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Medical Forum / General / Dentistry / June 2007should I avoid these treatments if I plan on orthodontics next year?
Hi! I have been postponing orthodontic treatment for a couple of years but will start in this Winter. I have an immediate need for some fillings and I wanted to have a few other issues looked into at the same time. I was wonderng if anything would be a waste of time or hinder the subsequent orthodontic treatment.. Fissure sealant for high risk teeth Flouride varnish to reduce sensitivity on some receding gums Replace amalgam fillings with composite *Crown to replace a repaired tooth on lower left where there is 1/2 unit Class II occlusion I have a full orthodontic report available.. It's a huge amount of money to spend ($8000) without properly researching things.. even more so when you consider it will be re-treatment for orthodontics I wore 12 years ago. I hope there is some expertise here to help me make a more informed decision. > Hi! > I have been postponing orthodontic treatment for a couple of years but [quoted text clipped - 8 lines] > *Crown to replace a repaired tooth on lower left where there is 1/2 > unit Class II occlusion Provided all of this work is actually needed, your general dentist is the best person to ask if all of these should be done before the orthodontics. Without seeing you, it is impossible to make specific recommendations. For the things you have described, they are generally done before the orthodontics. However, your situation maybe unique so that not all of them should be done before. That's why your dentist is the person to ask. For example, if your orthodontics will potentially leave small spaces between some of your teeth, it may be best to wait until after the orthodontics to replace some of your fillings or do the crown. Please ask questions to your dentist. > I have a full orthodontic report available.. It's a huge amount of > money to spend ($8000) without properly researching things.. even more > so when you consider it will be re-treatment for orthodontics I wore > 12 years ago. I hope there is some expertise here to help me make a > more informed decision. This leads to the question.....why is re-treatment necessary in your case? What were you told by the orthodontist? Can you post photos of your teeth? For all of the other dentists on this group...is $8000 a lot of money for a re-treatment? Here in Canada, nonsurgical cases by orthodontists are usually no more than $6000. John 1. Aren't crowns, unless acrylic provisionals, done AFTER the ortho? 2. If mercury fillings are servicible, can't they be replaced AFTER the ortho? 3. In the areas of recession, usually the canine-premolar areas, is there ENOUGH attached tissue i.e. do you need epithelialized gingival grafts to increase zone of attached tissue, to withstand ortho forces, and that varnishing the exposed roots will not provide enough resistance to the forces. 8. Where are you located for this 8K makeover? Hi! Thank you for your prompt answers and sorry for the slight delay in replying. I very much appreciate that you guys are giving professional advice in a public forum. I have some images of my teeth now: http://www.chrismurray.eu/teeth/teeth2.jpg This is a general image showing occlusion http://www.chrismurray.eu/teeth/teeth3.jpg Showing receding gums http://www.chrismurray.eu/teeth/teeth2.jpg Showing the discoloration on 3 http://www.chrismurray.eu/teeth/teeth.pdf The orthodontic report I am in UK and the $8k USD quote is from a Harley Street Orthodontic practice. I'm a little sceptical about Harley Street in general - too many people just setting up there thinking that the location alone will give them adequate credibility and trust to get customers.. I'm also aware that I could probably fly over to Canada/USA and have treatment and a holiday for a cheaper price.. The ortho report doesnt mention it but I have lower 8/8 hidden under gums - they have grown sideways. Both top 6 have amalgam fillings. The original orthodontic treatment in 1996 was free under the NHS (UK's free dental care system) and removable retainers supplied which I wore for several years afterwards, but perhaps not long enough... I think there are better retention systems available to orthodontists now that were not available to NHS patients... to help keep them in the right place this time I have a little spare cash now to fix my teeth and my aims are as follows: 1. Improve occlusion and not have to "rock" my jaw from side to side to get proper occlusion on the left side 2. Staighten both arches 3. Replace the temporarily fixed lower left 6 with a crown 4. Replace the amalgam fillings with something durable and tooth coloured 5. Do something like fissure sealant to help prevent future decay on teeth at risk 6. Repair the front top 3 7. Whiten my teeth 8. be taught how to smile without looking like Cherie Blair 9. Repair or control the receding gums I cannot speak for what is a fair fee in the UK, but the treatment plan sounds right on. A final result like yours after any type of orthodontics in the past needs further clarification. This is not an acceptable final result, but I don't know what treatment was done and if any treatment was refused. The NHS is one reason I shudder when Queen Hillary of NY and Michael Moore start to spew propaganda about how we need national health insurance in the USA. I love it.  Signature/ Amatus / > Hi! > Thank you for your prompt answers and sorry for the slight delay in [quoted text clipped - 39 lines] > 8. be taught how to smile without looking like Cherie Blair > 9. Repair or control the receding gums > The NHS is one reason I shudder when Queen Hillary of NY and Michael Moore > start to spew propaganda about how we need national health insurance in > the USA. I love it. It is unlikely that any universal health care system that the US would introduce would include dental care, in my opinion. It would make an incredibly expensive situation even more incredibly expensive. AC, what is your issue with universal health care (ie. one that does includes medical procedures only, not dental)? NHS is a horrible example of universal health care. Other countries do it much better, but also, not without their problems. John Universal health care always ends up costing more than is reasonable for care that is usually restricted in some way. I would much prefer to see protection for medical personnel and facilities that do their best to take care of the patient (fewer frivolous lawsuits), and a properly tiered health care system, where you buy the level of care you can afford. Right now, everyone thinks they are *entitled* to Rolls Royce level of care. I think Buick or Mercury level of care would usually be adequate. Signature/ Amatus / >> The NHS is one reason I shudder when Queen Hillary of NY and Michael >> Moore start to spew propaganda about how we need national health [quoted text clipped - 10 lines] > > John >Universal health care always ends up costing more than is reasonable for >care that is usually restricted in some way. I would much prefer to see [quoted text clipped - 3 lines] >everyone thinks they are *entitled* to Rolls Royce level of care. I think >Buick or Mercury level of care would usually be adequate. What !? no Isletta level of care ? IMO the inherent nature of government bureaucracy makes most 'departments' the most inefficient delivery model possible. If medicare/medicaid is any indication of how national health care would work in the US it is easy to see how disasterous Hillary Care would become. The US system certainly has flaws but if the model is the UK or Canadian systems we're all in deep doodoo. Eventually both of these systems will collapse under their own weight and then you will have the government deciding who lives and who dies. JM2¢ > Universal health care always ends up costing more than is reasonable for > care that is usually restricted in some way. Yes, but a private insurance company to whom you pay your premiums would do the same, with a lot greater ease, in my opinion. > I would much prefer to see protection for medical personnel and facilities > that do their best to take care of the patient (fewer frivolous lawsuits), Fewer frivolous lawsuits in America? That will never happen. > and a properly tiered health care system, where you buy the level of care > you can afford. Right now, everyone thinks they are *entitled* to Rolls > Royce level of care. I think Buick or Mercury level of care would usually > be adequate. So, if I didn't sign up for the plan that allows a heart transplant (one of the most complex and expensive surgeries one can receive, equivalent to a Rolls Royce by your comparison) and I suddenly need one, how does that leave me? People who grow up with universal health care don't think that way. John NHS Dental care isn't that great but NHS medical care has been very good to me. We're definitely moving in the right direction with smoking bans and a tax rate proportional to your % bodyfat with tax credits for gym attendance/cycling to work etc.. Anyway.. I thnk we should start a new topic for discussing national healthcare systems - there's clearly some strong opinion. In the meantime would someone please comment specifically on the receding gums and discoloured top3? http://www.chrismurray.eu/teeth/teeth3.jpg Showing receding gums http://www.chrismurray.eu/teeth/teeth2.jpg Showing the discoloration on 3 1.Tooth/alveolar arch discrepancy (obvious that you had serial premolar ext. for ortho Tx.) plus 2. Thin gingival phenotype plus 3. Toothbrush trauma plus 4. grinding/clenching plus 5. occlusal disharmonies equals your multi-factorial problem. Treatment - gingival grafts, occlusal adjustment, Sonicare, NTI. Good luck with your Tx. Let us know what NHS dental says. I think the problem is that if you tell your MD/DO that you have a headache, you will get an MRI, a Cat-Scan, full set of cranial radiographs, blood assays, Ultrasound of the neck, etc. when all you needed was an aspirin now and re-eval to see if the pain goes away tomorrow. If you do need the Heart transplant, then you should be able to buy a level of care that has you recuperating (after IC unit) in a ward with 15 people. You don't all need a semi-private room. Signature/ Amatus / > >> Universal health care always ends up costing more than is reasonable for [quoted text clipped - 21 lines] > > John >I think the problem is that if you tell your MD/DO that you have a >headache, you will get an MRI, a Cat-Scan, full set of cranial radiographs, >blood assays, Ultrasound of the neck, etc. when all you needed was an >aspirin now and re-eval to see if the pain goes away tomorrow. A good physician will not order all of these tests. Perhaps s/he is hoping to avoid a frivolous lawsuit :) > If you do need the Heart transplant, then you should be able to buy a > level of care that has you recuperating (after IC unit) in a ward with 15 > people. You don't all need a semi-private room. When my wife had my son, we requested a private room. For this, at the hospital we were at, it required me to pay an extra $275/day (I have no other supplemental health insurance through an employer that would have covered this, but most people do). I wonder what this would cost in the United States? However, it may not be available when requested. A room with 3 others would have cost nothing more. The average stay after a heart transplant is only 12-15 days. John >> I think the problem is that if you tell your MD/DO that you have a >> headache, you will get an MRI, a Cat-Scan, full set of cranial radiographs, [quoted text clipped - 18 lines] > > John I think a private room cost us an extra $500 or so when our daughter was born. This was almost 11 years ago. Steve When Strad was born, all they had in the maternity department were private rooms. Signature/ Amatus / >>> I think the problem is that if you tell your MD/DO that you have a >>> headache, you will get an MRI, a Cat-Scan, full set of cranial [quoted text clipped - 24 lines] > > Steve |
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