The Dental Topic Thread: I'd like to be a resource if needed

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tooth

Trad climber

B.C.

Mar 29, 2013 - 12:29am PT

So what's the rest of the story Splitter?

splitter

Trad climber

Cali Hodad, surfing the galactic plane ~:~

Mar 29, 2013 - 11:57am PT

So what's the rest of the story Splitter?

I've been kind of regretting even posting the first one, and I didn't want to trash this positive & well meaning thread with another one of my epic downer, this kind of sh#t only happens to dirtbags, stories. But, since ya requested it...

I was pounding nails on the South Shore (Tahoe) one summer ('79) and managed to f'up my lower back up pretty good. I ended up in the Truckee Hospital. The doc put me in traction, etc. and I was in there for 18 days and counting (they didn't seem to know how much longer i was gonna need to stay). But that was about as long as I could handle it, so I just up and split one day.

I was still in pretty bad shape, with very little money, so when I finally arrived at my brothers place in San Diego (he let me recoup there) I was broke. The hospital bill was waiting for me, since I had gave his address as a 'permanent address'. You can imagine what that looked like (don't recall the exact amount) so I applied for Medical, and received it, which covered the cost.

Medical, at the time, also covered dental and I had one small cavity that I had detected so I decided to get that taken care of (i was okay'ed for around 3 months of Medical). So I randomly pick this dentist out of the San Diego phone book. And I went in. To save time I will inform you now, it took six (6) different visits too 6 different dentists to get that one small cavity fixed.

They all followed the exact same system/procedure. I would go in, be placed in a dental chair and a full set of x-rays would be taken by a tech/nurse (or whomever) then they would pack my mouth/gums with gauze and the dentist would come in and administer the shots. Probably fairly standard.

I recall, a couple of times trying to explain what tooth I was in there for, but was usually cut short by the nurse/tech and reassured that the dentist would see what needed to be fixed. And by then, my whole mouth was so numb, I could only mumble anyway.

Every one of them pretty much followed the same procedure once they began work also. Long story short, they would remove every filling in my mouth, drill the underlying surface (supposedly cleaning away any new decay) and then refill or cap (when necessary) each tooth. My mouth was so numb, I couldn't tell if he had fixed the one I had initially went in for or not. The first five (5) didn't. I finally got the 6th dentists attention, after he had supposedly finished.

I told him that he missed one, and tried to show him by running my tongue over my lower left teeth. He didn't even look (my tongue and lips were so numb, I couldn't really tell where I was sticking my tongue, but it was in the general direction of the cavity). All he said was, "How did you know there was a cavity there?" HE obviously knew there was a small cavity there! And therefore, imo, all of the dentist I had visited probably new there was a cavity there also. I have NO clue why they didn't fix it...'nip it in the bud' (so to speak). So he fixes it without even looking at the x-ray, he knew it was there. The point is, I would have only gone to one dentist, the first one, had that one fixed it.

They were ignoring the x-rays they took. Because I had just had every one of them fixed. I kid you not, they were drilling teeth that had NO decay, and refilling them. And, for some reason that I have no clue of, they were skipping this small cavity that was on my lower left side.

I mean, I picked six random dentist. I don't recall why I never went back to any of first five to get that one fixed that they missed, I guess I figured if they had missed it, the weren't worth going back too. I had no idea that they were drilling down my teeth and getting closer and closer to the nerve root each time. I just figured that the prior dentist had missed something, and they were getting or fixing it.

I know that when a significant amount of time goes by (5-10 years, perhaps) decay could often build up under one or more of my fillings and they would remove them and clean them up (remove the decay) and refill them, particularly if it was a capped tooth. But, I had gone to each of these dentist within this three month period that I had the MediCal, not enough time for decay to build. I simply figured that the prior dentist had perhaps missed or skipped something and they were getting what they missed.

I'm not sure what else they did, perhaps drilled teeth that had no decay or fillings to begin with, I don't really know. But, about 1-2 years later, the sh#t really hit the fan.

I recall seeing headlines announcing a, "Big crackdown on MediCal fraud." I thought, since I had gone to six dentist, that perhaps I was guilty of abusing the system. I was ready to fight it, because I had only wanted to get that one tooth fixed.

I left my brothers house and had returned to the eastside for the winter of '81/'82. And my brother sent me this 800 # with a woman/caseworker's name. He said that she was trying to contact me. She called a bunch of times over a 1-2 year period. I never called back because I figured that they wanted to prosecute me for fraud or whatever, I never called her back. So, eventually she stops calling (but I kept her name and # in my wallet).

Then, one morning around '85/'86 I see this breaking news story; "Judge decides to award the full amount of $250K to each patient." (from each doctor/dentist that the medical fraud had been brought against).

Those who had been awarded the malpractice in connection with the fraud were going to be awarded somewhere between 25K-250K for each one (doctor, dentist who had been guilty of fraud / malpractice). The Judge decided to award the claimants (which I would have been one had I called her back) the full $250,000.00 each per fraud case.

I couldn't believe it. I dug the 800# out and managed to get a hold of her. She said I would have been one of their star witnesses, and would have collected 250K from each of the doctors! BTW, I eventually ended up either loosing, or needing root canals on all of those teeth (sooner than later).

I would have been a millionaire and then some, $1,500,000.00! I would have bought property. My damn goal was to buy a, "two story log cabin with a view of the White Mountains in one direction, and Mt Tom in the other" that I mentioned on another thread recently.

Oh well.

EDIT: I left out one part that was particularly abusive or at least negligent (in my opinion). One of those dentist left me on laughing gas (the only dentist that put me on it) and sitting in the chair waiting for him, from 2:30 (when i began my visit) to 6:30 (when he finally finished). I sat there, (under anesthesia/laughing gas) until 5:30 (3 hours) waiting for him.

I recall requesting (before i was put under) Fleetwood Macs album Rumors to listen too on the headset, when they gave me a choice of music. I new that album by heart, since my roommate had it and I listened to it all the time. I counted all the times I listened to each side as it played over and over as I sat there that 3 hours high on the gas waiting for the dentist. I new something wasn't right, but you are powerless to respond.

After he finished the majority of the work, he took me off the gas but I was still as high as when I was on it. I could hear him yelling at me, "WHAT IS THE MATTER WITH YOU? I TOOK YOU OFF THE GAS (that was a BIG surprise to me, i was feeling exactly the same as when i was on it) YOU BIT DOWN TO DAMN HARD AGAIN AND YOU CRUMBLED ALL OF THE FILLING. NOW I'M GOING TO HAVE TO DO IT AGAIN (rebuild it)." I could tell he was really pissed, but I had zero control. I was supposed to gently bite down on the carbon paper that would leave a mark of the high points on the filling. I was still so f*#ked up that I couldn't tell if I was biting or not.

He finally let me go, and I had to sit out in the parking lot until after 10:30 PM (over 4 hours) before I got the nerve to drive home. It was like I was drunk. I am amazed that I didn't crash or something. I took all side streets so I wouldn't get ticketed. It was around 5-6 miles to my house. I recall being kind of dingy for at least a week. And felt some effects of it for months afterwards.

splitter

Trad climber

Cali Hodad, surfing the galactic plane ~:~

Mar 30, 2013 - 11:10am PT

Tooth -- What's up, no comment?

I didn't get any feedback on my 1st post, and like I said, had some reservations in regards to following it up with a 2nd post. You requested it, so I complied. So, I was hoping for the same courtesy from you, but it's not necessary (particularly, if you don't feel compelled to do so). i was mainly sharing (and perhaps venting a little).

I haven't read any of this thread, just the OP. It probably would have been more appropriate for me to post on the other medical thread "What's wrong with Medicare?" (or whatever it's called). I posted my opinion & experiences there in regards to Medicare since I worked in the field for close to 20 years as an OTR, hence I treated & billed Medicare patients, many who were Medi/Medi (MediCare/MediCal) and I'm very familiar with that system and why, imo, it has been shot to hell (simply put).

And, I had actually "randomly picked" seven (7) dentist (not just 6). I left out the first dentist in my story, because I think they let him slide because he did the initial treatment, in which the teeth probably did need the work done.

I am not certain what the whole picture was, what exactly they had defrauded the government on and precisely how they victimized me since I only had a brief conversation with her on the telephone.

I didn't mean to malign your profession, and certainly not you guys in particular, but just wanted to say that I feel the system was defrauded, raped and abused for many years by the people (doctors/md's & dentist) who should have respected it most...and now it is no longer there for those who are in desperate need of it (disabled/elderly, etc).

I am well aware of the need for such services as MediCal (dental) and it is no longer available (at least not in Cali). And I am all for taking trips to faraway places and offering your services (KUDOS), I did the same at one time with mine (as an OTR, upper extremity wound care, burn care, splinting, therapy, neuro, blah, blah, etc in conjunction with Orthopods, Neurologist, MD's in general, etc) and perhaps I will again, God willing. In other words, I'm all for it, because its a big and hurting world we live in.

But there are people here in America that have teeth that are aching just as much, a toothache is a toothache, eh? And poverty is poverty. Maybe you excepted Medical patients when it was available. Not sure, but I would have looked at it as a service to the needy (with at least partial reimbursment/nominal coverage), much like a trip to Tim-buk-too (or wherever) minus the photo op, albeit. ;)

Well ... rant over!

BTW, a friend/acquaintance of mine is a dentist and is a great guy (haven't seen him in years, though). He did the FA of the Chinese Water Torture Route on El Cap Route, while a student at Loma Linda University Dental School, Darrel Teske, perhaps you know of him!

And, thanks for this thread Micronut, although I haven't read any of it, I suspect it has been & will be a beneficial addition to ST.

edit: Like I have said elsewhere, I worked & had health coverage for many years (up till '03) including dental. So, I've seen both sides of the coin (fwiw). ...wudevah!

tooth

Trad climber

B.C.

Mar 31, 2013 - 06:47pm PT

Sorry. I was climbing. Back from the weekend. I'll read your rant. But I did read and your stories already. Sorry to hear, but entertaining. I'm always interested in stories of people who end up with dental treatment that they later question. I hear a lot of patients tell stories like this, and usually they have complex situations that they don't understand. I don't want to be the next bad guy on their list, so I really slow down and do the most urgent treatment first and spend as much time as possible educating them. Sometimes they still don't get it. I can't figure out why you went to a third dentist... and on to a 7th! (this happens quite a bit) - and have t heard or even seen (in the books of practices I bought) fraud like you described. Incredible. How did you hit 6 of them in a row like that? Were they advertising to MediCal patients in the yellow pages?

Oh, and for the mission dentistry, I know of over $100,000 of free dentistry given to people in town last year. People who not only need it, but value it. I have a hard time with people who don't want to pay their $8 co-pay but have two Starbucks in their hands at the front desk. There are those who alternate cleanings with their family who get a little help every other visit once I find out. Or the guys who walk 1.5 hrs across town and make it on time , no car or bus money, and do one filling a year( which essentially accomplishes nothing when you have 15 cavities). They get everything done so that what they can pay for will keep them from needing anything but a cleaning every 6 months.
I do stuff overseas because I get requests from there. It also helps locally by bringing other health care professionals and inspiring them to do more than sit on a beach in Mexico on their days off. I can't do half a million of free work a year, but a group of us can. Sometimes it just takes a new experience to get others into it as well.

We don't have the same mediCal system that I used to work with In SoCal. Makes it better for both parties.

mark miller

Social climber

Reno

Mar 31, 2013 - 08:02pm PT

Yo micronut,
being as you are the only one in this area of the country that has knott operated on me in the last 36 years, maybe we should get together and write a history of procedures and practices over the years. I was involved in a construction accident where the elevator crushed through my jaw half way through my skull and the rebuilding technologies of the 70's on ward, it's been a slice of life.
I can only hope that no one else gets to experience. Fortunately now they keep me on PTSD medications and I get through it day by day.
Maybe we can even climb and have a brew....

micronut

Trad climber

Topic Author's Reply - Apr 11, 2013 - 11:11am PT

Sorry everyone, haven't tended to this thread lately. I'll look upthread and try to answer the recent questions as soon as I have time.

Phil B.
Good question. Things like Arestin and other antibiotics that are "shoved/injected" under the gumline have a place in dentistry, but honestly I don't use them much at all, and I'm a gum specialist. The reason is this.

1. Even if you "kill" all the bacteria in the mouth lets say, on a monday, several days later the majority of them are back within 40 days. The body tends to re-populate, just like in the gut. There is a natural "flora" that is established and maintained. You take an antibiotic to reduce specific types of bacteria, and those "under the gum" antibiotics are good in killing some of the more potent "bad" players, but there are limitations to how long and how thorough.

2. The dose of Doxycycline is often really low, and the ability of the medication to stay below the gumline for very long is an issue.

3. There is a positive hydrostatic pressure under the gumline that "percolates" fluid called gingival crevicular fluid, up from down inside the pocket. when you inject down into the pocket, there is a tendency for the medication to just "float" back up to the top and out.

4. If there is something down deep under the gumline trapping bacteria...a big old filling, a crack, a furcation.....or tartar/calculus, you have to go get it and fix it. Putting antibiotics down there is just putting lipstick on a pig.

So, in isolated cases, where the deep scaling and root planing hasn't worked all that well, but the patient cannot afford surgery or the disease isn't deep enough to warrant surgery, I use it sparingly in the deeper sites. I charge about 40$per site, just to cover my costs. And I see pretty nice tissue results.

But many dentists use it as a sales pitch and to make money. You have to look out for those guys.

Good luck. AND FLOSS EVERY DAY!

Scott

Crimpergirl

Sport climber

Boulder, Colorado!

Apr 16, 2013 - 01:36pm PT

Micronut:

Thought I'd follow up regarding my earlier tooth questions in case you were interested.

Recap: Tooth 20 (lower, left all the way back molar) was cracked so the dentist recommended a crown.

I started the procedure for a crown. A couple days later, the tooth is killing in a way I know means it needs a root canal. I get the root canal.

Dang thing never quit hurting though everyone kept telling me I couldn't feel it (which angered me).

Whined about it for almost two years. Finally, days before I left for a 3 week out of town trip, my lower left jaw really started hurting like I need a root canal. I went to a new endodontist and he thought the problem could be #19. I got a root canal on it.

That was Nov. A few days into my trip, a good part of the partial filling comes out. Boo.

Get back to town, get the crown. Nothing much had changed. Oddly though #20 was feeling better. But #19? Felt like I want to pull #19. Throbbed. Woke me up at night.

I didn't make another trip to the dentist as I was tired of all the trips and being told all was well and that I couldn't feel the tooth since I'd had a root canal.

Hit the dentist a few weeks ago for a standard cleaning. They ask how all is. I tell them the same thing that I'd been saying for three years: my lower left jaw hurts and I want to pull my tooth. Also inform that I can no longer close my mouth properly and that #19 feels like it's lifting out of my jaw during the night. Thought I sounded like a crazy person.

They take a new x-ray and comment on such change in less that four months. Infection. Bone loss. Tooth Reabsorption. (I thought only cats got tooth reabsorption!)

So I'm in bed right now with a seriously swollen face after #19 had to be cut out yesterday. Got a bone graft and stitches and other fun stuff that accompanies all that.

While my mouth is throbbing a bit, I can say that the feeling that I want my tooth pulled has gone away which I'm very thankful for. I am a hillbilly now and will remain that way until I get the implant in 6 months or so.

I brought the tooth pieces home. They are gruesome! There are three pieces: crown, and each root. Figure I'll mount them as jewelry as the little devil cost me 5k total.

micronut

Trad climber

Topic Author's Reply - Apr 16, 2013 - 02:17pm PT

Callie,

WHat a drag. I'm so sorry you had to go through all that. Not just the dentistry, but the feeling that you were hurting and nobody was listening. In my opinion, without x-rays or other diagnostics, this is what happened.

1. The tooth was indeed cracked, not just up around the crown, but down deep, vertically along the root.

2. The dentist could not see the fracture because they are often hairline and not in the visible plane of the x-ray beam, being a 2D image of a 3D situation.

3. Though you had a root canal, it never felt right, and even hurt, because the periodontal ligament still has pain and "feeling" fibers, and bacteria can re-infect the site slowly along the fracture line, like a mini highway for bacteria.

4. I ALWAYS suspect a vertical root fracture if somebody has lingering, persistent pain after dental treatment that does not go away and "feels just not quite right."

5. The x-ray finally showed some darkness after the thing finally "blew up" and bacteria and abscess and resorption caused significant bone loss.

6. I may have recommended extraction of that thing long ago, right off the bat, and replacement with an implant, since they are so predictable, good looking, and definitive, but no need for me to Monday morning quarterback here. The thing is, they should have listenedwhen you siad it wasn't right.

7. You might be a hillbilly for a while while the bone graft repairs and an implant integrates, so I'd recommend some Daisy Dukes, pigtails and paint on freckles. Go for the Farmer's Daughter look, you could pull it off.

Say hi to Dave and I hope your episode with this tooth is soon over. E-mail me if you ever have any other issues, and maybe consider another dentist if you have lost some trust with him. Or talk to him and tell him how you feel. Maybe this one was just one of those tough to diagnose situations.

Scott

Don Paul

Big Wall climber

Colombia, South America

Apr 16, 2013 - 02:18pm PT

I just had a molar pulled out last Thursday. (in Colombia) Cost nothing at all, just like medical care. Dentist gave me something called diclofenaco, to reduce inflamation and pain. Three 3 ml doses. In Colombia they just give you the syringe and you have to find someone to inject it. Do you have any friends who can inject this? he asks. Not sure if they really want to, can I inject myself? He looks at me funny then agrees, so I get a handful of syringes and ampules, but pretty quickly find a friend who's injected lots of cows on the family farm. Problem solved. That drug worked great, by the way. No narcotic effects and really did eliminate the pain.

Crimpergirl

Sport climber

Boulder, Colorado!

Apr 16, 2013 - 03:11pm PT

Thanks Scott - you did indeed call the vertical fracture and need to extract a while back. BTW, I mentioned this possibility to my dentist after you mentioned it but she did not flinch.

Weird thing is that she didn't even recognize the infection/bone loss/reabsorption from the x-ray. Rather she had someone else look at it. I find that a bit scary. I would think even and "ordinary" dentist would know what that looks like. Maybe time for a new regular dentist.

So happy to have that pest out of my head!

The swelling is absolutely spectacular! I look like elephant man. Hope that goes away soon. I have to teach tonight so I'll be scaring people on public transportation and in the classroom. :)

micronut

Trad climber

Topic Author's Reply - Apr 16, 2013 - 03:16pm PT

Don Paul,
That stuff is made for getting rid of Tapeworms! Stop it now!

Just joking. Its Diclofenac, a fairly effective NSAID, like Motrin, Ibuprofen or Aleve. I think you might get better pain relief from 800 mg of Advil, Motrin or Ibuprofen in tablet form....and you don't have to have a buddy inject you. Which is probably kind of fun for your friends though. I don't want to rob them of the experience, but you may not even need it if you do some warm salt water rinses and keep ice on it for a couple days. Good luck.

Vaya Con Dios!

Scott

dirt claud

Social climber

san diego,ca

Apr 16, 2013 - 03:17pm PT

Hope you get better Crimpie. Thanks for this thread Scott, just noticed it. Very cool of you too offer this to the taco tribe. Now, if we could get a lawyer and physician on here who gives free advice we would be set,lol :-)

Crimpergirl

Sport climber

Boulder, Colorado!

Apr 16, 2013 - 03:22pm PT

Haha! I totally took the tapeworm hook. Good one!

Don Paul

Big Wall climber

Colombia, South America

Apr 16, 2013 - 03:36pm PT

Thanks Scott - Im fine but its cool you're helping people out like that. If I had a tapeworm I would probably leave it alone since its always so hard to lose weight.

All that's left now is to cut out the sutures after a week, scissors will probably work fine and I wont need a cattle rancher, just a paper pusher of which there are many around here.

skywalker

climber

May 9, 2013 - 05:58pm PT

Hi Micronut/ Scott

I just went to the dentist for a tooth I broke a couple days ago. Let me premise that it had a root canal 20 yrs ago and has been slowly ground to a pulp (no pun intended). Its the far back lower molar. The dentist gave me several options two of which require bone removal to make room to fix. The other was simply removing it and that its not that bad because its the 1st molar.

It was interesting that he noticed my bite was not correct and there was some discussion about me breaking and dislocating my jaw (break at the joint) 20 years ago. He didn't tell me what decision to make but hinted that due to lack of space in the back and an incorrect bite that it maybe better to correct the bite and cut my losses.

I had it pulled (not pretty for me) today. Afterward he said I was better off without it. I'm scheduled for a full evaluation in a month. Its the first time I saw this guy but he was super confident in his abilities and seemed like my super hero in this problem.

So....might I be better to call it good and rather than an implant in that small space and the bone restructuring required, use the effort to correct the bite and move on. I'm 40 by the way with a full set of teeth otherwise.

Thanks for offering! I felt he wanted to give me my options but wanted me to decide and I would like advice as a non patient. I know it all depends but any thoughts would help moving forward.

S.../Dan

climbski2

Mountain climber

Anchorage AK, Reno NV

Jun 13, 2013 - 12:29am PT

I think Micronut is on ElCap at the moment. Or perhaps just getting down.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Apr 18, 2014 - 02:30pm PT

Skywalker and Swellymoon. I just checked this thread for the first time in almost a year. It kinda fell off my radar.

micronut

Trad climber

Fresno/Clovis, ca

Topic Author's Reply - Apr 18, 2014 - 02:37pm PT

Skywalker. How you doing with that molar gone? If it really is a "first molar", which means it is the closest molar to the front...2nd molars are behind that and 3rd are your wisdom teeth.....you should look into a replacement.

If it is indeed your first molar you probably really want to look into replacement with a dental implant. The first molars are somewhat the cornerstone of the back teeth and it really helps long term to avoid other issues with your bite down the road if you have a good first molar. Especially if you have a history of issues with your occlusion, you may want to consider a consultation for an implant. They are wonderful and very predictable and typically less painful than the extraction. Have a surgeon do it, not a general dentist who also "does implants."

Let me know if I can help in any other way.

Scott