Tuesday, July 15, 2014

Tooth Dilemma

The financial stress is causing an increase in symptoms (swollen lymph nodes, sore throat, increased fatigue, cognitive issues).

I saw the oral surgeon today. When he looked at my x-ray he said "how much pain are you in?" I said virtually none. I have intermittent pain but nothing substantial. Nothing like the back pain I experience daily.

He said he didn't see signs of a blatant infection in the x-ray but said "I know Dr. **** and he's very conservative. He wouldn't have referred you if he didn't have good reason". I said but he based his decision on the x-ray.

The surgeon said he must have had a clinical reason and said this tooth isn't viable.  I told him that what started this whole thing was my crown fell off. He said there must be decay or maybe the dentist suspected a cracked tooth. I said "he never mentioned a cracked tooth" and again repeated he based his decision on the x-ray and told me the tips of two roots were infected and it had gone into the bone to which the oral surgeon repeated "he wouldn't have referred you if he didn't think it were necessary". The dentist did mention he could see decay at the top of the tooth and suspected there was leakage into the canals which caused the infection.

Anyway we proceeded with the consult. The oral surgeon said one of the roots extends fairly far into the sinus which might mean that I end up with a hole in the sinus so I need to be careful not to blow my nose for two weeks after the surgery. My anxiety shot up at that point.  He also said because it's an old root canal that he would recommend I go under general anesthesia vs the light sedation because "we have to dig and there will be bone cracking" and more painful so best to be under. I asked what the general anesthesia included and he said "propofal, fentynal, versed" and a couple other things.

The oral surgeon had never heard of POTS so I had to explain it to him. He didn't look like he believed me. He said that makes more of a case to go under general anesthesia because otherwise I would feel it because the options without epinephrine aren't that effective for a procedure like this.

He recommended a bone graft because I don't have much bone there.  My options for what to do in place of the tooth are 1) implants which are ridiculously expensive at over $4000 2) a bridge which means filing the teeth on adjacent sides down. One of them has a crown so that isn't a good option and I'd be at risk for more decay because you can't floss with a bridge so it ultimately might be more expensive plus would last only 8-10 years. I don't think I will be around that long so that part doesn't matter but the discomfort of filing down two teeth doesn't sound fun. Plus I don't think the tooth with a crown has enough tooth left. It was close to needing a root canal about 18 months ago.

The third option is a retainer type device that has a tooth in it. For some reason the sound of it sort of creeps me out. Anyway he said people tend to have a hard time tolerating having a big device like that in the mouth all the time.

The fourth option is to do nothing but it would mean the back molar would start to lean in.  And the tooth that needs extracting a prime chewing tooth.

So I don't know. I contacted the dentist who referred me and said the oral surgeon didn't see the same infection so he reviewed the x-ray again and said "there is an infection and oral surgeon's tend to see very bad infections". But they are contacting the surgeon's office and will wait for their report and contact me so I know how to proceed. They also said I could go to an endodontist for confirmation of the infection. But that would cost more money.

I don't want to get a procedure done that isn't urgent but I also don't want to wait until it's bad enough to need antibiotics. I'm now allergic to Penicillin. I told them that I had a weird reaction to it about a year ago where my lips started tingling as well as my tongue and that I felt like passing out so they said "that's a clear allergic reaction".  Bummer.

The referring dentist said the infection will progress and that my immune system is already fighting it. Not having a very good immune system in the first place doesn't bode well.

The thing that was disturbing aside from the sinus issue is the financial part. It will cost $1385 which isn't as bad as the dentist had said but this doesn't include implants/bridge or follow up appointments.

I asked if I could use my Care Credit card. They said yes but they will only extend payments out for 6 months which means a monthly payment of $280.33. I can't pay that amount. That would mean having less than $75 per month for groceries.  If I don't have a bone graft it's about $400 less.

The other bummer was that I had to pay for the entire consult fee today which means my grocery budget for the next two weeks is down to $50 or less.  I was hoping I could put it on Care credit but they said they only allow that for over $300.  It's crazy.

I'm already paying for medical bills plus the emergency dentist appointment I had last week to put the crown back in. They were clear the crown would last anywhere from 1-3 months.

If anyone out there knows anything about these things I sure could use some advice about what to do.


Lee Lee said...

Sorry to hear all of this Terri. You really are so strong to deal with all this with such grace. I'm sure a way forward will present itself, just hang in there. xo

Liz Lauren said...

Sad to hear about that, hope everything is gonna be alright soon