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Medical Forum / General / Dentistry / February 2007

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Dental History & Evaluation requested

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kwthom@gmail.com - 12 Feb 2007 01:37 GMT
Greetings to the group!

First-time post; have read dozens over the last several hours here.
For your review and comment, I present my personal dental history -
opinions are welcomed on what I should consider for my course of
treatment. (yes, I've been doing a large amount of reading & educating
myself...but I'm still shaking in my boots...I gotta get over this!)

Would a written history such as this be beneficial to a provider?

4? year old male presenting with classic symptom-driven treatment for
dental issues for the past 17+ years.  Dental anxiety exacerbated by
moderate trypanophobia and concern over dental treatment costs.
Dental insurance coverage by employer limited to $2000 per year;
expect to have additional expenses for work not covered by insurance.
Ideally, present insurance coverage would cover a nominal percentage
of the costs associated with treatment, with balance covered by
financing if necessary.

Goal would be serviceable dental remediation over several visits to
occur before year end 2007.  Ideally, all work would be performed by
caring & compassionate staff in small "mom & pop" dental
surroundings.  First item of time line below would be first treatment.

Personal dental history and time line:

January/February 2007 - #31 moderate evulsion; highly mobile (~1/2
tooth width side-to-side) - discovered after eating popcorn - tooth
initially abscessed?  Suspect tooth requires removal.  Periodic
episodes of pain lasting one hour or more, followed by several hours
of no pain.  Tongue periodically "plays" in that area, which agitates
the pain - cycle repeats.  Two or three episodes of pain daily on
average. 500mg acetaminophen --or- 25mg ketoprofen used to treat as
needed.  Beginning to lose sleep due to pain.

July 2004 - #13 - Auto-extracted - tooth ruptured (large cavity
filling disintegrated) into two major pieces; probable root fragment
in gum line; no pain at present time.  Did not seek dental
professional at this time.

~1998 - #4 - Professionally extracted.  Due to "lecture" of dentist
during this visit, no further treatment was considered, though needed
at the time.

~1992 - 1994 - #9 chipped; periodic fragments of tooth detected.  Rear
surface of tooth currently ~50% intact; unknown if candidate for
restoration by any means.

~1991 - Both #8 & #7 professionally extracted; no. 7 was quite mobile,
with receding gumline and bone for quite some time.  Last cleaning
performed this time; due to dental condition at the time, performed in
four quadrants (deep cleaning?) by R.D.H. (unknown) with local
anesthesia.  Refused to return to office after second treatment, due
to unsupportive office staff over financial issues. (office eventually
was paid full amount)

~1990 - #2 root canal & crown installed; one large filling #30 - same
office as above.  Probable last thorough cleaning I've had.

~1978 - No. 1,16,17 & 32 extracted under general anesthesia by oral
surgeon recommended by orthodontic treatment.  Experienced some
difficulty in recovery from anesthesia; dry sockets.

1973 - 1979 - Orthodontia in Cal. (1973-1975) and Az (1975-1979).
During this time, #4d or #3d (can't recall specifics) was removed by
oral surgeon and #6 was exposed, and brought into place during
orthodontic treatment.  Major portion of ortho treatment was to
correct underbite condition; part of treatment was shaving between
several teeth in front by ortho in order to make room to shift and
adjust position.

Minimal dental visits during childhood - estimate one (or less) per
year from 1965 thru 1971.  No visits recollected to general dentist
from 1971 thru 1974.

Obviously, thirty-plus years of neglect is going to cost some coin.
I've read my options; implants, immediate denture, bridgework, etc.
and I'm really at a loss.

Do I start with a general dentist, then get referred to a
prosthodontist, or should I just find a prosthodontist and start
there?  How much work would a typical general dentist perform?

So many questions...be gentle with your answers.

Thanks for your time.

K.
Steven Bornfeld - 12 Feb 2007 03:32 GMT
> Greetings to the group!
>
[quoted text clipped - 84 lines]
>
> K.

    Find a good general dentist.  You have prosthetic needs clearly, but
also clearly periodontal and likely other needs.  Let the dentist make
referrals as necessary.  The alternative is to go to specialists in a
piecemeal fashion, and your treatment is almost certainly going to be
complicated enough to have someone to pull it all together.

Good luck,
Steve
 
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