Teeth--your opinions on repairs, please

[peaceplease]

Hi everyone!

Little question, then some background (if needed):

My dentist says it's always best to keep your teeth.  I have a lot of fillings to do (again,) thankfully no crowns or anything like that yet.  Along w/Sjorgren's, my teeth are de-mineralizing despite taking 100,000 IU Rx of Vit. D/month (which means my other bones may be de-mineralizing a bit as well.)  I've been disabled/completely unable to work for the last 9 years (very hard as I'm only in my 30's) and Medicare/Medicaid doesn't cover dental, so with it all being out of pocket, money's tight, always, so I need to be able to make smart decisions where the most money's spent.  Christmas eve a quarter of a back tooth broke off (I must've swallowed most of it.)  I went in, had it fixed and within a week and a half of the fix another piece of another tooth gave way.  So, there went about $400 and I have several smaller fillings to go.  A year before I had to spend over $1000 on fillings, all in one appt.  I don't think my dentist of 15 yrs has ever seen Sjorgren's as devastating as this is becoming. 

How much should I spend to restore my teeth?  And/or when's the point of no return, when do I give up and get dentures (it'd cost $200/tooth to extract, and I have all my teeth, then oral surgery for a moderately deformed hard palate and torides (bony growths, projections, grown out from my gums--they sit under my tongue,)  then the many thousand dollar cost for dentures.

Thank you,

peaceplease

A bit of history...

Sjorgren's is one of the 10-ish moderate to severe autoimmune disorders I have.  It's played heck with my eyes (to date I've had my 2 bottom punctums cauterized twice, the first cauterization didn't take--my next appt. w/ the cornea dr. is Feb. 2nd, the top 2 will probably be done then.  Until then, I'm on anti-inflammatory/steroid drops.  Then from there it's a question about whether I'll need moisture chamber glasses or not.)  It's also played heck in my mouth.  All the glands in my mouth go dry/get blocked frequently, so lots of hot compresses on the outside and extremely tart candies for the inside, but only when needed.  From about age 6 I've *always* had to have fillings and fillings and fillings--havoc on the nerves.  Also, for the last few months, esp., I haven't been able to eat anything but pureed and very soft foods, my throat spasms, voice dramatically changes and I've had to have the Heimlich maneuver too many times, it's frightening (reasons span from crico-arytenoid RA along w/ the rest of the RA to severe degenerative disc disease w/ deformed C-spine.  I've been scoped through my nose to my vocal cords, now another referral is going through to scope again--likely lower--as well as another referral for an ENT.)

So, that's life for now : )

[Joe S.]

First I would like to welcome you to this forum. I have no answers for you. I have had several pulled, uncounted fillings, and I do not remember how many root canals. I have just a few molars left. The ones that I had pulled helped my mouth (TMJ) and bite to feel more comfortable.

[eyeamdry]

peaceplease-This is not an easy question and there is no perfect answer.  If you could give us a little more information, maybe we might be able to let you know how we have coped (or not).  A thirty year old will have a different situation than a sixty year old.  Are you working?  Do you have dental insurance?

Without knowing anything but what you've written, any dentist on earch (alm,ost) will want to fix your teeth up, and up, and up.  It's good for business.  But if you know you're working two jobs to pay for the baby's formula, you have a different take on it.  I've had bad teeth since I was a small child.  Out of 4 kids I was the only one to keep most of my teeth beyond 21.  I have a few of my own with fillings, many crowns, a removable partial and so forth.  I am in 60's so I think I can keep most of what I have without selling my burial plot.  Lucy

[Crymeariver]

As long as I have healthy gums I will try to keep my natural teeth.  I'm on a schedule to get a crown whenever I need major work on a tooth or old fillings replaced.  Of course now I have a broken front tooth and a chipped one so I don't know what they will suggest for those.  Mostly it has just been back teeth so far.  If Sjogren's was causing gum disease I would probably consider replacement.  

But for the about $10,000 for the dentures and oral surgery you could get half your mouth crowned over time as/if needed and they'll last maybe until old age and then when or if needed you can get the partial or full dentures.  I hope your dentist can help you with your decision.

[season]

Unfortunately, there is upkeep to the teeth and it is never easy to decide what to do. It is just way too expensive. I was faced with the same delemma back in the summer and I knew I couldn't afford the work done that was needed. Over 3 thousand for two teeth.

I chose the payment plan and hopefully I will be able to pay the payment.

I wish you the best of luck in deciding what to do.

[irish]

peace, Welcome to this site. You sound an awful lot like me. I have had sjogrens for many years, probably since around 20 years of age. I started with the teeth acting up in my thirties.

In my 40's they started to require the root canals and the crowns. I did not know what I was in for and the amount of dental work I had done was beyond belief. I can't tell you right off the bat how many root canals I had but I had 13 crowns plus several bridges plus a partial denture. By the time I got around to having the rest of my teeth pulled I had 19 left that needed to be pulled.

In January of 2002 I had 10 cavities filled. My dentist made a few smart remarks to me and I left that office knowing that I would not be back. He refused to pull my teeth. I searched around that spring and summer and finally found a dentist who would pay attention to me. In November of 2002 I had 17 cavities. I refused to get the filled and told him I wanted them pulled. I told him they were always breaking off and they just felt sick.

He started slowly pulling them 1 or 2 at a time and I had more abscessed teeth when he pulled the,. To add fuel to the fire, I had normal x-rays. My teeth were bloody rotting in my mouth. I could feel it and taste it and it still looked good, at least the ones I had left. Finally in 2003 he pulled the rest of my teeth. It was the biggest relief.

I am going to advise you to get your teeth pulled. You may be young, but you have a lot of other physical conditions that add stress to your body. Your teeth will not get better. They are going to continue falling apart and the infections will start to show up. When a person has teeth that are breaking up and falling apart the bacteria just go crazy. Once you have infections they have the aiblity to hide out in the tissues and just keep causing soft tissue infections. Teeth can start to rot under the crowns. I have had that happen a couple of times and they have to cut away part of the crown and get down in there to incise and drain the root. Painful, spendy and another way to spread infection.

People with autoimmune disease are not good prospects for healing and the chances of infections are higher. I think that with all the autoimmune diseases you have, your body would be happy to get rid of the stress of those teeth. I got my dentures and have never looked back.I have had one really good set of dentures. The second set didn't turn out as well, but I adjusted to them also. I think attitude is the big thing. Once you get them adjusted so they don't rub it is possible to use the paste and get along. I have to replace the paste a couple of times a day sometimes, but it sure beats running to the dentist, worrying about eating a marshmellow and breaking a tooth off and paying for those huge dental bills.

I can eat sweet corn and just about everything else, have to cut big hamburgers into 4 pieces to eat them and caramel candy is the one thing that just doesn't work. Good luck. Irish

[Pisces24]

Are you sure since this is Sjogren's related - you can't get this classified as a MEDICAL and not  a dental issue.
I would think if you could get a dr to certify that it is SJS causing the dental problems then it would be classified as a Medical issue and covered.

Sorry I don't know Medicare/Medicaid that well. I used to when my folks were living but then didn't have dental problems.   I would check that out though.

Good Luck!

[Patze]

Hi Peaceplease,

Let me also welcome you to the SJS World and family!  When you have some time, look around the board as there are a lot of topics on teeth in the ether's here by using the search engine in the upper left hand side of this page.

Like the others, having work done on your teeth is such a personal choice, and I can't tell you to have it done or not either.  As I'm not in the medical or a dental field (past or present), all I can do is tell you my story.

I've had my mouth rebuilt twice and I won't do it again.  The first time it cost me the same as if I had bought a really good used car (no dental insurance at that time).   The second time, it was pushing a couple of grand plus with insurance (what a difference).  Now if the fixes would just stay fixed for a while (what few "natural" teeth I have left are starting to crack and break again, ugh)!   Gosh, I gotta go see that man again.

Good luck with your decision, and don't forget to keep us updated, okay?

Take care and be safe -

Patze

[deeindiana]

I was a dental assistant for many, many years. My first suggestion would be to get a second opinion or consider switching to a dentist who realizes that patients with auto-immune diseases tend to have serious dental issues. A simple way to find one is to call an oral surgeon in your area and ask if he/she could recommend someone. If all your xrays are up-to-date, it shouldn't bee too costly to get a second opinion.

Dentists prefer saving your natural teeth, and not because they see fixing your natural teeth as a way to pay for their kid's college (although we all know that it does . They know that dentures are a good substitute -- BUT many people find wearing them a misery. Especially people who suffer from dry mouth, tend to have mouth sores, TMJ pain, choking issues, are sensitive/allergic to dental materials, etc.  And once your natural teeth are pulled, there's no going back.

That said...

I agree with those here who said that seriously decayed teeth and dental infections are very unhealthy for your entire body. Especially for people with compromised immune systems. They need to be dealt with - one way or the other. Either extracted or repaired. Only you can decide which is best for you. But a second opionion might go a long way towards helping you decide.

I hope you find good solutions to your problems. It sounds like you could use a break! Take care of yourself!
Deb