Is a dentist obligated to provide care for a dental emergency?

I was wondering if an individual has a dental emergency, are dentists required to give them care? For example, if they have a tooth that is broken and the there is possible nerve exposure? I know that if you go to the emergency room, the hospital cannot turn you away. So I was wondering if dentists have to treat you too? Even if a person doesn’t have insurance?

– Jennifer in Florida


You are correct when it comes to hospitals. Even if an individual cannot pay, they are required to treat you. This policy may vary from state to state, but if the hospital receives funds from the government, that is likely the case. But if you go into the emergency room with a dental emergency, unless there happens to be a dentist on staff, they will likely tell you to go see a dentist. It is possible they will provide a prescription for antibiotics or a small dose of pain medication. But again, they will recommend you see a dentist.

In the field of dentistry, a dentist has the right to refuse treatment to anyone. It is also sad but true, but many people will wait until they are in pain to seek dental care. So what many people consider an emergency, may have been troubling them for weeks or months. Then in the middle of the night when they cannot stand the pain any longer, they want to have it treated. Many dentists do not believe that this type of behavior entails a true dental emergency. Now if you fall on an uneven sidewalk and fall on your face and break a tooth, now that is a dental emergency.

If an individual is a patient of record, which means that they have been seeking regular preventive maintenance, most dental offices will make every effort to fit them in as soon as possible. Other dentists actually build their practices around accepting all dental emergencies, even if an individual has never been into the office before. Some go a step further and provide emergency care after hours and on the weekends.

But if someone’s approach is that they don’t have money, yet expect to be treated, that is a different story. A dentist deserves to be treated for the services provided. You wouldn’t run into the grocery store and say, sorry I don’t have money but I’ll pay you later.

This post is sponsored by Brook Park emergency dentist Hylan Dental Care.

Getting all my teeth out.

I have a rare gum disease and just found out I have to have all my teeth out and I’m only 22 years old. This is really freaking me out and frankly, I’m embarrassed. Aside from my girlfriend, I really don’t want anyone to know that I’m missing all my teeth. Will dentures be really noticeable?

– Bart in Texas


First of all, if there is any way that any of your teeth can be salvaged? Most dentists agree that it is always best to save as many natural teeth as possible. If this is not a possibility due to your gum disease, you need to strongly consider dental implants. Implants are the most ideal treatment to replace missing teeth for many reasons:

  • They prevent facial collapse. At 22 years old you need to take this risk very seriously. You jawbone will recede and in 15-20 years, it will be likely that you won’t be able to support a denture. Implants prevent facial collapse. If your dentist hasn’t mentioned facial collapse to you yet, find a new dentist. You are too young to ignore this.
  • Implants look, feel, and function like normal teeth. Since the implant is surgically implanted into the jaw, you will be able to eat and talk normally. You won’t have to worry about an appliance moving or slipping around at embarrassing times.
  • No one will tell. It is understandable that you were concerned with the appearance of dentures. With dental implants, no one will be able to tell that they aren’t your normal teeth.

Dentures can be made to look natural and lifelike. But in your case, the cons far outweigh the pros. Although dental implants are more expensive, the cost to your self esteem, dental health, and overall quality of life in the long run will be greatly hindered with choosing dentures.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: problems with dentures

Take care of dental abscess at home?

I have a large dental abscess and am scheduled for oral surgery to have it removed. Problem is that the oral surgeon is on vacation so it won’t be for another week and half. I was given some antibiotics to help reduce the swelling and size of it, but they haven’t done anything to help. It’s not really causing me pain, just wanted to know if there was anything else that I could do to help it. I have a condition that will not allow me to take non-steroidal drugs. Can I reduce the swelling at home?

– Jen in New Mexico


The best thing to do for your situation is to try and get the surgery moved up, even if that means going to a different oral surgeon. The infection is inside the tooth and a root canal treatment or surgery for removal is really the best solution. There isn’t anything you can do for it at home. Call into your dentist and ask what oral surgeon they use as a back up when their primary surgeon is unavailable.

Although, the swelling doesn’t need to be reduced prior to the surgery, you can do some warm saline water rinses or use a warm compress at home. The heat will help to encourage and stimulate some drainage. Please don’t try to do prodding or removal of any kind at home. This is an infection and could very easily turn into an emergency situation with dangerous consequences. Tetanus can be life-threatening. Just don’t risk it.

If you start to have issues with opening and closing your mouth, notice increased facial swelling, or have problems breathing go immediately to the emergency room to avoid complications.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I got a price from Clear Choice Dental Implant Centers and want to find reviews.

I have been doing my research about getting dental implants on four of my top and bottom teeth, for a total of eight. I went into Clear Choice and received a quote for $42,000. Is that comparable to what I can expect elsewhere? Or is that outrageously high? I am looking for any input or Clear Choice reviews I can find for comparison.

– Elaine in Oregon


It is always good for any kind of major procedure like eight dental implants, to get a second opinion. Then, you will have some basis for comparison. One common Clear Choice review is that it seems like most people end up getting the same treatment plan. And since implant dentistry is so intrusive, every individual has a different set of issues. A one-size fits all approach is never a good sign.

Often times, the Clear Choice approach involves removing the remaining teeth and getting all-on-four dental implants. Well not everyone is the best candidate for this treatment plan and you really should at least consider an approach that tries to salvage what healthy teeth you have. It is unclear if that is the treatment plan that was recommended for you, but again seeking a second opinion is always a good way to go.

There are two very reputable implant dentistry organizations that you should look for when you are considering an implant dentist; the International College of Oral Implantologists or American Academy of Oral Implantology. If a dentist is either a fellow of the ICOI or board certified by the American Board of Oral Implantology, or a graduate of the Misch Institute, then they would be able to give you a valid second opinion.

As far as where the price they gave you would compare, it does sound high. But you didn’t elaborate on the exact treatment plan, if it involved any bone grafting or if they were actually going to to the all-on-four dental implant procedure? Most dentists aren’t that confident in the longevity of all-on-fours.

Lastly, when you do go in for the second opinion, be sure that you do not reveal what Clear Choice recommended. You want them to make an unbiased recommendation, based on what they think is best for your personalized needs. So you probably don’t even want to recommend that they are the second dentist you are meeting with.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Dentist cannot get me numb!

Why can’t I get numb? My dentist is stumped and I am downright scared. I have been into the dentist 11 different times to have a couple of my front teeth treated. They are starting to die from an old injury. He also thinks one of them is infected, but the nerves are still alive. So they need to be treated asap, but at my last visit he gave me five injections and I wasn’t numb. He also used a numbing gel agent on my gums, but I could still feel everything. Since I can feel everything he reimbursed me, but I still need root canals done. But I can’t stand the fact of all that drilling and being able to feel it. Help! Have you ever heard of something like this happening? I am in so much pain and just want to get it all over with. I can’t keep taking so much pain medicine everyday.

– Gerald in Massachusetts


Thank you for sharing your story. Hopefully you will be relieved to know you aren’t the only one that this has happened to. Although, not every dentist has encountered this phenomenon, so it can be puzzling.

Here is an explanation for what you are experiencing. The truth of the matter is that most people are anxious or even fearful when they have to go to the dentist. This is even more true when you have to get a major procedure done, like a root canal. It is also understandable how fearful you are considering you have been in multiple times and had dozens of injections and still can feel the dentist working. So your dental fear is likely very high, like you have explained. What many dentists have not experienced or may not realize is the effectiveness of Novocain is influenced by an individual’s anxiety. For some individuals, the anxiety actually cancels out the Novocain. For some, it may virtually impossible to get numb.

So to begin, your anxiety needs to be addressed. Talk to your dentist or find a dentist that will prescribe you some anti-anxiety medication. This combination of medication with the injection should do the trick. Nitrous oxide is also an option, if the dentist uses that sedation dentistry technique. A small dose of Valium or Halcion will calm your nerves, make you more relaxed in the chair, and enable the numbing agents to work correctly. If you haven’t taken anti-anxiety medications in the past, it would be a good idea to have someone take you to and from your dental appointment. You may not be able to drive home.

Hopefully this helps and you are able to get your root canals taken care of right away and be free of pain.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Not sure I can afford the dentist, but I can’t take the pain anymore!

So I haven’t been to the dentist in years. Honestly, my teeth felt fine so I just didn’t make it a priority. I have always felt like I have pretty good dental health so I didn’t think this was really that big of a deal. Well, a couple weeks ago I noticed that my tooth kind of hurt when the temperature changes, like after I ate something cold. Then it started happening more often and it’s gotten to the point where it throbs at night and the pain persists throughout the day. I know I should go into the dentist, but I really don’t have any extra money right now. Do you think my visit will be expensive?

– Jeff in Wyoming


Well, you are correct that you need to get into the dentist sooner than later. Based on the symptoms you have described it sound like you may need to have a root canal. The tooth that has been ailing you could very well be infected. So if you keep put it off you may end up with an even more expensive dental emergency. Call into your dentist and explain what is going on so that you can be seen as soon as possible. A portion of the expense for the root canal will hopefully be partially covered by your dental insurance.

Sometimes patients think that this will go away and although the pain does subside as time goes by, it doesn’t mean that the infection has been taken care of. What this usually means is that the nerve has actually died, so you cannot feel the pain. But if the infection is not taken care of, it can spread. And in some cases, an infection left unattended can be life threatening if it spreads to the brain or gets into the bloodstream. Not trying to scare you, but this is a serious problem that needs attention.

If fear of the dentist has kept you away, there are sedation dentistry methods that will enable you to receive the care you need and you won’t even remember anything about the appointment. Or if it really is the fees that are keeping you away, be upfront with your budgetary concerns when you schedule the appointment. You may be surprised but many dentists will work with you on payment. For example, if a lot of dental work is required, sometimes dentists will phase treatment out overtime to keep dental care affordable. They can start with the urgent needs first, so you can pay as you go. Others offer affordable payment plans with low financing options. Sometimes a dentist will create an individualized payment plan within their own practice to accommodate your needs.

Moving forward, it will be beneficial for your smile, as well as your budget if you keep up with regular teeth cleanings and exams. The sooner potential problems are discovered they can be treated more economically.

This post is sponsored by Cleveland dentist Hylan Dental Care.

My dentures fell out!

I’m only 63 and my dentures are falling out unexpectedly. I can’t live with this kind of constant fear about them slipping out in the middle of eating with my family or even with a client. Long story short, my teeth were always in bad shape growing up and into my adult years, mainly because my family couldn’t afford dental care growing up. So it has been over 10 years now that I have dentures. This is just not acceptable. Now that I can afford dental care, I don’t have any teeth! I have other problems with my dentures too.

– Dennis in Wisconsin


You are experiencing a condition that is called facial collapse. What is happening is that the bone that used to support your teeth is shrinking because your body is so efficient that it is using the minerals that were used to support your teeth before, in other parts of the body. Unfortunately, not every dentist is upfront about educating patients about facial collapse and other denture problems. The truth of the matter is that many people that have dentures are very unhappy with the way their dentures fit. They can cause painful sores, your chewing efficiency is reduced drastically, and as you’ve experienced they can slip out at embarrassing times.

If you don’t do anything about this, you could end up a dental cripple. And since you are pretty young, this is a real possibility for you. A dental cripple doesn’t have enough bone left to even keep a denture in at all! Often times they are so ashamed of the way they look and feel, their social life and quality of life is negatively affected.

There is good news. Dental implants prevent facial collapse. They are more expensive than dentures, but it sounds like budget isn’t such a problem for you now. Dental implants are surgically placed into your jawbone. This means that bone loss will be prevented around each dental implant that is placed. Even if you don’t get a full mouth of dental implants, every implant that is placed will help to secure your denture. You will be much happier with incorporating dental implants. But it is very important that you find an experienced implant dentist because there is a possibility that you may need to have bone grafting done. Sometimes this kind of surgery can be very complicated, so do your research. Meet with multiple dentists and ask about their credentials and experience, as well as how many implants they have placed.

Thanks for sharing your story. Hopefully it will educate others that are considering dentures, before it is too late!

This post is sponsored by Cleveland Dentist Hylan Dental Care.

Gums around implants turning gray…is this normal?


I just had two implants placed last month, replacing teeth that have been missing for a few years. I observed that the gums surrounding the dental implants are turning a gray color that’s very noticeable when I smile. I’m thinking this has something to do with the material used? Now I feel like I shouldn’t have paid so much money for this. Is this even normal?

– Jeffrey in Texas


I understand your concern, but your situation is not uncommon. The dark color of your gums is likely the collar of the dental implant showing through your gum tissue. This can happen especially if your gum tissue is too thin. When the gum tissue is too thin at the sight at dental implant placement, along with the implant not being placed at exactly the right depth, a grayish color (which is titanium, the material that makes up the implant) can be visible at the gum line. This can also lead to gum recession in that area over time.

One option to remedy this would be to do a soft tissue graft to thicken the surrounding gum tissue. Or perhaps your surgeon can switch out the head of the implant from titanium to Zirconia; a tooth colored material that would eliminate the gray color (if you have not had your permanent crown placed yet). Definitely check back with your dentist to examine the area, make sure there is no bone loss, etc., and from there discuss your cosmetic options.

Thank you for sharing your story. Too many people compromise on quality when it comes to dental implant costs. There are dentists out there that will cut corners or cut costs in the materials that are used. This sadly ends up costing the patient more money in the long run. So be sure to do your research and select an implant dentist proper training, credentials, and experience. Proceed with extreme caution when you come across cheap dental implants. Most likely, it is too good to be true.

This post is sponsored by Cleveland dentist Hylan Dental Care.