I have been having a problem with a dental office I recently began visiting. Two dentists are at the site (one is retiring) and one recommends one thing, then when I sit in the chair to get the work done the other dentist comes in and recommends something completely different. I am going to switch to another dentist.. however I am now in the position of having to pay for work that they have already started... Now for my question.

I have a lot of decay due to medications. Apparently I had a lot of decay in tooth #10 (next to front tooth on the left). The dental hygenist "demonstrated" this decay by poking a hole in the tooth, then when I was flossing the floss got caught in the tooth and it broke in half. I went back in and the retiring dentist said that the tooth would be fixed by putting a post and a crown on, as well as doing a root canal (I had already been scheduled to have a root canal due to the decay).

So I sit down in the chair to have the work began and the "other" dentist comes in and begins work on the tooth. After it was numbed and he drilled for a while he stopped and told me that because the tooth was so decayed there might not be enough to support a crown and post and that instead of putting the money into that, when it may eventually fall out, I may want to have the tooth extracted and wear a temporary one called a "flipper". The other option was to have a "bridge" put in which would involve drilling down the other 2 surrounding teeth. I wanted to stay away from extracting a front tooth so I told him I really would prefer to try the root canal. He also told me I had to decide that day because he would not be able to do a root canal if I did not decide that day (I do not understand this either). Anyway, I decided I want to risk the root canal, even if it does not last, if I can avoid extracting the tooth.

However, once I got home and looked at the paperwork, it appears that he has decided to do a "core build up" and porcelain crown... he is not putting in the post.

My question (sorry for the above rambling but felt like it necessary) is... IF THERE IS ALREADY A RISK THAT THERE IS NOT A LOT OF TOOTH TO HOLD THE CROWN IN, WOULDN'T IT MAKE MORE SENSE FOR BOTH A POST AND CROWN TO BE PUT IN?? While I am not wild about having a post put in my mouth it does sound like it would be more stable. Any info re. crown vs. post crown would be appreciated. Thanks!

I would go with the extraction and bridge. It's more sound. Otherwise you are risking something that is only going to last for a while. Then you'll have to get the extraction anyway. I had a tooth that was in such a bad condition that the breakage occurred while muching on a PRINGLE. LOL. I had a filling, then a root canal, and finally an extraction then bridge. I prefer the bridge far better than shooting pains which I still had after the root canal. As far as two disagreeing dentists in the same establishment. I would definitely switch dentists. That's so unprofessional.

Sometimes the "core build up" IS the post. I wonder how he was able to do it when he told you there might not be enough tooth to support a crown. I suppose he must have decided there WAS enough tooth.
A more permanent fix would be to remove the tooth and put an implant in.

In my University we went through steps, first try post and crown and then if that fails you go for a bridge or an implant. Most of the work I've done through post and crowns if the case is well chosen and the work is well done it has a high possibility of lasting more than 6 or 7 years. I would rather that with my natural root because your natural tooth keeps your alveolar bone from resorption.. a bridge can't do that. In the future if the work starts to fail you will have enough bone to go for implant. If you go for a bridge the neighbor tooth will be affected somehow... and, if your caries problem is too HIGH, a bridge is actually contraindicated. This is coming for a dentist who love to bridges, but, it has its indications.