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Medical Forum / General / Dentistry / May 2006

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Rotadent versus Water Pic

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Tony Sivori - 22 May 2006 02:53 GMT
My teeth, the ones left anyway, are in very good shape with the exception
of one upper wisdom tooth and the adjoining molar. They both have mild
periodontal disease. If memory serves the numbers mentioned were 3 to 5
mm. The hygienist said my plaque control above the gum line was excellent.

My dentist wanted me to buy: a $100 Rotadent, get a $30 prescription
antibiotic / fluoride rinse to use at home, then come back for a deep
cleaning plus pay for a $30 numbing treatment and $300 antibiotic
(Arestin) (both to be applied during the deep cleaning) and except for the
cleaning none of which is coved by my Delta Dental (although my
prescription coverage would probably pick up the $30 antibiotic rinse).

The whole thing was going to be $400 out of pocket for two teeth with a
mild periodontal problem. This all seems a bit much, to me. So a few
questions:

How much do dentists make from the sale of a Rotadent, and the brush
refills? Given the mild state of my gum problem, might a $30 water pic
work just as well?

Plus, when I hit the ceiling for $300 worth of not covered by insurance
antibiotic, he readily reduced it to 5 surfaces which came to $84.

Would it be reckless to try a water pic, perhaps filled with Listerine,
and extra diligent brushing and flossing of those two hard to reach teeth,
then a follow up  surface cleaning (covered 100% by my insurance) late
this year to see if the periodontal problem was in retreat?

Years ago I had a wide spread periodontal problem, bleeding gums and the
like. But a lifestyle change got rid of that - now I brush, floss and
gargle like a madman. Would it be too much to expect to lick the remaining
two problem teeth without spending $400?

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Tony Sivori

Steven Bornfeld - 22 May 2006 03:33 GMT
> My teeth, the ones left anyway, are in very good shape with the exception
> of one upper wisdom tooth and the adjoining molar. They both have mild
[quoted text clipped - 28 lines]
> gargle like a madman. Would it be too much to expect to lick the remaining
> two problem teeth without spending $400?

    I'm personally not comfortable with selling merchandise out of my
office, because it brings up these issues of conflict of interest.
    There's nothing wrong with Rotadent, and I have no idea what your
dentist's markup is.
    Personally I'd make sure your oral hygiene is the best it can be, do
the deep scaling and re-evaluate.  I wouldn't be suggesting Arrestin
beforehand, as you may get enough improvement with the deep scaling to
make the Arrestin unnecessary.
    In any case, I'd consider which upper teeth you have left.  If you have
a decent complement of teeth in your upper jaw, and esp. if the pocket
is between the wisdom tooth and second molar, I'd think seriously about
removing the wisdom tooth.  This is sometimes a difficult area to keep
clean, and unless it's a strong potential holding (abutment) tooth for a
bridge or partial, you're going through a lot of effort to save what is
often a low-priority tooth.

Steve
Tony Sivori - 23 May 2006 05:04 GMT
>> Would it be reckless to try a water pic, perhaps filled with Listerine,
>> and extra diligent brushing and flossing of those two hard to reach
[quoted text clipped - 8 lines]
>     In any case, I'd consider which upper teeth you have left.  If you have
> a decent complement of teeth in your upper jaw,

I have an upper partial that is partly held by the molar that is next to
the wisdom tooth. The partial replaces three front teeth (two front most
and one adjoining), and one molar on each side.

> and esp. if the pocket is between the wisdom tooth and second molar,
> I'd think seriously about removing the wisdom tooth.  This is sometimes
> a difficult area to keep clean, and unless it's a strong potential
> holding (abutment) tooth for a bridge or partial, you're going through a
> lot of effort to save what is often a low-priority tooth.

I hadn't thought of that, that is definitely an option I'll consider.
There is no lower tooth below the wisdom tooth, so it is doing me no good
as far as chewing. I'm somewhat reluctant to make extraction a first
resort, but if it turns out to be aggravating the problem, out she comes.

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Tony Sivori

 
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