Three different dentists all give conflicting advice

Joined
Feb 3, 2015
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Dear Dentists of the World,

I am a 26 year old living in London and I was hoping for some advice as I've spoken to 3 different dentists and all have different recommendations on what work I should get done.

First, I’ll give some details about the dentists I saw:

Dentist A: This is a dentist that offers NHS services (certain treatments are subsidized by the government) and private treatments. The dentist I saw graduated dental school 2009 and has been practicing since Early 2010.

Dentist B: This is a private dentist in central London. The dentist graduated in 1991 and has been practicing since.

Dentist C: This is another private dentist in central London. The dentist I saw graduated in 2006 and has been practicing since.

The number references I am using are referring to this chart: http://upload.wikimedia.org/wikiped...svg/1024px-Universal_Numbering_System.svg.png

In September 2014 I saw Dentist A for a routine checkup and they suggested replacing an existing (white composite) filling in tooth 19 (lower left) due to decay that appeared underneath the filling in an x-ray. The tooth was not causing any pain or discomfort, but as per the dentists recommendation, I had the filling replaced with another white composite. The dentist suggested that because the filling was large and close to the nerve that I may experience some discomfort when the anesthetic wears off but it should subside within two weeks (in the end I didn't get any pain after the anesthetic wore off).

In December 2014 I went to Canada and got a cleaning done while I was there. During the cleaning the hygienist said I had good teeth and was cleaning them well. They also noticed a chip in tooth 30 and suggested I get it checked by my dentist when I get back to the UK.

Tooth number 19 was perfect until January 2015 when I started getting very mild (2/10) pain/numbness constantly for about 2 weeks. The tooth was not sensitive to hot/cold and I didn't need to take any painkillers but I was concerned. Because of this, and the Canadian hygienist suggesting I get a checkup, in January 2015 I booked an appointment with Dentist A.

During this visit the dentist took an x-ray of tooth 19 and suggested that because the filling was so close to the nerve, the next step would be root canal treatment and crown, but I could wait for 2 - 3 weeks to see if the pain subsided, at which point a root canal would no longer be necessary. Additionally, the dentist said I had a small chip in the side of tooth 30 (lower right) which has an existing white composite filling (as the hygienist pointed out to me previously). The dentist suggested the chip had early signs of decay and therefore should be replaced with another filling.

I decided to seek a second opinion so a few days later I saw Dentist B who did the following:

  • Took a periapical x-ray (the whole jaw at once).
  • Did a test where they put a very cold liquid on four teeth one by one (two healthy teeth and 19 and 30) - this didn't cause any pain and all felt about the same cold sensation on each one.
  • One by one they put a cotton wool roll under each of the same four teeth asking me to bite down hard. No pain on any of them.
  • Did the same test as above but with a solid plastic thing. Again no pain on any of them.

They explained the x-ray to me in detail and showed me a dark line right under the filling in tooth 19. He suggested this was decay and the best next step would be to replace the filling again. Contrary to Dentist A, he said there was enough space between the existing filling and the nerve and if he refilled it (removing the decay) there is a 90% chance the tooth will be fine. He also saw the chip in tooth 30 which is where the existing filling meets to the tooth, and suggested early signs of decay and that I should also get that filling replaced. When I asked he said there is a 90% chance of this being successful and not requiring a root canal or further treatment.

Because of the conflicting advice I decided to see a third opinion. By this time I am no longer having pain in tooth 19.

Four days later I see Dentist C who does the following.

  • Takes 4 more x-rays (by putting something in my mouth and pointing the x-ray machine at specific areas).
  • Puts cold liquid on tooth 19 and another healthy tooth. I do not feel a difference in either (no pain just a cold sensation).
  • Asked me to bite down while putting a hard plastic object under tooth 19. We do this 4 times on the same tooth (different position each time). No pain.

This dentist then suggested that I don’t need anything done right now. They explained that after a large filling I had in September, the root can take up to six months to adjust and sometimes you can feel discomfort during this time, but as the pain is very mild and the tooth is not sensitive they wouldn't recommend getting the filling re-done or a root canal. Also when they showed me the x-ray the dark line that appeared in Dentist B’s x-ray (taken 3 days prior) was not visible anymore, and it looks completely fine.

As for tooth 30, they did not notice the chip but I bought it to their attention saying another dentist suggested the filling in this tooth is re-done. They then checked again and said they can see the chip but he cannot feel any decay, and the x-ray does not suggest any decay. They went on to say that as the existing filling in the tooth is large, if it did need to be re-done it may need a crown (or something similar which I can’t remember exactly) placed on it to strengthen it. They suggested I visit back in 3 months so they can check the progress of each tooth to see if any work needs to be done.

So after getting conflicting advice from three dentists, each with many years of experience, I have no idea what to do. All of them were friendly and very convincing when explaining their suggested treatment. I’m not a dentist myself, so I have no idea which one to listen too.

I would hoping someone on the forum could help me by giving some advice. How can the x-ray from Dentist B show a clear dark line under my filling but the x-ray by Dentist C shows nothing. Are certain x-rays more accurate than others? Is it normal for different dentists to give conflicting advice like this?

Ideally I would prefer not to have to seek a 4th opinion because I don’t think it’s healthy to get so many x-rays in such a short time frame.

I would greatly appreciate any advice.

Thank you,
Mike
 

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