- Les in Colorado

Les,

That is an interesting question and it is understandable that you are questioning the root canal treatment process. It isn’t out of the realm of possibilities that a tooth infection could spread into the salivary gland. That said, the tooth would have had to be infected. The thing is that the tooth with the root canal treatment should not be infected if it successfully healed. This would have shown up on the dental x-ray.

Therefore, the answer to your question is no. It doesn’t sound like there is any correlation between your daughter’s salivary gland infection and her recent root canal treatments. Since the root canal did not fail, it is not possible that the infection spread.

Best of luck. Hopefully this information is helpful as you try to further pinpoint the cause.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: pediatric dentist, emergency dentist

Thanks, Joe in Arkansas

Dear Joe,

The antibiotic Clindamycin is a broad spectrum antibiotic and is mainly used by those patients allergic to Penicillin and/or at risk for bacterial endocarditis which is a serious infection in the heart. Usually patients that are at risk for this and having a dental procedure done that can cause bleeding are recommended to take antibiotics prior to any dental treatment. Other patients that may require to take this medication have some form of congenital heart disease, a history of endocarditis, or even a transplanted heart that develops valve disease. Even patients that have hip and knee replacements are recommended to take antibiotics prior to dental work for at least up to two years following their surgery. Clindamycin prevents joints infections with those who have had total joint replacements. At times patients don’t respond to Penicillin, so Clindamycin is given for major infections that have been long lasting.

Clindamycin is a safe and effective antibiotic, however all medications have some concerns and side effects. The two most common side effects of Clindamycin are stomach pain and diarrhea. Let your dentist know of any other medications or vitamins you are taking to ensure there is no drug interactions and always follow the prescribed dosage that is recommended.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: emergency dentist

One of my upper molars was extracted. Right after the tooth extraction, the dentist set the bridge right on top of the area. There was no time between when the extraction took place and when the bridge was placed. I was told by someone that the area should have had pressure applied to it to avoid a blood cot. Do you know if my dentist did something wrong?

- Jordan from Minnesota

Jordan

It is always difficult to make specific recommendations without having seen you in person. Although, it sounds as if everything has worked out okay. So in all likelihood your dentist probably did the right thing.

Even though you did not decipher whether or not the bridge was a permanent dental bridge or if it was just the temporary. Either way, usually there is some pressure applied to the tooth extraction site before placement. Although, for some patients there is actually very little bleeding and within a few minutes it has subsided. The pressure is a technique that is used if the dentist isn’t going to be monitoring it right after the extraction.

One of the benefits in having the dental bridge placed right away is that there is no time for any of the surrounding teeth to move. Sometimes if there is significant time that passes where there is no tooth in that area, the teeth can shift around and cause bite problem or other issues.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: dental implant vs bridge

Thanks, Peter in Illinois

Dear Peter,

As dental professionals patients gag often, however there are some that have a severe gag reflex so your not alone. Research suggest, that about one out of every five patients gag during a routine dental exam or while dental work is being completed. Many people have a fear of the dentist or get nervous prior to an appointment and this brings on anxiety. We are not sure if you experience anxiety or not but it sounds like you would truly like to get your dental work finished, however having anxiety prior and during treatment makes ones gag reflex a lot worse.

As by now, your dentist knows of your gagging problem and should be willing to work with you. If not, find one who will. If you choose to find another dentist, it is important to let him or her know of your gagging problem. There are several ways to suppress ones gagging reflex. One way to prevent gagging is to have a topical numbing agent, like hurricane spray, dispensed in the mouth. This will numb the tissues and help suppress gagging. Another option is to put table salt in your mouth and swallow it. Just a dash of salt actually prevents gagging well. A rubber dam can used during restorative dental treatment. This device is placed over the tooth that is getting worked on to prevent debris and water from reaching the back of the throat. Some patients even benefit from nitrous oxide, which is laughing gas. This actually helps reduce anxiety and relaxes one, however you are still aware of what is happening around you. This adds a little more expense to your treatment, however well worth it and significantly reduces most gagging in those who suffer from it.

When gagging is severe it may be difficult at times for even a highly experienced dentist to treat a patient. Most of these types of patients though suffer from a dental phobia as well. Valium is a sedation dentistry technique where the dentist issues the prescription drug to help sedate the patient and make them feel relaxed and comfortable. As a last resort, one can be put to sleep by general anesthesia. Most dentist are not qualified to perform this, however those trained in this field have gone into dental offices and worked with the dentist in sedating patients. This usually is not covered under dental insurance and can cost several hundred dollars.We recommend you consult with your dentist regarding your options. Since gagging is a problem for you we also advise you to keep your dental appointments short and schedule them in the mornings. Best of luck.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I just got a chip on my porcelain bridge. I actually have an eight-teeth porcelain bridge on top and I was wondering if the one that has been damaged can be repaired?

- Linda in Oregon

Linda,

Based on what you have described, your porcelain dental bridge can be repaired. Although, it does require a certain level of expertise and special training to do a nice job. It will be a similar process as placing a porcelain crown. You may want to consider meeting with a cosmetic dentist. This is because there are many techniques that are not taught in dental school that a cosmetic dentist utilizes.

Here is what you can expect. First, the area will be cleaned, rinsed, and etched to prepare it for dental bonding. If your bridge is fused to metal, than the metal will also need to be prepared. Hydrofluoric acid is one method used for etching, another method uses a microetcher. The latter uses fine aluminum oxide particles to perform the etching. This will all be localized as to not etch the surrounding areas so the glaze on the existing teeth isn’t ruined.

Next, the porcelain will need to be primed using a special agent and then it is used to coat the repair area with resin. Again if your bridge is fused to metal, it will need to be etched with a metal bonding agent. When this work is done by an expert cosmetic dentist it is very natural and life-like and the chip will not be noticeable at all.

Composite bonding resins will be the next step and they are layered to match the exact color of the other porcelain. This composite will be polished so it mimics the luster of your natural teeth.

Once it is all said and done, it would be wise to avoid smoking and excessive coffee intake so the bonding doesn’t pick up stain. Alcohol consumption will affect the lasting color as well.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Thanks, Dan in Arizona

Dear Dan,

The best way to determine if you actually have an abscess forming is to have dental x-rays taken of the area. A true abscess will show up on an x-ray and your dentist will be able to properly recommend treatment for the tooth. Some abscesses start out with being pressure sensitive either by the touch of your finger or while chewing foods. As the infection progresses it becomes sensitive to temperature, more to hot then cold, however can be both. Many people complain of a dull ache throughout the day or an aching tooth that wakes them up in the middle of the night. Dental abscesses can irritate the gum causing swelling and redness. You should contact your dentist right away before you it turns into a dental emergency situation.

Sometimes patients don’t realize they have an infected tooth because the tooth infection is draining out into the mouth, eliminating many symptoms. If this is the case, a pimple-like formation will develop on the gum above or below the tooth. Even if the infection is draining in the mouth it would still have to be treated. An infected tooth left untreated over time can cause nausea, vomiting, loss of the tooth, and sometimes death.

If you have an infection your dentist will most likely put you on antibiotics to clear up the infection. Teeth become infected because the nerve in the tooth is dying. When this happens a root canal and dental crown are recommended to preserve the tooth. If patients opt out of root canal treatment the only other option would be to extract the tooth to alleviate further symptoms. Replacement options for missing one tooth include a dental implant or a dental bridge.

This post is sponsored by Cleveland dentist Hylan Dental Care.

- Shelly in California,

Shelly,

Since the remaining root was removed at the emergency dentist, a removable flipper could work or your son could wear a  retainer with a tooth affixed to it. Since your son is still young, his mouth is still developing. The mouth and teeth will continue to change so a dental implant or dental bridge probably isn’t the best choice for a child. It is important to have some kind of appliance placed in the space where the tooth was. This is because you don’t want the teeth to shift around or move into that open area. Otherwise you will be dealing with more crowding and misaligned teeth, as well as the potential for other problems.

Here are some choices for you to consider:

• Hawley Retainer – An acrylic appliance that is suctioned to the roof of the mouth. A fake tooth is attached to the wire retainer. It is removable and is probably the most economical.
• Delineator – Many dentists may not have heard of this option, because it is relatively new to the market. If you think you may want to get a dental implant once your son gets older, this could be an excellent option. It is comprised of acrylic and plastic and actually is kept in place with the surrounding teeth. It will look natural and will be very sturdy and best of all it helps to ensure successful dental implant placement in the future.
• Essix Style Retainer – This is an appliance that kind of looks like a teeth bleaching tray or an Invisalign tray. It is clear and the tooth is attached directly to it. It is not noticeable when it is worn.

As your son matures, a dental implant will be the best way to replace his tooth permanently. It will look, feel, and function just like a natural tooth. So you may want to do talk with your regular dentist about the appropriate timing for your son.

Hopefully this provided you with some information that you will be helpful when you meet with your family dentist.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: dental implant vs bridge

- Violet in Virginia

Violet,

Cracking or lesions in the corners of your lips is called Angular Chelitis. For many, the condition remedies itself. But for some, it is very painful and has been known to bleed. There are many causes. Although the dentures may not be causing the problem, it could be due to an issue before your dentures were placed. When one is missing teeth or when your teeth were removed, specifically in the front of the mouth, the mouth can over close. Without the teeth, this area of the mouth lacks support. The denture may be contributing to the irritation if it is not fitting correctly. You probably want to get into your dentist to see if it needs to be remade.

Others develop Angular Chelitis from:

• Iron deficiency
• Eating disorder
• Habitual biting or licking lips
• Excessive dry skin
• Protein deficiency (typically occurs in elderly)
• Infection from bacteria or fungus

A topical antibiotic will take care of infections on the skin, but you may want to meet with your doctor to ensure any vitamin deficiencies are not present. It is important to pinpoint the cause so you can be properly treated and find relief once and for all.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Thanks,

Carl in New Jersey

Dear Carl,

You are not alone.  Thousands of people fear the dentists for many reasons.  I applaud that you are attempting to face this fear and overcome it.  The best thing that you can do is to go to the dentist when you are not in pain.  A lot of our dental fear is rooted in past experiences.  Look for a dentist that specializes in dental anxiety.  These offices understand the fears associated with dental treatment and are ready and willing to help you. They cater to cowards and often allow extra time with patients so that you will not feel rushed and anxious.  You are going to need a few gentle dentist appointments with the right dentist to rebuild your confidence. You will need to build a relationship of trust between you and the dentist or hygienist and this will take time.

Before treatment, ask them to “Show and Tell” by explaining what they will be doing and what instruments they will be using. This is to ensure that there are no surprises and helps you feel more in control. If the sounds of the office trouble you, you can bring headphones and music to listen to if you think that might help.  Also bring a friend with you to the appointment for support. It is comforting to know that someone who cares is waiting for you after your appointment.  If things are still too overwhelming, your dentist may suggest a mild sedative before your appointment or even nitrous oxide sedation during treatment.  Nitrous oxide is sedation dentistry in the form of a gas that relaxes you while you are in the dental chair.  It may be something that will help you until you get a few appointments completed and begin to feel more comfortable.  With some perseverance and the right dental office you can overcome or at the very least, manage your dental fears.

This post is sponsored by Cleveland dentist Hylan Dental Care.

- Gordon in Iowa

Gordon,

What you have described is very rare. If a dental crown is properly placed it will not fall off. It may be time to begin seeking another opinion from a different dentist. And if you decide to go that route, than it may be in your best interest to research and find an experienced cosmetic dentist. As far as your question about the dental implant, I would again seek another opinion. If this current dentist can’t place a crown properly, you really don’t want to take your chances with a dental implant. Dental implant failure is all too common from dentists that attempt to cut corners or save on costs.

A well placed crown is highly dependent on quality tooth preparation. If the shape of the tooth is too tapered than the crown will have difficulty staying in place. So that could be what happened in your situation. Again, a cosmetic dentist will be familiar with the technology required to properly bond the crown to the tooth, whether it is metal, porcelain, or some other material.

Good  luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.