Re: Prolonged delay of treatment for periodontal diseases

From: Dr Steve (nospam_at_home.net)
Date: 03/14/05 

Date: Mon, 14 Mar 2005 23:38:23 GMT

I would have no problem keeping the teeth and restoring them if the patient
signed a form saying there would be ZERO guarantee after walking out the
door and that the patient understood that the procedure was the patient's
preferred treatment not mine. Fees would either be full fees or slightly
higher as it is harder to restore mobile teeth with poor periodontal health. 

-- 
~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................
This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................
"Mark & Steven Bornfeld" <bornfeldmung@dentaltwins.com> wrote in message 
news:F1pZd.4319$aS5.3987@trndny05...
> Jonesy wrote:
>
>> I have been to two periodontists and a prosthodondont who all agree to
>> remove all the uppers - which to me seems hasty.   I don't know if one
>> influenced the other; or of if they are basing their opinion on my
>> financial state, or what? All I know is, if I remove that tooth I will
>> have to do something if I want to be left with an acceptable smile -
>> either pull them all out, or make a four tooth bridge which they say is
>> a very bad idea - and that's what I don't get.  One also suggested
>> something might be "going one" on #8 but another one disagreed.
>>
>>
>>>>>You claim that 12-13-14 are all connected making that a "fixed"
>>
>> non-removable bridge.<<<<<<<<<<<<<<
>>
>> No, there no fixed bridge on 12,13,and 14.
>> #13 is a space.  #14 is a cantilever bridge - a fixed bridge made up of
>> two crowns - on the side of 13 adjacent to 12 is a tiny wire resting in
>> a tiny whole drilled into the side of crown #12.
>>
>> #12 is an independent tooth with crown.
>>
>> If infected tooth12 is pulled the periodontists say #13 should also be
>> removed by drilling, because it will then have nothing to support it on
>> the 12 side and therefore, will put extra stress on #14, an achor
>> tooth.  I think that's the only thing that makes any sense to me that I
>> can agree with -
>> But, when #12 is removed there will be remaining on that side of the
>> mouth:  9, 10, 11, and 14.  And both periodontists, and a
>> prosthodontist are in agreement hat it would be "wrong" to make a
>> bridge on weak teeth.
>>
>> It wouldn't last long, they say and I don't understand why not?  The
>> infected tooth #12 received some oral surgury (osseous) about three
>> years ago but it did not improve.  It is now loose and sensitive.
>>
>> I don't know if one influenced the other; or of if they are basing
>> their opinion on my financial state, or what? All I know is if I remove
>> that tooth I will have to do something - either pull them all out, or
>> make a four tooth bridge (or five is someone recommends) which they say
>> is a very bad idea!  (Why is it very bad?????)   They say:  it won't
>> last long and it's only a matter of time before another area of the
>> upper mouth will act up.  It will be a waster of pain, money and time.
>> When any tooth under the six tooth bridge on the other side "goes" it
>> will be curtains for that bridge.  It has two spaces now.
>>
>> The reason for bone augmentation is because it is supposed to be best
>> (so I'm told) at time of tooth removal.
>>
>> My head is just swimming with conflicting opinions about what to do.
>
>
> I'm missing what the conflicting opinions are, except that the dentists 
> agree you need to have all your upper teeth extracted, and you don't want 
> to do it.
> You have a sub-optimal situation, but not an uncommon one.  I've had 
> patients twist my arm to save teeth in a situation such as yours.  I even 
> sometimes will agree to it IF they fully understand that saving the teeth 
> is likely to be a stopgap measure, and it is very likely despite any 
> treatment the remaining upper teeth will be lost, probably in the not-too 
> distant future.
> Of course, you are extremely likely to find a dentist to do what you wish, 
> take your money, and you may luck out.  Greater chance though that if you 
> are not fully informed of the risk, that dentist will have your money, and 
> you will be unhappy.
> If you think the dentists are making a clinical decision on other than 
> clinical grounds, by all means get another opinion.  But I'd avoid a 
> dentist who tries to make you happy by telling you what you want to hear.
>
> Steve
>
>
>> I'm sure I can find a dentist to make me a four or five tooth bridge if
>> I look hard enough - but I keep hearing those periodontists and that
>> prosthdontist saying things like: no good DDS would do that.  They
>> don't think my teeth can be saved - period.
>>
>> I'm left with getting that infected tooth out if it doesn't get better
>> (it's getting harder to live with) and having a perm bridge made
>> anyway... or having them all out and proceeding with a transplanted
>> denture about six months after the upper gum heals - using a regular
>> bridge in the mean times.  UGH!  I don't want any of these things.
>>
>
>
> -- 
> Mark & Steven Bornfeld DDS
> http://www.dentaltwins.com
> Brooklyn, NY
> 718-258-5001

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