Question for a Dentist - conflicting advice

Dee01

My tooth broke on Sunday (while eating lamb, so must have been coming) and I couldn't get to my usual dentist. I went to a well known dentist in Dublin City Centre to have it repaired. Before she repaired the filling, she took a panoramic x-ray.

At the end of the appointment, she drew up a treatment plan for me which recommended 6 fillings (with two of them probably needing root canal) and a cleaning.

I have two issues with this treatment plan;

1) I was only at my own dentist in December for a cleaning and was advised that as there was no plaque build up, there was no need for a standard cleaning (scale and polish)

2) I sent the x-ray to my own dentist and they advised there was definitely no need for root canal treatment and that the cavities must have been tiny as they were not showing on the x-ray.

My own dentist recommended that I get 3 crowns on the more heavily filled teeth down the line, but that it was not urgent as I am not suffering with any pain.

Could any dental professional offer me any advice on these severely contrasting plans of treatment based on the same x-ray??

I would really appreciate any feedback on this.

Mingetoad

Firstly, let me say if you saw a third dentist, you probably would have got even more 'conflicting' advice.
I would be uncomfortable diagnosing so much with a panoramic x-ray. These are good for an overview of the teeth, but unless the teeth have abscesses or very large decay, they aren't very good for diagnosing fillings or root canals.
The fact you saw your dentist in December and no fillings were recommended does conflict with a panoramic x-ray diagnosing 2 probable root canals. Did your usual dentist take x-rays of the teeth in December? It is possible that two of the teeth that he advised will need crowns have got decay under their fillings and he hadn't spotted it without an x-ray.
Regarding the cleaning- hard to tell without seeing your mouth. You may have picked up a lot of plaque since December. More likely is that the dentists have differing standards of what requires 'cleaning'. I have worked in practices with dentists who demand their patients have the cleanest mouths to continue treatment with them to guys that tell patients they are fine when they are very far from it.
If you have a good relationship with your usual dentist and you trust him then that should give you some comfort. If he didn't take x-rays in the last while I'd suggest you ask him to take bitewings of the teeth involved and see what he thinks.

Oral Surgeon

Dee01 wrote: »

My tooth broke on Sunday (while eating lamb, so must have been coming) and I couldn't get to my usual dentist. I went to a well known dentist in Dublin City Centre to have it repaired. Before she repaired the filling, she took a panoramic x-ray.

At the end of the appointment, she drew up a treatment plan for me which recommended 6 fillings (with two of them probably needing root canal) and a cleaning.

I have two issues with this treatment plan;

1) I was only at my own dentist in December for a cleaning and was advised that as there was no plaque build up, there was no need for a standard cleaning (scale and polish)

2) I sent the x-ray to my own dentist and they advised there was definitely no need for root canal treatment and that the cavities must have been tiny as they were not showing on the x-ray.

My own dentist recommended that I get 3 crowns on the more heavily filled teeth down the line, but that it was not urgent as I am not suffering with any pain.

Could any dental professional offer me any advice on these severely contrasting plans of treatment based on the same x-ray??

I would really appreciate any feedback on this.

You can post the X-ray for us to have a look at but and this is a big but.... Some decay is best diagnosed clinically and not radio graphically, most dental decay is best diagnosed by small bitewing X-rays (not the opg you had).
Generally speaking, to see decay on an opg X-ray- it must be fairly significant... Again to see reason for root canal treatment (very deep decay or apical changes on a tooth root) on an opg means it must be obvious....

Bottom line is your own dentist could be monitoring/ missing things or the new dentist could be over treating.... The truth probably lies somewhere in the middle....

Most dentists would agree that the more often you change dentist, the more treatment you receive as a new dentist may fill a small suspecious stained area that your own dentist knows is nothing as he had been looking at it stay the same for 10 years.....

Dee01

thanks guys - i will post the x-ray on Monday and would love some opinions good or bad - thanks for taking the time to comment )

Dee01

Is this clear? Uploaded from my fon.....

Oral Surgeon

Dee01 wrote: »

Is this clear? Uploaded from my fon.....

Not very clear atall, loads of pixels but I see decay.... I'd like to see the high res pic though.....

Dee01

Oral Surgeon wrote: »

Not very clear atall, loads of pixels but I see decay.... I'd like to see the high res pic though.....

Will I try PM it to u?

btkm8unsl0w5r4

Cant say for sure, but with what amount of previous treatment it is highly likely you need a bunch more. Some decay is under a few filling (as far as I can make out) and the decay in the UR7 look like it could be involving the nerve so the root canal is possible.

Usually dentists dont just give you a list, but sit down and point out the issues, did you see for yourself what the problems were?