Help me lose a tooth.

December 13, 2006 9:22 AM

My teeth have been in disrepair for several years now, and I've been saving my money for nearly as long to have them extracted (and replaced by dentures) en masse. Unfortunately, I discovered yesterday that at least one tooth has grown impatient with that schedule.

The tooth is on the bottom-right side of my mouth (left side to an observer), and while there is no pain or visibly obvious swelling, I can feel a firm bump where tooth meets gum, almost like half of a very small marble.

The tooth in question is in such a state of disrepair that the numb & yank method may not be an effective solution; I suspect that the dentist will need to actually cut into the gum and extract whatever fragments of the tooth remain.

Which means I'll need an honest-to-god oral surgeon... and I haven't even gotten to the complicating factors yet.

1. I don't have dental insurance, hence the 'en masse' strategy for cost minimization, and while I almost certainly have enough money saved (~$13,500) to pay for this operation, I'd rather spend as little of it as possible (see above 'en masse' strategy).

2. I have non-refundable airplane tickets to Florida (I live in Salem, MA) for December 22nd-27th. It'll be the first time I'll have seen my parents in two years, and if I pull out they'll be damn near inconsolable.

So here are the questions:

Is having the procedure done and being in 'flyable' condition by the 22nd a workable goal, or should I risk putting it off until after Christmas?

In the interests of minimizing costs and getting it done quickly, I don't want to schedule an appointment with one office just to be bounced to another for the actual procedure. How can I best ensure the office I make an appointment with is properly equipped?

posted by The Confessor to Health & Fitness (11 answers total)

Response by poster: !

Scratch that second question, unless you can think of a good 'discount' way to have it done; I just realized that I was looking in the *abridged* yellow pages. The real book (which I have open now) has a separate category for Oral and Maxillofacial Surgeons, which is a good starting point.
posted by The Confessor at 9:29 AM on December 13, 2006

The dentist might want to get the whole process over with as soon as possible, you should allow as much healing/stabilizing time as you can after the extractions and before fitting for the dentures.

Deal with that one problem tooth, don't try to rush the whole job.
posted by StickyCarpet at 9:30 AM on December 13, 2006

I would think that any oral surgeon would be capable of removing tooth fragments. I had several teeth removed that had broken at the gumline and the surgeon had no trouble at all. There was no cutting involved for me. He was picked at random from a list that my dentist gave me, so I think it's fairly safe to say that if you can get an appointment, they can get the job done.

If you can get the procedure done in the next few days you should be fine by the 22nd. After my procedure there was really only 2-3 days of discomfort. Just be sure to follow the surgeon's aftercare.
posted by cabingirl at 9:32 AM on December 13, 2006

One thing to check on, if you have health insurance, many plans cover oral surgery. While it won't completely cover everything like dental insurance would, it might make the cost of tooth removal much more doable.

I know my plan covered the removal of my wisdom teeth.

Good luck.
posted by teleri025 at 12:33 PM on December 13, 2006

You may want to consider that, if any of your teeth are at all salvageable, some dentists may not agree to pulling all of your teeth in order for you to have complete dentures. From what I've heard, full dentures can effect quality of life (although I'm sure so do chronic tooth problems) -- they are uncomfortable, can take a while to get used to using, and can make some things impossible (like eating certain foods). And, of course, once you go down that road, you can't go back.

I'm only saying this because I don't want you to get your hopes up, or to go with just the first person you see. Your plan is to have it performed before next week, right? I think the extraction of all remaining teeth is more of a serious procedure than that, and warrants careful consideration of your options.

Another vote for taking care of them one at a time, on a need basis (starting with the one you mention), if that's at all possible. And wait until after you see your folks -- as you said, you've been dealing with tooth problems for years, now.
posted by penchant at 1:33 PM on December 13, 2006

Response by poster: I apologize if I was unclear; I'm saving for eventual mass extraction, but I'm only planning on having one obviously unsalvageable tooth put out of its misery at the present time.

Thanks for the heads up regarding health insurance. I have TriCare Standard from a medical condition I picked up when I was in the Navy; I'll see if it will cover any associated costs.

I went down to the closest oral surgery office I could find in the Yellow Pages and was quoted only $325, which is certainly a manageable expense given my savings and living situation.
posted by The Confessor at 2:33 PM on December 13, 2006

There was a newspaper writer in Detroit who had all of his teeth extracted and replaced with ceramic false teeth anchored with steel pins to his jaw. He raved about it. (Bob Talbert, who was also one of the speaking voices on the intro of What's Goin' On).

However, and I don't want to be unnecessarily negative, yours is a dumb plan. Dentures suck, on the whole, and it's generally cheaper to spring for some mediocre dental insurance rather than trying to remove all your teeth at once (do you have any idea how much that's gonna suck as far as eating goes?)
It's even cheaper to get braces, some root canals (what you have sounds like an abscess), and the rest of your dental work done than the scorched earth plan you've got now. Leave off the dental apocalypse, put your money toward decent care, and you'll likely be fine (though honestly, a dental surgeon consultation would probably be your best bet).

As for questions you'll want to ask in getting this dealt with:
Find your current dentist (you do have one, right?). Get them to recommend an oral surgeon (the two in Ann Arbor, though you're not here, are Payne and Fear, and I always hoped they'd get a practice together). Ask that oral surgeon about their policy regarding pain medicine. While not a complete picture, this will tell you more about the surgeon than most other things. He'll tell you whether you'll be put under or given local, and what other people have complained about. From my extraction experience, that's by far the most important attribute of a surgeon.
posted by klangklangston at 3:10 PM on December 13, 2006

Save yourself future grief. The low bid isn't necesarily a sign of poor care, but do whatever it takes to find the top provider in your area so you can get this done right the first time. U of M may have a dental school, and that might be a good place to start.

Good luck.
posted by foxy_hedgehog at 3:28 PM on December 13, 2006

I'll agree with those that have told you that you'll be ok on the 20th if you have it done now. I'm guessing the lump you feel is a small bone spur, that will need to be removed.

As for the rest of the proceedure, I neglected my dental work for a number of years, long story, not proud of it, last March I took the step to get the work done. I went to a dentist that did "sedation dentistry". He evaluated, recommended saving some lower teeth, but agreed the top were a loss.

The whole process took from March until May, you'll need a number of fittings for whatever plate/denture they recommend.

Find a good dentist who can recommend the best route, don't make any assumptions going in. They will likely recommend that you keep whatever teeth you can, they can anchor a plate to existing teeth, cheaper and easier than the peg in your jaw route, but the peg option is probably the best way to go in the long run if you can afford it.

And, as for the sedation dentistry, it was great, I remember nothing, felt nothing...

Good luck....
posted by HuronBob at 3:38 PM on December 13, 2006

Could the bump be torus mandibularis? Many people have them, and they're usually so harmless most people do not really notice them. They feel like a hard round bony bump and do not usually hurt.

The ones on the wikipedia picture are huge – they come in all sizes and can be as small as a matchhead.
posted by stereo at 4:38 AM on December 14, 2006

There's always dental tourism. I give this advice not to help you find someone who will remove all of your teeth, because in my opinion you really ought to reconsider that, but to tell you about cheaper options for reasonable dental care.

If you google "dental tourism" you will find some good options. Research them thoroughly. There is a company in Budapest run by Mellow Mood Group (terrible horrendous awful name I know) that I've heard some good things about. The Czech Republic is also good. Just make sure that whoever you go to, you have references references references for.

A friend of mine got a root canal and cap done by a very professional, friendly Croatian dentist in Prague for eighty dollars (this was in 1999). At that rate, you could get your teeth fixed up real nice and have a pretty little vacation while you're at it.
posted by jennyjenny at 6:10 AM on December 14, 2006