MY SMILE LOOKS TERRIBLE BUT I CAN'T AFFORD THE DENTISTRY - WHAT CAN I DO?

My smile looks terrible, so I don't smile any more.  I can't afford the dentistry.  What can I do?

How many times do I get asked this question!  Usually it is from a new patient who I have never seen before and they have come in to see what we can do about their smile.
So many people assume that it is just to expensive so they never come in and even ask the question.  That is the worst situation because for many people the fix really isn't that bad or that expensive.  You really need to ask the question so that you can get an answer.
Many people assume that things are terrible when the solutions are often small and simple.
There are of course cases that are more complicated and more expensive but let's go over some cases and see some solutions.  Of course I can in no way cover all the possible scenarios but here are just a few easy ones.
"My teeth are yellow and they embarrass me".  The solution is teeth whitening!  From in office to buying whited strips at Walmart.  Both work well and you can keep your cost low.
"Crooked teeth".  I always wanted straight teeth but couldn't afford it.  I refer to the orthodontist.  The typical case is $6-7,000 dollars (CDN).  The people I work with ask for a deposit then they put you on a payment plan for about 2 years so it works out to about $200 dollars a month after the deposit.  Sometimes, if patients are hard up for the deposit then I will speak to the Orthodontist and sometimes I can get the deposit  waved and get them more payments.
Now comes the tricky stuff where it is more difficult to give you an idea of cost without seeing the case.
Sometimes a patient needs all their teeth out and new dentures made.  The cost of the extractions will depend on how many teeth are left and how difficult the extractions.  Then the cost of new dentures.  There are some extra costs, not really hidden as your dentist will discuss these with you before you start.  No dentist likes to get into a situation of  "I didn't know" or " you didn't tell me".  These costs include things such as immediate denture cost (denture going in at time of extraction) and reline costs (to make the denture fit the gums after a few months).  Also a possible remake of the denture if it still doesn't fit well because the gums need time to settle to their final shape after the extractions.  If you can wait two to three months after the extraction to make the dentures you can save yourself a lot of these costs.

These are before and after dentures. Not bad!

Of course not everyone needs dentures. Some people just need to replace there existing fillings and make them look good.

Here we just cleaned the gums and so you can see the red line around the gums disappear and now look pink. We replaced the fillings in her four front teeth and just did a better job.  The result was great.  The cost including the cleaning was about $1200.
   Of course I am cherry picking here.  There are cases which are a lot more expensive but if you don't ask you won't know.  Perhaps your solution is not as complicated as you thought it would be.

All the best
Dr. Ron Barzilay
www.rondentist.com

enjoying dentistry in Hamilton Ontario

If you have any questions, just send them as a comment to the blog and I will reply.

I had a root canal many years ago and since the crown falls out all the time and it bleeds and smells really bad.

Sometimes you get a letter with questions that touch on numerous issues.  I received one such letter this past week and I would like to share it with you.

Hello Dr Barzilay,
I had a root canal many years ago and since the crown falls out all the time and it bleeds and smells really bad. After telling my dentist over and over again they referred me to a specialist who just found out that the dentist who did the first root canal missed a canal and it got infected that's why i was having so much pain. My question is if i get a crown on it again will it keep falling out? Or did it fall out because it was infected. Also my appointment to get my crown on isnt until 2 weeks from now how do I keep this clean from getting infected again I have a huge hole there it is my number 3 tooth. Thanks

Wow, these are great questions I thought I would put up this letter on the blog for discussion.  There are a lot of important issues that have been brought up here that deserve discussion and many things that I have seen throughout my years of practise.

1)  Why has this crown been falling off since it was placed.  A properly place crown does not fall off.  If this  crown has been falling off since it was placed we can only assume that it was not placed properly.  Meaning that perhaps the underlying tooth is too short to give retention to the crown and if so it may be necessary to lengthen the underling tooth or find retention by another method.  Another reason the crown could come off would be if the tooth was rotten underneath but we will assume that this was not the case since it was coming off from the beginning and a new crown would not have decay underneath.  My question here to the writer would be, how many years ago was the crown done? and what does falls out all the time mean?

2)  Bleeding gums and a bad smell around a crown can mean that the crown is loose and bacteria is getting in around the crown causing inflammation of the gums. ( when you touch inflammed gums they bleed).  Also, if the crown is loose and bacteria and debris are getting between the tooth and the crown you can get decay of the tooth and supporation of the debris leading to bad odour.

3)  Is the crown falling off related to the missed canal and pain you were having?  No.  The missed canal will not cause the crown to come off.  It most definetly may be the cause of your pain among other possible reasons (such as a moving crown or a cracked tooth).

4)  If you get a new crown on the tooth, will it keeping falling out?  You must get a new crown on the tooth and if it is done properly should not fall out as the original should not have fallen out.  Remember, the crown holding onto a tooth is just related to the physical properties of the tooth.  In other words, if the crown has what to hold it will hold.  If it doesn't have what to hold we have to start thinking about either making the tooth longer so there is more of what to hold or perhaps extracting the tooth and placing an implant as a regular crown will not hold.  You have to ask your dentist flat out "will this crown hold?"

5)  Now this last question is really important.  The patient say she has a huge hole there and wants to know how to keep it clean so it won't get infected.  Her appointment for the new crown is in two weeks.  Sometimes a hole is a result of the temporary filling being compressed into the crown space, in which case you may be getting bacterial leakage and you should go back to the dentist to top up the temporary filling.  This is simple and not a problem.  If for some reason there is no temporary crown or filling then that is a problem as bacteria can percolate through exposed root canals and cause reinfection of the canals.  Speak to your dentist regarding this.  The last issue here is also, as I have mentioned in point 1,  if  you are going to be having a new crown done in two weeks, ask your dentist what is different that now that will make the new crown stay on.


All the best

Dr. Ron Barzilay

Enjoying dentistry in Hamilton Ontario

www.rondentist.com

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