Q.
Dear Dr Caplin, I would be very grateful to recieve your view and informal advice. I am a British ex-pat living in Bahrain and following a visit to the dentist today, I would like to get a second view. The dental practice is well regarded but in Bahrain I am cautious of local health care. I have had some discomfort in my upper left middle molar (the one next to the back molar). FYI I have had my wisdom teeth removed some 15 years ago (I am 35). The discomfort is in the form of a sharpe pain with some cold foods, and recently sometimes when chewing. The pain does not last beyond a split second or so. The dentist x-rayed the area and did not mention any problems or decay. He said I simply needed to floss 3 times a day. He said (whcih I saw on the x-ray) that there is a gap between this tooth and the back molar of about 1mm or so, and that this is the cause. Meat gets lodged in the gap and apparantly causes decay/acid which is causing the pain. Simple flossing will stop the pain. He also recommened that I consider a bridge between the two teeth to block the gap and prevent food lodging. My first question is: Is this the only problem that is likley to be occuring? It seems a little straight forward. Is it possible that regular flossing will stop the pain and sensitivity? Or could there be something more significant going on? My concern then arose when he spotted my two front crowns. These are in need of replacement as they are over 15 years old and I have some gum disfiguration (very minor) from the few occassions I have knocked the caps out in my teens. He then suggested that if I had a budget I should get the front caps sorted to give me a better smile and use floss for the molar. My concerns are not cosmetic, but are with the pain in the molar so I want to ensure this is sorted as a priority. He quoted me GBP 1,200 for the molar bridge and GBP 1,400 for replacement of the two front caps. Having not had major dental work done in the UK for some time I would be grateful if you could advise if these costs seem reasonable. I’m sure they are not the cheapest in comparison to some UK dentists however, I would prefer to pay an appropriate amount (i.e. not the cheapest) to recieve good quality treatment. I look forward to your response at your earliest convenience. Regards Mr J Wolfe,