Yesterday I had my first dental exam in a long time. I have an appointment scheduled for next week to have two root canals with crowns. I am trying to determine if I should ask about more conservative treatment, or just accept what I was told.
Background:
I've always been of the belief that I had “good teeth”, as far as decay goes. I never had a cavity in childhood, nor most of my life until now (I am now 50). As a result of this, I've been complacent. My oral care regimen has been mediocre at best, consisting of half-assed brushing once a day, and some desultory waterpiking. And I hadn't had a checkup in over 30 years before yesterday. It is also notable that I have developed a habit in recent years, off and on, of snacking on chocolate all day! This with my neglectful hygiene regimen. Other than the chocolate snacking, and occasional other candy habits here and there, my eating habits have been pretty good (no soda, no acidic drinks, little alcohol, no smoking).
Suddenly, recently, I started waking up to the fact that things were deteriorating orally. For one thing, I noticed some gum recession. For another, I started getting a little pain on the chewing surface of 31. I eventually realized that this latter was enamel wear. 2 has grown smooth above it-- hence it appears to be the result of bruxism, which has been a problem. Then I started to notice decay along the gumline affecting the exposed roots.
I have my appointment, get my cleaning. The hygienist says my teeth are doing pretty well as far as hygiene. No tartar. The dentist comes to look for a few minutes, tells me I need root canals and crowns for 30 and 31, to “save the teeth”.
My Concerns:
First of all, because I have lived my life stupidly, I am very poor, and am on poor person's insurance. Everything is covered, but I find myself in doubt at times about the quality of care I am receiving, and am also concerned that “upselling” may be an issue. The dental practice I am going to is a bit on the large side, with multiple locations in my area.
There was no discussion of different treatment options; little discussion at all. I never even had a face to face interaction with the dentist, I was just in the seat having things done to me.
The two molars have the decay at the gumline. There is no pain, except in the aforementioned enamel-worn chewing surface, and even that is very little (only hurts when something dense is pressed in there, causing pressure, presumably, along the whole surface; even hard crunchy things give no pain). I have a little metal pokey dental tool I got at one point-- when I poke into the visibly decayed areas on the gumline of these two teeth, there is no pain (in contrast, 32 came in crooked which causes it to be pressed against my cheek, has a big cavity, and most definitely hurts when poked, and also from food now [and is getting pulled of course]). So my big question is: are the root canals necessary? I assume the crowns are, as from what I gather, fillings would have trouble inhering in the exposed root area? But I am concerned about what I have seen said about “killing” the teeth with the root canals, and how that can lead to future issues with brittleness. Neither the dentist nor the hygienist said anything about the teeth being infected. From what I understand, if there were infections, the root canals would be obligatory, but assuming they are not infected, what do you all think?
They did not send me home with copies of the x-rays; I called this morning and asked for them but they needed me to come in and sign a release.
So my main questions are 1. Would you, from what you know, be doing the root canals? And more generally 2. given how BAD my habits were, both in terms of hygiene regimen, and my recent chocolate habit-- since I have now mended my ways on both counts, is it plausible that my teeth may hold up well going forward? I do realize that the gum recession is a variable that increases vulnerability, but again, I have been cruising along for a long time with bad habits, and only now am experiencing issues.
[Pic is of 30]