Do I really need that dental work?

Question: I have not been to a dentist in about a year and a half since I recently moved to the area. My new dentist told me that I have seven cavities and need two crowns. I have no pain and everything feels great. I am reluctant to go back to him because I don’t think I have any dental problems. What do you suggest?

Answer: This is one of the most common questions I get from a new patient who was dissatisfied with their previous dentist. The answer is not as simple as it might seem. In general, a patient who questions the accuracy of the dentist’s diagnosis falls into one of three categories. He or she is either fearful of having the treatment done, does not like how they were treated by dentist or the staff, or has not been given a clear explanation of what needs to be done and why. To put it simply, the patient does not trust the dentist.

When ever you have doubts about the type of treatment that you need, ask questions. In this instance, you might ask how you can have all those cavities and need crowns, but not have any pain. The dentist can then explain that most cavities will often have no symptoms. It is not until the cavity is fairly deep that you begin to feel sensitivity to cold or hot foods and beverages. By that time, the tooth will often require a root canal to treat the cavity that has infected it.

Remember that pain is not always an accurate indicator of the beginning of a dental or medical problem, for that matter. Like dental disease, medical conditions such as heart disease and many cancers often progress in an unsuspecting person who feels no pain.

A crown is recommended on most back teeth (molars and premolars) if the tooth has had extensive damage, a large broken filling, or has had root canal therapy. The crown (cap) fits over the damaged tooth to restore its strength and appearance. In most of these cases, the tooth will not have any symptoms.

The best approach for a patient and their dentist is to have an open dialogue about what dental problems exist, and what treatment options are available. If you are skeptical about the cavities that are diagnosed, ask the dentist to show them to you with an intra-oral camera, on the x-ray (if possible) or other method. If you are fearful about the treatment needed, ask what things the dentist can do to insure as comfortable an experience as possible.

Always trust your instincts. If you feel that something is just not right about what your dentist is telling you, get a second opinion. A dentist who is honest and has integrity will not mind if you want another opinion.