X-ray reading second opinion?

[jestss]

Hi, could I get a recommendation on what I should take care of in order of urgency? I have limited funds at the moment, so I'm hoping there are a few issues here that won't kill to push back a few months. Hope the quality of the images isn't too bad to read!



Baby teeth A and K never had any adult teeth come in underneath. Dentist said the roots were holding surprisingly strong and didn't recommended doing anything about them until the x-rays showed there was decay beneath the fillings.

Sharp pain only when biting down on food in tooth #14. Pain/sensitivity in A, and K, #14 when drinking/eating cold things.



In order, these are three images of #1, two of #16, and one each of #17 and #32.

Bottom wisdom teeth are aligned with the rest of the bottom teeth, but upper wisdom teeth flare out sideways, slightly towards the cheek, and are really hard to clean. Worried about leaving #1 is my mouth for too long because how bad it seems. I think I once had very dull pain with it, but that stopped pretty quickly so I didn't think much of it. It is still sensitive to cold. I don't think the x-ray shot of #1 is a very good/full one, but if there's anything that can be seen from the limited info, please tell me.


Thank you!

 

[honestdoc]

I think #A, K, and 14 are the most urgent. Hopefully you have enough financially to restore them. Return promptly to your dentist when you can to treat your other concerns.

 

[DocT]

Absolutely agree with honestdoc. Just would also include tooth #13 due to pretty extensive lesion / caries on distal; you definitely don't want another root canal, since #14 already requires one. So, I would start with #13-14 to
1 - prevent root canal #13 and
2 - emergency situation with #14.
3 - A and K both have large decay under existing restorations and probably are going to go any way; wouldn't worry much about them, unless you are planning to restore them with also root canals and crowns
4 - keep an eye on #29 since that one also has a lesion on distal and you never can rely on x-ray image in attempt to estimate the real size of defect
5 - wisdom teeth most likely not going to cause any problems in the nearest future.

 

[jestss]

I think #A, K, and 14 are the most urgent. Hopefully you have enough financially to restore them. Return promptly to your dentist when you can to treat your other concerns.

Absolutely agree with honestdoc. Just would also include tooth #13 due to pretty extensive lesion / caries on distal; you definitely don't want another root canal, since #14 already requires one. So, I would start with #13-14 to
1 - prevent root canal #13 and
2 - emergency situation with #14.
3 - A and K both have large decay under existing restorations and probably are going to go any way; wouldn't worry much about them, unless you are planning to restore them with also root canals and crowns
4 - keep an eye on #29 since that one also has a lesion on distal and you never can rely on x-ray image in attempt to estimate the real size of defect
5 - wisdom teeth most likely not going to cause any problems in the nearest future.

Thank you so much for the advice! I have a few other questions after getting another exam and a full set of x-rays with a different local dentist recommended by family.

For A & K, one dentist recommended extraction and implant for both, while the other just recommended fillings for them. I expect I would still need to get implants down the line, but I am 22 at the moment, and have heard that it is best to wait until late 20's or later to get implants. How true is that? Would I be better getting them repaired and revisiting in a couple years when I'm older, or just leaving them until they hurt or fall out to do implants, presumably much sooner than if I got them repaired?

I was also recommended deep cleaning by the second dentist, as I was told I have pockets and early signs of gum disease, which could get much worse if left untreated (x-rays attached). How urgent is this compared to 14, A & K, 13, and 29, and is there anything I can do to reverse or slow it down if I don't get it treated right away?

Finally, the first dentist listed a lot fewer cavities (13, 14, 29) to work on than the second dentist (2, 3, 12, 13, 18, 19, 29, 30, and 31) than. Am I fine in assuming that the second dentist is just more aggressive in treatment, and that the other ones listed are lesser cavities I should be fine with leaving for treatment further down the line? I will definitely be visiting the dentist regularly in the future, so they should be able to catch any issues before they worsen, right?

Thanks again!

 

[DocT]

When you are aiming restorative work, like fillings and crowns, panoramic x-ray is not the best one. Second doctor obtained much more accurate radiographic data and he is right, all those cavities are pretty visible.