Tag Archives: cavities

Root Canal Treatment

Can You Have a Cavity Without Outward Signs?

I went to my new dentist for a regular check up. She suggested that I need a root canal treatment because of a cavity inside a tooth. She wants to send me to a root canal specialist. I should mention at my last dental appointment, in which I had x-rays done, there were no signs of any problems. There is no sign of decay on the outside of the tooth either. Can you have a cavity without any signs? This feels like a red flag to me. I have a second red flag when I saw the name of the specialist was the same as hers. I jokingly asked if all dentists in that area had that last name. She told me it is her husband. So, I feel maybe she is just sending work his way. Can a tooth have a cavity with no signs of decay on the surface?

Natalie

Dear Natalie,

Example of internal resorption
Internal resorption in a lower premolar. X-ray courtesy of East Hill Endodontics, Kent, WA.

When it comes to decay, there must be an external point of entry. The decays starts on the outside working it is way in. Even then, the only time a root canal treatment would become necessary is if the decay get’s down deep enough in order for it to turn into a dental infection.

It’s possible your dentist could have been referring to something different known as internal resorption. Though, if that is the case, she should use more precise language in order to help her patients understand exactly what is going on with their bodies. Internal resorption happens as a result of an inflammatory response, which generally means that there must have been some trauma to the tooth. The result is that the pulp of the tooth begins to eat away at the tooth from the inside. I’ll be honest that we don’t yet know why this happens.

Given the concern about a conflict of interest and a sketchy diagnosis based on the terminology she used, I recommend that you get a second opinion. Your dentist is required to give you a copy of the x-rays when asked for. Take these to another dentist. Don’t tell them who your dentist is or what the diagnosis was. Just ask them what they see and would recommend based on the x-rays provided.

I hope this helps.
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Pediatric Dentistry

Pediatric Dentist Insists on Fluoride Even When Insurance Won’t Cover It

I’m trying to decide if it’s worth it to get a fluoride treatment every dental visit with our pediatric dentist. They always pressure me too even though our insurance only covers it once a year. Is it really necessary if we use fluoride toothpaste?

Cathy M.

Dear Cathy,

Child sitting in Pediatric Dentist chair

It’s expensive raising children and I know how important it is to save every dime you can. Though, sometimes spending a little bit of money saves you a lot. Your pediatric dentist is correct, getting a fluoride treatment every time is one way you’ll not only save money, you’ll save them unnecessary dental work in the future.

I’m glad you use a fluoride toothpaste. Every bit helps. But toothpaste doesn’t contain much. The fluoride your dentist provides is much stronger and is painted on so your child doesn’t ingest it. Fluoride is known to protect against decay and even reverse early decay. That simple procedure is one of the most useful things you can invest in. I would also be sure you get dental sealants as well on their molars.

The last thing you want is to save $30 on fluoride only to have to spend $200 on a filling. Or, if the cavity grows quickly, needing a pulpotomy (a child’s version of a root canal treatment).

Preventative dental care is one of the best things you can do for your child.

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Affordable Dentist

Dentist is Humiliating Me Because I’m Broke

I felt like a total failure when I went to the dentist. I hadn’t been able to go for two years, because I don’t have insurance and I have to save up for this kind of thing. It turns out those were two bad years for my teeth. I need five fillings and two crowns. First, the dentist derided me for not coming in sooner. Then, when I told him I couldn’t afford all the work he lectured me and said if I didn’t I would lose all my teeth or die. I was so humiliated because he said all this in front of his staff. But what is a patient supposed to do if they can’t afford something? I can’t produce money out of thin air.

Louis K.

Dear Louis,

That was bad form on the part of your dentist. It was unfair of him to lecture you for something you have no control over. It’s even more unfair that he humiliates you for needing to do this in stages. And, you should know, it is totally fine for you to do this in stages. Not everyone can afford to do all their work at once. You need to find a dentist who is willing to work with you financially.

In the meantime, have this dentist list out the work which needs to be done in order of priority. Which cavities or infections are further along. Do those first, giving yourself time to save up for the other procedures. There are also dentists who work with Care Credit. It’s a medical credit card, which will allow you to have all the work done at once (if you’d like), then pay it out. Often, depending on your credit, you can choose your terms. Some have zero interest.

Your dentist is right about one thing, though not the way he handled it. People do still die from tooth infections. In fact, a father in his thirties passed away this past February from not getting to the dentist in time. Some patients make the mistake of thinking just taking an antibiotic will be enough. It won’t. It will stave off an infection for a while, but because there is no blood stream in a tooth, there’s no way for the medicine to reach it. A dentist has to physically dig out the decayed material. So, while you can put this off for a bit, don’t wait too long. That’s why I asked you to have the dentist list out the work in order of urgency.

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Affordable Dentist

Can’t afford to fix my teeth

I saved up to get my teeth cleaned and get some whitening done. I was disappointed when the dentist told me I needed some other work done before the whitening. I have two cavities. One of them so big I need a crown. I can’t afford this. Now, even if I find a way to pay for the work I don’t want, I can’t get my teeth whitened. I’m really disappointed. Can I get the teeth whitened, if my teeth aren’t bothering me?

Maddie K. – Florida

Maddie,

It must be terribly disappointing to you. Here you thought you were finally going to get a bright, new smile and instead you’re stuck spending your money on maintenance for your teeth.

Hopefully, you’re working with an affordable dentist who will work with you financially. There is a way to stage your treatment so you don’t have to pay for all of it at once. Your dentist could list the most important treatment first and work your way down. I suspect it would be the tooth that needs a crown.

Some dentists even give free teeth whitening to new patients. your dentist may be willing to cut you a deal on on the whitening at the end of your treatment, because of all hte money you’ve had to spend. I can’t speak for him or her, of course, but it won’t hurt you to ask.

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