<p>You sound exactly like my dentist! I would go to you in a heartbeat.<br>
It’s great to get feedback from a dentist on this thread. I hope everyone will read your post.</p>
<p>zeebamom –</p>
<p>I didn’t realize there were any dentists that still clean teeth. I thought they all have dental hygienists. The last time I had a dentist who cleaned my teeth was when I was in high school over 35 years ago.</p>
<p>Proud Mary –</p>
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<p>It just strikes me as being very odd that all of your fillings wore out at the same time unless they were all approximately the same age.</p>
<p>The dentist we use does not accept our insurance so he is VERY honest. We have a business trade going with him. We went to him because I got jerked around when it came to a root canal and subsequent crown that went along with it…our dental coverage is pretty weak and out of pocket expense was steep…turns out , one of our customers makes all of the crowns for the dentists in several counties in our area . When he told my husband how much he charges the dentists for the crowns , we made a deal with him ( also his brother is our dentist now ) We travel over an hour to see him , but we love him as well as his hygienist .
I have felt scammed by dentists more than once so finding this doc makes me very happy !</p>
<p>As for the honesty of roofers, my friend had her roof replaced. Being a flat roof, she got a rubber roof, which is more expensive than the usual. A few years later when a problem, occurred, the person checking it out told her she needed a rubber roof??!? Yep. She had gotten ripped off. that other roofer even left a tar bucket up there all of those years that she had not noticed. What did she know.?</p>
<p>Also I pad for gutter cleaning and vent cleaning that did not happen. Barely a quarter of the job was done.</p>
<p>During the past year both D’s visited dentists and were each told they needed 7+ fillings…one, more than 10. Neither had ever had a filling and both were very shocked and called me in panic. I set up an appt for them to meet with their childhood dentist in another state for a second opinion. She told us that it was a philosophical issue. Imaging is now very good so previously unseen potential trouble spots show up on X-rays and the philosophical question is what to do about them. Apparently, many dentists feel they should be treated and filled before they get any worse, but the down side of so doing is that any filling will need maintenance over the years. Her approach was to wait and see because frequently they don’t get any worse and given both kids were beyond the age where they were most likely to develop cavities, she felt the chances were good that they did not need treatment at this time.</p>
<p>I think we need to figure out where the dentists go when they need to see a dentist. They probably have a much better idea of who would be competent than we do unless it’s blatant as some of the posters have run into.</p>
<p>I agree with turbo as well - some people have no idea about dentists so their recommendations are IMO invalid. My W has never had a cavity so her opinion on the dentist means nothing to me. Not only that, but unless a dentists commits detectable fraud or is rough and hurtful, I think most people don’t really know if their dentist is making the best decisions in the interest of the patient or not. I’ll bet a lot of the dentists doing unnecessary work receive plenty of recommendations because their patients don’t really know what’s going on. It’s scary if you think about it.</p>
<p>Most of my fillings were from when I was 9 or 10 to my early 20s, which, by the time I had them replaced in my 50s were 30 - 40 years old. The process of them wearing down (and out) was on-going and some were in better shape than others but I think it was a good decision to replace them before the corroding led to bigger problems.</p>
<p>At this point, my whole family, my brother, SIL his Ils and close friends all go to this dentist and he does a lot of work on some of us, and only cleaning and exams on others. DH passes the exams with flying colors as do most of my kids. One has my lousy soft teeth and has be careful but he’s been in the clear. My one son broke a tooth and so had to go through reconstruction, but no cavities involved. I’ m the unlucky one who gets referred to the specialists. </p>
<p>I’m telling you , had I replaced all of these filling about 3-5 years ago, I would not be in the situation I am in now. Once they are over 30 years old, I think they are at risk, and really, it’s smarter to give them another 30 year lease while they are still in good shape and know decays or issues have arisen. You want to replace them before they wear out, not when the first sign of it shows up, because decay can be the first sign. LIke Proud Mary, my fillings were from elementary school till my teens. And I think replacing them in one’s late fortys, early fiftys in terms of age is a smart idea. When crowns, oral surgery, endodontists have to get into the picture, the cost, the time, the trauma, the pain is really way up there. I am living it right now.</p>
<p>I understand what you’re saying, but I still agree with the conservative or minimalist approach that dentmom4, my dentist, and the ADA advocate.</p>
<p>Some dentists simply see $$$ when they see good insurance. The good ones know what to do and what NOT to do procedures wise. Ours will not do extractions or Endodontics aka root canals. He has a cadre of specialist buddies that do some pretty crazy far out stuff (redo root canal from the gum instead of taking the old one out - previous clown did not fully remove the root). The procedure was half the cost and zero pain.</p>
<p>We also found out in-network is rarely worth it…</p>
<p>Cpt- I am in the same boat with huge aging fillings. It is hard to predict the exact order of when each will fail and how to walk the line between crisis and being pro-active. This week I lost a huge piece of tooth around an old filling. Another crown. I am now tipping towards pro-activity as they all need replacing relatively soon and it feels better to anticipate it.</p>
<p>Travelnut, that is exactly how my problems started. After that first one, they all started going like dominoes. In less than two years, I’ve gone from perfect dental check ups to constant work on my teeth which I think will go on for the next two years. I have major work now that has to be done on all four main molars. That’s before even addressing any prophylactic measures. I’m so upset about the extent and expense of this. </p>
<p>I will tell anyone that with fillings that are showing even a bit of wear or are hitting the 30-40 year mark to get them replaced even if “it’ain’t broke”. And I am not a dentist trying to make a buck, but a patient making the dentist’s buck". This is really a major expense and ordeal for me.</p>
<p>After reading this, I feel so fortunate. I love my dentist, and I love his hygienist, who he’s had for the last 20 years I’ve been going to him.
The hygienist gives me a really hard time if I’m not doing my job of keeping my teeth really clean. I get a professional cleaning every 4 months, and she insists that I floss and use these little brushes between my teeth every day. I have to say it helps a lot. I don’t like to be scolded, so I really try to keep my teeth as clean as possible. :o
I did need to re-do a root canal last year on an old crown, so my dentist sent me to an endodontist for the procedure, which was expensive. I need a new filling this year, but my dentist always shows me the xrays where the problem is, so it’s hard to argue when you see it there in black and white. I don’t feel I’m being ripped off. In fact, when my insurance reached it’s limit last year, my dentist charged me the lower amount that I would have paid with insurance for the remainder.
What I really appreciate is that he understands that, because of my cancer meds, I can’t ever have a tooth pulled, so he takes my dental health very seriously. He is pretty pro-active, and will fill a tooth as soon as any decay becomes evident. That’s fine by me. It’s so much better to take care of the little problems before they become big ones. I still have 3 of my 4 wisdom teeth, and all of the rest, except for one, at 62. My grandmother had a full set of false teeth by the time she was my age.<br>
We should be grateful our dentists are helping us keep our original teeth that probably weren’t meant to last 80 years.</p>
<p>I am on my 3rd or 4th also, Cpt. All remaining vintage fillings will have to be replaced. Now all I “want” to do is cross them off the list as done. I can’t outrun them so I want to tackle them ASAP. Big ticket items, but I am feeling that the sense of relief will be great. A lot becomes cumulative as one ages, so at least this can be mostly off the table. </p>
<p>Good luck. I concur completely with getting these assessed and addressing them systematically if they are showing wear and tear.</p>
<p>We lucked out in that most of our dental work was done when we had the Golden version of dental insurance and coverage was much better. </p>
<p>Crowns and the like used to cost $400, or $800 with a root canal. And insurance paid 80% of UCR which was what most dentists charged. Yearly max was $2200 or so. </p>
<p>10 years later a crown & root canal is $1500-1800, of which only 50% is covered (crown) and yearly max is $1800.</p>
<p>The free market is working its magic I guess.</p>
<p>turbo93, we are very fortunate to have excellent dental insurance. Ours pays 80% of UCR for root canals and crowns. Pays 100% for just about everything else except cosmetic stuff. There has only been one year when I exceeded the yearly max.</p>
<p>Ours was like that back then… We got a substantial amount of dental work done including orthodontics for two, a total of 8 crowns redone, 2 wisdoms pulled, and the ultimate, a dental implant. </p>
<p>Then Mrs. T. changed jobs and their new dental plan is very good but very expensive (their vision is also pricy but very good). So I get dental for me and the girls thru my employer… </p>
<p>The fun part is that various dentists did suggest extra goodies based on our “good insurance”…</p>
<p>Like Dentmom4, I too am a dentist and hesitated before posting in this thread. I will not blindly defend all dentists because as in all professions, there are all types.
Several things to consider;
What to look for in an office? Has the staff been there for many years? A dentist who has staff leave every six months may be a tyrant to work for and have other issues. If the staff have been there for years on end, it may be a reflection of a well-run office . In addition, does he/she take a lot of Continuing Education? While many states require a minimum of 30 hours every two years, many dentists will often take 200 hours a year or more to keep up on the newer techniques. You can often tell who is taking these courses by the letters after their name. FAGD, MAGD, ABGD signifies that they have taken 500, 1200 or more hours of CE and passed a rigorous test. There are many good ones who don’t have those letters indicating Board certification but it’s one way to start.
Silver or white fillings? Amalgam (silver) fillings have been around for 150 years and can be placed in a wet environment like the mouth and still hold up for many years. Over time, they will break and potentially discolor adjacent tooth structure. In addition, part of the filling material is mercury, in a solid form. The composite/bonded fillings/white fillings look nicer BUT are much more technique sensitive and require extreme dryness to be done well. If not, it will break done and require replacement or a root canal. I’d estimate that half the offices in this country no longer place amalgam ( silver) fillings. In addition, there is an environmental component of disposing of all the old silver filling materials. An amalgam separator can filter out 99.5% of the mercury containing materials to avoid getting in the water supply.
Crown or filling??? Any material or tooth can only bear so much stress. My rule of thumb as I explain to patients is that any tooth that is restored with 50% of the structure in filling material or more is a candidate for a crown (cap). That way if it does break later on, they understand why. Old adage, “ if I tell you beforehand, it’s an explanation. If I tell you later, it’s an excuse.”
Why did one dentist find 5 cavities and another find two? Unfortunately there is no easy answer to this as it’s both an art and a science. I have patients that I have seen for 20 years and they have areas on their teeth that we have ‘watched’ for long periods of time, as it is ‘arrested decay” that demineralized and then stopped. Another dentist looking at the same patient for the first time, may declare that decay that needs treatment. Based on experiences, one may be more aggressive or more conservative. It depends on diagnostic tools like Diagnodent, a laser that fluoresces and finds demineralized or decayed areas earlier than conventional methods.
Crowns, Bridges, Implants and dentures are only as good as the lab that made them. Ask your dentist two questions, a) how long have you used this lab? B) Is it in the United States? (where it is FDA regulated). A dentist who hops around from lab to lab may only be interested in the cheapest labs and “ you get what you pay for”. A dentist whose work is coming back from a foreign lab may have no idea what impurities are in the crown. A well-made crown/bridge or implant should require a minimum amount of adjustment chairside and it isn’t cheap.
Second opinions. If I sense any hesitation on the part of a patient as to my recommendation for treatment ( and I often give multiple treatment plans describing it as “there are many ways to get there and what’s right for one person is not always right for someone else.”) I will make a copy of their radiographs and urge them to get a second opinion. Someone who is comfortable with their plan will have no objection and often encourage another opinion so that the patient is secure in their decision.
Dental insurance started in the 1970’s and it offered $1000 per year on average in benefits. Fast forward 40 years and many of these plans still provide that same $1000 which now becomes the “tooth a year” club if you develop major problems that require root canal, post and a crown.
If you have a PPO plan ( preferred provider org) look at how many dentists participate with the plan. If it is a large amount ( 40% or more in an area) it is probably a decent plan ( more decent for the patient than the dentist). If there are only 2 or 3 dentists who participate, think about why that is. Often it is because the reimbursement is so low, it is below overhead and many dentists have chosen not to participate……Those offices that have only a few participating offices will often be clinic type settings with new graduates…….Caveat emptor…
I could go on but that’s just off the top of my head……</p>
<p>Very informative, jandjdad. Thank you. This dentist appears to be a very nice guy, but the hygenist turnover is ridiculous. The office is very luxurious and he promotes whitening and other cosmetic procedures. He told me that he wanted to “get those old silver fillings out of there and replace them with nice white fillings.” After researching this, and when I do replace the fillings, I think I’ll stick with the “ugly” silver stuff.</p>
<p>I love my current dentist but we had a nutso one years ago. In the middle of cleaning my teeth ( and I too have many large metal fillings) he started rambling on about George Bush Sr and his health plan. The dentist tried to convince me that I needed to get all these teeth crowned now because if George did this plan, I wouldn’t be able to afford it later. I left that practice and in twenty years, I have only needed one crown.</p>