Freaking out about a kocked out tooth!

Help! What do I need to do for a tooth that just got knocked out? Is this an emergency? Any advice would be super helpful!

– Kendra in Massachusetts


You want to get in for an emergency dentist appointment as soon as possible! The sooner you get in, the higher the chance that the dentist will be able to save your tooth. We are talking within the next 30 minutes is ideal.

Most general dentists leave time throughout the day to accommodate an unexpected dental emergency. Call ahead so they can be ready.

In the meantime, handle the tooth by holding it on top or on the chewing surface. Make sure to rinse the tooth with water to try and clean it as best you can. Avoid the tooth root. Try not to touch it because any bacteria may inhibit the ability of the tooth to reattach. You can actually put it back in your mouth, between your cheek and gum to keep the moisture in. It is absolutely imperative that the tooth doesn’t dry out. If you are not comfortable having the tooth in your mouth, you can actually place it in a glass of milk to transport it to the dentist.

Time is of the essence. If your dentist can’t see you, keep calling until you find one that will.  Dental implants are the best solution to replace a missing tooth, but if you make it soon you may be able to have them save it.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Conflicting recommendations between Clear Choice & my Periodontist?

I am frustrated because I feel like I don’t know what to do? I have an ill-fitting denture on the bottom and have been very uncomfortable for years. The last time I was in at my dentist, he quoted me for an implant-supported denture and told me to seek a second opinion from a periodontist. He told me that there was a possibility that I would require bone grafting. I see commercials all the time for Clear Choice Dental Implant Centers, so I decided it would be worth it to hear their two cents too. Clear Choice said I don’t need bone grafting and my dentist and the Periodontist I met with recommended that I do need bone grafting. I’m feeling confused and wondering who is just trying to get more money out of me or who has my best interests in mind?

– Carl in Florida


It is difficult to give you much feedback because it isn’t quite clear the treatment plan that Clear Choice provided you. But it sounds as if it is safe to assume the treatment plans are not the same.

If you have a traditional denture (which it sounds is the case) then several dental implants can be used to support the denture to stabilize it and make it more comfortable. In order to ensure these implants act as an anchor to the denture, there needs to be adequate bone present at the implant site. If there isn’t enough bone density, then you run the risk of the dental implants failing.

Clear Choice Dental Implant centers often times recommend what is called the all-on-four procedure. One of the main factors in this recommendation is that there is typically more bone toward the back of the mouth, therefore eliminating the need for bone grafting. They utilize this bone location by angling the implants to hold the denture with only four dental implants. But make sure you do your homework, because there are many implant dentists out there that flat-out refuse to perform the all-on-four procedure because their is a higher failure rate, approximately five percent by a 2011 study. Then if it fails, you will have to get bone grafting done anyway.

So, try not to have the mentality that one dentist or practice is trying to get more money out of you, but take the time to find the right implant dentist that you can trust. The more opinions and research you do upfront, especially in deciding whether or not you require bone grafting, will be well worth the expense and stress if the treatment is unsuccessful.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Crap! I swallowed my crown. Is this an emergency?

I have had a porcelain crown on one of my molars for a few years now and the other day after lunch, I noticed an uncomfortable feeling while I was chewing. In fact, it was super-sensitive and I wanted to avoid chewing. When I took a closer look, my crown was gone. I guess that means I swallowed it! So now all I have is this tiny tooth stub. Of course, today is Saturday. Crap! What do I do? Do you think this is a dental emergency? It’s not like my tooth is agonizing me or anything, but it sure doesn’t feel normal and I can’t leave it unprotected. Or maybe I can wait until after the weekend and it’s not that big of a deal. Please let me know your thoughts.

– Paul in Virginia


It is understandable that you are concerned about swallowing your crown. Although, don’t feel panicked. So don’t worry, this too shall pass – literally. But all jokes aside, this is not an issue that you need to see an emergency dentist to resolve. A dental crown will have no problem working itself through your digestive system and shouldn’t cause you any discomfort. So you are probably fine to wait to consult with your dentist until Monday, or whenever there are regular business hours. Now here is the interesting part, it is entirely possible to try and retrieve it, clean it up, and re-cement it. Although, that is completely your decision and best that you consult with your dentist about that possibility. It could be that the crown was failing anyway and would absolutely be best that a new one is created.

The bottom line is that what you are dealing with is not a dental emergency. That said, it is expected that you will experience some sensitivity. It would probably be in your best interest to avoid chewing food on it and to stay away from very cold or hot drinks. The outer enamel of the tooth was removed when the tooth was originally prepared for the crown, so that is why it looks like a stub. So there is very little protection left for the nerve endings.

There are some people that find temporary crown kits available at local drug stores. That may help you manage the sensitivity until you are able to get into the dentist. It also wouldn’t be a bad idea to call your dentist to notify them of what is going on, even if you only leave a message. Staff occasionally check messages over the weekend or have certain protocol in place to handle emergency dental situations. So getting that information prior to Monday morning will help notify them of the situation and may possible allow for the earliest appointment time during normal business hours.

This has happened many times, so try not to stress out about it. The sensitivity is actually a positive thing because this means that the tooth is still living and will likely not require a root canal.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Am I being paranoid, or can any dentist do the job?

It has been determined by my dentist that an implant is the best treatment for my missing tooth. I agree, and when I asked for a referral he told me he does them himself and I wouldn’t have to go anywhere else. While that sounds good, I thought implants were a unique specialty and was surprised that my general dentist does them. I asked to see pictures of previously successful cases, and he had none to show. I’m a little uneasy as it’s a major procedure, and other than his promise to make them look great, and the “discount” he is offering me to get them done, I’m not getting any reassurance. How do I know I found the right implant dentist? Can any dentist do the job, or am I just being paranoid?

– Sandra in Minnesota


You’re not being paranoid. You are correct; dental implants are a major procedure which takes a great time and financial commitment. Many dental professionals place implants. Their knowledge and education can range from learning how in a weekend course, to a short-term training program. As in any surgical procedure, you want to do your homework and choose a well-qualified expert. Most likely, a well versed professional will be credentialed by the American Academy of Implant Dentistry, meaning they are knowledgeable and skilled as well as have plenty of postdoctoral or continuing education in that area. You can always check their website to locate a provider. If your current dentist cannot provide pictures, or a success rate, or answer all your questions easing your anxiety than he is not the man for the job. Dental implants can be costly, but it costs nothing to get a second opinion to solidify finding the best implant dentist for you.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: dental implant vs bridge

Is my son’s tooth problem an emergency?


My son is nine years old and he keeps complaining about one of his back teeth hurting. I can’t seem to see anything wrong but he doesn’t usually complain about things like this. I called into our regular pediatric dentist, but he is not available for a couple weeks. Do you think I need to try to get into another dentist sooner? Is this a dental emergency if he is complaining about it? Or do you think it’s okay to wait until our next check-up?

– Bethany in Indiana


It is very difficult to gauge the seriousness of your son’s toothache based on what you have described. For some kids a hangnail will have them screaming or a rip in their jeans will put them over the edge. The bottom line is that you know your child best. So if it isn’t typical for him to complain about discomfort, then it may be worth investigating. There are many family general dentists that will see children. So even if it isn’t a dental emergency, don’t feel like you have to wait to see your regular pediatric dentist.

Even though you may not visibly see a problem with your son’s tooth, that doesn’t necessarily mean you are in the clear. A small crack in the tooth, or an infection inside the tooth are not issues you can see. Also, deep cavities sometimes cause pain and would be difficult to detect if you were not trained. These issues would require an x-ray to rule them out.

Really there is no way to tell if the toothache is a dental emergency without going in. There are many emergency dentists that will see you the same day. But it would be wise to let them know it is a child you are calling about when you schedule an appointment. Or maybe try calling your pediatric dentist and seeing if they recommend someone while the regular dentist is unavailable.

Best of luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

How Can I Ensure the Best Possible Outcome When I Have My Dental Implant Placed?

I’m scheduled to have a dental implant placed in a couple of weeks. I was very excited about replacing my missing tooth and finally being able to smile again, but I just found out one of my co-workers had one done not too long ago and hers failed. She said she had to have it removed, then have bone grafting and spent all kinds of money to have it fixed, not to forget all the time she has spent in the office. I had no idea there was a possibility the procedure could fail. Now I’m worried that I will have the same problem too. How can I be sure I have the best possible outcome when I have my dental implant placed and why didn’t my dentist warn me that there could be future problems with it?


Amanda in South Carolina

Dear Amanda,

Your concern is understandable. Although implants have a very high success rate of up to 98%, the chance that you may be one of the unlucky 2% really should have been explained to you. This is part of the process of informed consent. If you haven’t been fully informed of possible complications, the doctor is not supposed to be treating you. However, some doctors will give you literature and forms to sign as late as moments before the procedure. Technically, this may legally cover them, but it’s not always in the best interests of the patient.

If you’re seeing red flags, you’re probably right to do so. When you’re preparing to undergo surgery for a dental implant, you want to be sure you’re choosing the best implant dentist for it. Not only does he need to be highly-skilled and knowledgeable, a true expert in the field, but he also needs to remember that each patient is an individual with his or her own concerns.

If you’re looking for the best implant dentist for you, find someone you are comfortable with and who you feel you can trust as well. There are certain things you can do to help prevent dental implant failure and specific medical conditions that will put you at a higher risk for it. Be sure you have discussed all of these possibilities with your dentist before you start treatment and you will be sure to have the best possible outcome.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Gagging at the dentist

I get anxious about going to the dentist, but not for the reason you would think. The sounds don’t bother me and I’m not nervous about the pain or anything. I fear the x-rays! Those things make me gag every time and it is very embarrassing. My mouth automatically rejects the bite wings. It has also been recommended that I get braces so I’m dreading the molds because someone told me that it will likely give my gag reflex issues. Do you have any tips?

– Betsy in Kansas


Dental hygienists have seen it all. You may feel like you are the only one that struggles with a gag reflex or gets dental anxiety when it’s time for x-rays. But there are thousands of people like you and most hygienists have seen it all. It would be in your best interest to simply tell your dentist or hygienist about your sensitive gag reflux. This will caution them to be extra gentle and explain everything to you when it is happening. Hopefully this will relieve some of your dental anxiety.

Here are some other helpful tips in dealing with a gag reflex:

  • This may sound strange but some dental professionals feel that sprinkling a tiny bit (1-2 grams) of salt on your tongue before an x-ray will stop the reflex.
  • You can request a numbing agent when it’s time for x-rays. This will numb your throat and mouth for a short time.
  • When it is time for the impressions of your teeth, request the fast-acting material.
  • Use of a rubber dam can help prevent any of the material from reaching the back of your throat which will hopefully cut down on gagging.
  • This sounds funny, but for many distractions work wonders. Lift your leg up in the chair. You will be focused on lifting your leg instead of feeling anxious about the x-ray.
  • Listen to music on the dentist’s headphones or bring your own music to listen to. This will help keep your mind off of it.
  • Some patients swear by taking a nasal decongestant prior to an appointment.

Sedation dentists may offer other treatment such as nitrous oxide, which will help you relax if you are particularly anxious. But again, it cannot be stressed enough how important open and honest communication will go with your dentist. So speak up for yourself! Hopefully these tips will help you feel more relaxed.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Would it Be Weird If I Wore Earplugs at My next Dental Visit?

I’ve had a tooth that’s been bugging me for a while. I know it needs to get taken care of, but I can’t stand going to the dentist. It’s not that he’s a bad guy or anything, but I’m jittery to begin with and then he and the assistants are continually talking to me and talking back and forth about what’s happening and the truth is that I don’t want to know what’s happening. I’d really rather tune out and have no clue what’s going on. It would be so much easier that way. Would it be weird if I wore earplugs at my next visit?


Kay in Virginia

Dear Kay,

In his book, “Mostly Harmless,” Douglas Adams wrote a little prayer: “Protect me from knowing what I don’t need to know.  Protect me from even knowing that there are things to know that I don’t know.  Protect me from knowing that I decided not to know about the things that I decided not to know about.  Amen.” Granted, it wasn’t a specific reference to a visit to the dentist, but it fits how many people feel about dentistry.

The best thing that someone with dental anxiety can do is to seek out a “gentle dentist.” Granted there isn’t a dentist alive who promotes himself as being rough, but there is a niche field in which doctors take extra care to provide a calming and pleasant environment which results in less discomfort for the patient, hence the term “gentle dentistry” that caters to cowards.

When you visit a gentle dentist, he will spend extra time with you to find out what triggers your anxiety and come up with ways to ease it or stop it before it takes root. Some people like to know what’s happening and some people don’t, so be sure to tell him what your preference is. He may think that the earplugs are a fantastic idea or he might even provide a Walkman or ipod. Some gentle dentists keep personal music players or books on tape on hand for patients just like you, but even if yours doesn’t, you can bring your own. A growing number of offices also provide protective eye wear. If it suits you, you can also combine yours with a sleep mask or simply close your eyes. It’s not important to be fashionable, so long as you’re comfortable and you have some sort of communication system worked out in advance.

This post is sponsored by Cleveland dentist Hylan Dental Care.