Dentist Question

[Dicehunter]

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 ?

 

[AverageNinja]

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.

 

[Dicehunter]

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.

 

[AverageNinja]

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 :lol:

So yeah, if you're not happy, leave.

 

[SPS]

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.

 

[AlienALX]

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.

 

[Avet]

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.

 

[Warchild]

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.

 

[Avet]

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.

 

[Warchild]

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.

 

[Avet]

Yes that is correct. Wisdom teeth are a different story all together, and require specialist treatment. That particular case of 90 degree orientation is far from normal. So i understand why you needed to sign a disclaimer, because it is hard to guarantee 100% success.

My point is that doctor referral should be standard before major interventions. Usually it is done only for more complicated procedures. Private practice doctors just want to charge you another procedure, and they give you few questions only. Dice's case sounds to me as a slightly complicated, because if infection, so i understand why his dentist wanted doctor's opinion.

Also an RTG scan is often requested so the dentist can see how is tooth implanted into a bone. Molars aren't normally in contact with nerve, but we are all slightly different.

 

[russler]

Every dentist seems different nowadays when one of my teeth split I was passed from pillar to post, went private after the second infection, who instead of pulling managed to save the tooth the only thing I had to do was run a course of antibiotics first, no mention of doctors referral.

 

[Dicehunter]

Well I consulted a private dentist only a 5 minute walk from my place and they said I should take my course of antibiotics until the massive swelling, Just like the guvs video a while ago, Goes down, Then they will do a root canal, Disinfect, Clean etc... and fill it with permanent stuff, Going to cost £300 in total which includes aftercare but worth every penny.

 

[Warchild]

Well I consulted a private dentist only a 5 minute walk from my place and they said I should take my course of antibiotics until the massive swelling, Just like the guvs video a while ago, Goes down, Then they will do a root canal, Disinfect, Clean etc... and fill it with permanent stuff, Going to cost £300 in total which includes aftercare but worth every penny.

300 is cheap cost me 1600 for wisdom tooth extraction

 

[russler]

Well I consulted a private dentist only a 5 minute walk from my place and they said I should take my course of antibiotics until the massive swelling, Just like the guvs video a while ago, Goes down, Then they will do a root canal, Disinfect, Clean etc... and fill it with permanent stuff, Going to cost £300 in total which includes aftercare but worth every penny.

£300 is cheap man (for private) mine was 700 for the canal and 450 for the gold crown, like you said worth every penny, nothing worse than tooth pain.

 

[Avet]

Well I consulted a private dentist only a 5 minute walk from my place and they said I should take my course of antibiotics until the massive swelling, Just like the guvs video a while ago, Goes down, Then they will do a root canal, Disinfect, Clean etc... and fill it with permanent stuff, Going to cost £300 in total which includes aftercare but worth every penny.

It is good that they can save it. It will be a lot of work but worth.

 

[Warchild]

£300 is cheap man (for private) mine was 700 for the canal and 450 for the gold crown, like you said worth every penny, nothing worse than tooth pain.

I think dental pain is one of the worst pains we go through in life. It can drive people to madness or far worse.

I count myself lucky I haven't had to endure the same issues many of you have.

 

[Dicehunter]

I think dental pain is one of the worst pains we go through in life. It can drive people to madness or far worse.

I count myself lucky I haven't had to endure the same issues many of you have.

One of the main reasons I have problems now is that when I lived and worked in Germany, The agency I was working for messed me around with paying me, Took them 8 weeks and in that time I had to survive on 1 apple per 2 days and water, I looked pretty close to Christian Bales "The Machinist" character which had long term health implications.

1 day I was sitting in my apartment and half of an incisor just fell out, No decay or anything, Pure white, It just fell out.

 

[AlienALX]

I think dental pain is one of the worst pains we go through in life. It can drive people to madness or far worse.

I count myself lucky I haven't had to endure the same issues many of you have.

It is truly awful. I am a biter. Not grinding, but biting down hard. It's autism, apparently. Any way, eventually they break and then I bite more the more it hurts. In this pic I had 6 teeth removed. They immediately put in the denture, but I never wear it any way.

I actually like having teeth pulled now. Every time one gives me any crap I just have it pulled. That pain is unabating. Deffo among the worst tbh. I had another 5 pulled out on the next visit, and have had two others pulled since. All my wisdom teeth are gone too.

 

[Warchild]

It is truly awful. I am a biter. Not grinding, but biting down hard. It's autism, apparently. Any way, eventually they break and then I bite more the more it hurts. In this pic I had 6 teeth removed. They immediately put in the denture, but I never wear it any way.



I actually like having teeth pulled now. Every time one gives me any crap I just have it pulled. That pain is unabating. Deffo among the worst tbh. I had another 5 pulled out on the next visit, and have had two others pulled since. All my wisdom teeth are gone too.

How did you let them get that bad? teeth biting/grinding wears enamel away but that still shouldn't resort to having so many removed? Teeth are usually incredibly strong, unless you are gorging on high sugar substances as well? or when you say biting do you mean clamping down on things like Pen tops/plastic etc?