I'm having a really tough time deciding what to
do. My regular dentist sent me to a periodontist (in the same office). He
did an evaluation by sticking a probe into the pockets between my gums and
my teeth. He found that the back teeth in all 4 quadrants measured 5,6,7, or
8. It was not painless. In fact he called out to an assistant that there
was bleeding on many of the teeth. The conclusion was that I have
periodontal disease, need osseous surgery, scaling and root planing, bone
grafting, a couple of root canal jobs, 2 implants, and a couple of crowns.
Cost will be about $10,000. There will probably be about 6 visits totalling
7-8 hours.

I have been going to the hygienist every 6 months and have followed all
instructions given to me and even purchased a water pick and an electrical
toothbrush. I have taken antibiotics for 3 months.

My problems in deciding whether to go ahead are FEAR, financial, health, and
age. I am 74 years old, have hypertension, had an endarterectomy, an
angioplasty, and 2 melanoma operations, all within the last 5 years. I have
had a LOT of dental work done in the past.

The doctor says he will not give IV sedation because, although he is trained
to do so, it is not practical, not necessary, and too expensive in my case.
He said he would use the usual type of injections used for regular dental
work. I asked if he could give me something stronger, but he said there is
nothing stronger, and what is the difference anyway if I am going to be
numb. He said he would not sugar coat his explanation. He is going to have a
hard time because my mouth is small. I will have discomfort but if I don't
go ahead, I will lose my teeth.

I have seen advertisements in the newspaper of other dentists that do
implants and some periodontal work that do use IV sedation, and do not
charge for a second opinion. I am wondering if maybe I should try one of
them. Another dentist warned me that not all these dentists are really
qualified to give sedation.

I have also read (don't remember where) that there are pills that one can
take that practically knock you out. I've already tried taking 2 valiums and
couldn't detect any effect.

On Fri, 11 Jul 2003 20:17:51 GMT, "ratmouth" <>
wrote:

>I have seen advertisements in the newspaper of other dentists that do
>implants and some periodontal work that do use IV sedation, and do not
>charge for a second opinion. I am wondering if maybe I should try one of
>them. Another dentist warned me that not all these dentists are really
>qualified to give sedation.
>
>I have also read (don't remember where) that there are pills that one can
>take that practically knock you out. I've already tried taking 2 valiums and
>couldn't detect any effect.
>
>

Get a second opinion and maybe a third one.
In light of your age it may be sufficient to do
a scaling and root planing only with regular
follow up care. You need more information.

What milligram valium ?
2 X 2 mg. will not achieve a perceptible
sedation effect in many people.

Best wishes,

I'm sorry that I did not write more clearly. I was trying to keep my message
as brief as possible. I did get the scaling and planing . Then I was given
an antibiotic for 3 months. Then a reevaluation was done and the
periodontist said there had been no improvement. He feels that I am wavering
too much and need to come to a decision as to treatment.

I am inclined to seek another opinion. I see advertisements that say "never
a charge for a second opinion". I phoned one of them and the girl said I
should bring in my X-rays. I tried to borrow them but was refused. So I
ordered copies at a cost of $25 but they were never done. I requested them
several times but was postponed each time. If I go for a second opinion
without the X-rays, new ones will be taken at a much higher cost (which I am
perfectly willing to pay). But I know that dentists are extremely busy and
don't like to waste their time unnecessarily. So, my guess is that a dentist
willing to give a free second opinion does so with the expectation of
getting my business if he offers a preferable treatment. This would probably
not be covered by HMO whereas my old dentist is offering a 25% discount.

I have also been reading about painless treatment with lasers, conscious
sedation with pills, etc. My periodontist doesn't offer any of these. He
just gave me a bunch of injections that left me kind of woozy after the
scaling and planing.

I really would like to hear from people that know or have had experience
with the issues I've mentioned.

Rat


"DrCnBseen" <> wrote in message
news:...

> << Subject: Periodontist
> From: "ratmouth"
> Date: Fri, Jul 11, 2003 4:17 PM
> Message-id: <PXEPa.11437$>
>
> I'm having a really tough time deciding what to
> do. My regular dentist sent me to a periodontist (in the same office). He
> did an evaluation by sticking a probe into the pockets between my gums and
> my teeth. He found that the back teeth in all 4 quadrants measured 5,6,7,

or

> 8. It was not painless. In fact he called out to an assistant that there
> was bleeding on many of the teeth. The conclusion was that I have
> periodontal disease, need osseous surgery, scaling and root planing, bone
> grafting, a couple of root canal jobs, 2 implants, and a couple of crowns.
> Cost will be about $10,000. There will probably be about 6 visits

totalling

> 7-8 hours.
>
> I have been going to the hygienist every 6 months and have followed all
> instructions given to me and even purchased a water pick and an electrical
> toothbrush. I have taken antibiotics for 3 months.
>
> My problems in deciding whether to go ahead are FEAR, financial, health,

and

> age. I am 74 years old, have hypertension, had an endarterectomy, an
> angioplasty, and 2 melanoma operations, all within the last 5 years. I

have

> had a LOT of dental work done in the past.
>
> The doctor says he will not give IV sedation because, although he is

trained

> to do so, it is not practical, not necessary, and too expensive in my

case.

> He said he would use the usual type of injections used for regular dental
> work. I asked if he could give me something stronger, but he said there is
> nothing stronger, and what is the difference anyway if I am going to be
> numb. He said he would not sugar coat his explanation. He is going to have

a

> hard time because my mouth is small. I will have discomfort but if I don't
> go ahead, I will lose my teeth.
>
> I have seen advertisements in the newspaper of other dentists that do
> implants and some periodontal work that do use IV sedation, and do not
> charge for a second opinion. I am wondering if maybe I should try one of
> them. Another dentist warned me that not all these dentists are really
> qualified to give sedation.
>
> I have also read (don't remember where) that there are pills that one can
> take that practically knock you out. I've already tried taking 2 valiums

and

> couldn't detect any effect.>>
>
> By all means get another opinion. Certainly scaling and root planning

followed

> up by reevaluation is imo the standard of care. Often times less work is
> involved once thourough initial therapy is completed. Your concerns are

well

> thought out.
>
> Stan
>

ratmouth wrote:

> I'm sorry that I did not write more clearly. I was trying to keep my message
> as brief as possible. I did get the scaling and planing . Then I was given
> an antibiotic for 3 months. Then a reevaluation was done and the
> periodontist said there had been no improvement. He feels that I am wavering
> too much and need to come to a decision as to treatment.
>
> I am inclined to seek another opinion. I see advertisements that say "never
> a charge for a second opinion". I phoned one of them and the girl said I
> should bring in my X-rays. I tried to borrow them but was refused. So I
> ordered copies at a cost of $25 but they were never done. I requested them
> several times but was postponed each time. If I go for a second opinion
> without the X-rays, new ones will be taken at a much higher cost (which I am
> perfectly willing to pay). But I know that dentists are extremely busy and
> don't like to waste their time unnecessarily. So, my guess is that a dentist
> willing to give a free second opinion does so with the expectation of
> getting my business if he offers a preferable treatment. This would probably
> not be covered by HMO whereas my old dentist is offering a 25% discount.
>
> I have also been reading about painless treatment with lasers, conscious
> sedation with pills, etc. My periodontist doesn't offer any of these. He
> just gave me a bunch of injections that left me kind of woozy after the
> scaling and planing.
>
> I really would like to hear from people that know or have had experience
> with the issues I've mentioned.
>
> Rat

No excuse for not providing copies of your x-rays. Demand them now.

Steve

>
>
> "DrCnBseen" <> wrote in message
> news:...

> or

> totalling

> and

> have

> trained

> case.

> a

> and

> followed

> well

--
Mark & Steven Bornfeld DDS
Brooklyn, NY
718-258-5001
http://www.dentaltwins.com

On Sat, 12 Jul 2003 13:57:33 GMT, "ratmouth" <>
wrote:

>I'm sorry that I did not write more clearly. I was trying to keep my message
>as brief as possible. I did get the scaling and planing . Then I was given
>an antibiotic for 3 months.

Periodontist? If you went to a periodontist you got the second best
treatment. If you went to the hygienist, well, so I am told, it will
add six years to your life!



Joel

> Then a reevaluation was done and the
>periodontist said there had been no improvement. He feels that I am wavering
>too much and need to come to a decision as to treatment.
>
>I am inclined to seek another opinion. I see advertisements that say "never
>a charge for a second opinion". I phoned one of them and the girl said I
>should bring in my X-rays. I tried to borrow them but was refused. So I
>ordered copies at a cost of $25 but they were never done. I requested them
>several times but was postponed each time. If I go for a second opinion
>without the X-rays, new ones will be taken at a much higher cost (which I am
>perfectly willing to pay). But I know that dentists are extremely busy and
>don't like to waste their time unnecessarily. So, my guess is that a dentist
>willing to give a free second opinion does so with the expectation of
>getting my business if he offers a preferable treatment. This would probably
>not be covered by HMO whereas my old dentist is offering a 25% discount.
>
>I have also been reading about painless treatment with lasers, conscious
>sedation with pills, etc. My periodontist doesn't offer any of these. He
>just gave me a bunch of injections that left me kind of woozy after the
>scaling and planing.
>
>I really would like to hear from people that know or have had experience
>with the issues I've mentioned.
>
>Rat
>
>
>"DrCnBseen" <> wrote in message
>news:...

>or

>totalling

>and

>have

>trained

>case.

>a

>and

>followed

>well

>

--
Joel M. Eichen, D.D.S.
Philadelphia PA

www.phillyducks.com
We’re Just A Duck Call Away!


STANDARD DISCLAIMER applies ~
meaning no one IN PENNSYLVANIA
has seen the tooth or teeth in
question so take this advice in
proper context ~ its the internet!

We is guessin'!

On Sat, 12 Jul 2003 11:25:23 -0400, "Dr. Steve"
<> wrote:

>HMO ? ? ? ?
>
>Possible Bait-And-Switch ? ??? ?
>
>In the USA, with the current HIPAA rules,,,, no dental office can refuse to
>give you a copy of any part of your records you want.

Oh Jeez,,,,,, is this so? In Pennsylvania its not. See my post above.

> They can bill you a
>reasonable charge for copying x-rays and many sheets of paper. However, $25
>is not reasonable. This could be an indication of whether or not you should
>continue any treatment with this office. You are entitled to a *good,
>usable* copy of any x-ray images for a reasonable copying charge. You might
>choose to ask this office for a copy of their HIPAA compliance form, which
>they are required to make available to you the first time you come into the
>office after April 15th, 2003. You should have signed a form saying you
>were allowed to review this HIPAA compliance policy form.

--
Joel M. Eichen, D.D.S.
Philadelphia PA

www.phillyducks.com
We’re Just A Duck Call Away!


STANDARD DISCLAIMER applies ~
meaning no one IN PENNSYLVANIA
has seen the tooth or teeth in
question so take this advice in
proper context ~ its the internet!

We is guessin'!

New dentist should request them from the old dentist, with your signed
approval of same.



Joel


On Sat, 12 Jul 2003 12:42:09 -0400, Mark & Steven Bornfeld DDS
<> wrote:

>
>
>ratmouth wrote:
>

>
> No excuse for not providing copies of your x-rays. Demand them now.
>
>Steve
>

--
Joel M. Eichen, D.D.S.
Philadelphia PA

www.phillyducks.com
We’re Just A Duck Call Away!


STANDARD DISCLAIMER applies ~
meaning no one IN PENNSYLVANIA
has seen the tooth or teeth in
question so take this advice in
proper context ~ its the internet!

We is guessin'!

My reaction to your fair minded, well thought out posts is to advise you to
seek a second opinion, usually, depending on where you are, NOT one that
advertises free 2nd opinion. Almost anyone can come up with a different
plan and you may still need the surgery to avoid losing your teeth. The red
flags to look for are:
What are the probings after Scaling and root planing and antibiotics (ask to
look at a copy of pre and post op),
Since that is not fool proof because the doc could make them up, ask about
the current mobility of each tooth. If they are relatively unmobile and no
infection, sometimes it is wiser to wait a while, have regular 3month apart
"periodontal maintenance" visits for about a year (my normal advise) then
get reprobed and evaluated for mobility and ATTACHMENT LEVEL changes
(slightly different than probing).
IF you still have 6,7,8mm probing depth and some mobility, you may be at
that point that if you don't do it you may lose your teeth. What is
important, however, here to evaluate is how much your awareness has
improved, how much more are you making efforts to brush floss and usually
use a interproximal brush to clean out the gaps as well as water pick.
If you have just made a major change in your health habits due to the fear
of losing your teeth, nothing can go that bad in a year to eval where it all
"settles in" at.
Also, ask how long they expect you to keep your teeth with your current home
care regiment and surgery.
This may be a very legitimate treatment plan, but if they are an HMO or even
PPO, they make more money if they do surgery than not.
get a second opinion at a dental school nearby. You instantly get more than
one opinion that way.
fmn
"ratmouth" <> wrote in message
news:htUPa.11591$ t...

> I'm sorry that I did not write more clearly. I was trying to keep my

message

> as brief as possible. I did get the scaling and planing . Then I was given
> an antibiotic for 3 months. Then a reevaluation was done and the
> periodontist said there had been no improvement. He feels that I am

wavering

> too much and need to come to a decision as to treatment.
>
> I am inclined to seek another opinion. I see advertisements that say

"never

> a charge for a second opinion". I phoned one of them and the girl said I
> should bring in my X-rays. I tried to borrow them but was refused. So I
> ordered copies at a cost of $25 but they were never done. I requested them
> several times but was postponed each time. If I go for a second opinion
> without the X-rays, new ones will be taken at a much higher cost (which I

am

> perfectly willing to pay). But I know that dentists are extremely busy and
> don't like to waste their time unnecessarily. So, my guess is that a

dentist

> willing to give a free second opinion does so with the expectation of
> getting my business if he offers a preferable treatment. This would

probably

> not be covered by HMO whereas my old dentist is offering a 25% discount.
>
> I have also been reading about painless treatment with lasers, conscious
> sedation with pills, etc. My periodontist doesn't offer any of these. He
> just gave me a bunch of injections that left me kind of woozy after the
> scaling and planing.
>
> I really would like to hear from people that know or have had experience
> with the issues I've mentioned.
>
> Rat
>
>
> "DrCnBseen" <> wrote in message
> news:...

He

and

5,6,7,

> or

there

bone

crowns.

> totalling

electrical

> and

> have

> trained

> case.

dental

is

have

> a

don't

can

> and

> followed

is

> well

>
>