el diablo robotico (platypus) wrote,
el diablo robotico

Yesterday's dental appointment was pretty easy. I didn't even require any anaesthetic; the dentist just prodded at the crater a little, agreed that I had indeed lost a chunk o' filling, smooshed some temporary filling gunk into it, whittled at the resultant blob a little, and had me make an appointment to get the lower left quadrant worked on next (he thinks it's more urgent than #29). Unfortunately, I'd been stressing about the appointment all day, and had a good 30+ minute wait in the dentist's chair to spend fretting even more. At the end of the appointment, I was just as shaky and lightheaded as if I'd been getting a root canal or something else awful and huge.

I'm nervous about getting this next quadrant done, to be honest. I'm halfway done (the lower right and upper left are finished). I know the lower left also needs to be done; clearly the fillings from my childhood have had it. But you know what happened last time I got a crown (from Evil Dentist)? Of course you do. The next dentist I met, Dr. A, said, "That crown has an open margin. It sucks, and needs to be replaced." It was so true that when I complained Delta Dental smacked Evil Dentist for me. I confidently let Dr. A re-do the crown. Later, I went to Dr. S for a totally-unrelated periodontic exam, and he said, "You know, that crown on #29 has an open margin." I said, "Like hell! I had it replaced because it USED to have an open margin!" and he said, "Hey, that's not my fault. You really need a crown lengthening done there if you want a crown that fits." And he got back to Dr. A about that, and he agreed, and I got the whole goddamn thing re-done again (and coincidentally had the root canal re-done as well, but that's tangential to the issue).

So here I am, getting more crowns. Dr. A seems like a responsible person. He appears to care about quality work. However, there's this question of whether his first replacement crown on #29 was good enough. He must care about margins, for heaven's sake; he's one of the ones who pointed out that #29 (as originally performed by Evil Dentist) had an open margin to begin with. But can I trust him to do the rest of this properly? Every time one dentist does a procedure on me, the next dentist I see says it's poor quality. When I first went to the dentist after nine years of not getting so much as a checkup, I went to Dr. Z in Madison. I liked Dr. Z; he was nonjudgmental and helped me deal with my phobias and got a reasonable amount of work done. (The one thing I was never quite sure about was the last procedure he performed before I moved: the crown he gave me on #31. It looks lumpy and weird and non-toothlike. It was my first crown, and my reaction when he showed it to me (immediately before cementing it on) was dismay. Were crowns supposed to look like that?)

So I moved to San Diego, had my little debacle with Evil Dentist, and then I had one checkup with a Dentist Whose Name I Can't Recall (I really don't know why I didn't stick with his office -- there was nothing wrong with him, exactly, but then Dr. A came recommended by friends, so I switched. DWNICR also identified the open margin on the original ("classic," perhaps we'll say) crown on #29, for what it's worth). When I first went to Dr. A, he talked about the need for quality work, and said that some of the stuff I'd had done in the past looked better than others. He said some of my very old fillings were of very good quality, but were deteriorating due to sheer age (obviously true). He also said that some of my newer fillings did not look quite up to that standard, and were in all likelihood going to fail a lot earlier than my childhood fillings. He talked about how one can get dental work done cheaply in Tijuana, but it's not likely to last. (That's right, he looked at the stuff Dr. Z had done and implied I'd gotten it done in Mexico on the cheap. I was a bit disconcerted by this, but ultimately took it to mean that, well, at least THIS guy really cared about doing good work.) He then gave me this four-quadrant plan we've been working on slowly for the last few years.

Given my history, can you blame me for being a little paranoid? I have no way of looking in the mirror and seeing if the work I'm getting is quality or not. Okay, my newer crowns don't look like used lumps of chewing gum; so far, so good. (And that wacky crown is why I'm willing to believe that Dr. Z really was perhaps a bit of a hack.) But I can't look at crowns and tell if they fit. I can't analyze my own x-rays. If the crown doesn't fit, stuff gets under it and gets at the tooth under there and there's not a damn thing you can do. I've got a fine brushing and flossing habit now, but I'm also going to have a significant number of crowns where my control over the outcome is significantly reduced. I have to count on the dentist to do it right. What could possibly suck more than getting my entire mouth fixed up by Dr. A, moving somewhere else, and having somebody (say, Dr. X, from THE FUTURE!) tell me, "All those crowns you got are really substandard. You'll need most of them replaced if you want to keep those teeth."

So where is this leading? I am thinking that perhaps, maybe, it might be a good idea to get a second opinion before proceeding. Not on what needs to be done; I'm pretty confident of that. But I'd like someone to look at the last quadrant I got done, the upper left, and tell me if the crowns are within the realm of decency. I know there's a degree of subjectivity; a random dentist may say, "That's not perfect, but I don't know for sure that I could do better." I'd just be more comfortable if I had some vague idea that yes, those look like competently-performed crowns, carry on.

But what dentist would be willing to look at me on a one-time basis, knowing I don't intend to come to him for treatment? And I really wouldn't want him contacting Dr. A for copies of my x-rays or anything; he's a good guy and all, but in my experience doctors get weird when you do something that expresses doubt. I'm thinking maybe I should visit that Dentist Whose Name I Can't Recall; at least he seems to know something about crowns... how else can I find a dentist who's qualified to tell me a good crown from a bad one? But what if he says something negative? What if he says, "You should get all the rest of your work done here"? Or what if he asks me who the other dentist is? What if he's reluctant to criticize? Am I just paranoid? If I call his office tomorrow... what the hell would I say? Do you agree that it's reasonable to want another opinion? I'd love to just trust in Dr. A, but... I can't. I don't think I can completely trust anybody in this (and a new dentist's opinion would also be scrutinized, I assure you). And I know: ask ten dentists, get ten opinions, no two alike. But I just can't stand to proceed blindly any longer.

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