I can’t take that pain after my root canal!

I had a root canal a few years ago. Now my tooth is killing me again! What is going on? The dentist says that the root canal looks fine.  She mentioned a possible crack. Apparently, I was told that if it is cracked I will lose the tooth. Also, she mentioned it could just be due to the fact that I need a new crown. Any advice or information you have would be greatly appreciated. I can’t stand the pain for another minute.

– Rachel in Arkansas,

Rachel,

There are many reasons that a tooth that had a root canal is now troubling you. First, it could be that the crown isn’t properly placed. So if it sitting up too high and is the first thing that hits when you are chewing, this could have irritated it and be causing pain. It may be as simple as the crown requiring adjustment. Has the dentist checked the bite to rule out this possibility?

Another possibility for pain could be that you are grinding or clenching your teeth while you sleep. You may not even be aware of it. The dentist should be able to notice signs of wear on your other teeth if this is the case.

The crack in the tooth is also a possibility. Although, this is difficult to assess and it may be wise to see an endodontist to diagnose this properly. Endodontists specialize in root canal treatments. And unfortunately if there is a crack in the tooth, it will likely need to be extracted. A dental implant or dental bridge are both options to replace it.

Here are some other possibilities as to why the tooth may be causing you pain:

  • Sometimes bacteria can get down into the root if it was not treated and filled properly. This could mean the tooth has once again become infected.
  • In some cases, the seal may have wore off or been washed away. This would cause a gap in the root canal, again ending in another infection.
  • There could be another canal or multiple canals that weren’t adequately treated.
  • If there is a crack or fracture, you could be dealing with an infection.
  • The crown may be compromised or was not properly fitted. It may be contaminated.
  • A root canal failure may be the result if the tooth wasn’t sufficiently cleaned or if the root canal simply wasn’t performed properly.

Sorry for all that information, but as you can see there are many possibilities as to why you are in pain. It would be good to have your bite checked if it hasn’t been done already. Otherwise, it would be a good idea to see an endodontist to see what the next action should be to take care of the tooth once and for all. If the pain is intolerable or keeping you up at night, this should be considered a dental emergency and you should try to get in as soon as possible to relieve your pain.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Told I don’t have enough space for dental implants.

I used to work on a ranch out in Montana. I have the best memories of those long summer days. But one of the job hazards was the fact that I was kicked in the mouth by one of the horses. I lost a tooth that summer and it didn’t bother me too much because I was a kid. Also, you couldn’t even see it when I smiled. But, now I think it’s time to get it taken care of, mainly because I think the neighboring tooth also needs to be extracted. This may be due to the fact that I haven’t seen a dentist in years. Anyway, when I finally got my butt in to see a dentist, he told me there wasn’t enough space so dental implants weren’t an option. He was recommending a dental bridge. But from all the research I’ve done I’m seeing that implants are by far the best solution. Why wouldn’t there be enough room if there used to be teeth in those two spots? I’m feeling frustrated because I finally want to get this fixed and this feels like a road block.

– Donald in Texas

Donald,

That is a good question which could be as simple as the dentist you saw may not be comfortable (or qualified) to place dental implants. This is a highly skilled area of dentistry and not just any old dentist makes an excellent implant dentist.

Also, you didn’t mention how many years had passed since your run in with the horse. Therefore, the teeth may have shifted over time into the space where the other tooth used to be.  That may be the reason he is stating that there isn’t enough room.

That said, it doesn’t mean that a dental bridge is your only choice. Most dentists prefer to keep as much of your healthy tooth structure in tact and since bridges require the drilling down of additional teeth that surround the missing ones – you should be able to find a dentist that will provide another alternative.

Mini implants may work for you. They are much smaller in diameter than standard dental implants. So if you are a mini implants candidate, this option may work for a smaller space. Although, mini implants aren’t as strong as conventional implants. It is also not unheard of for a dentist to move forward with a standard dental implant and then adhere two replacement teeth on the same post. The bottom line is that you should have options. So if your dentist isn’t willing or comfortable, it may be time for a second opinion.

Good luck to you and thanks for sharing your story.

This post is sponsored by Cleveland dentist Hylan Dental Care.

 

Looking for options to compare with Clear Choice.

I am missing two teeth. When I saw a Clear Choice Dental Implants Center commercial, I went in to see what they were all about. I have had a partial denture for many years but really hate it. I don’t feel like I should have to deal with a denture in my forties. So I’m interested in dental implants. When I went in for my Clear Choice consultation, they told me I have some periodontal disease going on. So, their solution was to remove all of the teeth on the bottom and get implants. I know it’s been a long time since I’ve been into the dentist, but I’m skeptical. Removing all my bottom teeth isn’t sitting right with me, and especially for over $20K! Wouldn’t they want to try and preserve what’s left of my teeth? Does this sound like a legitimate recommendation? If not, what other options do I have?

– Ben in Georgia

Ben,

Although, Clear Choice makes everything look super simple and hunky dory on television, you aren’t the first person that is seeking a Clear Choice second opinion after their initial consultation. Many Clear Choice reviews show that they have hidden charges and tend to have enormous treatment plans for issues that could have been addressed much more economically. They also have a reputation for high sales pressure tactics in certain areas of the country.

As far as your options go, recommendations vary greatly based on the dentist you see. It would be a very good idea to seek a second opinion. Typically, dentists will do everything they can to salvage as many of your remaining teeth as possible. Also, they will try to keep as much of the natural tooth structure in tact as possible. Even though Clear Choice may have painted an “all-or-nothing” kind of approach, it doesn’t have to be that way.  That is nothing against the professionals that work for Clear Choice, it just is becoming more of an increasing trend in their recommendations.

Saving your natural teeth should always be a priority or at the very least, an option. So if that isn’t a possibility, you may need to keep looking. Periodontal disease can complicate matters, so it will be important to address that concern before moving forward with dental implants.

But just to give you an idea of your possible options at a different practice, they could range between two independent dental implants to replace your two teeth, a dental bridge, or some other hybrid option. It is better to research a certain dentist’s credentials on cases similar to yours than to go into the office with a preconceived treatment idea. But you are right to be skeptical when anyone tells you they want to remove all your bottom teeth!

Thank you for sharing your story and good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is a knocked out tooth an emergency in a child?

So as a parent of three, there is one thing that I vowed and to do and it was to never judge another mother. But something happened last weekend at a bounce house where I took my kiddos and I have a question. Again, I’m not trying to place judgement but it has me pondering what was the right thing to do and what would I have done in that situation.

So, here’s the deal. The bounce house is crazy. Kids flying everywhere jumping, crashing, spinning, you get the picture. Well, there was a little boy, probably three or four years old that appeared to have knocked his face particularly hard. I didn’t see what he hit, but he had a mouthful of blood and was pretty worked up. Someone else told me he lost a tooth. The mother of the boy calmed him down, gave him a drink, and sent him back to play. Should this have been treated with like a dental emergency? I was wondering because from what I understand if a tooth gets knocked out, it is typically an issue that should be addressed right away at the pediatric dentist. Or am I misguided? Please advise.

– Pat in South Carolina

Pat,

Thank you for your question. When it comes to trauma to the mouth, it is difficult to address in generalities. Of course, if there was a chip or a knocked out tooth, an exam by a dentist is always a good standard to follow.  If the child was older and that was a permanent tooth that was knocked out, then yes the mother should have immediately taken the child to the dentist. An emergency dentist appointment would have been required to save the tooth or treat it as soon as possible for the best result. If the tooth was placed in a wet towel or the inside of the child’s mouth between his teeth and cheek, or even in a glass of milk would have given the highest percentage to reattach or save the tooth.

But with a younger child like you mention, there is a good chance that was not a permanent tooth. So the sense of urgency isn’t as high. That said, the tooth root or some other part of the mouth may have been seriously injured, so a dentist visit is never a bad idea. Or at the very least a phone call to the general or pediatric dentist to see what was recommended for this particular situation. If the tooth was knocked out completely, a space maintainer may be suggested to help keep the other teeth from moving into the gap. This will continue to help the permanent tooth below to come in properly.

Since the boy returned to playing, it may have not been a true dental emergency either. Your instincts are correct and every parent and child is different. In some cases, impact to the mouth can appear very serious and really end up more as a fat lip or minor issue.

Bottom line is that your dentist likely welcomes any questions and would happily check out a child, especially if they endured a mouth trauma.

This post is sponsored by Cleveland dentist Hylan Dental Care.

 

Cleaning chewing gum off your bleaching trays

We see this occasionally – a teeth bleaching patient who can’t leave the chewing gum alone and learns, the hard way, that the gum sticks awfully to the bleaching trays. We were thinking that the patient would probably just need a new bleaching tray, but we saw a post online on another dental blog that has a way to remove the gum.

They were talking about Invisalign in this case, but this would also work for bleaching trays, which are very similar. To remove chewing gum from your Invisalign aligner trays, they said that mineral spirits would take it off very cleanly. We tried this on a bleaching tray, and it works very well. Then clean off the mineral spirits with soap and water.

They cautioned about confusing mineral spirits (or turpentine) with acetone, which is a very different chemical. Acetone will dissolve the plastic, they said. We didn’t try that, but just trust their knowledge.

This blog is sponsored by Cleveland dentist Dr. Brad Hylan.

For those intrigued by Invisalign invisible braces, check out our FastBraces – they move your teeth fast and comfortably.

 

Who can I see for a third opinion about Clear Choice?

I’m in a predicament and need to seek out a third opinion. I need major work done, and my current dentist gave me these options for my upper teeth: full dentures, snap on dentures with four implants or full implants (the latter having a price tag of $35,000). I know for a fact that I don’t want dentures. I went to a Clear Choice office which quoted me a price of only $5,000 more than my dentist for the “All on 4” for my uppers and lowers, which I will need done as well. That sounds a lot more reasonable and enticing, but I’m not sure the best way to go. Since Clear choice was my second opinion, who can I seek for a third opinion, or rather get independent advice, or possibly use?

– Paulette in Kansas

Paulette,

It’s always great to seek out the advice of a few professionals, especially with the work being so involved. Clear choice, though their dentists are all very knowledgeable about their craft, is a “corporate brand” if you will. Seeking the direct advice of a professional not trying to sell a specific product is always a good idea, even if it’s a third, or fourth opinion.

It wouldn’t hurt to look up reputable prosthodontists in your area. Their area of expertise is esthetics, restorations, and full-moth reconstructions. They know best about every restorative option for your mouth, and can advise you in the right direction. They will also likely work closely with other dental professionals like Oral Surgeons and Periodontists who they can refer you to, to further explain in detail about the implant surgery. From there, you can be more informed about which way you decide to go. It’s always good to get a second opinion after visiting a Clear Choice Dental Implant Center, or any implant dentist, for that matter.

Sedation Dentistry for Zoom Whitening?

I have extremely sensitive teeth. I never really had any cavities or dental work, but severe sensitivity has always been a problem. I am having Zoom whitening done next week and I’m so afraid about the pain factor as I’ve heard you can get very sensitive afterward. My sister had in office teeth whitening and was out of commission for at least 2 days afterward as she said she’s never felt so much pain in her life; as if all of the nerves in her teeth were exposed. Since I know sensitivity is a problem for me, I’m wondering if the dentist will use sedation/anesthesia on me so I can make it through the procedure. Is that possible?

– Becky in Michigan

Becky,

You are correct in our thoughts about the sensitivity factor associated with teeth whitening, especially in-office whitening such as Zoom whitening. However, sedation dentistry is generally reserved for restorative work, or children (and adults) who may need that something extra to keep them relaxed during procedures. While sedation dentistry will put you in a relaxed, comfortable state allowing you to feel no pain, it would be a waste during a procedure like whitening. First, Zoom is painless while it’s being done. The “pain” you are referring to is actually sensitivity, as the whitening process tends to dehydrate your teeth making them quite sensitive; an effect you may feel more so if you have sensitivity to begin with. This sensitivity usually happens after the procedure. So while you may feel some zings here and there while under the lamp, the bulk of sensitivity will come the following 24-48 hrs. The best you can do is plan ahead by trying to desensitize your teeth with a fluoride rich toothpaste/mouthwash or something your dentist can prescribe. Doing this for a while prior to the appointment can help. And of course if you feel any discomfort during the process, let your dentist know so they can discontinue use of the lamp.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Should I be expected to pay for my implant if it’s loose after 2 years?

I had a dental implant placed about two years ago. It is now very loose feeling, and I’m afraid it will fall out. I spent a few thousand dollars on this procedure, and am afraid I will be charged if it needs redone. Am I expected to pay for my implant all over again if that’s the scenario?

– Tamara in Ohio

Tamara,

First and foremost, you should go back to your dentist if the implant is loose; it shouldn’t be. Let your dentist review the situation and find a reason as to why that’s happened. There could be a number of things. It could be just the restoration (crown) on top of the tooth that’s loose. It could be the anchor (abutment) that holds the actual dental implant, and/or the implant itself. Once your dentist sees exactly what’s loose, they will know the best way to repair it and what additional costs if any you would be liable for. Sometimes in the case of a dental implant failure, your dentist will bring it to the attention of the manufacturer to get the replacement free of charge. Or a simpler scenario: your implant crown just needs re-cemented.

Overall, dental implants are a long-term solution that should last upwards of 20 years if properly maintained. After just one year, you shouldn’t have a problem. However, as I’m sure your dentist reviewed the risks associated with implant dentistry, nothing is guaranteed. Sometimes, they can fail, be rejected, or malfunction. Depending on the specific reason it is coming loose, you should expect your out-of pocket cost (if any at all) to be nothing like what you paid for the implant in the first place.

This post is sponsored by Cleveland dentist Hylan Dental Care.