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Old 02-04-18, 10:29 AM
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Dentist Question

So 3 days ago a molar split in half, I went yesterday to get it drilled and filled, Although I wanted it taken out but the dentist said I need a referral from the doctor which sounds odd to me.

She said yesterday that the tooth is totally savable and today she said oh no it's totally dead, As I had to go back today due to having an infection in the same tooth which she deemed ok but which has made the right side of my jaw swell up like a melon.

She wouldn't look me in the eye, Kept looking over me when she was talking to me and was in a rush to get me out as fast as possible.

So my question is, Why would I need a doctors referral to get a dentist to take a tooth out ?

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Old 02-04-18, 10:40 AM
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I do not know how these things go in the US, but in the Netherlands, dentists are free to pull teeth as they see fit - as long as you (the patient) agree. Judging by how you describe your dentist, I'd find a new one. I obviously don't know your history with her though, so do as you may.
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Old 02-04-18, 10:41 AM
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Originally Posted by AverageNinja View Post
I do not know how these things go in the US, but in the Netherlands, dentists are free to pull teeth as they see fit - as long as you (the patient) agree. Judging by how you describe your dentist, I'd find a new one. I obviously don't know your history with her though, so do as you may.
I'm in England not the US

I saw her yesterday for the first time and today the 2nd time, Just amazed that a doctor would treat a patient like that.
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Old 02-04-18, 10:52 AM
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I'm in England not the US

I saw her yesterday for the first time and today the 2nd time, Just amazed that a doctor would treat a patient like that.
Right, gotcha, I thought you'd moved to the US for some reason.

If you haven't seen her before all this, I would get out. She doesn't sound like a good dentist to me. I wouldn't take the chance.

Not quite the same, but I recently switched orthodontists myself. I had braces removed at age 15, but it turned out my jaws were crooked and whatnot, so they went back in at 18. I'm 21 now, and my teeth still weren't good. Went to another orthodontist last week, and she did some adjustments. They're pretty damn close to perfect now. My braces can probably be removed early June

So yeah, if you're not happy, leave.
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Old 02-04-18, 11:05 AM
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Is this an NHS dentist? Private ones should do it fine if you request it, they may have concerns on how safe it is, in which case you may need a hospital referral.
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Old 02-04-18, 11:49 AM
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lol BS. I went down for a checkup last year and had one pulled out whilst I was there.

Dentists will always tell you that as there is no cash in it for them. I had a tooth filled once (like yours, a molar that had split in half) and the dentist filled it. Got to America, took a bite of a cheese steak and the filling simply slid off. I was in agony for weeks, eventually having to pay a dentist to temp fill it until I got home, who told me that it was far past being saved and should have been pulled.

My vanity years have long since passed, so any issues at all now and I get them pulled.
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Old 03-04-18, 03:48 AM
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You need a doctors referral because tooth pulling is a surgery. You need a full checkup before it. Blood work, heart condition, allergies, etc... If you are a diabetic, or have high blood pressure there are different procedures that need to be applied while pulling teeth. Dentist can't do those things, so he/she refers you to a doctor.

Edit: As for the condition of the tooth... She may have overlooked something on the first examination, or infection developed despite her best efforts. This things happen in medicine. Also you are not her only patient, maybe she had another emergency case, or private emergency, and that is why she was rushed. You can't judge her without knowing the facts. It is standard procedure that tooth which is causing the infection is extracted and all puss drained.

Edit 2: I must also add that having teeth in your jaw is extremely important. Without them in the bone geometry and anatomy of the jaw is seriously compromised. Every effort must be made to keep them in. The best example are the old people without teeth, and you can see their jaw protruding forwards. This also happens with use of artificial teeth that you can pull out and put in jar (like in cartoons), because they make contact with soft tissue and not the bone. The only proper solution with teeth loss are titanium bone implants, so that the pressure of the chewing can be transmitted into the bone.

So AlienALX please keep as many teeth as you can, and repair them instead of just pulling them out.
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Old 03-04-18, 07:07 AM
Warchild Warchild is offline
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Originally Posted by Avet View Post
You need a doctors referral because tooth pulling is a surgery. You need a full checkup before it. Blood work, heart condition, allergies, etc... If you are a diabetic, or have high blood pressure there are different procedures that need to be applied while pulling teeth. Dentist can't do those things, so he/she refers you to a doctor.

Edit: As for the condition of the tooth... She may have overlooked something on the first examination, or infection developed despite her best efforts. This things happen in medicine. Also you are not her only patient, maybe she had another emergency case, or private emergency, and that is why she was rushed. You can't judge her without knowing the facts. It is standard procedure that tooth which is causing the infection is extracted and all puss drained.

Edit 2: I must also add that having teeth in your jaw is extremely important. Without them in the bone geometry and anatomy of the jaw is seriously compromised. Every effort must be made to keep them in. The best example are the old people without teeth, and you can see their jaw protruding forwards. This also happens with use of artificial teeth that you can pull out and put in jar (like in cartoons), because they make contact with soft tissue and not the bone. The only proper solution with teeth loss are titanium bone implants, so that the pressure of the chewing can be transmitted into the bone.

So AlienALX please keep as many teeth as you can, and repair them instead of just pulling them out.
Its only surgical if its a lower dental. As the nerves pass over the jawbone responsible for the muscles in your face it is specialist work. Often the lower teeth are fused to the jawbone. For upper molars, a dentist can extract at their own discretion.

So chances are if its lower molar, that is why you need a referral. Also a dentist will always try to save the tooth unless it will cause complications later on. a split molar is usually salvageable.

And don't just get your tooth pulled for the sake of a little grief. You will regret it later. Unless you are happy wearing dentures before you hit 60 yrs old. I have always looked after mine. Only wisdom teeth have been removed for me and I don't have any fillings or cavities. I always use corsodyl as a mouth wash after brushing. Disgusting but useful.
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Old 03-04-18, 07:34 AM
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Originally Posted by Warchild View Post
Its only surgical if its a lower dental. As the nerves pass over the jawbone responsible for the muscles in your face it is specialist work. Often the lower teeth are fused to the jawbone. For upper molars, a dentist can extract at their own discretion.

So chances are if its lower molar, that is why you need a referral. Also a dentist will always try to save the tooth unless it will cause complications later on. a split molar is usually salvageable.

And don't just get your tooth pulled for the sake of a little grief. You will regret it later. Unless you are happy wearing dentures before you hit 60 yrs old. I have always looked after mine. Only wisdom teeth have been removed for me and I don't have any fillings or cavities. I always use corsodyl as a mouth wash after brushing. Disgusting but useful.
No mate it doesn't work like that. There are no nerves for your face passing over the jawbone. Trust me i was teaching anatomy for 3 years at faculty of medicine. Facial nerve goes through your cheek, well away from the teeth, and jawbone. Lower teeth are easier for pulling out because the top ones are in close proximity to maxillary sinus, and extraction could result in opening communication between maxillary sinus and oral cavity. If that happens you need maxillofacial surgeon to repair the opening.

Because there is an infection, and swelling the procedure will be more complicated that if it was just tooth extraction, and that is why she probably asked for doctor exam.

On first picture you can see the nerves for teeth going through bone.

On second picture you see facial nerve going over the muscles and underneath the skin.

On third picture you can see how close are teeth's roots to maxillary sinus.





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Old 03-04-18, 08:01 AM
Warchild Warchild is offline
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exactly the point i am making. In your first picture you have pointed out the nerves that "can" cause complications, expecially for Wisdom tooth extraction.

The Trigeminal nerve which branches out into the Inferior alveolar, and mandibular, passes through the jawbone which can actually be in contact with the wisdom tooth. I'm far from knowledged but I think one of these provides sensation to the lower jaw/face including the lips.



Maybe I worded it wrong but this is the nerve which in many cases means you sign a disclaimer before surgery. A normal dentist typically does not handle extractions like this. Both wisdom teeth for me, required a specialist as a normal dentist was not allowed to even touch them. Once in UK, and once in Norway.

To add further complications for me, my wisdom tooth was angled at 90degrees and the nerve passed alongside my roots (all four of them) What made it worst of all is that the soft membrane that surrounds the tooth was incomplete meaning my tooth had fused to the jaw.

As I said, this is not my area of knowledge, but when you experience it, some things stick in your memory. I see my mistake though. I shouldnt have stated over the jawbone but through.
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