Table of Contents

1. Introduction
2. Why is it a good idea to seek a dental second opinion?
3. How do you go about getting a dental second opinion?
4. Common scenarios that patients pursue a dental second opinion for

Introduction

It isn’t uncommon for you to question what your dentist may recommend for you. A dental second opinion occurs every day and is helpful to hear from another dentist on a situation. Experiencing no pain or discomfort, yet your dentist is telling you that you need treatment? Are you contemplating the necessity of this treatment? Most consider a second opinion from another dentist. However, there's a new approach to obtain a second opinion dentist without visiting another office.

Download “Opinion Two” in the app store or visit Opinion Two for a fresh take on your dental situation.

Why is it a good idea to seek a dental second opinion?

Dentists, as ethical professionals, prioritize your well-being. Yet, differing experiences lead to varied opinions. Your treatment choice should be informed, and any doubts or questions should be clarified. If alternatives to the proposed treatment exist but aren't mentioned, it's your right to inquire. Also, understanding why one treatment is preferred over another is crucial. You're entitled to a second opinion dentist's perspective on your situation.

How do you go about getting a dental second opinion?

The first critical step is to obtain x-rays and photos from your primary dentist. Offices should provide these without hesitation, usually in digital format. With the “Opinion Two” app, you can conveniently upload this data and receive a second opinion dentist's insights within minutes. The traditional route would involve visiting another local dental office and sharing these images for analysis.

Common scenarios that patients pursue a dental second opinion for

Filling replacement

What’s involved: Fillings can be either amalgam (silver fillings) or composite (white fillings), which can break, chip, wear out or have a cavity get back under them. In order to replace them, the entire old filling is removed and any problematic areas such as a cavity or cracks in the tooth and a new filling is placed.

When it is indicated: Cavities can be seen on x-rays or just by looking at the tooth. Chipped and broken fillings may lead to sharp areas on your tooth or food impacting between your teeth. Photos of these broken areas can allow you to see what the dentist sees.

When you should question: If you aren’t experiencing pain or discomfort, this can be confusing to hear that you need to replace something. If your dentist merely tells you that the filling is old, this isn’t a valid reason to replace it. 

The cost: This depends on how many surfaces the filling covers, but also depends on your specific insurance coverage (if you have dental insurance). If you do not have dental insurance, filling replacements range from $100-500.

Crown or Onlay

What’s involved: A dental crown is a full covering that seals off your tooth. A dental onlay can be thought of as a partial crown that can cover a portion of your teeth. Problematic areas are removed and a crown and onlay are cemented to your tooth to try to replicate the original anatomy of the tooth.

When it is indicated: Broken or fractured tooth structure in areas that withstand significant forces when chewing requires stronger materials like crowns and onlays to keep your tooth functioning. Large fillings with undermined tooth structure or large cavities can lead to the need for a crown or onlay. Cracks in teeth are commonly seen around old amalgam fillings that can lead to large chunks of your tooth breaking off – your dentist may suggest proactively crowning your tooth to prevent a potential problem. Teeth in the back of the mouth that have root canals are also indicated to have a crown on them in order to be strong enough to maintain your chewing.

When you should question: The opinions of dentists can vary when a crown is necessary. Onlays aren’t as common and usually insurance will not cover them, but they allow for the dentist to be much more conservative with the amount of tooth structure removed. The way all of your teeth come together has a significant impact on the decision between a crown and a large filling. The general way to look at fillings is that if there is more than 50% of your tooth that will be covered by a filling, it most likely will need a crown. A conservative crown can also last you much longer than a large filling.

The cost: Usually a buildup will be included in this cost, which is material used to build your tooth back up. This total cost is usually what is presented to you, but the buildup isn’t always necessary, it just depends on the condition of your tooth. The range for crown and buildups is $500-3,000 – largely depends on the dentist and area you are in.

Root canal

What’s involved: A root canal is cleaning out the nerve space of the tooth and removing bacteria present. The inside of the tooth is disinfected, cleaned and sealed off with a material called gutta percha, limiting the chance that the tooth becomes reinfected. 

When it is indicated: Large cavities, deep cracks into the nerve of the tooth or trauma can lead to the need for a root canal to be recommended. These things can cause significant pain that presents in the form of a toothache – hot sensitivity, throbbing or spontaneous pain. Sometimes, the tooth won’t bother you at all because it may already be necrotic (dead). Your dentist may inform you that a root canal could be indicated depending on the extent of the cavity when the tooth is opened up. Other times, a crown may be done that disturbs the nerve of the tooth, which can lead to symptoms requiring a root canal.

When you should question: Your dentist should either be able to show you the infection on the x-ray at the end of the root of the tooth or go through tests with you to determine the extent of discomfort and which tooth it is originating from. Sometimes cavities can appear close to the nerve of the tooth on the x-ray, but you don’t have symptoms. Teeth that are recommended for root canals, but have a significant amount of tooth structure missing or the cavity is close to the bone surrounding the tooth, I would highly consider a second opinion.

The cost: Not including the crown that may be indicated to go over the tooth, the root canal cost depends on the tooth being worked on. Molars have several nerves to clean out, compared to front teeth that typically have one nerve canal. The cost is usually in the range of $400-2,000.

Extraction

What’s involved: The removal of a tooth involves taking the problematic tooth out, cleaning out the area of any debris or infection and most commonly having a bone graft placed. A bone graft is usually indicated when taking a tooth out in order to save the volume of bone in the area. Once a tooth is removed and nothing is placed to save the volume, the bone will resorb over time. If you decide later on to pursue a dental implant, a larger bone graft may be necessary to build everything back up. 

When it is indicated: Large cavities, deep cracks in the tooth that make the tooth non restorable or trauma can lead to the need for an extraction to be recommended. Root fractures on teeth that previously had root canals is not uncommon at all. Root fractures make teeth non salvageable and the only solution is to extract the tooth. Teeth can be very borderline between trying to save them or take them out. Wisdom teeth are also a very common topic for extractions. Usually around 16-21 wisdom teeth will come in and it is recommended to have them removed, unless you have room for them to erupt in place.

When you should question: This is the most common second opinion we see. Should I keep the tooth or take it out? Teeth can have a significant amount of tooth structure missing or large cavities that require heroic procedures to try to save it. Can these teeth last you? Maybe, but it’s not very predictable. If you are happy getting a few years out of a tooth after going to great lengths (and money) to try to save the tooth, then that is your decision. Taking teeth out and placing an implant is more predictable and can last you much longer if maintained. 

 

A perfect way to get a second opinion is to download the app “Opinion Two” or go to www.opiniontwo.org.

 

The cost: Bone grafting is usually not a covered benefit by insurance, but it is important to save the bone volume where the tooth is taken out. Some dentists may not offer this service. The extraction cost is usually around $80-350 and bone grafting can range from $200-1,500.

Bridge vs. Dental Implant

What’s involved: Both of these topics involve a missing tooth that has two neighboring teeth on either side. A bridge involves preparing your neighboring teeth similarly to a crown, so two crowns will be connected in between. An implant involves placement of a titanium (used most commonly) post that your body will integrate around, a time period of healing and then placement of a crown on top of the implant.

When it is indicated: Bridges were traditionally the treatment of choice in this scenario because implants weren’t as predictable as they once were. Implants can keep neighboring teeth healthy and a bridge will always depend on keeping the neighboring teeth clean to maintain the bridge over time. So, if anything happens to the neighboring teeth, the entire bridge needs to be replaced.

When you should question: Your dentist may not have a 3D x-ray machine called a cone beam CT scan that allows for a 3-dimensional view of where you have a missing tooth. They may send you to a specialist to evaluate this missing tooth area. If your dentist doesn’t have this technology and says they can place an implant without it, I would recommend seeking a second opinion. The bridge option is the second best option and if this is the only option given to you, I would also seek a second opinion.

The cost: The price of a bridge relies on the cost of materials and work provided by a dental laboratory (most of the time). The price of a bridge compared to an implant should be about the same. An implant involves the titanium post, an abutment (connector between crown and implant) and the crown that goes on top. The cost for a bridge and the bundled cost for an implant/crown is usually $5,000-8,000.

Conclusion

Securing a second opinion dentist doesn't have to be expensive or cumbersome. With tools like “Opinion Two”, getting clarity on dental issues has never been more accessible. Don't stay in the dark about your dental health; be informed, be empowered.

A second opinion doesn't have to cost you an arm and a leg.  Download “Opinion Two” in the app store or go to www.opiniontwo.org and get an opinion on your situation.

It isn’t uncommon for you to question what your dentist may recommend for you. A dental second opinion occurs every day and it is helpful to hear from another dentist on a situation. Are you experiencing no pain or discomfort and your dentist is telling you that you need treatment? Are you wondering whether you need this treatment or not? Most people will think about getting a second opinion from another dentist, but did you know there is a new way to obtain a second opinion without going into another dental office?

Download “Opinion Two” in the app store or go to www.opiniontwo.org and get an opinion on your situation.