Who Knew Dental Work Could Inspire Debate?

In My Humble Opinion
1

As a bit of background:

I recently cracked a tooth. It was a pretty good crack, going entirely across the top surface of the tooth. Not extremely deep, thank goodness, but biting down on it was like getting an electric shock to the jaw. I wasn’t sure what was going on, but I stopped chewing on that side of my mouth and got myself off to the dentist.

The dentist made the diagnosis and showed me a picture of what was wrong and yep, that was goddamned crack. Fortunately, decay had not set in. He laid out my options and cost of each and I opted for a crown. With my dental insurance my out-of-pocket cost was $500.

I mentioned this to one or two people and was a bit surprised at the range of opinions on this.

There was the guy who said pull it and get an implant, get a complete new tooth, don’t waste the money on a crown it won’t last more than a couple months. Huh. I asked him if he was willing to pay for such an implant. Of course not! Then it ain’t happening, because my dental insurance won’t cover a dental implant and it’s way too much for my current budget.

I ran into a couple people who said either they had been in a similar situation and just yanked the tooth (one did herself with a pair of pliers - I know some tough, DIY gals!), or that’s what they would do. I thought about it - if it had been, say, one of my three remaining wisdom teeth yeah, I would have just had it pulled (my dentist leans toward “get those three out regardless” but concedes none of them are a problem right at the moment and certainly the cracked tooth was more of a priority). But this is a bicuspid and thus visible when I smile and I have a teeny bit of vanity, I admit. Although even if it wasn’t so visible I think I’d still consider a crown. Some of the folks opting for “just pull it” are low income and that is in fact the very cheapest option (especially as a DIY project) but not all of the people in this category are poor, some have more wealth than I do.

$500 isn’t pocket change to me, but I do have the funds to pay for that up front. I mean, hell, I put more than that into maintaining my car or pickup on an annual basis, I don’t see it as an extravagance to spend that on myself given I can afford it.

Just curious what other Dopers think. What would you do?

2

my teeth have always been so soft that even getting braces put on wrecked them and the fillings I had just fell out with parts of the tooth soon after So getting them pulled would of been beter than losing the bits and chunks until I just have stubs of teeth left…

But the state covers my dental so I have to go with what they pay for …

3

Well at least you cracked it and the dentist didn’t do it himself … he cracked a piece of tooth off so hed have room to pull another ……I ended up losing that tooth too

actually I just remembered I have had a diy pliers extraction when I was a kid tho the tooth was loose because an infected lump under it but it came in crooked and it was so wobbly but it had a root type of thing deep in the gum …. moms bf pulled it out with a pair of needle nose i remember he made me rinse it with hydrogen peroxide off and on for an hour would of cost 500 to have it removed in 1983

4

If your dentist offered you the crown option, and didn’t propose root canal, that probably means that the tooth is good shape aside from the crack. You might want to confirm that clearly with the dentist, but if so a crown sounds like a sensible option. Aside from the cost, an implant seems to me like unnecessary traumatic intervention if the tooth is sound.

If you go for the pliers extraction, you might want to pull the one on the other side too so that your toothless grin is symmetrical.

[IANAD, but I have a lot of experience as a patient, having fallen off a bike and smashed a bunch of my teeth out as kid. 4 tricky implants, about 10 crowns.]

5

ETA: if the tooth is sound, your friend’s claim that a crown would only last a couple of months is nonsense. That might happen if you have a terrible dentist or are really unlucky, but it’s certainly not the expectation.

6

I would certainly be nervous about people who advise pulling teeth out with pliers. What if there is an underlying infection?

Find a good dentist and follow their advice. (It’s not the 1800s!)

P.S. I’m sorry you get charged so much for dentistry.
I recently had a crown put in by my NHS dentist. It cost £27 ($36.)
Last year I needed to have a troublesome root (the tooth had sheared off) removed from my gum using local anaesthetic in hospital. Since I live in the UK, under our wonderful NHS, it didn’t cost anything.

7

I did specifically ask about that. He said that the crack was nowhere near the nerve/pulp, the tooth was sound (other than the crack), and there was no decay. Then he showed me the x-rays (this guy does like to show me pictures… but then, I like looking at them so I know what’s going on). Essentially, this involved removing the cracked bit and then covering what was left with the crown so the root/tooth is still live.

Me, too - sure, the crown isn’t going to last forever but if in 5 or 10 or 15 years I eventually lose the tooth well, that’s a bunch more years before I lose that tooth and by then maybe implant technology will be cheaper/better and maybe I’ll have the funds for that.

Or, maybe if you have tooth problems like nightshadea (sorry to hear about that). I have fillings that are nearly 40 years old now. My current dentist has examined them and says they’re still good. In general, my teeth are better than average, having needed only a few small fillings up to this point. While I’d like to think that’s because I’m awesome at oral hygiene…um…no, I’m not. I got a better roll of the genetic dice for teeth. That’s down to luck. You can improve that sort of luck by good habits, or screw with it with bad habits, but I could see where if you have some sort of structural problem with your teeth that crowns aren’t going to work for you.

I had a young coworker who treated his dental abscess as a DIY project and wound up in the hospital with sepsis. Yes, there is a risk. Usually people get better if they remove a bad tooth because, well, they’re removing something gone bad but sure, things could take a turn for the worse.

$490 is exactly what I paid. Actual retail price is $1625 according the itemized statement I received. I’m “only” paying 30% of the full cost because I have dental insurance.

The retail cost of this sort of thing in the US is why folks near our southern border sometimes opt to go to Mexico for dental work, and other people in the US use pliers on themselves.

>sigh<

So many other places do this sort of thing right, why can’t we?

8

I had a crown replaced last year that had been in my mouth since 1992.

I think it’s a good rule of thumb to keep as much of your natural teeth as possible as long as possible. Pulling is a last resort.

9

Dentist here. I vote get the crown. My advice is usually if you trust your dentist then go with his/her recommendation. If they are saying it isn’t bad enough for a root canal the crown should last much longer than a couple of months. If the tooth isn’t saveable a fixed bridge is an alternative to an implant. The cost is similar but timeframe much less. As for people claiming to pull their own teeth, I’ve seen it but only on teeth with severe periodontal disease. Trying to pull a healthy tooth with pliers will result in fracturing the crown portion off and leaving the roots.

10

At this point I definitely trust my dentist - not only is he very good at explaining (and showing) what the problems are, but he also is good at making procedures I’m nervous about into almost non-events. *Almost *non-events.

I guess I’m getting to a point where decades of wear-and-tear are starting to catch up to my teeth. Even so, I suspect I’m still better off than most people at this point in my life. Also, unlike a few years ago when I was worried about covering the cost of a mere cleaning (and wound up needing a wisdom tooth pulled) I’m financially better off so cost isn’t quite as much a concern as it used to be.

I’ve known quite a few people who, like Cheesesteak, have gotten more than 20 years out of a crown. I understand that there are few to no guarantees in life, but it seems my odds of long-term success here are good.

Re: DIY tooth-pulling… most of the people I’ve spoken to who have done this do, in fact, have gum disease that’s apparent even to this layperson. And I expect more than one did break off the top of the tooth and have bits of roots lurking in their jaw. I am a bit baffled at the state of some of my acquaintances’ teeth - I run to the dentist at the first sign of something wrong and I am a complete wimp when it comes to any sort of mouth pain. Their mouths have to hurt all the time. :confused:

Anyhow - off to have the permanent cap installed this morning in about an hour and a half. Even with the temporary, it’s great to not have pain when chewing any more. Not that I was *trying *to chew with a cracked tooth but sometimes I’d forget any try that side of my mouth which was… unpleasant.

They most painful part I anticipate will be paying the second half of the bill. In addition to that I’m also paying rent, utilities, my credit card, and a bill for legal matters all in one day, close to $1800. Ouch. But hey, it will be good not to owe money to anyone after today.

11

I voted other. I trust my dentist and he’s an early adopter of technology so I’d get his opinion before I decided anything. I’m not an expert and dental technology has progressed by leaps an bounds in the last 30 years. I’d want to see what the most up to date options were.

12

I’m the typical person that grew up in the 60s & 70s with lots of fillings. Must not have had fluoride in the water! Over time some of those old fillings have broken, etc. When that has happened I’ve always been given a crown. I’ve had a couple of my crowns since the late 80s! I’ve never had to replace a crown nor have I’ve never heard of a crown lasting only a couple of months.

13

I have many crowns that have been there 10, 20, 30,… years and only one has ever had to be replaced. That’s how I voted.

14

I like kumquats but I voted for a crown. They aren’t forever and sometimes have to be replaced but they do give a good look and a good quality of life.

15

Well, brand-new permanent crown is in place and it looks good. Here’s hoping it lasts decades.

16

I have crowns that are old enough to vote. And drink. That one guy was full of it.

I had one tooth crack in half, and the dentist sent me to a DDS to get it extracted and get an implant. Implant has been put on hold because I’ve had other worries, so I still look like a hillbilly in training.

17

For the avoidance of doubt - hey, this is the internet, you never know - I’d like to note that I was assuming that the self-extraction with pliers option was a joke, and I rather think OP was too.

18

Uh… no I wasn’t. I really do know people who have done self-extractions with pliers. I know, sounds incredible, doesn’t? But yeah, there are people out there doing it.

You probably don’t want to know about the guy I once met who used superglue to fix a broken incisor.

19

Good dental work accompanied by good home care can last quite a while. My oldest crown is over 40yo and youngest 10yo. Oldest filling over 50yo. Way too much Dr Pepper as a kid. Sugar is the enemy of teeth.

20

Oh yes, I don’t doubt that. I meant the notion that you were seriously considering it as an option for you.