[Kieran]

Thanks again DVY; so much good information in this thread.

Regarding metal allergies, I just realised I have had metal braces for the last two years with no issues so I imagine that I should be okay.

Just one final question I forgot to ask before. My front central incisor is chipped/broken, and I would guess that I'm missing approximately one third of the tooth or slightly more. How much is it safe to extend the tooth by when placing a crown, and still get good retention? I know that typical prep would be a reduction of about 1.5-2.0 mm, but is it okay to lengthen a tooth by more than this, or would I require a post and core build up?

[thegmanifesto]

(05-07-2013 12:37 PM)DVY Wrote:  

(05-03-2013 05:20 PM)thegmanifesto Wrote:  

DVY -

Went to a new dentist and they told me I have some spacing at the top on my very back molars.

They want me to go to an orthodonist to get a retainer to wear at night, or in 5 years may suffer some bone loss.

I floss two times per day, but I guess my gums are red back there. I can't see them obviously.

Is this a good move, from what I can tell you?

Or a hustle to get me to buy a $800 retainer.

Keep in mind, I have no problem spending what it takes on my dental health, but I obviously am allergic to getting hustled.

You are getting hustled. Esp that I know you are in your late 30s or early 40s. This is a common semi-scam. Maybe their is a little bit of spacing, but the retainer wont solve much. 2nd molars dont really move past the age of 25. The only common time they move is if their is no opposing tooth, and it starts supra-erupting (coming down).

If still concerned, next time you come back to LA, I could take a look.Gratis

Invest a bit of money into a waterpik (40 dollars). This will help w/keep that area in the back clean. Its tough to floss back there, and I would say 80% of the problems are manual dexterity issues/mental avoidance issues. Can be purchased online or at most stores (CVS, bed/bath and beyond, etc etc).

Haha, bone-loss is not caused by spacing. This is just laughable. Doom-slinging con-artists!!!! Its caused by inflammation (usually from food getting stuck down there). IE use a waterpik to help irrigate that area.

PS- I make retainers for 150-200 buxs, and I am still making a decent profit. This guy is a rip-off artist.

Thanks.

Yeah, I guess they were actually going to charge me $350 for the retainer.

I am skeptical of this dentist though.

He is a real "flash dentist". You know, the kind of guy who drives a white Lamborghini with red interior. That type of dentist.

The only reason I go is it is right across the street from me.

And there are always models in the lobby waiting.

Other than that, I feel like I am paying for the guys champagne bill that night.

[Travelsick]

Anyone ever tried those gel whitening thingies? I ordered some last time I went to the hygienist and my dentist dropped them off last night. Says I shouldn't eat anything colourful right before or after.

I'm sort of worried I'll end up with blue or red teeth.

[The Fantasist]

(05-07-2013 12:30 PM)DVY Wrote:  

@Vorkuta- its best if its placed ASAP, but a month more is basically a non-issue. IF you have a flipper (partial denture) to hold the space, you could even wait more (say 3-months). But having that crown is amazing. You can smile/eat/laugh w/impunity...

Good to hear it all worked!!!! Im glad that I saved you a grand or more. =).

Yes I can't wait to have it fitted finally. At the moment I have this little post/peg in my implant which just looks hideous when I smile and I'm self concious of it. Soon I'll be grinning in photos again.

Yes, cheers for the advice a while back. Should our paths cross down the road somewhere I'll be sure to spend a chunk of that grand on a few beers for you.

[DVY]

@Mvolt- Dont really know enough about Castille's soap. But its probably ok (just dont swallow any). You could probably brush your teeth w/a wet t-brush and itll work about 90% the same. The brush is really to very lightly mechanically remove any debris.

@Thomas Rhymer- ill do a full post on this, but ALWAYS SOFT T-BRUSH.

@IKE- good to hear! Use the large one, but dont put it to full blast. The travel-size one isn't powerful enough. You should still floss at least 1/week. Don't forget brushing/waterpiking is more important prior to sleep than in the morning! You dont want debris sitting near your gums/teeth at night (when salivary function/buffering is lowest).

@Travelsick- I covered this previously, and why I feel like whitening is a giant scam (temporary results w large % of pateint experiencing sensitivity issues). But yes stay away from all colored foods during bleaching and 2 weeks after- coffee, tea, curry, gatorade, wine, dark beer etc etc. This whole whitening thing is really not life-practical.

[DVY]

@Kieran- its fine. The rule of thumb is that we need at least 2mm of tooth structure to place a crown. Obv the more tooth the better, but your fracture should be fine (no RCT/post/buildup needed). If you have a heavy bite, it might be worth it to get lingual (tongue-side) metal surface . Up to you and the dentist to decide really. Or they might leave a few metal spots where the bite is "high" and there isnt enough space for porcelain.

[Kieran]

Thank you again for taking the time to respond DVY.

[Bad Hussar]

How to put my question in as few words as possible. OK, here goes:

Post and Core with Crown vs 2 Mini-Implants with Crown vs 1 Regular Implant with Crown

The affected tooth is a molar on the upper jaw so may be sinus lift issues. Not sure one way or the other yet.

My personal preference would be for the post and core but I always read that this can only be done if enough of the tooth remains. But when looking at pictures of post and cores before the crown is placed it seems the whole tooth above the gum line is removed anyway. So as long as you can do a root canal on a tooth, why can't you do a post and core?

As for the mini-implants vs regular implants. I've seen arguments for/against each position. Would you say that the assertion that having 2 min-implants spreads the load more naturally and is therefore better carries any weight? Obviously mini's are far cheaper and can be placed in circumstances where regular implants can't or would require bone grafts. Just concerned that since the mini's are....mini they would eventually cause more bone loss than a regular implant.

[DVY]

@Bad Hussar- RCT/post and crown is probably the easiest, both time and money-wise. This should be #1 if possible (depending on how much tooth is left)

2 mini-implants is a terrible idea for the upper molar area esp w/an extraction. Trust me on this. Doesnt work well. Failure rates are very high. This is below the standard of care in the USA. Doesn't predictable work in soft bone (extraction site on the upper molar area). I only do 4 minis to help support an lower full denture that articulates against a full upper denture. The mini's pop out all the time if subjected to heavy bite (i.e. molars).

Depending on the bone quality as well as length and width, the best if you go for implants is to extract the tooth, place a bone graft. Pray that you dont have to do a sinus lift, come back in 4-6 months and do a short length (7-10mm length) wide diameter platform (if possible). This will take about 1 year or 1.5 years if w/sinus lift. Lot of headache, lot of of uncertainty. Thats why I dont recommend it as a #1 option.

Do the RCT/post and crown and be done w/it. Implants aren't the "end all, be all" that they are touted to be.

[Bad Hussar]

^^^ Thanks DVY

I certainly hope a post and core can be done. Implants seem like a massive headache to be honest. I just have to bite the bullet and get a medical opinion on the tooth. The article I'm linking to below kind of gives me hope, since the tooth I have an issue with is nowhere near as far gone as this one, and somehow the dentist managed to make a post and core work. That's why I was musing about whether a post and core could be done as long as a root canal could be done:

http://www.alaska.amedd.army.mil/dentac/..._Teeth.htm

PS: Can you explain the benefit of gold fused to porcelain as opposed to non-precious metal wrt crowns? I'm sold on the metal rather than all porcelain or zirconia, but am unsure why gold is better than other metals. I typically smirk rather than smile like a Cheshire Cat so it'll make little visual difference to me.

[DVY]

The biggest difference is that Porcelain fused to metal (aka non-precious) has much higher nickel content. This can create allergies in a small % of population.

2nd differences is that gold is bacteriostatic (bacteria doesnt proliferate well on gold).

Honestly, for most the benefit is minimal. The cost isn't.

[DVY]

(05-09-2013 02:04 PM)DVY Wrote:  

The biggest difference is that Porcelain fused to metal (aka non-precious) has much higher nickel content. This can create allergies in a small % of population.

2nd differences is that gold is bacteriostatic (bacteria doesnt proliferate well on gold).

Honestly, for most the benefit is minimal. The cost isn't.

Edit- funniest thing is that these dental guys are such scam artists! Zirconia is being marketed as "metal-free". Zirconia is a METAL. a white-colored metal. These porcelain crowns have alumina particle inside, aka METAL. metal-free doesn't work well.

[DVY]

Edit- Meant to say most "porcelain-only" crowns have alumina particles inside**

[MidniteSpecial]

I'm in my mid twenties and have never had a cavity. Does that mean I will never have one? Or is there a chance I can get one down the line?

I brush my teeth with neem toothpaste.

http://www.amazon.com/Neem-Active-Toothp...roduct_top

I can't stand any commercial toothpastes I hate the way it makes my mouth taste.

Also I read fluoride is next to mercury and lead on the poison chart? Is that true?

[DVY]

@Midnite- you have a low risk of getting cavity. This means you will likely not get a cavity ever in your life. That doesn't mean you shouldnt brush. Highest cavity risks are from teens to mid 20s. There is another spurt around 55 to later life, because salivary function/buffering slows.

As for T-paste no clue.

Couldn't find this "poison chart", but I assure you elemental mercury is on a whole different level of toxicity. Thankfully, even in dentistry, miniscule amounts are released when mixing the silver filings. Most mercury is bound in substrates of Silver-mercury-copper-tin complex.

If you wanted to talk about toxicity, chloride gas (chlorine is a derivative) is extremely toxic. And elemental sodium too. Us americans have odd fixations on random things.

Danger is usually in what the average person doesn't know, rather than what is known- Radon seeping from the ground, carbon monoxide poisoning from faulty furnaces, mold and other spores from older wood, pesticide run-off, industrial waste by-products, diseases carried by other carriers (like rats, mosquitoes, flies, etc).

Reaction between sodium and water-

[DVY]

Vent-post- Dealing with Imbeciles from a Billion Dollar Company

Our dental office was in the market shopping for a dental sensor (basically electronic X-ray sensor that attaches via USB to the computer).

We had various companies come to the office, and our favorite imaging products was Carestream Dental. So we had negotiations w/the rep, he checked out our computer systems. And gave us a price quote of 10.3k dollars including a 5 year warranty, installation and support.

We bargained w/them down to 9.3k. Great.

We received our imaging system 2 weeks ago Thursday. Call them to install on Friday. Install staff refuses to install system because "it is not compatible -You have Windows 7 home, not Windows 7 proffesional". We call the rep Friday afternoon. Call Saturday. Call Monday.

Finally Tuesday late afternoon after hounding the representative, leaving voicemails for him and his manager and all of his superiors, we FINALLY get a call back.

Weds, he comes in w/the main technical support guy for Los Angeles area. They take a look at our system, and say yea, we need to upgrade your software. 12 computers is about a grand in software fees and probably another thousand or so in technical support fees. Rep promises to sort this out and get back to us the next day.

Thursday, MIA. We call him. No response. More voicemails. More emails.

Friday, MIA. More calls. More voicemails. More emails.

Monday, MIA. More calls. More voicemails. More emails.

Finally on tuesday, we get a email back from the "manager", saying we can return the product but w/a 750 dollar restocking fee.

Back and forth, we go. Today, reaching the end of our leash we called Amex and put a dispute charge on this payment. Amex stopped payment, and we will see how it all plays out w/the dispute charges.

How a multi-billion company can conduct affairs like this is beyond me. Selling something that isn't software compatible, dodging calls, hiding from customers, refusing to take product back that was mis-sold, not getting back to you in proper time-frames via email. Ludicrous and imbecilic behavior.

[Kieran]

(05-09-2013 02:04 PM)DVY Wrote:  

The biggest difference is that Porcelain fused to metal (aka non-precious) has much higher nickel content. This can create allergies in a small % of population.

2nd differences is that gold is bacteriostatic (bacteria doesnt proliferate well on gold).

Honestly, for most the benefit is minimal. The cost isn't.

Is there any difference in the appearance? For example does the metal show through the porcelain more than gold?

Thanks

[DVY]

@Kieran- No aesthetic difference.

[Bad Hussar]

(05-16-2013 05:51 PM)DVY Wrote:  

Vent-post- Dealing with Imbeciles from a Billion Dollar Company

Our dental office was in the market shopping for a dental sensor (basically electronic X-ray sensor that attaches via USB to the computer).

We had various companies come to the office, and our favorite imaging products was Carestream Dental. So we had negotiations w/the rep, he checked out our computer systems. And gave us a price quote of 10.3k dollars including a 5 year warranty, installation and support.

We bargained w/them down to 9.3k. Great.

We received our imaging system 2 weeks ago Thursday. Call them to install on Friday. Install staff refuses to install system because "it is not compatible -You have Windows 7 home, not Windows 7 proffesional". We call the rep Friday afternoon. Call Saturday. Call Monday.

Finally Tuesday late afternoon after hounding the representative, leaving voicemails for him and his manager and all of his superiors, we FINALLY get a call back.

Weds, he comes in w/the main technical support guy for Los Angeles area. They take a look at our system, and say yea, we need to upgrade your software. 12 computers is about a grand in software fees and probably another thousand or so in technical support fees. Rep promises to sort this out and get back to us the next day.

Thursday, MIA. We call him. No response. More voicemails. More emails.

Friday, MIA. More calls. More voicemails. More emails.

Monday, MIA. More calls. More voicemails. More emails.

Finally on tuesday, we get a email back from the "manager", saying we can return the product but w/a 750 dollar restocking fee.

Back and forth, we go. Today, reaching the end of our leash we called Amex and put a dispute charge on this payment. Amex stopped payment, and we will see how it all plays out w/the dispute charges.

How a multi-billion company can conduct affairs like this is beyond me. Selling something that isn't software compatible, dodging calls, hiding from customers, refusing to take product back that was mis-sold, not getting back to you in proper time-frames via email. Ludicrous and imbecilic behavior.

Reading your post I was thinking: Just don't pay the bill. They'll soon phone you back after that. Didn't realise you'd paid by credit card. Sounds like very bad business practices by Carestream. At the very least they should apologise for not realising you didn't have the required software and accept the returned device without any fee.

If they had any sense they would have phoned you back right away, apologised, and tried to convince you that their scanner was so good you would be better off upgrading Windows 7 to use it rather than going with a competitors product.

Sounds like you were dealing with an amateur rep who was hoping that you'd just forget about it and he'd still get his commission. Unbelievably short-sighted.

[DVY]

VP of said company called me. Offered to install windows 7 professional on all our computers. I refused, and requested full refund. She said that refunds are a 15% restocking fee (my 750 figure should actually be 1.4k). I told her that this is unacceptable.

I don't even want to get near this company w/a 10-ft pole. Nothing but drama and headache from dealing w/them. Can you imagine how shitty their service will be after 1-2 years? Unbelievable.

Amex froze payment to their company, and this charge is in dispute. Well see how it plays out.

[WestCoast]

Clinpro 5000 is that stuff legit. Note my dental history blows, they gave me a sample.

[cardguy]

Is removal of wisdom teeth mostly a scam?

And why is the back of my front lower teeth incredibly sensitive to the cold - whilst the rest of my teeth are fine? Luckily it is easy to protect that side of the teeth from coming into contact with cold foods (mostly ice cream).

Also - I am very sensitive to taste and flavours. So I brush my teeth about 5 times a day. Not good I guess. But I can't stop it.

And any tips to avoid morning breath?

Sorry for all the questions!

[Thomas the Rhymer]

I went to my oral hygienist yesterday. Why does a thorough tooth cleaning have to be so painful? Or should I find an oral hygienist who is able to clean teeth without inflicting pain? I'm not complaining about the final result, my oral hygienist really knows how to dig out plaque, but I hate the fact that I have to endure a torture session every 6 months just to have clean teeth.

And I'm still waiting for advice on choosing a toothbrush.

[dk902]

Funny I had the same experience with my oral hygienist yesterday. She left no stone unturned whilst she was blabbing on about the pros and cons of Sweden vs UK.

But I just grinned and beared it. Couldn't exactly grit my teeth though!

I'd also like to know about the wisdom tooth thing. People I know have had theirs out and when they have a second opinion they didn't need to.

However I've been advised after seeing the dentist to have mine removed. Ive seen the X-Ray and it's leaning into the tooth next to it, as he said if it gets infected and there's issues it will take out the other tooth too. This would be a preventative measure as opposed to when it's really bad somewhere downthe line.

I'm inclined to think he's genuine though.

[DVY]

Toothbrush Data-

1) Get a soft T-brush.

2) Brush softly. Brushing is actually the wrong word. You should buff your teeth. The theory is that you dont "scrub" away debris. First, you rinse to get rid of major chunks. Second, you do a light buffing motion to GENTLY let the bristle of the brush touch every surface. There should be just enough pressure to make the bristles reach in between your teeth, but not so much that you "feel" it. 90% of people are brushing too hard.

The analogy is a car. Rinse it to remove debris, then light buffing motions to clean it.

3) Throw away your brush when the bristles start flairing out widely. The bristles are fine, but the angulation of the bristles is not conducive toward reaching in between teeth (unless you brush at weird angles)

Couple more thoughts-
More people have recession (from hyperzealous brushing) because on their dominant side. For most, there is worse toothbrush-enabled gum recession on the right side, because its easier to press harder on the right side than across the mouth on the left side.

Flossing is important because there is that last little bit of tooth that the brush can't reach. For a certain small % of the population w/weak enamel, its imperative to brush and floss regularly for cavity control.