Dentists differ and patients....

your desired user name

I recently went to Dentist <removed> in Swords for a check up. It had been a few years since I had visited a dentist and I expected that I would need a bit of work done, not that anything was bothering me.
I wasn't prepared for what he suggested though.
I need 2 new crowns.
He needs to make a shield for me to wear going to bed as he claimed that I am grinding my teeth while asleep and am wearing them down.
I need to replace almost all of my fillings as they are cracking and if I dont do something about it soon, I could lose the teeth.
Having my teeth whitened was also recommended.
To start the long process, he said that my next 2 appointments should be with the dental hygienist to rectify my serious gum disease problem.
He said a few grand should sort me out and I could claim it back from Revenue.

I decided to have a second opinion. I went to Dentist P.....
I didn't mention the other dentist.
He checked me out, told me my teeth were in good condition, cleaned them, took an X-ray and said to return in a year. It cost €140.

Anyone any similar stories?

dudara

I don't see a Consumer Issue here - in addition, none of us are dentists, and cannot second guess the opinion of either dentist.

Moved to Rip Off Ireland

dudara

sesna

your desired user name wrote: »

I recently went to Dentist <removed> in Swords for a check up. It had been a few years since I had visited a dentist and I expected that I would need a bit of work done, not that anything was bothering me.
I wasn't prepared for what he suggested though.
I need 2 new crowns.
He needs to make a shield for me to wear going to bed as he claimed that I am grinding my teeth while asleep and am wearing them down.
I need to replace almost all of my fillings as they are cracking and if I dont do something about it soon, I could lose the teeth.
Having my teeth whitened was also recommended.
To start the long process, he said that my next 2 appointments should be with the dental hygienist to rectify my serious gum disease problem.
He said a few grand should sort me out and I could claim it back from Revenue.

I decided to have a second opinion. I went to Dentist P.....
I didn't mention the other dentist.
He checked me out, told me my teeth were in good condition, cleaned them, took an X-ray and said to return in a year. It cost €140.

Anyone any similar stories?

How do you know which dentist was wrong?

Sounds like you need a third opinion, not just the one that suits you.

davo10

Your first dentist identified an occlusal problem, all the treatment he recommended is to restore your teeth and prevent future problems.

Virtually everyone grinds their teeth at night at some time, particularly in times of stress or broken sleep. It is an involuntary action which we cannot control or stop. The first time people become aware of it is when their partner complains or when teeth/fillings start to wear down and break.

Your first dentist may have seen evidence of occlusal wear and fracture/ditching of fillings. These may not need to be replaced immediately but left as they are they may wear to the extent that the dentine may become exposed/sensitive/decayed. The night gaurd prevents you from grinding your teeth off each other so is a good idea.

The teeth that may need to be crowned may be heavily filled and worn down by grinding, they may not show any decay/pathology but may be at high risk of fracturing due to grinding, which may then require extraction if they do break.

With excessive grinding, the upper central incisors and canines tend to wear and shorten so that all front teeth look the same length, this can look back cosmetically so your denist may have advised crown upper 2 front teeth to restore them to their natural length, when I do this I always ask the patient if they want their teeth whitened because the crowns are made to match the colour of the teeth the day the impressions are taken, if the patient has their teeth whitened later the crowns stay the same colour and look darker than the other teeth, so teeth whitened first then crown shades taken to match new brighter colour.

Some dentists do not look for nor recognise the effects of excessive grinding so do not discuss preventative/corrective treatments. Pathologically your teeth may be fine but as any of the readers who have had to have extensive teeth rehabilitation due to the effects of grinding their teeth down, the treatment tends to be long, complicated and expensive as the teeth often need multiple crowns at an exactly correct vertical height, if this is done wrong (often seen in treatments done quickly abroad), the crowns start to shatter due to excessive load.

All in all, your first dentist diagnosed a problem which may not effect you today but may in the future, guess you'll have to wait and see.

rubadub

dudara wrote: »

in addition, none of us are dentists, and cannot second guess the opinion of either dentist.

There are a few dentists who post in the dental forum (of all places ) and I think there is some system of private messaging to get recommended ones by people.

I got a mouth guard myself, a good 10 years ago now, think it was ~£130 at the time. I kept losing the damn thing and ended up getting another -this time a rugby/boxing style mouthguard for a few euro on ebay. These are much bigger than my proper dental one, and of weaker softer silicone. You pop it in hot water and then mould it to your teeth. I have a sander in work and sanded it down to be thinner and it worked fine.

I must get another as my original is wearing through and I have seen chemist sites online selling ones specifically for teeth grinding -so I presume they would be thinner than sport ones.

davo10

rubadub wrote: »

There are a few dentists who post in the dental forum (of all places ) and I think there is some system of private messaging to get recommended ones by people.

I got a mouth guard myself, a good 10 years ago now, think it was ~£130 at the time. I kept losing the damn thing and ended up getting another -this time a rugby/boxing style mouthguard for a few euro on ebay. These are much bigger than my proper dental one, and of weaker softer silicone. You pop it in hot water and then mould it to your teeth. I have a sander in work and sanded it down to be thinner and it worked fine.

I must get another as my original is wearing through and I have seen chemist sites online selling ones specifically for teeth grinding -so I presume they would be thinner than sport ones.

Fantastic advise for an occlusal/parafuctioanl dental problem, kinda like a band aid for a stress fracture, will you advise OP on what to do in a few years time when teeth are wearing/fracturing?, way ta go moderator.

Ghandee

davo10 wrote: »

Fantastic advise for an occlusal/parafuctioanl dental problem, kinda like a band aid for a stress fracture, will you advise OP on what to do in a few years time when teeth are wearing/fracturing?, way ta go moderator.

In fairness, they don't advise the op to take/do anything, maybe I'm reading it wrong, but as far as I can see, they're merely saying that THEY had a mouth guard, I can't see where they have dispensed advice, suggesting the op does the same!


Every one friends now?

your desired user name

Thanks for the input.
Maybe I do need a 3rd opinion.
The first dentist is obviously very good.
He's in the top 20 for PRSI payments last year earning over €270k from this source alone.

http://hse.ie/eng/staff/PCRS/PCRS_Publications/dentists2009.pdf

smelltheglove

Both myself and my sister visited the same dentist for a few years. Beofre I got married we both went in together, my sister went in first. When I went int he dentist took a good look and said that at least mine were better than my sisters, a grand or two will have them sorted and prevent loss, after that I would just need to maintain. My sister was told she needed crowns, fillings, bridges etc all sorts and that it would be 10k plus to get it all sorted.

So I went in every month had my gums cleaned in quarterly sections, fillings etc as required, ended up costing about 2k in the end including some whitening. My sister just got the pain sorted. She always suffered with mouth ulcers which the dentist could not explain nor the doctor and would get an abcess from time to time.

Anyway my point is this, ignoring the main advice from the dentist, my sister ended up getting a very large abcess. She got some antibiotics which did not work and then her jaw locked. To cut a long story short she ended up in intensive care on a ventilator as the infection grew to her throat which swelled so much she could not breathe unaided. She lost 5 back teeth if I recall which the hospital had to remove to drain the infection. There were a number of reaons why this could have happened. My sister had not been looking after herself just after having her first baby, she did not take the dentists advice and the dentist did not prescribe her the antibiotics on time, she only received the prescription on her second visit in a week.

You have received some advice from one dentist and some from another, you prefer the cheaper option but if it is a chance that the other problems mentioned could cause you so much hardship isnt it best to get a 3rd opinion on it?

davo10

your desired user name wrote: »

Thanks for the input.
Maybe I do need a 3rd opinion.
The first dentist is obviously very good.
He's in the top 20 for PRSI payments last year earning over €270k from this source alone.

http://hse.ie/eng/staff/PCRS/PCRS_Publications/dentists2009.pdf

This list is for medical card treatments, they are fee per item and do not specify if they were paid to only one dentist or hygienist (the clinic owner has the contract with the HSE to provide treatment on med card, if he has dentists or hygienists working for him, the gross amount goes down beside his name only even though 1, 2 or 10 dentists did the work).

OP do you mind if I ask what the purpose of this post and the link was?, what has his clinic's earnings from treating HSE patients got to do with your treatment?

channelsurfer2

i visited the same dentist mentioned by the OP with a filling that had come loose and he said the exact same things to me... bamboozled me with technology and xrays on his fancy screen saying if i i didnt act now and have a root canal and crown it would be the end of the tooth.... a week later I went to my regular dentist whoi couldnt get an appointment with earlier. I asked my regular dentist to xray the tooth the same as this dentist had done and he said there was no way i needed a root canal etc or a mouthguard... I have been with my regular dentist for 15 years. he said mabye in years to come i might need it if the filling didnt do its job.
make up your mind for yourself.

davo10

channelsurfer2 wrote: »

i visited the same dentist mentioned by the OP with a filling that had come loose and he said the exact same things to me... bamboozled me with technology and xrays on his fancy screen saying if i i didnt act now and have a root canal and crown it would be the end of the tooth.... a week later I went to my regular dentist whoi couldnt get an appointment with earlier. I asked my regular dentist to xray the tooth the same as this dentist had done and he said there was no way i needed a root canal etc or a mouthguard... I have been with my regular dentist for 15 years. he said mabye in years to come i might need it if the filling didnt do its job.
make up your mind for yourself.

So your regular dentist said you may need it in the future, what OP was advised was a treatment plan which will reduce the likelihood of treatment, in other words it may prevent problems. If you do need root canal treatment, will you and your dentist then acknowledge that this dentist was right and predicted the problem?

channelsurfer2

no because the dentist said i needed immediate action as the tooth would not last more than a week..... that was 18 months ago.. its perfectly fine still.... if the dentist had said to me as my own dentist had said you may need root canal in 5 to 10 years depending on how the tooth gets on then i would have had much more respect for him.... i just felt very pressurised that if i didnt get it done there with an immediate appointment then the tooth would fall out...

davo10

I wonder how many dentists have had patients say to them "if you had told me before that it needed a root canal treatment before it started to hurt, I would have had it, now i'm in pain when it could have been avoided".

If a tooth has a deep filling and is showing painful symptoms, is tender when biting, swelling on gums then it is fair to assume that the nerve is in trouble. The dentist may advise you that you need root canal treatment based on the symptoms exhibited on that visit, on occasions the nerve can settle down again and the symptoms go but they tend to return again in the future.

The dental issues section is littered with people complaining that they went to the dentist in pain, the dentist wanted to moniter/prescribe antibiotics or just put a filling in but now they have an abcess so believe the dentist was negligent, yours is the opposite situation, the dentist advised root canal but the symptoms went away so you feel you were being conned.

Lastly, that high tech equipment is for your benefit not the dentist's, it costs and absolute fortune to have digital x-rays and intraoral cameras. Digital x-rays reduce exposure 10 fold, are incredibly fast to "develope" compared to film and there are no toxic developing chemicals, intra oral cameras are hugely beneficial for showing patients what is going on in their mouth and for discussing treatment plans, would you be happier visiting a dentist with just a chair, two drills, a couple of forceps and a syringe?

Damn if you do, damned if you don't, again if you get an abcess on that particular tooth in the future, will you accept that the dentist was right?.

Incidently, the nerve in a tooth can die without becoming painful, and you can have an abcess without painfull symptoms (you may see a small whitish swelling above a tooth which increases slightly in size and bursts occasioanlly), the first time the patient may feel pain is when the abcess is established/ the tooth fractures and then it is too late, out it comes.

your desired user name

davo10 wrote: »

This list is for medical card treatments, they are fee per item and do not specify if they were paid to only one dentist or hygienist (the clinic owner has the contract with the HSE to provide treatment on med card, if he has dentists or hygienists working for him, the gross amount goes down beside his name only even though 1, 2 or 10 dentists did the work).

OP do you mind if I ask what the purpose of this post and the link was?, what has his clinic's earnings from treating HSE patients got to do with your treatment?

As far as I am aware, this is a single dentist practice. There is a dental hygienist or possibly 2 on the premises.

The link shows how popular a practice he runs.

Do you feel that I should go to another dentist as the second one seemed to think that my gums were fine. He made no mention of me needing 2 sessions with a dental hygienist to rectify my serious gum disease problem?

davo10

your desired user name wrote: »

As far as I am aware, this is a single dentist practice. There is a dental hygienist or possibly 2 on the premises.

The link shows how popular a practice he runs.

Do you feel that I should go to another dentist as the second one seemed to think that my gums were fine. He made no mention of me needing 2 sessions with a dental hygienist to rectify my serious gum disease problem?

Sorry, I am not in a position to advise you on what you need to do, again gums rarely cause problems overnight but if left untreated, gum disease can cause chronic bone loss and tooth mobility.

Sardonicat

In fairness to the OP, you are assuming that the 2nd dentist was incorrect. We have no way of knowing that is the case. It does seem a bit strange that the two dentists differed so sharply. It can only mean that one is a rip off merchant or the other is utterly incompetent. Neither is an accusation of small consequence. God forgive us lowly lay folk for suggesting either!

davo10

Sardonicat wrote: »

In fairness to the OP, you are assuming that the 2nd dentist was incorrect. We have no way of knowing that is the case. It does seem a bit strange that the two dentists differed so sharply. It can only mean that one is a rip off merchant or the other is utterly incompetent. Neither is an accusation of small consequence. God forgive us lowly lay folk for suggesting either!

Why can it only mean that one is a rip off or one is incompetant and how would you know which is which?, only time will tell. They may both be giving correct diagnosis, they may both be right or they may both be wrong. If the patient does nothing and loses teeth in the future, the first one would be right and the second one wrong, both could argue their case for treating at this particular time, or not as the case may be.

Every Doctor in the world does not give the same diagnoses for the same symptoms, you examine the patient, you consider differential diagnosis, you try to confirm your diagnosis using special tests such as x-rays or vitality testing or periodontal probing etc then you advise on the best course of treatment in your opinion.

I see patients for second opinions and treat patients other clinicians do not want to undertake and two of the most commonly misdiagnosed dental problems are malocclusions and periodontal problems, the very things the OP is being advised about. Issues arising from the aforementioned may not become obvious today or tomorrow, it may be next year or in five years as anyone who has had to have teeth removed because they became loose will tell you, most are aware for many years thet their teeth were becoming mobile but it happens so slowly that they always think it can be treated some other time.

malocclusions can cause teeth to wear down/fracture and the jaws to become painful, again this may take years but as above, anyone who has had to wear bite raising appliances and then get multiple crowns to restore their teeth to their original dimensions for cosmetic/jaw pain reasons will tell you that they knew what was happening but didnt take much heed of it.

These corrective treatments can be complex and expensive so it is better to prevent them in the first place. Again I must say that I am unable to advise the OP on the best course of action but Sardonicat do not jump to the conclusion that one dentist must be right and one wrong, it's smallminded.

Anon47

your desired user name wrote: »

I recently went to Dentist <removed> in Swords for a check up. It had been a few years since I had visited a dentist and I expected that I would need a bit of work done, not that anything was bothering me.
I wasn't prepared for what he suggested though.
I need 2 new crowns.
He needs to make a shield for me to wear going to bed as he claimed that I am grinding my teeth while asleep and am wearing them down.
I need to replace almost all of my fillings as they are cracking and if I dont do something about it soon, I could lose the teeth.
Having my teeth whitened was also recommended.
To start the long process, he said that my next 2 appointments should be with the dental hygienist to rectify my serious gum disease problem.
He said a few grand should sort me out and I could claim it back from Revenue.

I decided to have a second opinion. I went to Dentist P.....
I didn't mention the other dentist.
He checked me out, told me my teeth were in good condition, cleaned them, took an X-ray and said to return in a year. It cost €140.

Anyone any similar stories?

If you do end up with a lot of work to be done I recommend you go North, you will save a bundle and the quality and service is at least as good (or in my case better) than in RoI. If you want to PM me I will let u know the name of the dentist i used for crown work.

mickoneill30

Is there a system for figuring out which dentists are good or do I just pick one from a hat.

I was in Thailand recently and went to one recommended by me to get a clean. It was the best clean I've ever gotten. She took ages, I had no pain, there was no blood and my teeth were spotless. It cost me €15 (which I'd imagine is expensive enough for Thailand).

My local dentists here do the same job in 15 mins, normally I get a twinge or too, and there's normally frequent rinsing to get rid of the blood and when I come out it's normally only an average job.

Unfortunately she told me I'll need to get 3 wisdom teeth removed and that it'd be a big enough job so I'll need to get a decent dentist here.
I'm not saying go to Thailand but I want to change dentists and nobody I know is really happy with theirs.

Philip01

Not all dentists are of similar kind. Some dentist charge reasonable rate while some others may charge more. Dubai usually offers a whole host of cosmetic dentists, orthodontists, and pediatric dentists, together with a number of nationally recognized experts who specialize in areas such as oral surgery. Online research can help you in finding a good Dentist for you and your family.