Hello,
I'm scheduled for a dental evaluation on January 23. I have a BAD feeling that in addition to a plethora of cavities that need to be filled, I'm going to be faced with the possibility of getting either a bridge or crown(and according to several dental sites, the cost is somewhere between $500-$900 per tooth. The area I'm most concerned about is obvious decay in the left rear portion of my mouth. I'm hoping it is just wisdom teeth that can be removed without any further intervention. Being 31 years of age now, my last visit to the dentist was September of 1998. They advised me then that the wisdom teeth were starting to come in but nothing needed to be done in the immediate future. Every time I brush the affected area now, I get a foul taste in the mouth, light to moderate pain, and sometimes, a lot of bleeding. The foul taste in the mouth persists between brushings.
To sum things up, I'm trying to get an idea of what I'm getting into before my visit. I have insurance and my dentist is within their network where I will obtain the full benefit. However, my plan can only cover half of the expense of bridge or crown work, and up to 90% of oral surgery and the like. Routine cleanings and check-ups are fully covered. Will my dentist be likely to demand the difference not covered by insurance on the day the services are provided or can they stretch it over a few months? I just want to be sure I know what to expect since it has been awhile since my last visit and I'm fearing the worst in terms of expense. Thanks! Jason

Hi Jason,

It sound like you have a good dental plan. You might have to pay up front, but you can discuss this with the dentist. He may agree to a payment plan. Ideally, you could just address one problem at a time. The important thing is to go in and face it. After that, it's just a step by step fixing process.

The foul odor in the left rear part of your mouth is probably from infection. They will address an infection first, with antibiotics, then correct the teeth that are contributing to it. Don't worry too much. Be glad that you have teeth to fix. Some do not.

Simone

Simone,
Hey! Thanks for the quick reply. I'm going to call the dentist Monday and see how they usually handle cases like this. I wish I had addressed this problem a lot sooner and had routine check-ups. My dad was on my case all of the time about how important it was to brush and floss or else your teeth would just fall out. I brush and rinse with Listerine on a regular basis but evidently it has not been sufficient enough to prevent the decay that is going on now. I drink a lot of Mountain Dew and other caffeinated beverages so it certainly hasn't helped. I'm sure the dentist will lecture me on that as well. Again, thanks for the reply and take care. Jason

Hi Jason,

Congratulations on taking the big step and returning to your dentist!

You may be presently surprised and not have as much decay as you think you do (I have many patients that come in thinking they have tons of decay only to find out that they only have a couple of problems and not as many as they had created in their minds.)

First of all, when you have your evaluation done the dentist should take not only cavity detecting x-rays but should also take one called a Panorex. This x-ray will show all of your teeth including your wisdom teeth. It will also show if there are any infections at the roots of any of your teeth, bone levels, and any cysts or growths in the jaw bone. If your dentist doesn't have an x-ray machine that does this then he will probably take about 16 smaller x-rays to check all the teeth, roots and bone levels.

You should also have a periodontal exam done. This is when they measure the "pockets" around the teeth. Healthy pockets are 1-3mm in depth anything over indicates periodontal (gum) disease (the deeper the pocket, the more advanced the disease). Gum disease can be a major contributing factor to foul taste and sore/bleeding gums.

Your treatment plan should consist of taking care of IMMEDIATE problems first such as any badly decayed or abscessed teeth. If you don't have any immediate problems then the very first thing you should have done is your cleaning. Depending on your periodontal measurements this could take more than one appointment.

Once your gums are healthy and not bleeding it will make it easier for your dentist to do any fillings that are needed. It will also make healing faster should you have to have your wisdom teeth removed.

Rinsing with Listerine is a good idea but remember, for it to be truly effective as an antibacterial rinse you have to rinse for 60 seconds at FULL strength.

You might want to invest in a power brush. The most effective brush on the market is the Oral B electric brush. There are many to choose from but choose the one with the single round brushhead as it will be easier for you to effectively remove the bacteria (plaque) from the teeth at the very back of your mouth.

The other thing you need to do is start cleaning between your teeth. Flossing isn't for everyone so find something else easier to use. You can find things like Stimudents, Softpiks, rubber tips, proxabrushes, sulcabrushes in your local drug store.

The very last thing your dentist should be planning on doing is any crowns or bridges. You want to be sure that your mouth is healthy before investing in any of these. If the bone levels or gums around teeth that are to support a crown or bridge are not healthy then there is a chance of you losing the bridge or crown in a few years.

If you have a lot of dental work that is needed, make a plan. It doesn't ALL have to be done in a year. Prioritize with your dentist so that you can use your dental benefits to the fullest.

As for the Mountain Dew consumption, the best thing for your teeth is to drink WATER. If you must have a soda, try to drink through a straw. When you don't, your front teeth act as sieves and the sugar sits between them and eats away at the enamel. Caffeinated beverages aren't the best thing for your overall health but the worst they do to your teeth is stain them. Adding milk to your coffee or tea will help reduce the staining, but watch the sugar you add... that will still be bad for your teeth!

Good luck at your appointment!

Hey Flossie,
Thanks for your reply to my question. I'll just have to take this one day at a time after my visit to the dentist. There is really no excuse for having not seen a dentist in 9 years other than typical laziness. Again thanks for your answer and take care. Jason

Hey Jason,
How did your dental appointment go?

Remember that many dental plans have limits of coverage for every year and I't generally not possible to get everything fixed in one year.

Dentists make a difference and technology in that profession has changed imensely. In a simple example instruments used to be right in front of your face. Now they are behind you and are put away before you get up.

Something that I was told, is that if your going to drink soda, use a straw. It's better for your teeth.

Having been neglected for so long, you should ask your dentist about the benefits of having a peridontal cleaning done, at least once, say 3 months down the road or in place of the 6 month cleaning. This cleaning gets closer to the roots.