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Medical Forum / General / Dentistry / June 2006Very General Question - Vague Opinions Wanted (Bad #17)
I'm serious, but since I no matter how close I hold my tooth to the monitor, general questions are about the best I can and vague opinions what I should expect! Years ago, a composite filling was put in #17 (I think; it's the one before the wisdom tooth). The tooth opposing it also was filled with composite by the same dentist and (I was told by another dentist) it was done badly, causing it to "blow out" and that tooth had to be extracted, so there is nothing opposing #17. #17 has since 'turned' so the chewing surface is grazing my cheek and is now very badly decayed. It doesn't hurt much, but it has an *enormous* hole on one side and less dreadful but awful decayed spot on the cheek side. I don't have dental insurance, and will be paying out-of-pocket. My first impulse is to have it pulled; even if could be pulled back into line, I have feeling it'd stray again since there's no opposing molar (I am not a candidate for implants, even if I did win the lottery). Aside from not losing (another) tooth, would their be any advantage to trying to save the tooth, perhaps with a crown? I have plans to discuss this in person with a dentist very soon, but would like to know a little more beforehand. Thanks!  Signature"Did Father shoot him? I will eat Grandfather for dinner." - Helen Keller, on learning of the death of her grandfather > I'm serious, but since I no matter how close I hold my tooth to the > monitor, general questions are about the best I can and vague opinions [quoted text clipped - 18 lines] > I have plans to discuss this in person with a dentist very soon, but > would like to know a little more beforehand. Thanks! You haven't given me any reason to doubt that your impulse to extract the tooth is incorrect. If there is a hugh hole and the tooth is in bad position, think of all the work that would be necessary to save a tooth that isn't chewing against anything! I have occasionally done crowns and even root canals on third molars. This is usually when it is the only back tooth on that side and it can serve as an abutment (holding tooth) for a partial denture. But the vast majority of these teeth should be taken out. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > > I'm serious, but since I no matter how close I hold my tooth to the > > monitor, general questions are about the best I can and vague opinions [quoted text clipped - 23 lines] > position, think of all the work that would be necessary to save a tooth > that isn't chewing against anything! I picture many, many dollars flying out of my wallet... > I have occasionally done crowns and even root canals on third molars. > This is usually when it is the only back tooth on that side and it can > serve as an abutment (holding tooth) for a partial denture. But the > vast majority of these teeth should be taken out. Thank you for your answer. Is the third molar the same as a wisdom tooth? If so, that impacted beauty is long gone and I miscounted my teeth; it's the one that would be in front of the wisdom tooth if it were still there (#16?). I'm still missing the wisdom tooth and the molar next to it on te lower jaw, so with the tooth in question gone, there'd be an equal amount of gum space above and below. Signature"Did Father shoot him? I will eat Grandfather for dinner." - Helen Keller, on learning of the death of her grandfather >>>I'm serious, but since I no matter how close I hold my tooth to the >>>monitor, general questions are about the best I can and vague opinions [quoted text clipped - 25 lines] > > I picture many, many dollars flying out of my wallet... First of all, I misspoke with my florid language. What I meant to say is that I agree the tooth probably should be extracted. The situation is a bit more equivocal for second molars (the tooth directly in front of the wisdom tooth--third molar). This is because root canals are more reliably done, and second molars usually have longer, more well-formed roots. >> I have occasionally done crowns and even root canals on third molars. >>This is usually when it is the only back tooth on that side and it can [quoted text clipped - 7 lines] > molar next to it on te lower jaw, so with the tooth in question gone, > there'd be an equal amount of gum space above and below. The answer I would want to give is very individual. It would depend upon the condition of the second molar (If you had to upright it, do root canal, crown, etc., what kind of shape would it be in afterward? Is it periodontally sound?), as well as your willingness to undergo the treatment necessary to save the tooth. If the tooth is not contacting any teeth in the opposite jaw, it is unlikely you will miss it for chewing. However, if your other teeth in this area are in poor shape and you lose them too, you may regret having removed the second molar so cavalierly. IOW, we have to look at the entire mouth. Of course, the other factor is that many dentists will no longer do anything like heroics to save a tooth like this. If it turns out you do miss the tooth, it is likely you can get an implant-supported replacement later. Ya, not cheap. The least expensive alternative is certainly removing the tooth and finding you don't miss it. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Of course, the other factor is that many dentists will no longer do > anything like heroics to save a tooth like this. If it turns out you do > miss the tooth, it is likely you can get an implant-supported > replacement later. > Ya, not cheap. The least expensive alternative is certainly removing > the tooth and finding you don't miss it. Thank you again. That's that what I suspect - due to its position and condition, it's best left out of my dentition. I have been told that due to my severe non-diabetic kidney disease as well as my diabetes that I am a very poor candidate for implants (too prone to severe infections and healing issues). This was a few years ago, and my kidneys have only gotten worse, so I suspect it's still true. Signature"Did Father shoot him? I will eat Grandfather for dinner." - Helen Keller, on learning of the death of her grandfather With kidney disease I would try to avoid potential hazards caused by rooth canal treatments / metal crowns. An additional advantage of pulling the useless molar is that you can take care for the largest and all important first molar as good as possible ( keep it clean ) so it will stay in the best condition possible. Erik REPLY If you see Jan Drew, ask her opinion ..... *** You wrote, Re: Very General Question - Vague Opinions Wanted (Bad #17) -------------------------------------------------------------------------------- With kidney disease I would try to avoid potential hazards caused by rooth canal treatments / metal crowns. An additional advantage of pulling the useless molar is that you can take care for the largest and all important first molar as good as possible ( keep it clean ) so it will stay in the best condition possible. Eri -- Joel34 > REPLY > > If you see Jan Drew, ask her opinion ..... HA! I'm the one with the bad teeth (and kidneys) and I'm going to have all my composites replaced with amalgams. These goddamn composites have been nothing but trouble and have cost me three teeth, including my soon-to-be-gone molar. I don't know if it was bad dentistry (placing such large composite fillings in molars or just bad work) or that composites suck, but I still have the teeth with amalgams. I less than three amalgam! Signature"Did Father shoot him? I will eat Grandfather for dinner." - Helen Keller, on learning of the death of her grandfather
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