Can't tell from afar if your new dentist is legit or not.  She does sound
like a bit of a salesperson, although there's nothing wrong with presenting
all of the potential, legitimate improvements - from a dental viewpoint -
that could be made for you.  Obviously, a great deal of dental work is
elective from a biologic standpoint, i.e. no impact on your physical
health, such as the Invisalign & bleaching.  I will point out the potential
for bleaching to a patient if I think their tooth color is really having a
negative impact on their appearance.  Same with orthodontics.

And it's certainly legitimate to address a 7 mm pocket. I'd think the
"gingivectomy" was just a localized procedure - I'd hope she wasn't going
to surgerize your entire mouth for one tooth surface of pocketing.  I do
have to wonder whether there might be a nonsurgical approach that'd work
for you.

Are her fees high?  You'd have to ask a local dentist that.  $1300 for a
crown would be a lot in Upstate NY, although there are certainly dentists
here who charge that, most of them prosthodontists.  "Average" would be
about $800.

You want my gut feeling?  Here it is, and the disclaimer is that I may be
completely wrong 'cause I haven't examined you myself: There are two types
of dentists, philosophy-wise, where I live.  The first group pretty much
pushes only the minimal amount of of dentistry that is necessary to
maintain a healthy dentition.  They might mention bleaching, orthodontics,
bad breath management and other "elective" treatments as they see fit, but
they're basically conservative clinicians.

The other group is - you guessed it - the marketers, the docs whose vision
is laser-beamed onto their gross income rather than their patients' needs.
They push bleaching and orthodontics at patients who don't need them, they
replace fillings that are completely servicable, they crown and onlay teeth
that don't need it......and the sad thing is, they make a more money than
group one.

But group one sleeps better.  Frankly, your new doc sounds like group two.
If you've truly been advised to replace all of your old fillings when a doc
declared you dentally fit 2 years ago, then either (a) your teeth are
falling apart awfully fast for a healthy young guy (b) doc #1 was
incompetent or (c) doc #2 is one of these "marketers".

Drop 40 bucks and get a second opinion.  If you don't know who to see, ask
your friends, ask a dental lab, ask a periodontist, ask at a dental school.

No way to be specific without an examination.  Often the first line of
attack of to scale and root plane the offending area, then re-evaluate.
Some offices like to open the tissue right away to make sure they can see
the roots and get them perfectly clean.  $345 is too much money for a one
tooth gingivectomy, but it would be right for osseous surgery in a quadrant,
so I don't know what they want to do.

However, reading your quotation:

makes me very suspicious.  If you don't like the looks of the amalgam
fillings and want them removed, that is fine, but don't do it because the
dentist does not like them.  Good amalgams will last for decades and CAUSE
NO HEALTH PROBLEMS.

Possible but unlikely.

When in doubt seek a second opinion.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com

<snipped for space>

Whew!!!

t, I've got a bit of advice for you.  You can call me sexist,
old fashioned, bigoted, anything you like, but it's advice
I live by.  I DO NOT seek medical or dental care from women
or minority providers.  However, I AM NOT claiming that ALL
women and minority MD's and DDS's are incompetent and/or
$ grubbing with little thought of much else, but *statistically*,
you're gonna be better off with a white male.  For some time
now, members of the previously mentioned groups have been much
sought after by the medical and dental schools of America.  Rules
have been bent to get them, and keep them.  I believe that many
of these graduates went into their field out of something other
than love of helping people (and making a little money at it of
course).

I have recently been seeing a dentist, for the first time in
several *decades*.  (BTW, he is astounded by the good condition
of my bone, gums, and teeth, which I've been aware of all along.)
I chose a Southern (like me), white gent, age 40...I actually
check all this stuff out.  I think I made a good choice, as I
have no doubt of his professionalism, even if he did hit me with
a $1200 crown.:)  But your experience reminded me a little of
an experience I had with a woman dermatologist 10 years ago.  I
had made an appointment with a white male derm. because of a
funny looking, and growing, dark mole on my chest.  The guy doc
did do the cutting of the thing out for the pathologists, but when
I went back a week later to get the stitches ripped (no exaggeration)
out, his female bimbo MD associate did the honors.  While she had
me in her grasp, she reminded me that they'd be glad to take any
of the other (normal, small) moles I had off too (for a nice fee
for each one of course)!  Sheesh.  I politely declined her offer.

It sounds like your choice was particularly egregious with her
actions.  I wonder how long she'll last...

--
Cliff

Tim,

Nothing that is in your post appears unusual to me.  My advice to
everyone is that it is always a good idea to get a second opinion when
you are facing this much treatment.  You will either find a treatment
that you like better, or you will confirm this dentist's diagnosis.
Either way you win.

Dentists have different philosophies.  One dentist may believe that it
is better to allow things to slowly get worse until the patient needs
even more treatment than you describe or even dentures while another
may be very adept at finding problems early and heading them off.

For example, a patient came into my office having broken a tooth.  I
could have fixed it with a crown, but that would not have taken into
account why the tooth had broken.  This patient had broken the tooth
and then a few fillings previously.  It ended up that he had a
malocclusion (bad bite) and needed braces to even the biting pressure
on his teeth.  His teeth had no spaces, and his front teeth were
straight, but his bite was causing serious wear to his molars.  When
the orthodontic treatment is finished, a crown will do the trick.

Get your second opinion, keep an open mind.  don't listen to sexists
and bigots.  My dentist is a woman and so is my eye doctor; I wouldn't
have it any other way.

Dave Leader, DMD