Dental Saga, part 2

[drwex]

Summary: things are basically OK. Just complicated and continuing.

Things had been going along just fine - well, except for one small thing - until about 2PM today when the temporary crown popped off. Oops. I was already scheduled to see the dentist at 5 so I went in at the appointed time.

Examination showed that the gum, although properly healed from the first surgery, was in fact still in a position to interfere with a permanent crown, which means I need serious gum surgery. Of course, the surgeon only works one day a week and is booked pretty solid. On the other hand, the desk people assure me that people cancel appointments for gum surgery all the time. I wonder why. So maybe I'll get in sooner than the presently planned three weeks.

During the three weeks I'm still wearing a temp crown and can't chew at all on the left side because the temp crown doesn't sit properly either. In fact the first attempt to put it on resulted in the damned thing popping off immediately, which was really annoying and now I'm twitchy about it popping off again.

Speaking of joys, that little thing I mentioned? Yeah, um, I chipped another tooth. The dentist looked at it and pronounced it basically sound, but once we're done with the current saga we'll start on that one. Can you tell how excited I am?

Sigh. It's my own fault. As a child and teenager I was crap at caring for my teeth and had untreated reflux pretty much all the time. As a result I have a lot of large fillings. Considering the fillings are supposed to have a lifetime of around 25 years it's somewhat impressive that they've lasted this long and I didn't have problems earlier. It's just that sometimes I want to reach back in time and talk some sense to younger me.

Comments

[wotw]

I recently suggested to my dentist that maybe it would make sense to remove all my old silver fillings and do pre-emptive root canals *before* the inevitable trouble starts. He had trouble taking this seriously, though I'm still not sure why.

I repeat the following second-hand

[drwex]

My dentist is one of those nerds who enjoys reading the research journals as relaxation. Here's what he told me:

Pre-emptive root canals have a very bad track record. There's nothing artificial available today that beats or even comes close to what natural teeth can do. A living root should always be maintained. Root canals always come with some risk (however small) of infection and a deep infection is always very very bad.

There is good evidence that it's better to remove fillings and crown, on the other hand. The crown's physics are such that it protects the tooth core and even though crowns have notably shorter lifetimes (5-10 years) than fillings (25+ years) the filling induces stresses that tend to split or crack teeth. Crowns also have an infection risk but it's much easier to deal with.

Again, all the above is hearsay from chatting with my dentist. You might ask yours about pre-emptive crowns.

Re: I repeat the following second-hand

[docorion.livejournal.com]

Well, that jibes with the limited amount I learned of dentistry from a) chatting with dental students (one of them was a regular guy-I-hung-out-with for the first 2 years of med school) and b) later study because I got curious about the matter (a *lot* of dental problems end up in the ED. We must see you; dentists may see you after you propitiate the proper gods with the appropriate number of chickens or whatever).

It's true of biological things generally-nothing we can do or make using engineering materials (titanium, steel, plastics and ceramics), in general, better than what you have, with very limited edge cases. Artificial knees/hips? Yeah, wear out after about 10-15 years, sooner if you're an active person. And you can only get so many retreads on those things before they can't be retreaded. So orthopedic surgeons, for instance, try Really Hard to fix joints in young people, instead of replacing them. Because you only get 3-4 artificial joints, and they work less well with each iteration, despite the fact that they're probably better with each generation.

[chienne-folle.livejournal.com]

Sorry you have dental crap to go through. And I know what you mean about wishing one could go back in time and talk some sense into one's younger self.

Yeah.

[taura-g.livejournal.com]

It's just that sometimes I want to reach back in time and talk some sense to younger me


So. Right. There.

[c1.livejournal.com]

It's just that sometimes I want to reach back in time and talk some sense to younger me.
But would he have listened?

I like to think so

[drwex]

Younger me lacked close adult male role models; he tended to listen to the few he could find.

I was just telling Pygment the necktie story, which relates to this.

[mrf-arch.livejournal.com]

Ugh. My sympathies on the pain and nuisance value.

Thanks

[drwex]

ISTR you've had your own share of these things.

[quietann.livejournal.com]

Sounds more than a bit unpleasant.

I grumble every time Ben and I go to the dentist; he *never* has anything wrong and I don't even think he's ever had a filling. he had not gone to the dentist for 10 or so years when I finally dragged him in, and there was *nothing wrong*. And it's not like he's perfect about brushing and flossing.

I OTOH have basically good teeth, but have been through 2 rounds of orthodontics, have a permanent retainer to show for it, have 2 crowns and a bunch of big fillings.

Yeah there's a large genetic component to it

[drwex]

A couple decades ago there was some work done on a vaccine against the bacteria that are primary causes of tooth decay. But there's so much variability that producing a vaccine that would work in wide use has proved elusive.

[blackanvil.livejournal.com]

Yeah, I had a filling go bad a couple of months ago, and during the follow-up, I heard the disturbing comment "That filling will be the next to [abscess]" If they know it's going to go bad, why not fix it now? Well, yeah, there's additional risk, and who knows, if it can last another few years, maybe the state of the art will improve enough to save it.

Lots of reasons

[drwex]

The state of the art isn't going to improve that much in a few year. However, dental work is expensive and even the best insurance rarely pays for this sort of preventive work. At best you might get it 50% covered which means you're going to be out of pocket many hundreds of dollars. Plus even people with good dental insurance have yearly limits and using up your yearly limit on work that isn't strictly needed right now can leave you out of pocket for MORE thousands if an emergency arises.