partly because I was variously too busy/had no insurance/afraid after X time elapsed that I'd be chastised for not maintaining regular visits.
Flash forward to late 2011 and I began to notice an occasional sensitive spot on one tooth and presumed it was a cavity. Ignored it (bad person, I know) and then in July 2012 Mr. Adams and I were on an extended road trip throughout the Western US when I felt electric-shock-type pain in that tooth and up into the gum (not when eating, just all the time). Bought some Ora-Gel and the pain subsided by the time we got home. I browsed online (Angie's List) to find a reputable pain-free dentist in my area and went to one with stellar reviews. The tooth in question was fractured and the nerve was dead from his POV, but he referred me to an endodontist. The endo removed the loose part of the broken tooth, applied a temporary filling and said a root canal was not possible, I needed to have the rest of the tooth extracted and then some sort of dental implant or bridge installed. I remarked to him that Dentist hadn't mentioned that things were so dire and went home with a packet of info. Later that evening Dentist called my home to say he'd spoken with Endo and then proceeded to comment on several points I'd mentioned to the Endo (like the fact that I'd mentioned I'd spent more time with the hygienist than Dentist during my appt). I was surprised that he'd been apprised of the details of my Endo appt so soon - in my experience it often takes a day or more for one medico to relay patient info to another.
Dentist (or, rather, his hygienist) had, at that initial appt, done a full set of X-Rays and a cleaning. She also measured the "pockets" in my gums. After Dentist's cursory exam he didn't mention anything about current cavities, just that I was in need of deep-root cleaning. At that time I scheduled (as instructed) a future appointment a few weeks hence. However, between that future appt and the partial tooth extraction I developed swelling and severe pain in the gum above that tooth and went back to see Dentist who diagnosed an abscess. He prescribed antibiotics and I returned 4 days later to have the rest of the bad tooth removed. He also took photos (not X-rays) of my teeth from various angles (full-face and then inside my mouth) and told me about tooth implants and recommended an oral surgeon, urging me to call ASAP for an appt. He also showed me the photos he'd taken and told me which of my current fillings would eventually have to be replaced and again mentioned the need for deep-root cleaning. No mention of any current cavities. As he guided me through the photos he said "We'll be maxing out your dental coverage for the year."
A few days later I received a letter from my insurance co stating that Dentist was not in their network and that I was paying possibly 45% more than necessary out-of-pocket for my co-pays as a result. To compound matters, Mr. Adams and I are moving to a new house and all of the physical and financial stuff associated with that started right after that last Dentist appt. Two days after Dentist extracted the second half of that tooth I received a voice mail from his office. Busy packing, I ignored it and received two more calls the next day, one of which said it was "urgent" that I called back. I did call back and the receptionist asked if I'd scheduled my appt with the oral surgeon yet to begin the implant process and I said "no." She then went on to say it was very important that I call him ASAP because my bone was shrinking as we speak and she gave me the impression that soon it would be too late to do anything about my missing tooth (it's the tooth immediately behind the canine on the right side, not a problem cosmetically). I told her about the letter I'd gotten from my ins co and she said that Dentist's fees were in line with reputable dentists in Oakland County and that the ins co's claim of "45% more" was an exaggeration.
So, finally on to my two-part question. Is there a crucial time frame involved from time of tooth removal to dental implant if that is the preferred route? Will it matter bone-wise that much if I wait six or eight months? (Ins doesn't cover implants, so I'll be paying out-of-pocket and we've got all these moving expenses right now...) And, since I haven't visited a general dentist in so long, I'm basing my experience on my previous dentist, who traditionally saw me twice per year for a cleaning and exam and then told me whether I had cavities that needed filling. Is it out of the ordinary for this guy to not have mentioned thus far whether or not I have any cavities? And is it unusual for his office to get immediate and detailed feedback from the offices he's recommended (endo reporting back my comments, oral surgeon apparently confirming that I hadn't yet scheduled an appt)? If I decide not to go the entire deep-cleaning route (which I probably need, but right now am concerned about taking care of more immediate dental needs like cavities for the time being, for the sake of time and money saving) and I decide to do so with another practitioner, is Dentist obliged to send my X-rays to the new person I select to save me the cost of new films? (NOTE: I do brush and floss regularly, but I'm nevertheless prone to cavities due to Sjogren's Syndrome.)