The Endodontist Visit

Well the bad news was what it cost, so the health related concerns are okay, I was pleased to say. (I had to pay up front and submit to insurance. Just one more thing that would, I'm sure, have been so much better covered jsut a few months ago when Alan had us on BCBS PPO. The Federal Employee plan covers a lot less. Go figure!)

Anyway, about the teeth -- the doc said I can take bisphosphinates, but first he recommends I have one tooth crowned, because the filling is large and might break, and he has a concern about tooth 15. This is a tooth way in back that my Boston dentist worked really hard on before I left...... a pocket had opened up behind it and I couldn't keep it clean, so it got a cavity -- which of course kept falling out, so in the end she drilled right up through the middle of the tooth in order to anchor the filling. That's all fine still -- and I'm not sure how relevant it is to the reason why the doctor is worried about it, but it does make me reluctant to consider getting the tooth pulled anytime soon.

See, the problem with bisphosphinates and jaw bone loss happens most often when teeth are pulled. One thing I learned today is that the bone changes caused by bisphosphinates last for 10-12 years after the person is done taking them. I forgot to ask my oncologist how long i'd be taking them for, and I suppose it probably depends on whether my dexa scan shows improvement in the bone density in my spine -- but I am going to guess 3 years, which is the duration of the study I missed. This means that if I am to keep tooth #15, I need to know that it is likely Ill be able to to keep it for a good 15-18 years. It feels solid and rooted to ME -- but I can see on the pan x-ray that was taken today that there is a good bit of bone loss underneath it (40%, the endodontist said) and the root is single, not double, as the others are.

SO I brought home a copy of the pan x-ray, and copies are going to go to my periodontist and dentist -- and my endodontist is going to talk to my periodontist. I'm happy that my teeth aren't in worse shape than this, at any rate. I clean my teeth in a careful painstaking way every night -- with floss, a hand scale, a proxabrush, and a flouride rinse. It's very validating to hear that maybe all my work is doing something. Now if only we had a crystal ball to see if that work will be enough to keep that tooth for the next 15-20 years......