If I have a dental emergency, do I have to tell what happenned?

I have a question about how a dentist reports a dental emergency. A couple nights ago, I was beaten and mugged. It was agonizing and mortifying. Let’s just say, I was in a bad part of town and not doing what I should have been doing. My activity was illegal. That’s all I’m going to say about that. So I obviously didn’t involve the police to protect myself. I thought my facial injuries would be fine in a couple of days. But as time goes on, I fell worse. My teeth are messed up and I know I should get into the dentist. I just don’t want to explain anything and I really don’t want to end up at the ER. Do you know if there are emergency dentists around that will protect my privacy? Or is a dentist under legal obligation to report a crime or situation like this?

–  A lady that learned her lesson

Dear anonymous lady,

That is an interesting question and an interesting dilemma. Confidentiality laws for dentistry are kind of a gray area. Generally, if a dentist or physician feels that it is in your best interest or in the public’s best interest, he or she may feel like they need to get the authorities involved. For example, if the medical professional felt that it was possible that you may hurt yourself or someone else they would feel compelled to report it. But if there is no reason to suspect this possibility, there is no legal obligation to report the visit.

You can expect the dentist to ask your some questions about how the injuries happened. This information would be valuable in diagnosing and treating your dental emergency. Yet it is entirely up to you how much information you share with this person. Lying would not be advised, but you could probably answer with a response along the lines that you would rather not discuss it. He or she would get the drift. But be honest about the details that could potentially influence your treatment.

If the dental issue isn’t getting better after a couple days, you need to schedule an emergency dentist appointment as soon as possible. The sooner you act, you will likely have more options for treatment and the best possible chance to save your tooth or teeth. Or if there is injury to your jaw, it would also require prompt treatment.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Could my sinus problems be from my dental implants?

I have six dental implants in the works to replace six of my upper teeth. This was about six months ago when the initial surgery was perform. Ever since then, I have had really terrible sinus issues. The pain and pressure has become too much to handle from the continuous sinus infections. I’ve tried everything I can think of to get over them. But nothing is working! I am beginning to wonder if it is all connected to my dental implants. Have you ever heard of this? When I called my dentist about it, he said there is no correlation. But I have never had sinus problems prior to getting implants. I have only had the surgery completed so far and am hesitant to move forward with the final restorations because I cannot live like this. The dentist sends me to my physician and vice versa. Please tell me you know the answer?

– Bart in Illinois


Sinus issues are the worst! Sorry to hear that you feel like you have been getting the run around. You may be onto something in correlating your sinus issues with the placement of the implants. But of course it is very difficult to make an assessment like that based on the little information you have provided.

So here are a few things to consider. Did your dentist do a CT scan or panoramic x-ray to help with placement of the dental implants? Among the leading implant dentists in the country, this is becoming accepted as the norm. But not every dentist takes this critical step. CT scanning can give an implant dentist the complete picture, including the exact location of nerves, the sinus cavities, and other anatomical placement.

If this important step has not been taken, it may be time to seek another opinion. Another reputable implant dentist may be able to better diagnose the situation or you may be interested in seeing an Ear, Nose, and Throat specialist at this point. An ENT or otolaryngologist should be able to pinpoint the cause of the reoccurring infections.

Until you have figured out the cause of your sinus problems, you may want to hold off on moving forward with original dentist. You don’t want to move on and risk dental implant failure. It could very well be that your dentist has done absolutely nothing wrong.  But dental implants mistakes are not uncommon. This is largely due to the fact that it takes extensive advanced training beyond dental school to place them successfully, yet this is not a designated specialty area within dentistry. The short story is that any dentist on the block can make the claim to do implants.

Thanks for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Scared of the dentist for many reasons.

Ever since I’ve known my husband which is over 15  years now, he’s been afraid of the dentist. He doesn’t talk about it much and honestly I have just leave him alone about it. I go in routinely because I understand that regular teeth cleanings can help prevent bigger problems down the road. He doesn’t see it that way. Not only does he get extreme anxiety about going in for an appointment, he cannot stand how expensive dental care ends up being. Well, he’s been dealing with a stubborn toothache that isn’t getting any better. I finally convinced him to go in to see what is going on but the thousand dollar price tag has him finding all these reasons to keep putting if off. Do you have any recommendations for someone like this?

– Jen in New Jersey


Not only does it sound like you are dealing with a major case of dental fear, the financial stress sounds like it is compounding the situation.

To address the anxiety your husband deals with, it would be good to look for sedation dentists. These types of dentists will likely go out of their way to accommodate the fearful patient. They will practice gentle dentistry techniques, go slowly to make sure everything is completely understood, and they will offer nitrous oxide or oral sedation under the right circumstances. Often times it is a negative or painful experience that has kept fearful patients away. So communicating that the entire visit will be pain-free goes a long way. Another term you can search for online is a cater to cowards dentist. Again, these dentists will usually have sedation dentistry and in some practices they try to create a tranquil, almost spa-like atmosphere to help put patients at ease.

In addressing the financial issues, many patients have this road block in moving forward with care. The right dentist will completely understand your husband’s concerns and will help come up with a plan that works for him. Many practices will suggest phasing treatment out over time. For example, this can be done by addressing the most urgent needs first and then waiting for a time period before taking care of other problems. This approach works well in paying as you go. Other practices have affordable financing options like CareCredit, or in-office discount plans.

There is a good chance that a toothache will only get worse, not better. Even if the pain subsides in a couple weeks, it doesn’t mean the tooth is better. Often times a root canal will be required to save the tooth. This type of treatment takes care of the infection so it doesn’t continue spreading to other parts of the body. The sooner the problem is addressed, the less pain and less expensive it can likely be addressed. Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Do I really have to quit smoking before getting a dental implant?

At my last appointment, the dentist is urging me to move forward with replacing my missing tooth. He is recommending a dental implant, but I am a smoker. He says he won’t do it unless I quit. As much as I’d love to quit once and for all, I just don’t know if I can. I swear I have tried dozens of times. What does smoking have to do with dental work? Shouldn’t I be able to choose whether I can get a certain treatment or not? Do you think he would know if I really hadn’t quit even if I said I did? I will make every effort to cut back but quitting isn’t likely going to happen. But I really want to replace my missing tooth. I hate the way my smile looks these days.

– Bart in New Mexico


The bottom line is that honesty is the best way to go with any doctor. Although you are the patient, he is fully invested in the success of your dental implant procedure. He likely feels fully responsible for the outcome. It is not uncommon that an implant dentist will recommend you quit smoking. Of course, there are some that dentist out there that will still do the procedure, yet they will highly encourage quitting.

Let’s consider this. If you were building a new home, would you build it on an uneven foundation? Even if you aren’t telling the truth, there will likely be symptoms that the dentist will notice when preparing you for the dental implant procedure. Discolored teeth, a fuzzy tongue, film on the surface of your gums, and bad breath are all giveaways.

Yet, the ultimate concern is how long the dental implant will last. Smoking directly affects a patient’s healing time since there is a reduced blood flow in the gums. Smokers are also at higher risk for gum disease which directly impacts the dental implant, it increases the risk for tooth decay and even infection. Smoking actually increases the risk for failure by three times!

So dental implant failure is the main reason that your dentist is making this recommendation, coupled with the added health benefits from stopping smoking. Hopefully this was helpful as you consider if you are a dental implant candidate.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Travelling to Mexico for dental treatment.

I need to get a couple root canals and crowns, and one dental implant. The dentist quoted me a fee I simply cannot afford. There is just no way. My friend told me to go to Mexico because the dental care is a fraction of the cost in the United States. I am a bit nervous to cross the border, but it is definitely tempting. Thoughts or recommendations on making this a positive experience?

– Bill in California


Don’t go. That’s the short answer. And really it is the only way to ensure you have a positive experience. Living in California, it may be extremely tempting since going south of the border is quite easy. Although there are likely to be some reputable dentists in Mexico, it is much cheaper for a reason. There are no regulatory boards in place like we have in the United States. Also, the sterilization and cleanliness practices are much different and subject to each dentist’s discretion. Also, in Mexico, dentists are not required to have dental malpractice insurance. So you are left with the word of the dentist if anything goes wrong.

The Food and Drug Administration in the United States is very involved in regulating dentist offices here. Therefore, you also need to factor in the possibility of the standards not being up to par. They simply have no recourse if something goes wrong.

Root canals and dental implants can be done affordable at the right dentist here in the states. A simply conversation about payment options or payment plans may make things more affordable. Or you can also consider phasing treatment out over a period of time by addressing the most urgent needs first. Just remember, botched work in Mexico could end up being much more expensive in the long run.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Managing tooth pain and anxiety after cancer.

I’m happy to report that I am a cancer survivor. My scans have been clean after two rounds of chemo. Undergoing this treatment has really damaged my teeth though. I used to have such a bright, shiny smile, but now I’m simply embarrassed. My teeth look ugly and they hurt. I have never had pain from my teeth, but it’s like that all the time now. I have never had a cavity either, but the way my teeth look now, I’m sure I’m in for a lot of work to be done. I feel like such a wimp after beating cancer, but I am so scared of the dentist now. Any advice?

– Rachel in Kanas


Congratulations on such an amazing accomplishment. Don’t beat yourself up. You are experiencing a completely normal side effect of chemotherapy. This type of treatment can demolish your tooth enamel and leave you highly prone to tooth decay. Some patients complain of painful oral sores and an achy, painful feeling after cancer. It is possible that some of your discomfort is due to the medications that have been prescribed for you as you combated that ugly disease. Yet it is quite possible that some of the pain may be due to dental problems that have developed that require treatment.

Even though you feel fearful about visiting the dentist, it is important to get in sooner than later. There are many ways that a sedation dentist can help you, from nitrous oxide to oral sedation. Dentists that offer sedation dentistry options typically are understanding and gentle. If you are upfront about your story and explain your anxiety, the right dentist can help you get back on track with your oral care.

There are even dentists out there that categorize themselves as a “cater to cowards dentist.” This type of practice may even be more like a spa, offering massages, aromatherapy, even paraffin hand treatments. The right dentist will have you looking forward to your next appointment, instead of dreading it. Good luck to you and congratulations!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Strange feeling in my tooth, but I wouldn’t call it pain.

I had a strange sensation occur a couple days ago when I was eating some chewy candy. It was an old silver filling and I swear, I felt it move. It was almost as if the filling wiggled inside the tooth. I haven’t noticed any pain or even any sensitivity. I can totally eat like normal and it doesn’t bother me brushing either. But I can’t get it out of my head and am wondering if it is at risk to fall out? What should I do?

– Will in Indiana


The best way to figure out if this is a potential dental emergency is to contact your dentist before it turns into a painful problem. There shouldn’t be any movement or sensation in a tooth when you are eating or brushing. So even though it isn’t painful, it may be wise to play it safe and get it checked out.

The average lifespan of a traditional amalgam filling is approximately 10 years, but in many cases they last much longer than that, even 20 or more. So there is a good chance an amalgam filling will need to be replaced sooner or later. There are many possibilities as to why this could be occurring including, the filling material is broken, the tooth surrounding the filling may be broken, or sometimes the edges of an amalgam filling will leak which means the tooth is susceptible to further decay.

Call your dentist and explain what happened. You may not need to schedule an emergency dentist appointment, but it is likely he or she will want you to come in. If you wait until you are experiencing some kind of pain, the treatment may end up being more along the lines of a crown or root canal which are also much more expensive than a filling being replaced.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Saving a tooth?

I have a very painful tooth that is bothering me day and night. When I was at a recent appointment to get it checked out, the dentist old that the cavity was down to bone level. He recommended bone lengthening surgery, a root canal, and then a crown in order to save the tooth. Truthfully, that recommendation freaked me out because I’m fearful of most dental treatments. Would it just be better to get it extracted and get a dental bridge? It sounds easier to me for some reason. Is it less expensive too?

– Larry in New Jersey


If a dentist states that the cavity is down to bone level, typically that means that the decay has reached beneath the gum tissue. What he has recommended is a procedure called crown lengthening. Your gum tissue will be reduced and the bone will be re-contoured. This is required in order to successfully remove the decay while at the same time having the appropriate space between the bone and the margin for the crown. If this important lengthening step is skipped, the crown will end up being placed too close to the gums and you will end up dealing with discomfort, irritation, and swelling. There is a good chance that your gums will be prone to bleeding as well, which will then increase the probability of bone loss around the tooth. Most dentists share in the  opinion to save a tooth if at all possible. Dental implants and bridges can be used to replace missing teeth, but you will never be as happy as you would be with your natural tooth.

So the decision is ultimately yours, of course. As far as the cost comparison, it will likely be similar. If for some reason the teeth that surround the decayed tooth have cracks or big fillings already, then a dental bridge may make sense. But if the surrounding teeth are in good shape, then ultimately you will be better off saving the tooth or considering a dental implant.

Meet with your dentist again and tell him or her about your concerns. Together, you will be able to come up with the right plan for your individualized needs.

Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.