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Dentistry/Saving molars

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Question
Hi Dr. Schwartz,

The dentist for my elderly dad replaced the fillings in his molars #2, #15, & #18.  He says #2 is probably dead (he did a direct pulp cap), and #15 & #18 will probably die b/c the filling is close to the nerve (i think he did an indirect pulp cap on one of these).  So now he says they will need root canals.  My dad was perfectly fine & pain free before this, but now he experiences pain when he chews food on what appears to be molar #19 (i've convinced him to go back & see if it's the new fillings).  I know the dentist wanted to put a porcelain crown on #19 b/c it's mostly filling at this point & he thinks there might be some decay under the filling.  Would the advantage of placing the crown outweigh the further weakening of the tooth in preparation for this procedure?  This is the only molar he hasn't touched, and at this point, i'm afraid he's going to make it worse.  I'm thinking it is best to try to save #19, and if my dad ever experiences pain in the other ones, he can just have them extracted?

Thank you for your time and consideration.

Answer
Hi Linda,

I would talk to your Dad about this and get his input.

I understand why the dentist wants to replace the filling with a crown. However, unless there is definitively decay under the filling, I would leave it alone. Why bother your elderly father for a 'possible' improvement. If anything, the improvements make him uncomfortable and take time for him to adjust to. As such, I wouldn't rush into any big dental treatment unless absolutely necessary.

Again, I don't blame the dentist and he probably is correct in his thinking. However, we also must look at the comfort of your Dad and determine if it's really worth the hassle.

Good luck!  

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Benjamin Schwartz, DDS FAGD

Expertise

I can answer a range of questions in dentistry, ranging from cosmetic dentistry, fillings, root canals, and comprehensive treatment. Specifically, my fields of interest are in CEREC technology, Invisalign (Invisable braces), and Endodontics (root canals).

Experience

Full time practicing dentist in New York City, treating all phases of adult dental needs. Specific focus on Invisalign cases, Endodontic (root canal) treatment, and CEREC single visit restorations.

Publications
Schwartz Benjamin, Boczko Fae, McKeon S. Oral Care For The Elderly. Perspectives in Gerontology December 2006

Education/Credentials
New York University College of Dentistry - D.D.S.
Woodhull Medical Center, 1 year post-graduate residency program - GPR

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