This patient was diagnosed in another dental office as needing 2 endodontic procedures. Examination Results: - Severe decay lower right first and second molars (#30, 31). - Inter-proximal decay in some other teeth, but not as severe as the lower right molars. - 4 impacted wisdom teeth (#1, 16, 17, 32). - Some large composite fillings in a few teeth. - The patient has an anterior open bite (This means his anterior teeth do not occlude, i.e., there is a space between the anterior teeth when he bites down). - Some minor crowding of the anterior teeth. Recommended Treatment: - Dental cleaning, oral hygiene instruction. - #30, 31 endodontics, build-ups and crowns or extract the 2 teeth, graft the sockets and replace the first molar and, possibly, the second molar with implants later (let the grafts/sockets heal for at least 6 months). - #29 (lower right second bicuspid) crown (significant distal decay). - IV sedation. - We could extract the impacted wisdom teeth at the same time we treat the lower right first and second molars, or we could extract the wisdom teeth in the next year or two. If we decided to extract the lower right first molar and second molars, I would recommend extracting the wisdom teeth at the same appointment so there was only one surgical recovery period.
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