Need Help with a Decision About Dental Procedure (Filling Renewal Because of a Supposed Cavity)

[chaLLas]

Dear all,

when I got my tinnitus half a year ago, I went to the dentist because the tinnitus distress caused facial pain and teeth clenching. He did a bite splint for me which also should re-align the jaw. To manufacture the splint, they did a X-ray of my head. There, they noticed that cavity is growing under one of my composite fillings. It is a small tooth in the upper jaw and the filling is almost down to the nerve, and so is the cavity (IF there is some).

So the dentist told me that cavity is in general growing slowly and we have to take care of it at the beginning of the next year the latest (which is now). The dentist told me he needs to do a ceramic inlay (700 €), because composite fillings are rubbish since such a filling now gave me cavity. He said the filling was made poorly and that it became untight over the years, so bacteria piled up below it.

I must admit, I forgot about the cavity for several weeks. When it came back to my mind, I thought I should see a second dentist because I had the feeling that the first one just wants to sell me something.

So I went to that other dentist which said he can't imagine that a ceramic inlay would be necessary. He got the X-ray findings from my other dentist and is now telling me that he can't see any cavity on those. He would have to remove the filling to see if there is something. But if there is something, should that not be 100% visible on the X-ray?! If I could, I would of course love to avoid the drilling. Knowing about that it might have to be done has been making me anxious for months now.

I do not know what to do. Of course, it would be great if there is no cavity and I could avoid the drilling (no laser drilling accessible in my region, I asked them all … )

On the other hand, if there really is cavity and it gets to the nerve, I am screwed.

I know this is again a special case to which there maybe is no right or wrong, because nobody external can tell. Maybe I can try to get the X-ray pictures and post them here? Anyone familiar with that?

Thank you in advance.

 

[Starthrower]

I must admit, I forgot about the cavity for several weeks. When it came back to my mind, I thought I should see a second dentist because I had the feeling that the first one just wants to sell me something.

Very wise decision to get a second opinion @chaLLas.

Oh..not sure what to suggest. One dentist said a cavity and one said no cavity?

At least the second dentist did not charge you for another x-ray. What does your gut instinct tell you to do?
This is a tough one.

 

[chaLLas]

Very wise decision to get a second opinion @chaLLas.

Oh..not sure what to suggest. One dentist said a cavity and one said no cavity?

At least the second dentist did not charge you for another x-ray. What does your gut instinct tell you to do?
This is a tough one.

Exactly, one dentist said there is cavity, and one said he can't see it on the x-ray. He also said to be sure, he would remove the filling so see if there is something, but well, of course I would like to avoid drilling if I can.

The second dentist received the xray findings from my first dentist. But even if they had done another x-ray, ones health insurance pays for it here in Germany.

My gut instinct tells me, that the first dentist might be right as he explained logically to me what needs to be done (because the cavity is close to the root, only an inlay reasonable). Yet I got the feeling that he wants to sell it so me since he did not leave the option to do another composite filling.

When I was at the second dentist, I had the feeling that he is not checking up on my teeth thoroughly, felt like he did not want to spend too much time with me. Yet, he even takes the time to answer emails from me. The fact that he wants to remove the filling tells me that he is not 100% certain that there is no cavity.

It is very hard to tell. Maybe I do not have the time to get a 3rd opinion if the cavity is there and near the root...

 

[Starthrower]

@chaLLas I think you are making the right decision regarding the cavity. The first dentist may have more experience with "seeing" things like this. And it is better to get it taken care of before it gets worse.

The cavity issue is not a "big" deal thing to go through. Just kinda scary weird when you first have tinnitus. I would think the drilling for this would not be too much nor damage or increase your tinnitus. But...an infection in the gum area...not too good.

Yet I got the feeling that he wants to sell it so me since he did not leave the option to do another composite filling.

The dentist told me he needs to do a ceramic inlay (700 €), because composite fillings are rubbish since such a filling now gave me cavity

Hum...I am not familiar with this but I would think the ceramic process seems more up to date?

Once you get it taken care of you will feel so much less stress.

How are you doing?

 

[chaLLas]

@chaLLas I think you are making the right decision regarding the cavity. The first dentist may have more experience with "seeing" things like this. And it is better to get it taken care of before it gets worse.

The cavity issue is not a "big" deal thing to go through. Just kinda scary weird when you first have tinnitus. I would think the drilling for this would not be too much nor damage or increase your tinnitus. But...an infection in the gum area...not too good.

Hum...I am not familiar with this but I would think the ceramic process seems more up to date?

Once you get it taken care of you will feel so much less stress.

How are you doing?

Thank you for your reply. I am doing kind of bad since I have not progressed in any way. Im am torn between just getting it done or ask for a third opinion ... I am so afraid of the drilling since my tinnitus still spikes so easy from noise ... and I fear that drilling would be overkill and will give me new sounds/sensations ... and if I do it will never know if there really was a cavity ... and when I permantly make my tinnitus worse, I will always think "what if there has never been a cavity and that all could have been avoided?"

 

[Starthrower]

Im am torn between just getting it done or ask for a third opinion ...

Morning from here @chaLLas! For you own peace of mind get a third opinion and then decide? It is always smart to get a few opinions if possible.

The drilling part can be dealt with in different ways for us. When you decide what to do and why we can talk about it more.

No reason to have yourself experience more anxiety.

 

[chaLLas]

I decided to visit the first dentist, which wants to do the ceramic inlay, and confront him with that the second dentist said (of course in a kind way - I don't want to upset anyone). I will see what he sais about that another dentist did not see any cavity on the x-ray.

I now also got the x-ray pictures. Does someone here know a thing or two about that and can maybe have a look at those pictures?

How do you deal with the drilling? I read different information about earplug usage at the dentist ...

 

[chaLLas]

*Update*

Have been to my first dentist today. He did another X-Ray and noticed another cavity on the other side.

He did some manual work. He was OK with not using power tools like ultrasonic cleaner. But he said he has to use the suction device because he needs to apply medicine to my gums and has to remove dental calculus. I did not bring earplugs since I have often read that it is not recommended to use them for dental work because of the occlusion effect. I tried to push my tragus while he was working and it seemed to help with the noise of the suction device. Yet I am not sure if my T is spiking because I was REALLY nervous and still am because I now have two cavities to deal with. I told him I have been to another dentist and of course he did not like that. I do not know if that is the reason why he found that other cavity to make more money out of me ... or if the cavity is real

I just don't know what to do now ... Somehow I do not trust him ... but I do not know where else to go. I can't go to multiple dentists now because they would always have to get the X-Ray findings ... I do not have so much time as it seems

 

[Ed209]

I decided to visit the first dentist, which wants to do the ceramic inlay, and confront him with that the second dentist said (of course in a kind way - I don't want to upset anyone). I will see what he sais about that another dentist did not see any cavity on the x-ray.

I now also got the x-ray pictures. Does someone here know a thing or two about that and can maybe have a look at those pictures?

How do you deal with the drilling? I read different information about earplug usage at the dentist ...

ChaLLas, do you have access to the x-rays? I know many high-end dentists and can get you a few opinions quite easily.

 

[chaLLas]

ChaLLas, do you have access to the x-rays? I know many high-end dentists and can get you a few opinions quite easily.

Wow, that is very nice of you, I got my first X-Ray from August last year, which only shows the cavity on one side. I guess it has been still very small in that state. I will see if I can get access to my X-Ray from today.

Thank you for offering that to me!

 

[Bill Bauer]

How do you deal with the drilling?

It is probably not a good idea to wear ear plugs or even ear muffs during a dental procedure because of occlusion effect. You will want to ask your dentist to drill for at most 5 seconds followed by a 10 second break. If a laser can't be used, find a dentist who uses electric-powered drills (as opposed to the traditional air-powered drills) as they are supposed to be quieter. For more details, check out
https://www.tinnitustalk.com/threads/dentist-laser-vs-ordinary.2791/#post-272983

 

[chaLLas]

Thank you Bill, I remember reading through this. Also, I read some other posts where people recommend to use earplugs. I am confused, but since I am a bit sensitive regarding the occlusion effect, I guess I will get it done "unplugged" - unlesss I can find a dentist that uses laser now in a very short time.

Today's procedure at the dentist with manual tools and suction device seem to have given me a bit of a spike, yet I am still very nervous ... maybe that is also amplifieing the symptoms.

 

[Bill Bauer]

Also, I read some other posts where people recommend to use earplugs.

You can wear earplugs if the doctor uses a laser.

You can wear earplugs at the beginning of your dental procedure, and then try pulling them out and see which one feels better.

 

[Starthrower]

Today's procedure at the dentist with manual tools and suction device seem to have given me a bit of a spike, yet I am still very nervous ... maybe that is also amplifieing the symptoms.

This does happen to me also @chaLLas but it is temporary and I am the world's worst dental patient.

I think once you make your decision about this cavity issue (many thanks to @Ed209 ) you will have the procedure and your anxiety and stress will be reduced. This waiting is the worse part. But you are making great decisions by getting opinions.

I tried the ear plugs and drilling thing. Not good at all because the bone conduction seemed amplified. It was much easier without plugs or ear muffs.

The dentist will drill for a few seconds at a time to help you. I have been through this a few times. It is important to make sure the issue is taken care of.

 

[chaLLas]

This does happen to me also @chaLLas but it is temporary and I am the world's worst dental patient.

I think once you make your decision about this cavity issue (many thanks to @Ed209 ) you will have the procedure and your anxiety and stress will be reduced. This waiting is the worse part. But you are making great decisions by getting opinions.

I tried the ear plugs and drilling thing. Not good at all because the bone conduction seemed amplified. It was much easier without plugs or ear muffs.

The dentist will drill for a few seconds at a time to help you. I have been through this a few times. It is important to make sure the issue is taken care of.

I will get my X-Rays on CD tomorrow. Then I will send them to @Ed209 and will try to get some more appointments with dentists in my region. There are like 20-30 dentists here. Maybe I need to look for one that is specialized on anxiety patients. Those seem to be the ones that accept the tinnitus condition and are ready to drill using the on-off method.

I just really hope everything goes well. I have not had cavity all my life ... now when I try to avoid dental procedures the most and upgraded my oral hygiene, I even get two cavities in very short time... how ironic. Thanks, life.

 

[chaLLas]

I have the X-Rays on CD right next to me. Unfortunately, my laptop at work does not have a CD drive -_- will make some appointments today and sending the pics to @Ed2019 in about 8 hours.

Thank you all for supporting me. I will keep this thread updated.

 

[JohnJohnJohn]

@chaLLas you could also try posting them to https://www.reddit.com/r/Dentistry/ where dentists hang out and may give feedback on x-rays.

 

[chaLLas]

@chaLLas you could also try posting them to https://www.reddit.com/r/Dentistry/ where dentists hang out and may give feedback on x-rays.

Thanks for the advice! I got Xrays of both supposedly carious teeth. I meanwhile had appointments at multiple dentists and they all said there is no cavity to be seen and that there is nothing to do for now.

That takes a lot of weight off my shoulders. I will have another appointment on monday and think I will also go check the reddit side. Seems I got off cheaply

 

[JohnJohnJohn]

That's brilliant news!! Good plan getting second opinions!!

 

[Starthrower]

That's brilliant news!! Good plan getting second opinions!!

I agree @chaLLas !!

 

[Ed209]

Thanks for the advice! I got Xrays of both supposedly carious teeth. I meanwhile had appointments at multiple dentists and they all said there is no cavity to be seen and that there is nothing to do for now.

That takes a lot of weight off my shoulders. I will have another appointment on monday and think I will also go check the reddit side. Seems I got off cheaply

This is why it's important to get other opinions. That first dentist was far too aggressive in his approach.

I'm glad it's worked out well for you!