Any dentists here in Club Cobra Land? Need opinions/advice

[blykins]

I had my routine 6 month checkup the other day, with x-rays.

The dentist found a cavity on the back of my #2 molar (passenger's side, rear). The thing is, it's under the gumline.

He's wanting to laser away the gum tissue there, then drill and fill as normal. I didn't have time for him to do it then, so I made an appointment for a later date to have it done.

I've been researching a little since then, and I've found that there is a lot of evidence saying that it's not a good idea to do what he wants to do for a couple of reasons: 1. It's hard to drill there and not upset the nerves in the tooth, which could be reason for a root canal later on. 2. Lasering of the gum tissue sometimes necessitates a tissue graft as the tissue will not grow back.

Anyone ever had this done? Anyone a dentist? Anyone play one on TV?

I'm thinking I should get a second opinion and it may be worthwhile to just have it pulled.

[Ron61]

Brent,

I am not a dentist by any means but had a very similar thing several years ago. Except my gums had actually grown up through the cavity and over the edges. I had to go to an oral surgeon and he immediately told me that the tooth had to come out. He cut the gum away from the tooth and pulled it as he told me that trying to fill it or do a root canal was just putting off the having to pull it. Maybe with the newer technology they can do it and not have any problems later. Best of luck either way as it needs something done.

Ron

[blykins]

Thanks Ron. I think I may make an appointment with an oral surgeon or a periodontist and get another opinion.

[Fox]

I am an oral surgeon...

and you problem comes down to the degree of decay. The shallow decay has a much better prognosis. The deeper it is or the closer to the nerve of the tooth, the more likely a root canal treatment will be required. That hard to assess clinically or on an x-ray. Sometimes that decision is best made after cleaning out the decay and seeing what is left. If the wisdom tooth in that area is present I might be more inclined to recommend to restore it, rather than manage the empty space. If it is the last one in the row and significantly decayed, I might be more inclined to take it out.

I would be all for seeing you get a second opinion... The more heroics to save a tooth, likely the poorer the long term prognosis. Keep in mind that this opinion is from a guy who makes his living taking them out...

-John

[blykins]

Thanks John.

That wisdom tooth is gone. I'm going to make an appointment with a periodontist this week and see what he says.

[blykins]

Hey John, do you think I should see a periodontist, or an oral surgeon?

[Fox]

As an oral surgeon I will say that I tend to think in the bigger picture... restorable or non-restorable / keep or extract. As far as teeth go, if all you have is a hammer everything tends to look like a nail and your opinion would likely not be all that clarifying.

As for how would you restore or prognosis, you will likely get a better answer from someone else.

Your dentist who does fillings says he can do it and if the nerve tissue was involved then the endodontist (root canal specialist) or your dentist could do the root canal treatment.

A periodontist on the other hand would be able to give feedback on whether a graft would be needed or what might be the consequence if a gum tissue graft was needed and not done. Seems to me that is the issue and I think that would be the place to get the second opinion.

Hope that is helpful. Let me know how it goes.

-John

[blykins]

Yes, that was helpful, thanks.

[undy]

The light weight aluminum fillings will allow you to bite faster, with greater precision. The steel fillings will provided more torque for greater chewing and a greater impact whem you chomp, although not quite as fast as their aluminum counterparts. I actually like the quicker aluminum fillings. It all depends on jaw construction and weight..

[jpfletch1]

I am a periodontist, send me a email with your number and I will give you a call. I do this every day. jpfletch@pacbell.net

[blykins]

Dave,

JP, I'll give you a call tomorrow. Thanks for the help.

[trularin]

I see the signs of maturity are evident in your recent results from the dentist.

First -- JOHN, I LOVE YOUR AVATAR!!!

Brent, you have got to stop using your teeth when working on those engines.

My best wishes with a speedy recovery!