We are a group of dentists who created an app (Dental Republik) aiming to increase dental access, reduce anxiety and prevent overselling of treatment. Ask us Anything

Do I really bleed from my cleaning because I don't floss? Or because you are poking me with a sharp piece of metal?

Combination of both ;). Your gums are less likely to bleed if they are not inflamed due to gingivitis when we poke you

Assuming a dentist on your app is able to recommend a treatment, how is a patient supposed to use this knowledge moving forward.

For example: a patient visits a dentist, a treatment is recommended, but the patient is unsure and uses the app for a second opinion. If the patient receives contradictory information from a dentist via your app, how should they proceed? Find a new dentist and give them all of the info from the previous dentist and the recommendation from the app?

Yes at this point it would be a good idea to find a new dentist.

We would recommend allowing the dentist to make their own judgement first without mentioning it is a third opinion so as to not cloud the dentists judgement. Afterwards it would then be best to compare information and proceed. At this point the patient would have spent $7,99 more than they would have otherwise without the app as the second opinion would have been needed regardless as the patient was unsure. The benefit of using the app is that the second consultation fee which is significantly greater than the cost of app could have been entirely avoided if the information backed up the first dentist.

[removed]

Almost all the dental profession think it is a good thing. Fluoride has been proven to reduce decay and is recommended by the World Health Organisation.

I understand the counterpoints to it such as mass medication and risk of fluorosis but I personally believe that the reduction in decay for the most vulnerable in society is worth it.

I'll leave a link here which raises some good points. There are three research points in the section titled "bottom line" which may help to convince the general public going forward.

https://www.hsph.harvard.edu/magazine/magazine_article/fluoridated-drinking-water/

Why can only 4 out of 5 of you ever agree on anything? What's with the one holdout?

Ego ;)

Is dental deep cleaning a scam? I went to a new dentist, and asked for a cleaning. They refused to give me one, and said I needed a deep cleaning, and that I needed to wait for 6 weeks for my insurance to approve the procedure.

I didn't get a cleaning, and insurance refused what they wanted to give me. Stating the xrays showed no gum-disease.

This is one of the things we aim to prevent. Eg you can upload the x-rays for review by one of our dentists in 24 hours.

Deep cleaning also known as Root surface Debridement is required in cases of plaque and calculus under the gum line when there are pockets between the teeth and the gums. This allows bacteria in plaque and calculus to accumulate. If this is allowed to continue the bacteria can cause destruction of the bone leading to the teeth becoming wobbly.

However the provision of deep cleaning when not necessary is relatively harmless (though it may lead to recession and sensitivity) so may be recommended by unscrupulous dentists seeking an additional fee which your insurance seemed to think was the case.

What's a good sign that you need deep cleaning or not?

If a person never needs deep cleaning and has no tooth pain, is an annual x-ray exam really the only thing recommended?

A comprehensive periodontal exam should be carried out.

There is a check list at the bottom of this page. https://www.perio.org/consumer/perio-evaluation.htm

An annual exam is needed to pick up anything that may become a problem as well as reinforce oral hygiene habits. Prevention is better than cure

Is Listerine mouth wash a scam?

From the evidence available (most likely paid by the manufacturers) it certainly appears to work in reducing the number of microbes in your mouth and hence help reduce plaque and calculus which can lead to periodontal disease.

If you are to use a mouth rinse (fluoridated mouth rinse is recommended) make sure you continue to brush twice a day for 2 mins (electric brush is ideal) and use the mouth rinse at another time of day to brushing such as lunch time. The reason for this is because your toothpaste has fluoride in it which you want to leave on your teeth, as fluoride is known to strengthen the enamel on the teeth. Using a mouth rinse even if fluoridated will wash away the higher concentration of fluoride found in toothpaste so it won't have the intended beneficial effects.

Wanna highlight something many might miss (and more don't know):

You are not supposed to rinse your mouth after brushing with toothpaste. You're supposed to spit the foam out, but not follow that up with a clean-water rinse after.

Thank you. You are correct,

We always say spit not rinse. So spit out any excess and allow the remainder to stay in the mouth.

What??? All my life I have been brushing and I rinse my mouth with water as if I was doing dishes.

I was the same until dental school. You don't know what you don't know.

You’re ruining my morning OJ though.

Wait 30 mins after OJ then brush. (wait is due to acidic juice)

Though morning breath may ruin the OJ too

Could you rinse before brushing?

If you wanted too but there is no real need to. As brushing does the job

I haven't been to a dentist in 12 years, Panic is a reason and finances are the main reason. Needless to say I need full dentures.

I can't find anybody to do it less than 3K (school for dentistry in Houston). Where can I go to get it done for a grand? It's all I can afford. Nothing fancy, no drilling or posts. Just pop them in and out at will like grandpa had?

Can't help you with that one unfortunately. Sounds like a dental charity or south of the border will be best bet.

Is it too late to start dental care at the age of 20? I didn’t get any education about this and always avoided brushing because of laziness but know I realise it was an error. Is it too late to start now?

Nope it is never too late. Find yourself a dentist asap.

Meanwhile we recommend an electric tooth brush for 2 mins a day. Split your mouth into 4 quadrants and spend 30s brushing each. Use fluoridated toothpaste. Some recommendations are elsewhere in the thread.

Remember to brush all surfaces.

Good luck

If I decide to sign up to answer questions what sort of “non-compete” clauses are in the terms? If I decide this is my new passion and create a competitor can you sue me under the terms you have your dentists sign?

Check out our clauses on the app.

In all honesty we welcome competition. We aren't financially motivated as you can see from our low cost pricing and small margins. We want to live in a better world where people don't take advantage of patients they have knowledge and power over. So the more the merrier

Water floss (waterpik), regular floss, or both. Have you seen a water floss be just as good as regular floss, or do they produce the same result and doing both is just overkill?

They both serve different functions.

Regular floss is best in my opinion as it scrapes off harder deposits as well as the soft stuff.

Water floss is good for removing softer deposits that can be removed with a jet of water. It is also good for those with braces to remove debris from between the bracket and the tooth. It is also useful for those who struggle with the dexterity side of floss.

Do both if you can it wont be harmful and is not overkill.

Otherwise do the one that is easier/preferred.I would rather my patients flossed with the one they were willing to use everyday vs not floss at all.

How much does it actually take to produce an invisible brace tray, and it is really worth the cost in thousands of dollars of its proprietary technology?

Hi, I can't comment on the cost of their technology as they have to cover their marketing, insurance, R&D with the dentist then charging their fee on top to cover their costs as well as make a profit.

What I will say is with invisible braces and trays, make sure you get them done by an orthodontist or somebody with specialist training rather than a general dentist who may not necessarily treat too many cases. If unsure ask to see their portfolio of work, as people are starting to take clinical photos to document their outcomes.

Also be wary with invisible braces they may end up taking longer to treat your problem compared to conventional options or teeth could relapse to their old positions so appropriate advice from a specialist at the start could avoid these negative consequences.

what are some dental care myths that even dentists tend to propagate?

I think the big one is that wisdom teeth must be removed prophylactically which is common in the US but not other parts of the world. If interested have a read through this article which highlights how wisdom tooth removal is a multi-billion dollar industry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1963310/

Is it accurate to location? E.G. Can they recommend stuff based on costs in California vs costs in another state where it might be cheaper if I want the least expensive option?

At the moment we don't track location as we value privacy and prefer to minimise the info we take.

However we can suggest the least expensive treatment as for example a filling will be cheaper than a crown regardless of state.

You can always include in your question your state location as the individual dentist answering may have the knowledge to recommend a cheaper state but I wouldn't bank on it.

If you brush your baby/toddler's teeth, and they only drink milk and water, and brush before bed, when do they need to go to the dentist for the first time, and how often do they need to go?

I know you said your brush but just as a FYI for others It is recommended to use a smear of 1,000ppm fluoride toothpaste as soon as they erupt.

As a baby I would just take them next time you go just to introduce them to the dentist and so they can monitor that baby teeth are coming through in order etc. Otherwise by first birthday is usually recommended.

From age 3 when the contacts of the teeth are closed is when the child teeth usually have bitewing x-rays taken

Are you dentists?

yes

My dentist gave me a new crown for a back tooth that didn't hurt. They messed up the glue and the whole thing was a mess. I felt like I got scammed and found a new dentist. Did I do the right thing?

Did the tooth have a large filling in it was replacing? Even though it may not have hurt, the crown could have been placed for a variety of reasons such as to replace a large filling thus improving structural integrity or to protect the tooth from further wear if it you grind. The reason should have been explained by your dentist for consent purposes and this may have helped you feel as though you weren't being scammed.

I think with the cementing mistakes can happen and everyone has bad days. Did the dentist offer to clean out the crown and re-cement? I think the best thing to do is first mention it to the dentist and see if they would resolve the issue for you. As it may have been an honest mistake.

If you feel as though you got scammed though and the dentist was not helpful the best thing to do is as you did and find somebody new. I recommend asking friends and family for recommendations and their suggestions.

Why do you take so many damn X-rays!?

We all have bets on to see who can make their patient glow in the dark first.

Seriously though it can be for a variety of reasons such as too diagnose tooth pain/ decay/ location of nerves or unerupted teeth.

X-rays are taken more regularly in patients who are at higher risk of decay

Why is dental insurance separate and optionL. So many problems can be traced back to bad dental health. Wouldn’t it make sense to insurance companies to cover that and prevent more expensive problems down the line?

It would make sense to me . Prevention is always better than the cure. But insurance companies want to make money and they must make more this way.

Here's a stat for you: An average of 320.8 million work or school hours were lost annually for dental care in the United States, of which 92.4 million hours were for emergency care. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772383/)

What is the best economical teeth whitening solution for someone who smokes occasionally, brushes properly and has yellow teeth now?

Probably a whitening toothpaste. My preference is sensodyne.

As you smoke the teeth will stain again though

Why are dentists constantly wanting new x-rays? Seems to come up at damn near every cleaning.

We all have bets on to see who can make their patient glow in the dark first.

Seriously though it can be for a variety of reasons such as too diagnose tooth pain/ decay/ location of nerves or unerupted teeth.

X-rays are taken more regularly in patients who are at higher risk of decay

[deleted]

They are paid a flat $4USD per case.

We don't intend for it to be a replacement for a salary, though it is possible depending on number of cases answered an hour (the average is 12 cases an hour).

We verify the dentists are qualified and they are then free to work as much or as little as they like when they like hence there are no set hours. At the moment we have a few mothers on maternity leave with us as well as a dentist who is travelling using us to supplement their income whilst out of the dental office.

We have dentists working almost 24/7 as they are in different time zones.

Are any of you one of the 1/5 dentists that don’t recommend trident?

One of us has a seemingly irrational fear of squirrels. Makes sense now

Is synthetic bone grafting to prevent loss of teeth due to periodontal disease a good treatment or a scam? It was extremely expensive and I'm told that my teeth may still fall out due to reabsorbtion later on (not guaranteed, but a possibility). Just curious on your opinion of that procedure.

It is definitely a viable treatment in the right hands (usually a qualified specialist in most countries).

I have seen some cases with excellent outcomes. It is often used to replace voids and defects in the bone. The procedure itself may not necessarily prevent loss of teeth with the underlying causes of the periodontal disease need to be addressed otherwise it can lead to failure. Underlying causes of periodontal disease include smoking, diabetes as well as build up of plaque and calculus.

How many 4 on post, conversions have you seen or done?

Hi not really sure what you mean. Do you mean 4 implants holding in a denture? (We call these implant retained dentures) I've seen a fair few of those which have always had a good retention to the denture from what I have seen. Personally I don't place the implants myself just maintain them as I am not an implant specialist.

Yes sir. I got them a year ago. What complications or problems have you seen with them? Also, any crazy horror stories from them?

Complications wise it's the major one is called peri-implantitis which is like periodontal disease that occur to your implants meaning they can end up loose. Best way to avoid is keep on top of your oral hygiene, using interdental brushes to clean between the implants. People often forget as they think they no longer have their natural teeth hygiene does not matter.

Other oral hygiene best practice is to clean the dentures twice a day with a brush moving the superficial debris and soaking the dentures in a denture cleaning solution to reduce the bacterial load on them. It is also important not to wear your dentures at night too as this can lead to a candida infection (https://en.wikipedia.org/wiki/Denture-related_stomatitis).

In terms of horror stories never any after fitting. They are usually implant related complications such as the dentist getting the angle wrong and the drill coming out the side of the bone. Also have seen a few patients where the dentist managed to drill through the nerve resulting in permanent numbness.

I had a dentist hit a nerve with an implant, caused numbness and quite a bit of pain for a few years. He didn't seem too concerned. The pain seems to have faded luckily, but it took me about another year to figure out something wasn't right and find a new dentist. No idea how much of what he did was necessary. So I am very interested in your app. Just wanted to say thanks for trying to create a solution.

Sorry for hearing that. Glad to hear the pain has faded.

Thank you for your support. Unfortunately with dentists there may be a temptation to carry out treatment that may be financially beneficial. Hopefully we can help reduce this where it is a problem

I have a water pick with the bristle tip. That seems to work good. I try to rinse and brush as often as I can to keep them clean. I can't remove mine, any other tips to clean? Better stronger mouthwash?

I do have a recurring problem and was given Nystalin. It does not work well and can't take orally. Originally I was given Alcortin but that shit is $500 a prescription!!!!!

OUCH thankfully mine went well, no real complications other than twilight not working and having to hire an anesthesiologist! That was pricey!!!

Thanks for the info!!!

With the mouthwash the over the counter should be good enough, try peridex or something with Chlorhexidine in though it can lead to staining long term as well as a risk of allergies.

Other thing to do is to floss under the denture using superfloss to keep the implant area clean as well as use a sulcus brush to clean where the denture meets the gum line.

Ouch can't help you with the prescription cost unfortunately.

How likely is it that wisdom teeth would come in oddly if I got my uppers removed, leaving the lower? I was convinced to get them all (basically jackhammered) out. During the procedure the sugeon regailed me of tales from his Big Game African hunts and I couldn't help but think my insurance was sending him on another.

I'm not sure on the likelihood unfortunately. I don't imagine it having an impact.

Tell him to leave Cecil alone, RIP.

2 years ago I had a tooth pulled. Then several months ago, I had a bridge placed as the 2 surrounding teeth were starting to lean inwards really bad. I’ve had maybe 10 bite adjustments since getting the bridge,actually had one today. Is this normal? Will they ever “even out”? I’ve asked my dentist if I’m being overly sensitive about needing the bite adjustments, and he said yea, but it’s because I have periodontal disease, and my teeth are shifting a lot. I don’t think I’m being charged for these,( never got a bill)but it’s getting frustrating going at least once a month for bite adjustments. I just want to know if there will ever be an end to it? And I guess it’s worth mentioning, because my dentist mentions it a lot, that I also have a tooth that’s cross bite that’s kind of close to the bridge. Thanks for your time!

So the bridge sounds as though it was to maintain the space otherwise you may not have had enough foom for a tooth.

The way you bite with the cross bite probably makes the bite adjust difficult to get right. I am sure the dentist does not want to see you once a month either and is trying his best to get it right. Fingers crossed it gets resolved soon.

Your teeth ideally the teeth supporting the bridge should not be mobile due to the periodontitis but the opposing bite may be changing complicating things. Ideally you would want to stabilise the perio before the bridge but the closing space may have made the dentist think there was a time pressure.

I have an overbite, except where that one stupid tooth is, it juts out from the rest of my teeth. And yes, he did say the 2 teeth surrounding where the tooth was pulled, I would’ve lost because they were leaning so far. I never had bite issues before the tooth was pulled. Any good rule of thumb for when I need to get a bite adjustment? My dentist says once it feels off, give it a week, and then if it still feels off, come in. If feels different almost everyday.

Don't have any particular tips. As you have had a fair amount of work done he probably means you need time to adjust as you did not have a tooth in that region for a whilse

What is this app and why is it misspelled?

The app allows you to ask qualified dentists your questions for a small fee. (cheapest option is $7.99). https://dentalrepublik.com/ Check our website and give it a try.

We want to provide knowledge to patients to help reduce anxiety as well as increase access to dental professionals where it may be unaffordable.

By increasing patient knowledge we hope that patients are less likely to be over sold treatment by dentists chasing a profit.

The spelling is due to the URL being available at an affordable price.

Could you give any advice on the quality of gold crowns, I have two sets, done at different times, the second set is a much lower quality metal crown, it feels a little rough and is discolored (lower ratio of gold I have been told), whereas my first set seems to be much higher quality, always slick to the tongue. How do we know what were going to get quality wise?

Sounds like your crowns have different percentages of gold in them as you have been told. For more info on the property of gold see the last 3 paragraphs on https://pocketdentistry.com/7-gold-and-alloys-of-noble-metals/

The only way you can tell is to ask your dentist. You taking an interest in this may cause them to order in a higher quality crown as less gold if obviously cheaper. However the way you bite can also determine the percentage of gold required as the crown may need to withstand more force thus have a lower percentage of gold which is a soft metal.

Another issue could be that your dentist uses a poor quality lab who's work is of low quality. This is a tough one to figure out as the only way you as a patient can tell is by asking family and friends who also attend that practice their experience with the quality of crowns.

Some dentists may also have sample demo crowns that you can see.

What should be done for my severe pain and headaches caused by TMJ?

Recommend to see your dentist:

Causes can include a high filling altering your bite. Stress and grinding - a night guard may help Arthritis in the joint etc.

[deleted]

You will still have to wear a retainer at night otherwise your teeth may move back to there original position.

good luck with your treatment

^this was a question asking about clear braces

I use toothpaste with sodium fluoride thru the day but finish up with a paste that has stannuous fluoride before bed.

I also brush first thing in morning before eating anyfood.

Are these practices fruitful or just waste of time?

Using fluoride is best practice.

It is recommended to be used twice a day. Once at night and once at another time of day. The brush before bed is most important.

More more information check the ADA guidelines. I am also fond of the delivering better oral health guidelines done by the Brits (yes i know the stereotype) but P17 is easy to understand https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention

OK but is using stannous flouride at night better in some way than sodium flouride?

Not 100% sure. This may help https://www.colgate.com/en-us/oral-health/basics/fluoride/stannous-fluoride-toothpaste--pros--cons-and-alternatives

what is the oddest treatment you have heard being recommended to a patient?

Rather than being recommended by a dentist I once had a patient come in who wanted the tooth they had extracted by another dentist earlier that day put back in as they had changed their mind.

WHOA! a couple more questions: is that (1) recommended, and (2) should a dentist even try to do that?

Not recommended and I did not try.

I ended up having a chat with the patient and alleviating their concerns and they were happy at the end of it.

Got braces when I was a teenager, 10 years later the front ones are still stained, is there any chance of getting rid of it or is the stain a place that lost enamel?

Depends,

staining could be due to demineralisation and may need composite or another solution depending. Another reason for the stain could be such as bonding cement from the bracket which simply needs polishing off.

[deleted]

You can use our app to get a rough idea of what is to be expected.

After that ask family and friends for local dentists that they recommend. The dentists will then provide a comprehensive treatment plan as well as cost. Hopefully it will be similar to what you are expecting at an affordable price.

Good luck

My dentist wants to pull my 4 year old’s front teeth, because of the way the adult teeth are growing in. “Insurance doesn’t cover it” was my red flag. Is this normal?

Wouldn't say it is normal as adult uppers don't come through until 7-8 years old so does seem early. https://www.mouthhealthy.org/en/az-topics/e/eruption-charts

Can't comment on the specifics of this case and why extract, but a second opinion would be recommended if you are unsure.

I used to live in the UK. I get my teeth cleaned and have a checkup every six months. X-Rays were never necessary.

I am now based in the US, but I go back to the UK every six months or so and continue to go the cleaning/checkup with my regular dentist. This summer, however, I can't make it back, so I want to get my teeth cleaned here, but nowhere seems willing to do it without X-Rays.

I like to minimize exposure to unnecessary radiation and of course I am also worried about unrequired dental work being pushed on me. Is there any way I can get my teeth cleaned without X-Rays?

Ask your UK dentist for a copy of your images. Should be able to take these to your next appointment.

I have never had a cleaning... is this bad? I always thought a cleaning was for cosmetic purposes only.... am I wrong?

Both my bottom two middle teeth are my original teeth. X ray showed nothing underneath them so they never fell out. I'm 32 now and having no problems with them, but they are starting to become a little miss coloured. What can I expect from them as the years pass and would they just need to be pulled at some point?

Cleaning removes plaque calculus and debris too.

Baby teeth are weaker so likely they will fail at some point and may need the gap filling. Denture, bridge or most likely implants are what you should be recommended to fill the gap

A few years back my friend (who is easily duped) explained a dental procedure he was about to get where gum tissue from a deceased pig would be used to fill in part of his (supposedly) receding gum line. He has great teeth and is a very healthy individual. Couldn't help but think he was getting an unnecessary procedure at the time, but I could be wrong. Any insight into that sort of thing?

All we can say is that unnecessary treatments are likely when there is a motivation to make money.

what lead to you guys becoming dentists?

We all first and foremost love helping people. Which is why we created the app.

One of us got into the profession having spent time in a community clinic observing those with learning difficulties receive treatment. It was awe inspiring watching patients who were unable to verbally communicate their pain or problem improve following treatment.

The rest of us all had our own reasons from our own treatment experiences , being practical or enjoying art.

What are your thoughts on home-made toothpastes? I've seen recipes for toothpaste made of coconut oil and baking soda, and also heard of green clay being used. Are those ingredients too abrasive? Will the lack of fluoroide have a major impact long term? And what about oil pulling, is that effective at all?

I would not recommend any home made toothpastes. The WHO recommend fluoride as do the majority of dental bodies that I am aware of.

Fluoride increases enamel strength by stabilizing the crystal lattice on a microscopic level.

I have not seen any evidence for oil pulling either.

What is the difference between an impacted wisdom tooth and one that hasn’t erupted?

Non erupted usually means it is fully enclosed in bone so still underneath.

Impacted have been stopped from erupting and can be part way through the gum aka partially erupted.

A year ago, my dentist did X-rays and said that I did not need my wisdom teeth taken out. When I went to a different dentist for a cleaning a week ago, he looked at those same X-rays and said that I did need them taken out. Would there be a reason one dentist reccomdends removal and one doesn't?

There can be a multitude of reasons. Everyone is different with some of the main reasons including education and the dentists knowledge, how conservative they are as a dentist, do they wait and see or remove before it is a problem. Another reason is money.

I live in rural Maine. A few days ago I had two composite 3 and 4 fillings and was charged over $400 per filling. I was and am in shock. Are these charges exorbitant?

It does seem a touch on the high side as the 3 and 4 are not particularly large teeth. But I can't comment about prices in Maine. Sounds like a captive audience too me.

I’ve been working to restore my smile for years and recently had a front tooth break to the point I needed an implant. I had the remaining part pulled and a bone graft done but I hate the retainer the dentist gave me in the meantime. I have started wearing a bandana instead because he gave me a clear tray with a fake tooth in it but it feels too tight on my teeth and really hurts the site they pulled from. It’s only been a week. So are there any other options for a temporary tooth while I wait 6months for the next step of this year long ordeal? I have been quoted at around 8500 for the whole process as I’m paying cash but I feel this is really high. Your thoughts on the cost of a typical implant would be appreciated as well.

Pain is to be expected as it has only been a week. I recommend to where the retainer as they gave.

A resin bonded bridge so a tooth with a metal bit to stick onto the back of the next door tooth may be an option.

Another option could be a "spoon" denture which is a removable partial denture with a single tooth on as a temp measure.

6 months is normal wait for the procedure. I can't comment on the price with due to different factors such as a bone graft.

Why is Algodones so much cheaper? Do you do work down there?

Probably cheaper labour costs, insurance costs and material costs.

No we don't work there.

Any thoughts on delmopinol mouth wash?

It is a well accepted mouth wash to reduce bacterial load. Make sure you use it a different time of day to when you are brushing (you want the fluoride from toothpaste to stay on your teeth).

Here's a paper that shows that Delmopinol results in less plaque than a placebo https://www.ncbi.nlm.nih.gov/pubmed/9763330

What are your thoughts on gum grafts?

I think they are a good treatment with really good results from what I have seen. Depends on the case and the patient like always.

Hello :) I've had LANAP surgery as well as tissue grafts for my periodontal disease. I thought I had found a really great dentist a few years ago, but I recently had an issue with a tooth, needed a root canal, they suggested extraction and implant (~$3900 before ins/ $2900 after). Called to get root canal prices, was told I would get an email and then....nothing. I ended up going to my parents dentist and having a root canal, I go tomorrow to get my crown put on.

The new dentist is suggesting the deep scale cleanings, but my old dentist had told me that my periodontal disease is too far advanced and I was wasting my money on the deep scale cleanings I had done previously. My old dentist is also the one that did the LANAP surgery and then a year later sent me to a periodontist for the cut and sew surgery. I guess my question is...What should I do? Should I do the deep scale cleaning with the new dentist or should I just go back to my old dentist?

Sounds a complex one and its probably better to have a dialogue with one of our dentists on our app for a full response.

I always recommend continuity of care where possible. A root canal is more emergency work and not as big a deal as surgery and maintenance and as you are happy with the treatment recommended and think the old dentist is great I would suggest going back and continuing with the long term care

Do I have to go to a dentist? I'd rather let my teeth rot and fall out. I have autism and the noise, pain (novicane doesn't work well) and experience really ruin my month.

Have you tried finding a dentist that does something like inhalation sedation. Rotting teeth can lead to abscesses which aren't pleasant

Isn't that nitrous? Literately the only times I have not had horrible interactions with my visits has been with that. But without medical I can't afford it, which sucks.

I had to get a root canal once. Doctor was shaping the metal rod for my implant and had glasses on me. Metal but manged to land on my nose and scar me. I'd rather just not be awake for this stuff. It's pure torture.

Yes Nitrous. I am sorry to here that. I wish I could help further. Good luck with your treatment journey.

What is your opinion of zirconium as it pertains to crowns? I have very little enamel on my teeth. Initially I thought it was due to reflux or grinding my teeth while I sleep, though the erosion did seem to correlate with a time in my life where I was doing a lot of grappling. That said, I am missing enamel on all surfaces, not just the surfaces I would bite with.

This loss seems to have slowed (I am now 36), but the damage is done. I am told I have good roots, but that I will likely eventually need at least crowns on my molars. I have considered doing a full mouth enhancement, but I do not want to put porcelain in my mouth as I still train and grapple. Is zirconium good enough for front teeth as well? Should I hold out for something better in the future?

Zirconium is a solid (quite literally) choice of material. And not a problem to use now should you wish.

A trial for its use on anterior teeth can be found here.https://www.ncbi.nlm.nih.gov/pubmed/20305846 "After a mean observation period of 39.2 months, no material fracture occurred and all crowns had acceptable surfaces. A survival and success rate of 100% was recorded, which suggests that the clinical method may be a reliable treatment modality for restoring severely compromised anterior teeth."

Thank you so much for your opinion. My dentist echoed the same feelings. He said I have a strong bite and I'd likely destroy any porcelain in my mouth in months. I am of the opinion that if I am going to restore my teeth, I want material I am going to die with.

You're welcome.

I have a bridge that just started to feel loose a few days ago (baby headbutted me). Before, my dentist said that when it gets loose, I'll need an implant and two crowns because "we don't really do bridges anymore". I don't want an implant. Just a root canal made my face incredibly sore for 3 weeks, and dental stuff makes me panic. The idea of an implant is basically torture. Why wouldn't they just glue my bridge back down? They said the teeth under look perfectly fine.

They should be able to glue it back down assuming the underlying tooth is healthy. I recommend calling up and see what they say, may be worth finding a new dentist who will. Implants seem overkill.

He may have meant that as an option in terms of catastrophic failure of the teeth.

Thanks so much for the answer! I plan to get in asap, so it doesn't have a chance to start decaying. It really is just a tiny bit loose on one side... would they just knock it off to reglue it? Doesn't sound easy!

No problem. More likely lift/pry it off. Can also use an ultrasonic hand piece which vibrates (not cuts) to vibrate the cement and loosen the crown.

Recently I have heard of toothpastes that claim to be able to build enamel such as sensodyne’s “Novamin” technology or a Japanese toothpastes called Apagard, “ the first nanohydroxyapatite remineralizing toothpaste.”

Can you comment on the efficacy of such a treatment? Do you know of any specific research articles that can affirm or deny their claims?

Here is a paper for you. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422065/

I have not read it . And can not comment further on its efficacy.

Is there a good resource to find the most cost effective dentistry for people without insurance?

Is there a directory of worthwhile dentists operating in Mexico?

Sorry I can't recommend anywhere. There must be online review forums though.