Angry with Pediatric Dentist

I am so upset right now I am shaking. I had my daughter in for a checkup and he told me there is a cavity on a back tooth and he’ll need to do a pulpotomy. I had some questions. First, what is a pulpotomy? Second, why can’t we just do a filling? Third, if it is a baby tooth, why can’t we just extract it and let the adult one come in? Rather than answer ANY of my questions he said, “Do you ever get tired of questioning experts all the time? Maybe you should trust I am the dentist and know what I’m doing.” I don’t think my questions were unreasonable. AND this is MY child. Not his. Would you mind answering the questions for me so I can decide what to do?

Jennifer

Dear Jennifer,

Four Smiling Children

I am sorry that you were treated this way. I will be happy to answer your questions. Before I do, I am going to suggest you find another dentist for your daughter. You need someone who is on your side and willing to answer every single question and concern you have. It does not have to be a pediatric dentist. There are family dentists who treat both adults and children. Now for your questions.

A pulpotomy is a child’s version of a root canal treatment. They are less involved than the adult versions. It is typically reserved for back teeth and is a last resort at saving the tooth that is infected. This leads to your second question.

If it is a matter of a simple cavity, then a filling will be all she needs. I recommend mercury-free composite fillings as the safest option. Once the cavity spreads to about 30% of the tooth, then a filling will not be enough and you would have to get her a dental crown.

Only if the tooth is infected would you do a pulpotomy. You did not mention that your daughter had an infection in the tooth, just a cavity, so that makes me wonder. It may be in her best interest to get a second opinion.

Your final question was a good one as well. In some cases, it is fine to just extract a baby tooth and wait for the adult tooth to make its appearance. Back molars are different. They have to last until your child is around twelve years of age. Otherwise, that space is left open for too long waiting on the adult molars. The adjacent teeth drift or tip into the spot. When the adult teeth finally do arrive, there is not enough room for them, which leads to crowding and the need for orthodontics.

If a back tooth does have to be extracted, her dentist would need to put a space maintainer there in order to keep the rest of the teeth in place until her adult tooth arises.

I hope this helps.
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Affordable Crown Costing Me a Fortune

I needed a dental crown and my dentist was going to charge $1000. I found another dentist about twenty minutes away who only charges half of that, which was much more affordable for me. Initially, that was great news, but it has fallen off six times since I got it, two months ago. Each time, the dentist puts it on again free of charge, but I still lose a minimum of two to four hours at work, depending on how long I am there. I get paid hourly, so this is cutting into my income quite a bit. Plus, my boss is not too pleased. Now, the stupid thing has broken and we have to start over. He said, I would only have to pay half price since I haven’t had it that long, but still, that is another $250 on top of MORE time lost at work. Is this normal?

Kelly

Dear Kelly,

Gilbert CEREC Crown

I’m sorry, let me understand something. He’s offering you a half-price crown because it didn’t last that long? Really? I believe you said you have had this crown a little over two MONTHS, right? A dentist crown at a MINIMUM should last five YEARS! Most go much longer than that. Do not pay him any more money or go back to this dentist. Instead, I want you to get a refund on the original crown. He does not know what he is doing.

Aside from the crown breaking years before it should even begin to show signs of wear, there is the issue of the bonding failing over and over again. Most dentists go their entire careers without a dental crown falling out. This dentist can’t seem to go much more than a week, and that is just with one patient. I probably sound harsh, but you are getting poor quality care and I don’t want you to go through any more with this dentist.

Cheap Versus Affordable Dental Care

There is a huge difference between a cheap and an affordable dentist. Let’s say, for argument’s sake that you go ahead and have the crown redone at half price. Now you are up to $750 not including lost income and time away from work. This time, the crown lasts two years before you need another one. That’s another $500. Now you’re up to $1250. The next crown lasts a generous 5 years (woohoo!). That’s another $500 and you’re up to $1750. If you’d gotten the original crown for $1000, you could have had a hassle-free crown that lasted up between 10-15 years, assuming your current dentist does good, standard work. As you can see the “cheap dentist” was much more expensive.

While there are good affordable dentists, you won’t usually see their prices so dramatically lower than everyone else. When a dentist is that much lower it is usually a red flag. Often that happens for one of two reasons. Either they are terrible at their job and have to keep their prices low enough to constantly draw in new patients, because he has no patient retention. Another possibility is they are new dentists and need to get patients. That’s fine. We all start somewhere. For a price that low, they’d have to cut corners to keep profits reasonable enough to stay in business. Those cut corners could negatively impact your outcome.

I would go back to your dentist, tell him your financial situation and ask if he or she would be willing to allow you to make payments toward your new crown.
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