Dental Woe Update: Dental Relief!

I have a happy/relieved update on the back molar dental woe situation.

Back when I first told you of the woe, several of you mentioned having had a back molar pulled and no implant put in, with no ill effects despite threats of ill effects. Another local friend mentioned the same thing: could not afford implant so threats were scary but moot; had back molar pulled, didn’t get implant; nothing happened.

I went to see my beloved and trusted oral surgeon prepared with a compromise: what if she pulled the tooth and did the first step of the implant, the one that needs to be done right after the tooth is pulled, which is to put in the bone graft; and then we just didn’t do anything else? Then, if my teeth started shifting or if I had trouble chewing or WHATEVER, the bone graft would already be in place and we could proceed with the implant; but if there were no ill effects, I would only be out the cost of the bone graft.

She counter-offered: she said we should just pull the tooth and not waste money on the implant OR on the bone graft. She said:

• after the initial adjustment period, I was not going to notice the loss of chewing surface

• teeth shift forward, not back, so my teeth were not going to shift

• the bone graft would cost $750 and my body would dissolve/absorb it after a couple of years if we didn’t use it for an implant, and she didn’t think we WOULD end up using it for an implant, so it would be a waste of money and bone

• she hardly ever does an implant replacement for the back molar, because there’s not much bone back there and not much room back there and there’s a pretty strong chance of the implant failing anyway

So she’s going to pull the tooth, it’s going to cost approximately $250 (something like $40 more if I want nitrous oxide) (I am going to want a little nitrous oxide, as a treat), and there is no huge looming implant expense to deal with.

This is one of the many reasons I love this doctor: she is philosophically opposed to unnecessary/expensive procedures, even if it would be to her own personal benefit to perform them. (I do not think my dentist is similarly philosophically opposed.) She did not argue against putting in an implant when one of my upper two front teeth perished: she felt that was a good value, and so did I. But an upper back molar? Pull it and be done with it.

35 thoughts on “Dental Woe Update: Dental Relief!

  1. Alexicographer

    Yay! That’s pretty much exactly what I was told (minus the detail about the bone graft not persisting, but we never got to the point of considering one, because of the not-recommended implant), plus my oral surgeon told a nice story about a patient of hers who declines anesthesia but did opt for a pre-procedure glass of sherry (which I believe was BYO), endearing both the surgeon and the unknown patient to me.

    Reply
    1. Swistle Post author

      This is so charming it makes me want to adopt it as an affectation. I can picture myself with a little crystal sherry glass, sipping the sherry as we all wait for the novocaine to work.

      Reply
      1. Shawna

        I’m not a drinker, but I do have a small sherry with my mother on New Year’s Eve out of wee crystal glasses, and it’s very fun. And apparently funny because when medical professionals ask how much I drink every week I say I have about 4 glasses of wine a year, plus a sherry on New Year’s Eve with my mother, plus the sherry she liberally pours over our Christmas trifle, they always laugh.

        Reply
  2. CC Donna

    I had my back molar pulled about 20 years ago and have never had a problem since. I have to search out where the empty space is with my tongue to discover which side it’s on and whether it’s upper or lower. (just did that and it’s upper right)

    Reply
  3. Tina G

    I am so happy you were heard and respected and got the option you wanted. I am filing this information away for if/when I ever need it, so thank you! Good luck with it and I hope all goes smoothly for you.

    Reply
  4. Kerry

    I somehow missed when this was first posted, but in case it is still useful information I had my back molar pulled 10 years ago, no implant. Absolutely the right decision. My dentist (who I drive two hours to see because I do not particularly trust dentists but this dentist is associated with a very good dental school and many of his patients are doctors and dentists and I figure they would be more qualified than I to catch him if he were padding his profits with unneeded care. Also, I thought he was cute when I was 25) recommended against the implant & said that it would likely be a waste of time and have a high risk of failure.

    I know other people who have gotten different advice from their dentists…admittedly under different circumstances and involving different teeth and it’s not like I’m an expert…and watched them go through long and painful and drawn out ordeals attempting to get an implant, and it makes me very skeptical about implants in general. Dental surgery is also associated with some heart risks for older women, so there is also that to pay attention to.

    Reply
  5. Maggie

    As someone who gets nitrous every time I have a dental procedure because I have terrible dental anxiety due to some very bad dental experiences I guffawed at “I am going to want a little nitrous oxide, as a treat.” Can’t stop laughing every time I think of it.

    Reply
  6. Maria

    I’m glad you have a trustworthy “let’s do as little work as possible unless it’s necessary “ dentist. Ours is like that too which is a relief after a bad experience with a previous one.

    Unrelated but I have read your blog for about two years and have always wondered: Is there a post that explained the name Swistle and is it related to your awesome skirt logo thing? And if not would you mind explaining the meaning behind the name and the skirt?

    Reply
    1. Swistle Post author

      I am SURE I have a post SOMEWHERE, but can I find it? No. It turns out that “Swistle” and “why” and even “skirt” are fairly common words on this blog.

      The name Swistle came about without much planning. I was semi-impulsively starting a blog, and it needed a name, and I hadn’t thought ahead but really wanted to get going with this impulsive blog-creation momentum. So I took a childhood nickname (Swiss—the usual attempt of a younger sibling to say an older sibling’s name) and added endings until I liked what I had—just as a placeholder name, maybe. It took perhaps 30 seconds. Then two days later the name wasn’t sitting right, so I changed the ending and made it Swistle.

      The skirt was sold by The Children’s Place, and I have forgotten the exact details (I think by the time it went on sale it was only available in sizes too small for Elizabeth?), but it turned into a QUEST. I had a screenshot of it on my computer desktop to help me look for it on eBay and so on. And at some point during that era, I needed a small image to use as a blog icon. I didn’t want to use a photo of myself, so I went looking for a good stand-in—maybe a picture of a cat, or the standard (at the time) close-up of one eye?—and I saw the picture of the skirt, and it seemed just right, and I picked it.

      They are not riveting stories, I realize. Happy accidents!

      Reply
      1. Maria

        Thank you! My curiosity is satisfied! I have to admit I thought the two were linked – my potential explanation in my head involved the skirt making a swishing sound that was somehow important in your life at some point. (Like college nickname or something.)

        Reply
        1. Swistle Post author

          YES, and in fact now I have a box of the skirts in my attic, gradually acquired from EBay! Elizabeth wore them up to the highest size they came in (7/8, I think?) and now I am saving them for…who knows. Grandchildren? Someone suggested I might be able to make a PURSE out of one of the skirts, which is a fun idea I have taken no action on.

          Reply
          1. Leeski

            Thank you!! I have also wondered about the genesis of the name Swistle, and it’s good to hear that Elizabeth did eventually get to wear the skirt(s)!

            FWIW I read through a lot of your archives while nursing/on maternity leave last year, and as I recall you referenced/linked a post on one of the external blogs you used to write for that was about how you came up with Swistle, but that whole blog/enterprise seems to be gone now, and sadly your posts may be as well? So grateful you and your wisdom are still here though!

            Reply
      2. Cara

        I think it says something about my girl mom life that I didn’t even think to question why a girly skirt would be your avatar…

        Reply
  7. Jenny

    I’m going to tell you my secret shame. I had to have a pre-molar pulled this summer. Apparently it was a big enough cavity that they couldn’t fix with a filling or a root canal. The oral surgeon said that an implant likely wouldn’t take, but the periodontist said it probably would. So I’m not sure what I am going to do. It doesn’t show up much (if I’m at a bad angle and have a really big smile, you can tell), no one has told me they can see it. Maybe they are just being nice.

    And I have a broken back molar that I had a root canal on 3 years ago. And now that tooth has to come out. I’m waiting until the new year for that.

    Avoiding the dentist for a few years was NOT my best life choice.

    Reply
    1. Swistle Post author

      Teeth are such UNRELENTING UNMERCIFUL HASSLE

      And I’ll bet no one CAN see that missing pre-molar: Henry has a pre-molar that just…doesn’t exist, like it never formed under his gums. He has a gap there, waiting for him to be old enough to have an implant put in. And I can’t tell AT ALL. I am his MOTHER, I see him ALL THE TIME, I am SPECIFICALLY TRYING TO CATCH SIGHT OF THE GAP—and I never see it.

      Reply
  8. Nancy

    I am currently also going through upper right back molar dental woe: I had a cracked tooth which initially felt like just an escalation of the sensitivity issues I had been having for a while but gradually worsened over a week into the worst pain I have ever felt, fortunately resolved by an emergency dental visit.

    Now I have to decide whether to go with the root canal plus crown option or extraction. I haven’t had any work done on that tooth previously but apparently it is a complicated case for a root canal.

    Reply
  9. Kate

    Your dentist charges for nitrous? Thankfully, mine doesn’t. I get so nervous I even get it when I go for a checkup and cleaning!

    Reply
  10. Shawna

    I have never had nitrous oxide because I’ve never had a cavity. Before you hate me too much though, I have thin enamel so I’ve had to have some work done due to wear and breaking off bits of tooth. The dentist never offered me nitrous for that work – one of which did require freezing because he had to essentially rebuild the backs of my upper front two teeth – and it never occurred to me to ask.

    Now that I’m getting older the wear is causing some sensitive spots that may end up needing to be drilled and filled in the next few years, so I’ll remember to ask about it if it comes up.

    Reply
    1. Shawna

      Oh and one of those pieces that broke off? A boyfriend was horsing around pretending to be me and crouched down to say “I’m Shawna! I’m short!” then lunged upwards awkwardly to kiss me… and clonked his teeth into mine, breaking off a chunk of upper front tooth! Gah! I’m still exasperated!

      Reply
  11. Susan

    This is such good news, not only for you, but also for me to tuck in the back of my mind for myself if I ever need a back molar removed.

    Reply
  12. Lisa

    I just had to chime in to say that I, too, have had my
    UPPER RIGHT MOLAR REMOVED! I had to get it yanked out about 5 years ago and haven’t had any problems or issues since :)

    Reply
      1. Mary Kate

        I unexpectedly joined this club this past summer. Welcome, glad to have you joining us. I’d love to share my story. :)

        I had a similar situation this past August and made a similar choice. The oral surgeon shared a similar explanation. I am now about 8 weeks out and do not regret the decision.

        Definitely get the nitrous oxide. I either refused it or it wasn’t offered. While the procedure was pretty quick. It is similar to having a big cavity filled— there is a lot going on in there plus you are required to keep your mouth very wide, it is in an awkward place in your mouth and they put this weird guard thing in that was annoying. So having something to take the edge off would be nice. Even without it, it was doable and was NOT the worst cavity I’ve ever had filled.

        I am a little fuzzy on all the details, especially about the recovery but:
        * definitely make sure you pamper yourself that day and for the next few days. You are going to want to be able to curl up with a good book under a cozy blanket with a favorite cat nearby.
        *similar to Mother’s Day, you are going to want to prepare the potential caregivers in your life if your expectations. While it was manageable, you will absolutely have swelling and there are some weird things going on in your mouth (maybe stitches?!?, the general loss of the tooth there). So they should definitely be ready to jump into their best caregiving role.
        * the healing process went well but takes a while. They’ll tell you in their discharge info but the actual area needed time to heal.
        *once that area is healed, it also took me a little while to get used to the new chewing situation. It wasn’t that it caused me any problems or discomfort, it just was a little weird. It is almost as if’d rearranged my bedroom furniture for the first time in 50 years and I keep forgetting.
        *if you can, I would wait until January to do it. However, it isn’t a requirement. I was in major pain so I was doing it come hell or high water. I would have even considered pulling the tooth myself.

        Reply

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