What to do about a traumatized tooth?

I was having a toothache for a couple days after I bit into something kind of hard. A week went by and I went in for my regular exam and cleaning. When I was in, the dentist told me that there didn’t appear to be anything wrong from the x-rays that were taken. He acted like it was no big deal and recommended that I try not to chew on it for a couple weeks. Well, I did that and the other day, I noticed that there seems to be some swelling and a numb kind of feeling in my bottom jaw. I haven’t noticed that the tooth is sensitive or anything, but it does throb on occasion. I have been taking some ibuprofen before I go to sleep so I don’t wake up from the throbbing. I am starting to notice it more during the day too, so I take ibuprofen when it is bothering me. Do you think the swelling will go away on its own, or is it time I went back in?

– Lewis in South Dakota


There is a possibility that your tooth has a crack in it. In some cases, something like this may not have shown up on the x-ray because it can take several weeks to show up. A cracked tooth is quite difficult to diagnose on an x-ray and often times patients are sent out to a specialist. Since you have mentioned swelling and throbbing, you want to schedule an emergency dentist appointment right away. Those symptoms are possible indicators of a tooth infection. An antibiotic prescribed from your dentist can help to clear up the infection and help with the swelling. If the tooth can be saved, you may end up needing a root canal treatment. Then, a porcelain crown is also placed on the tooth to protect it since it will become brittle. It is important that an infection is treated as soon as possible. The nerve of the tooth is dying and needs to be removed. The sooner you act, the higher chance that the tooth can be saved.

If your tooth has a crack or fracture in the root, than a tooth extraction will be inevitable. The missing tooth can be replaced with a dental implant or even a dental bridge. Get into your dentist right away, so you can find out your options and learn more about the pros and cons of a dental implant vs. bridge.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Bluetooth toothbrush and brushing apps

I saw an ad for a Bluetooth toothbrush.  It has an app for your IPhone or IPad.  Have you heard of this?


Jeff in Texas

Dear Jeff,

I have heard of this and did a little investigating on the subject.  I have no connection to the product.  I think it is the Beam Toothbrush and is a digital way of keeping track of your tooth cleaning.    The brush connects with an app on your phone and automatically records when you brush and for how long.  It will even tell you when you have missed a tooth brushing. It appears the brush head is very basic and similar to a very inexpensive manual tooth brush.  For the geek, it may be a quirky gift or even for a parent who wants to keep tabs on their child’s brushing habits but it seems a little much for the average person.  Electric toothbrushes have timers to keep track of this and the technology of the bristles and cleaning is much more effective.  There also are apps that will keep track of your tooth brushing and flossing without the Bluetooth connection.

A couple of these are:

  • Tooth Brushing Motivator by Motivetrix
  • Flossed Today
  • Toothbrush Helper
  • Brush It Up by WonderApps

This post is sponsored by Cleveland dentist Hylan Dental Care.


Pus after root canal?

I have a tooth infection and went to see a specialist for a root canal. The root canal isn’t complete, so I only have a temporary filling. My next appointment isn’t until next week and I’m concerned because there is pus coming out of where they did the injections. Is this an emergency or is it normal under my circumstances? I only have pain pills, no antibiotics.

– Dennis in Ohio


Since you are experiencing pus at the root canal site, the infection is still an issue. It is likely that the pus isn’t coming from the exact area of the root canal, but you may have developed what is called a fistula. This term refers to the area between an one section of the body and another, kind of like a passageway, where the fluid is trying to leave the body. This isn’t necessarily a dental emergency, yet you need to contact the endodontist that you are seeking treatment from. It is relatively common in the mouth after a root canal or even a tooth extraction.

A fistula can heal on its own. Although, it needs to be treated with an antibiotic. In some cases when you have a tooth infection, a basic root canal may not properly disinfect the tooth. An apicectomy may be necessary. This minor surgery can be done in the office. A small incision is done above the infected tooth and the tip of your tooth root is removed. This will take care of the infection.

You can expect that your endodontist will want to get you on an antibiotic. So give them a call sooner than later so they can decide if you need to be seen before your appointment next week.

This post is sponsored by Cleveland dentist Hylan Dental Care.



Eruption of Wisdom Teeth

I am a 19 year old girl and my wisdom teeth still haven’t came in. How old are you when they do? Does everyone get them? My mouth is to small for my teeth already. Would that be the problem?

Thanks, Kari in North Carolina

Dear Kari,

Not all people develop wisdom teeth, however many people have them. About 35% of the population never develop wisdom teeth. Wisdom teeth start to form in the jaw bone around the ages of nine and ten. As wisdom teeth roots develop, usually between the ages of 15 and 20, this is the time to have them surgically removed in order to make ones recovery easier, as well as to prevent crowding of the teeth, infection, pain, and decay of nearby teeth or in the wisdom tooth itself. Usually between the ages of 15 and 25 is when people start to develop problems with their wisdom teeth.

Due to the fact that your mouth is so small and if you have your wisdom teeth they will probably never erupt fully and will only cause problems like the ones we mentioned in the first paragraph. Most peoples jaws are too small for the proper eruption of wisdom teeth and become impacted which means they do not erupt completely. In order to determine if you have wisdom teeth you will need to have your dental professional take a dental x-ray called a panorex (see below) as well as complete an exam for proper diagnosis. By looking at the image below you can see the wisdom teeth which are the very last teeth on top and bottom. Look closely at the wisdom teeth on the bottom they are not fully erupted and will most likely never erupt completely.

We recommend you visit your dental professional for an evaluation to determine if your wisdom teeth are present in the jawbone. They will be able determine if they are indeed there and offer you the best advise on what your next steps are. You may have to have teeth extractions so they don’t interfere with your existing teeth.


This post is sponsored by Cleveland dentist Hylan Dental Care.

Dental implants with Diabetes?

I have had Diabetes all my life. I was wondering if this will prevent me from being a dental implants candidate?

– Roger in Texas


In order to be a good dental implants candidate, it is important that you are in good overall health. So it is quite possible if your Diabetes is controlled that you would absolutely be a candidate. Now if it is uncontrolled, this could be a different story. Dental implants really have become popular as a solution for missing teeth in the 1980s. They are a great alternative to replace a missing tooth or teeth, provide stability, as well as preventing facial collapse which is a bone loss condition. The success rate for dental implants has improved among Diabetic patients. Statistics show that dental implant failure among individuals with Diabetes is only at about 6%. This percentage of patients had Diabetes that was uncontrolled and were likely smokers.

Now when the Diabetic patient has this disease under control, the success rate is higher. Make sure you undergo sufficient screening before moving forward and also get a complete review of your health history. If metabolic control is inadequate, it would be in your best interest to delay dental implant treatment. Although, a patient with good metabolic control should make sure this status is maintained for multiple days in a row before surgery. This will increase the body’s healing capacity after surgery. It is also imperative that a Diabetic patient take a full (10-day) supply of antibiotics beginning on the day of surgery. This will keep risk for infection down. It is also good to stop smoking before the surgery. This will greatly help to reduce dental implant failure.

Be open and honest with your dentist. Discuss your concerns and be sure to research their credentials and track record in treating patients with Diabetes.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Unhappy with Snap-on Smile.

I decided to get the snap-on smile and am not happy with it. I have always had a gap in front, right by my canine tooth. It really irritates me with how it looks. So my childhood dentist told me to give the snap-on smile a try. But I really am disappointed with it. It looks super fake to me, it’s big, and makes my teeth look bulky. All the research I’ve done says that I will not be able to get a refund. This purchase was a good bit of money for me though, so I feel like I need to at least wear it. Do you know if anything can be done to slim it down? Any insight would be appreciated.

– Gina in Missouri


Sorry to hear you have had a negative experience with the snap-on smile appliance. It is possible that your dentist may not be artistically inclined. For cosmetic dentistry it takes a lot of training beyond dental school for beautiful results. It would be good to discuss how you are feeling with your dentist to see if anything can be done to improve it. As far as a refund, it will be very unlikely. So hopefully your dentist can work with it.

Many general dentists come from a more functional mindset than cosmetic dentists. They are used to fixing a dental problem instead of focusing on beauty. As far as the bulkiness, this is actually a common complaint for snap-on smile patients. This is because it snaps over your teeth so it isn’t the most natural looking. The snap-on smile is good for a temporary time period or occasion, like a job interview, wedding, or graduation.

For a missing tooth, a partial denture or flipper partial may be a better solution. This kind of appliance snaps in place in the mouth and replaces the missing tooth or missing teeth with artificial teeth. This approach will not add anything over the top of your natural teeth. You may be able to talk to your dentist about this as an option. And since you were so unhappy with his original recommendation, maybe he would be willing to discount it or not charge you for it. Who knows, maybe your dentist is just starting out with cosmetic dentistry or maybe you are the first snap-on smile case that he has done. He may also be unhappy with the result. It never hurts to ask.

Best of luck to you!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Dental dams

Why do dentists use a dental dam? I really don’t like the way it feels in my mouth. It seems like whenever I need a dental treatment, it is used.

– McKenzie in Mississippi


Dental dams or what are sometimes referred to as rubber dams are comprised of latex. They are typically used when you need a root canal treatment and sometimes a dentist may use them to fill a cavity. The main benefit of using a dental dam is to keep the tooth and the work area dry. If the tooth that is being worked on remains dry than there will be less bacteria. This is because there is bacteria in saliva. This is especially important during a root canal treatment since the procedure is being done to remove the infection. Bacteria in the tooth area may cause a reoccurring of the infection.

Another thing that is helpful to a dentist using a dental dam is that it keeps the tongue out of the way of the area where the dentist is working. It also helps to keep water, any tooth particles, as well as dental materials from being swallowed. If you are a patient that gags a lot, it can help because it can help avoid triggering the gag reflex. Today it is very common for dentists to use white fillings instead of silver amalgam filling. With white composite it is essential that the tooth stays dry so the bonding technology can work properly. If bacteria interferes with this process the chances for future tooth decay are higher.

If you are especially nervous or anxious about the use of the dental dam, talk to your dentist about it. There are many techniques or sedation dentistry treatments that can help you relax.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is the dentist responsible for putting an estimate before he does the work?

Is a dentist supposed to check with the patient’s insurance before they do dental work? If they don’t and your insurance only covers a little are you obligated to pay the rest? Maybe I need to start by looking for an affordable dentist.

Thanks, Sandy in Rhode Island

Dear Sandy,

Most dental offices accept insurance and bill the dental treatment completed to the insurance company. The office manager should have discussed your dental treatment with you after your dental exam. Once your dental insurance information is in their software program, they can access how much they can charge for each procedure based on your benefits and give you an estimate of how much your remaining balance will be. Remember though that this is just an estimate and your dental insurance may not pay all the fees that it seems like they would, however it’s usually pretty close. Any remaining amount due that you insurance will not pay will be owed by you even if it is more than what was estimated.

Now some dental offices do not take any insurance at all and they set their own fees. Patients usually pay the dentist first in this case, and most of the time the dental office will fill out paperwork to help you get the benefits you are owed from your insurance company.  If this is the case you may be responsible for calling your dental insurance carrier finding out what they will and will not cover. Some offices won’t file for you and make you do the filling yourself. We recommend you call your dental office and see if they accept your dental insurance and ask them for an estimate of your dental treatment. Find out too if they will bill your insurance for you because this will save you time.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: Get affordable dentist care.