Expert: Rafael Mosery,D.D.S. - 2/11/2009

Question
I have consulted with several Dentists and Oral Surgeons over the last few weeks, and am yet to get the same recommendations.  I am completely confused at this point.

One Dentist wants to extract half of my molars and give me partials, another says most of them can be saved with root canals and/or crowns.  I am already missing some molars and want to have implants.  One surgeon says I must have a sinus lift before the implant, another says it is not necessary.  Each seems to have a loyalty to a particular procedure, brand or type of implant.  And every Dental Practice seems to have "sales pitch".

No matter what I end up doing, it will be very expensive.  

This is my health, and I want to get the right treatment.  But at this point I feel like I need to go to Dental School, just to know what I really need!

How do I go about making the right choice?

Answer
I appreciate your quandary.As a patient it seems like there should be a black and white decision to be made.This may sound corny to you but the bottom line is that dentistry is an art.What I mean by that is probably each doctor you visited had their particular reason for offering you the treatment plan they did.That's not to say they're all equal in quality,longevity,comfort etc.
Let's take this apart without the luxury of an exam.
The teeth might be saved with root canals,post and crowns.That's going to be time consuming and costly and unless a solid foundation required of the teeth and the supporting structures is present it would be short lived.
Next option, removal and placing a partial.The least desirable in terms of preserving the remaining teeth (that will now be burdened with retaining the partial),comfort and function is also compromised.Next, implants  without a graft, this may very well be possible and this would be determined AFTER the teeth are removed.
So really it boils down to the long term you might better off with removal and implants with or without a graft.Either way would be ok if it could be justified and the Dr takes the time to explain your particular case to you.It's all about communication.