Tag Archives: second opinions

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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Affordable Dentist

Dentist “Bait and Switched” Me with Prices

I had was diagnosed with a cavity two months ago. They said it was small enough we could just watch it for now because I told them I didn’t have much money. But, a few days ago it started hurting. Because I already knew the problem I just called around to a few dentists who advertised as affordable to see what their prices were. This one dentist was significantly cheaper than the rest so I booked with him. Then, when I get there he says the decay is too extensive and he’ll have to do a crown. That is way more money than I’d planned for. I left without having the work done. Should I get a second opinion? Do you think I’m being bait and switched?

Bruce

Dear Bruce,

Dollar sign hatched from an egg
Cheap does not always equal affordable.

There are a few things going on here. First, is financial. You need an affordable dentist who’s willing to work with you on payments. But, you’re making a common mistake in equating affordable with cheap. There are good dentists who find ways to be affordable but probably aren’t the cheapest. Then, there are dentists who quote cheap prices, but end up costing you more money because either their skill or the quality of their materials are sub-par.

It’s also possible, the dentist wasn’t trying to pull one over on you. The original diagnosis was a couple of months ago. That, combined with the fact that the tooth starting hurting, tells me the decay has spread. Once decay gets to a certain point a filling isn’t enough and a crown becomes necessary. If it blows up into an infection, you’ll need a root canal treatment as well.

Get a Second Opinion from Another Affordable Dentist

It’s okay to trust your gut. If you truly feel like this guy was trying to pull one over on you then you should get a second opinion. You can bring your x-rays from your previous appointment for the second dentist to examine which will save you on additional x-rays.

Remember, cheap doesn’t mean affordable. Look for dentists who offer payment plans and phased treatment options. But, check their reviews to make sure they have a good reputation.

This blog is brought to you by Drs. Kevin and Hillary Peck.