[MaterPrimaePuellae]

I know almost nothing about teeth; mine have always been so healthy that I haven't paid much attention. Dh is not so lucky, and I need some advice. Anything you can suggest would be SO appreciated!!

Dh (late 20s) has a cracked tooth-- a rear molar (the furthest back in his mouth). I have seen the x-rays, and the root is VERY close to being exposed. The dentist said he will prob. need a root canal if it is not crowned soon ($1500).
We have dental ins., but (of course) it covers crowns at... 0%.

Dh also has a HUGE wisdom tooth which is completely sideways and almost pressing against the base of this cracked tooth.

We are considering extraction instead, which our insurance would cover at 80%. It seems to us that this might also free up some space for the wisdom tooth? The dentist we saw today was very big on "aesthetic dentistry," so we didn't even bring up the possibility of extraction at the time (also the baby was crying and we were frazzled!)

There must be disadvantages to this, though. Would an extraction cause his teeth to shift? It doesn't seem to me that an extraction so far back in his mouth would be noticeable, but am I wrong about that?

Again, I would really appreciate any advice. $1500 is a *lot* of money for us, so if this is "cosmetic" procedure, it's not worth it. If it's necessary, though....

Alas.

 

[WaitingForKiddos]

I feel ya...I just posted in TAO about my mouth issues.

From what I was just told today about my bottom wisdom teeth which are facing sideways....they must come out. Even if they are next to an extracted tooth (as is also my case) it will not just move into the new spot but grown into it in such a way that the other teeth could be messed up.

Now, I'm no DDS, but I would say extract the wisdom tooth #1 and then deal with the crown. Or rather, don't go out of the way fixing a tooth that is butted against a sideways wisdom tooth. Those wisdom teeth make bad, bad neighbors when they are sideways.

Stupid teeth.

BTW, go get a second opinion that that crown. Lots of DDS offices can tell you their 'no coverage' price over the phone. 1500 for a crown seems a bit high to me...even w/o insurance. Ask about in house insurance plans too.

 

[MaterPrimaePuellae]

Thank you!
So, you have had a rear molar extracted? Has that caused you any problems? Given the wisdom tooth issue, it does seem silly to "invest" in a tooth that might be destroyed, anyway (and my Dh suspects that this tooth was vulnerable to cracking because of the wisdom tooth).

Ah, the wisdom tooth. My husband's old dentist told him that it was the largest wisdom tooth he had ever seen, and I can believe it. It is humongous. I don't know what we'll do about it.... but I know we'll be springing for the "Gold Plan" of dental insurance for the year we decide to attack it!

 

[Sri Radha]

I am a dental hygienist. $1500 is expensive for a crown alone, however he may need a build up, and post and core if much of the tooth is missing. I would never choose extracting a tooth if it could be saved. When you extract a tooth it can cause other problems such as the other teeth moving into the space. That can cause gum problems and even more possible tooth problems down the road. The way to remedy that is a bridge (more expensive) or an implant (even more expensive).

80% is very good coverage for crowns. Most people's insurance only covers 50%

 

[MaterPrimaePuellae]

Quote:

Originally Posted by Sri Radha 80% is very good coverage for crowns. Most people's insurance only covers 50%

No, it's 0% for the crown, 80% for the extraction.

Yes, he requires a buildup as well, which is 250 of the total.

It is a porcelain crown; is it possible that we could get a different one (I think there are stainless steel ones?) for less?

Sigh. I was afraid this would be the case, re: the damage to his mouth from removal.

 

[mommabear207]

i've also had to deal with these problems so i think several things.
first its better to keep all the teeth you can. removing not only causes tooth loss

but some bone loss below the gums too.
removing teeth causes a reaction with the ones surrounding
wisdom teeth don't actually grow correctly into a spot, if they're messed up they stay that way and they are softer teeth which makes them poor candidates for leaving in ones mouth.if you do you'll prob. be going back to the dentist for a filling (or even a crown).
crowns are actually better than fillings too cause they are restorations not temporary fixes that need replacing after 7 or so years.
now the top two things you can't really do much about but as for the rest well you could extract both the cracked one and the wisdom tooth at the same time. and seeing how there is nothing behind those nothing is going to move up weird. but if you can save it i would but thats also up to you. its really just a shame that we have to make choices like this based on money and not whats best for keeping or teeth. shows how screwed up insurance is.

 

[paquerette]

I had extractions 3 years ago. The top wisdom teeth and the adjoining molars. The wisdom teeth were not completely erupted and had decay, plus causing decay to those molars. The repair work would have been extensive to try to save anything (the option was to save 1 molar on one side and 1 wisdom tooth on the other while extracting the others) and I really just wanted it over and done with. I haven't had any problems since. The other teeth haven't shifted or anything. I can feel the spaces behind them, so it's not like my mouth was so small that that couldn't happen either, it just hasn't.

 

[WaitingForKiddos]

Quote:

Originally Posted by MaterPrimaePuellae No, it's 0% for the crown, 80% for the extraction. Yes, he requires a buildup as well, which is 250 of the total. It is a porcelain crown; is it possible that we could get a different one (I think there are stainless steel ones?) for less? Sigh. I was afraid this would be the case, re: the damage to his mouth from removal.

All porcelain? Again, I'm no DDS, but it's been suggested for my molar crowns to be gold AND porcelain. Porcelain, unless it's a LAVA brand (ie: the Prada of crowns) just can't stand up to the major impact molars face. Never get 'metal' though...it's going to break and crack and be a mess. So, from my knowledge, you have an option between a solid gold crown (and know that it's a gold alloy) OR a porcelain fused to gold. It's a back molar so if DH doesn't care about having a glimmer of gold when he laughs big, save the money and get the sold gold.

There's many, many different types of crowns. Don't be conned into the name brand one for a molar that needs extra work. If it was a front tooth I'd be saying something different.

Again, stupid teeth!

 

[Sri Radha]

Molars should have porcelain and metal (either gold or silver). Molars have the most biting pressure and porcelain alone doesn't cut it.

They do make all metal crowns. If you go that root I recommend all gold. Where do you live? $1500 sounds expensive to me but it could be your area. My office is $800 for crowns plus whatever add ons you may need like a build-up etc. When I lived in NJ the going rate there was $900 approx.

 

[MaterPrimaePuellae]

Thanks, everyone, for the replies. It sounds like an extraction is not worth the savings, though we will probably find a good dentist and get a second opinion just to be safe. Yes, i did get the impression that the cost at the first dentist was high. It was a very fancy office, and their main focus was on cosmetic dentistry. We have the opportunity to upgrade our dental insurance in 4 mos, so we might try to keep it at bay (maybe even a filling in the interim?) until we can upgrade. I don't even know if that is possible....

 

[Mama2Kayla]

I just had my back molar extracted 6 months ago. It was the same situation as your dh, cracked and 90% chance of needing a root canal. My wisdom tooth next to it was sideways but almost in all of the way.

I chose to have it extracted for $ reasons. It worked out well and now my wisdom tooth has straightened out and almost filled in the space where the extracted molar was once placed. The dentist I just visited is now recommending I keep the wisdom tooth in my mouth.

Good luck!

 

[MaterPrimaePuellae]

meghan,
Thank you! It sounds like exactly the same situation (except that my husband's wisdom tooth is completely sideways far below his gums; I don't see how it could ever come in). When you chose this route, did the dentist tell you any possible problems it could cause? or was it just another option? There is SO much money in the crown vs extraction that I feel it's hard to get a good unbiased response, you know?

 

[Mama2Kayla]

Quote:

Originally Posted by MaterPrimaePuellae meghan, Thank you! It sounds like exactly the same situation (except that my husband's wisdom tooth is completely sideways far below his gums; I don't see how it could ever come in). When you chose this route, did the dentist tell you any possible problems it could cause? or was it just another option? There is SO much money in the crown vs extraction that I feel it's hard to get a good unbiased response, you know?

Well, they really did try and talk me into a root canal/crown. Like your dh, I went to an upper scale dentist office. Really big on all of the latest things, etc. I just felt like their main argument was based on the stigma of loosing a tooth, and the cosmetic aspect of the procedure. They did mention my teeth could shift, or the matching tooth on the bottom could loosen due to a lack of top molar to "meet" it. I researched for about 3 weeks before making my decision and read everything online I could about extractions. I even saw another dentist for a second opinion( He was holistic and up to date on all of the root canal dangers).

It really boiled down to the location of the tooth. It wouldn't be visible to anyone else, and since it was all the way in the back, I felt like any shifting would me minor since it wasn't in between 2 of my teeth. I planned of the possibility of getting an implant put in should there be any problems to come down the road. However, since my wisdom tooth has moved into the gap I don't think I will need an implant. My bottom molar now meets the wisdom tooth instead of the extracted one

.

Also, the chance of having an issue with a root canal seemed pretty high, and I wasn't willing to risk it for a tooth no one would ever notice missing. If the afflicted tooth was in the front, I would have definitely tried to save it.

Anyway, I hopes this helps you some. Good luck to your husband and feel free to pm me if you have any more ?'s