Hi,

My #7 and #9 crowns (upper front teeth that is) need to be redone for
cosmetic reasons (darn, they were made 5 years ago by the most
expensive doc in town). And now #8 needs extraction. My prosthodontist
recommends putting a temporary bridge over the three teeth.

My question is, just how badly does my #8 need extraction. This
question is important for me for two reasons: 1) the surgeon's first
available oppening is not until May 18th, and that's for consultation
only; 2) I need to go to Russia ASAP, for up to half a year.

Now a little about #8. There is not much left of it. It currently has a
crown glued to a post, and the whole thing falls off once or twice a
day when I eat or talk, so I try to avoid doing either of those things
in public. :-(  While in Russia, that crown+post fell off and would not
fit back into the root canal. A dentist pushed it into the root canal,
which was painful, and the gum around became all white, I could see
that. He concluded that the root therefore must be cracked, with some
gum tissue protruding into the tooth (?). He said the crack can't be
seen on the x-ray because it goes sideways, parallel to the x-ray film.
He claimed that the whitening of the gum was not caused by him pushing
the crown directly against the gum - in fact, he said it was not even
touching the gum outside of the tooth perimeter, of which I was not
entirely sure.

I sought the 2nd opinion about that #8, again, in Russia. Before I
could say anything, the doctor forcefully pushed the crown into the
root canal (which almost made me jump up to the ceiling), cut off a bit
of gum she said has overgrown, and now the crown does again fit. At
first, she said there is no crack; however, when I mentioned the 1st
dentist's opinion, she probed more carefully inside the root canal, and
sure enough, the probe went into the tooth structure on the right, I
felt it, and she said "here is the crack".

The 3rd opinion comes from an experienced American orthodontist. He
probed, did not find any crack; however, when I relayed the above to
him and asked to probe again, he said that tooth needs to be extracted.
He did not probe again however. Perhaps this was because we were away
from the chair by the time and he did not have any more time for me.

So what do I do? My father is there alone in Russia, waiting for me to
come. He is old, and it's not good to leave him all by himself. Despite
the fact that Russian dentists somehow get all that fancy high-tech
equipment way before Americans do (no, seriously), there is no
accountability there. No law. You are completely at the doc's mercy,
especially if they think you are rich. In the absence of a very strong
referral, I was not successful in finding a dentist I felt I could
trust. Just trying to make most of less than ideal situation..

So what do I do? Go ahead with the plastic temp bridge (a $1,500 thing
which I was told can last up to 2 or 3 years), fly to Russia, monitor
the bridge carefully (x-rays are cheap there, and I can send them to my
American dentist or perhaps even post them on this board), and then
extract the tooth at the first sign of trouble? If so, do I cement the
bridge permanently or temporarily? What are my risks? If the tooth does
go bad, will I have symptoms? Just how bad can it go?

Thanks in advance. My hat goes off to the dentists who are passionate
enough about their work to help people here on the voloneer basis.