<p>After a grueling session at the dentist today, I found myself really confused and I was just too exhausted (and embarrassed) to review what happened. This is not the dentist’s fault: he was explaining as he was working, but I guess I zoned out. It’s bothering me that I didn’t follow, and I am hoping that someone from this magical group of “parents-who-know-many,many-things” might provide some insight. </p>
<p>I broke a part of a molar tooth over the weekend. There wasn’t any pain (although it felt weird) and the break was under the gum line. Upon examining the area, my dentist said I would first have to go to a periodontist, but then changed his mind, and that’s when the ordeal (and the spacing out) began. At the end, I thought I was home-free, but then the receptionist checked and said I have to go back for a filling…wait…wasn’t that what happened? I feel like I am in a bad episode of the Twilight Zone (or maybe the Groundhog Day movie).</p>
<p>You shouldn’t be embarrassed. You were being somewhat distracted at the time with fingers and implements and injections in your mouth.</p>
<p>I think you should call your dentist office back tomorrow and ask for a synopsis of exactly what work was done. If you don’t understand parts of it then tell them you don’t understand so they can explain it in a different way.</p>
<p>(I’m not a dentist but have plenty of experience in the chair)</p>
<p>((((Hugs)))) Dental work stinks. But yes, you should call the office. I was having a cleaning this morning and they were talking about a patient who was dancing in the halls after his procedure…apparently didn’t remember a thing about it the next day…</p>
<p>GGD, You are right–I should call. I can’t be playing “guess the dental work” online. </p>
<p>KK, No mention of a root canal–I would remember that (I hope)! There is definitely a filling in the former broken area. I thought this was heading toward a crown, but apparently not.</p>
<p>stradmom, LOL! I was pretty chipper (get it, 'chip’per) starting the procedure. (In fact, after the injection, the dentist waited and then tested to see if the area was numb, and I goofed with him just a bit.) By the end, there was no dancing…not even a little spring in my step. Thanks for the hugs.</p>
<p>Obviously this is a general observation, not having examined you…
Several things can happen when you break a tooth. If it is a vertical fracture through the root of the tooth, it is non-restorable and needs to be extracted. If you broke a substantial part of the tooth, (I use the rule of 50%- if more than 50% of the tooth is missing or a filling, consider a crown/cap) it could require full coverage, that is a crown/cap to protect the remaining tooth structure. Now here is the complicating factor. If the break was due to decay that extended into the nerve, or the break exposed the nerve inside the tooth, or if there is insufficient tooth structure remaining to support a crown, it could require endodontic treatment (root canal). For a crown to succeed, it has to be placed on ferrule (solid) tooth structure and not filling material. If the break occurs below the gumline, it may require a trip to a periodontist for a crown-lengthening procedure to expose more of the tooth structure to fabricate a well fitting crown.
In your case, it sounds like, maybe, the dentist thought you might need a crown lengthening but considered otherwise and thought possibly the tooth could restored with a filling and not a crown. It is not cookbook and many times experience dictates what the recommended teeth is for an individual patient based on patient’s past experience (have they broken other teeth, hygiene?, occlusion) as well as the dentist’s experience.
Good rule of thumb is to ask for the dentist ( or any professional) to write down what he/she is recommending. With computers in the operatories, it takes all of 2-3 minutes to type it up and print it out and gives the patient peace of mind, cutting down miscommunication and eliminating the " what the heck did they tell me?" moments…</p>
<p>jandjdad, Thank you for the response–you have highlighted some of the issues and I appreciate your thoughtful reply.</p>
<p>Here is what I know: The molar already had a cavity filling in it prior to the piece breaking off. The dentist said that what broke off was actually a healthy part of the tooth (not from decay). He did say that I would need to go to a periodontist to have more exposure to make a crown. Then he said he thought perhaps I didn’t need to go to the perio if he cauterized some gum tissue. This is where I lost him. After the gum work, he said he was going to prepare the tooth for a filling…but did that mean instead of a crown? He tried the first time, but when I gently bit down (as a test), the filling broke. He said the problem has to do with the way I bite and the way the teeth align. He repeated the filling procedure and this time it held. Yay–I thought I was done–with no perio or crown! I go up front to check out with the receptionist, and here’s the confusing part: I need another appt for a filling. I am now thinking he meant he needed to do another filling for the original cavity area.</p>
<p>I like your idea of asking for a written-down version of the steps taken, especially when there is a change of plans during the procedure. I guess I am one of those people who like to know, and it bothers me that I was confused and too embarrassed to ask. Lesson learned.</p>
<p>Thanks again to those who replied, both here and privately. What a compassionate and wise group…but I already knew that! :)</p>
<p>I would think it is required by law in most states, or at least as a minimum the ethical thing to do, to give a dental patient a written recommended primary treatment plan after an initial exam. If you went in with a painful emergency, I can understand the dentist getting busy and doing work right away without having a written plan given to you first…but in normal mouth exams I think the dentist rightly upfront should give the patient a written evaluation with estimated charges.</p>
<p>lizard, In my particular situation, a written plan is not necessary. I have gone to my dentist for 20 years and value his judgment, level of skill and ability to communicate (and empathize)! I think your idea has merit if you are going for an initial consultation and are looking to evaluate the options.</p>
<p>just adding here–another thing I’ve learned is that there is more “art” to dentistry than I had orginally realized. Things aren’t black and white–each situation has variables and there may be more than one way to handle a given problem.</p>