Nervous to take my child with Special Needs to the dentist.

I have a child with special needs that Ive been avoiding taking to the dentist. I know its going to be difficult, as my child cannot sit still, nor will he be able to tolerate a stranger poking and prodding in his mouth. He has bought to my attention some discomfort in his mouth. I can see a very large brown/black spot on two back teeth; likely the culprit of his pain. I’m guessing he has some nice sized cavities to be filled. This makes me even more nervous, as I cannot imagine him withstanding an appointment of that nature. I know I have to take him, but am procrastinating due to my own anxiety! How do dentists handle children like my child? Do I have to see a pediatric dentist?

– Layla in New Hampshire


Your concern is understandable! Though your are nervous about your son’s reaction, you will ultimately do him a big disservice by putting off a much needed visit. First, if you haven’t already, research the pediatric dentists in your area. Most pediatric dentists have extra training on working with children, especially those with Special Needs. Second, rest assured that if its determined he needs teeth filled or other work, they will have plenty of options to help your son relax and make it through his dental procedure. The likely offered option will be sedation dentistry. Sedation is the use of medication to make your child very calm for a procedure, but not sound asleep, and is done in the dentists office. This is the best method to help manage high anxieties. There are a few types of sedation dentistry: nitrous oxide (laughing gas, which is inhaled) oral sedation (taken by mouth), and IV Sedation (which is administered through a needle through the hand or arm). Depending on the work that needs to be done, you and your dentist can determine the best type of sedation dentistry for your child’s needs. Then your child will feel better, and so will mom!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Do I Have to Tell My Doctor About My Achy Tooth Before My Trip?

I’m booked to travel soon with a group who does charity work in developing nations. I’ve been on the waiting list for three years and I’m very excited about finally getting the opportunity to go with them. There are a number of things I have to do before they let me go, though, and one requirement is that I get a letter from my dentist saying that my teeth are fine. The problem is, I’ve had one tooth that’s been hurting on an off for a few months now. It’s not a dental emergency or anything- it always goes away after a day or so. Part of me feels like I should have the doctor check it and part of me thinks he will catch it if something’s wrong and that telling him might blow my chances of getting clearance. If I miss out, I have to go back on the waiting list and might not get another chance. Do I have to tell my doctor about the achy tooth?


Scott in Massachusetts

Dear Scott,

As Shakespeare once wrote, “No legacy is so rich as honesty.” While your charity tour is incredibly admirable, your honesty in this situation is essential. It may not seem like a big deal now, but that tooth could blow up overnight and become a dental emergency.

You really need to get a proper diagnosis. It’s possible that the nerve of your tooth is dying. Sometimes, a tooth will die quickly, but sometimes, it will be dramatic. Just like the stage actors of yore, a tooth can cry out in agony, play dead, and then revive again to give the audience more thrill. It can do this repeatedly for months until it silently utters its final farewell or explodes in a fit of rage, causing much damage, and infection, on the way out. When this happens, it is a dental emergency and it will require swift treatment and antibiotics to stop the infection from spreading and to keep you pain-free.

If you tell the doctor, he can run additional tests to look for indications that this is what’s happening. Because teeth can die for all sorts of reasons, it might not be obvious something is wrong unless you give him a description of your symptoms.

It’s doubtful they will be able to provide anything beyond urgent palliative care on your trip. So, if your tooth flares up, it can put a serious damper in how much help you can provide the local people. It’s best for you, and for those you want to help, if you make sure your own medical needs are seen to first. Good luck and have a safe journey.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Was Clear Choice Right or Should I Get a Second Opinion?

I just came back from Clear Choice and I wonder if I should get a second opinion. I’ve only heard good things about them, so when I was finally ready to get my dental implants done, I decided to check them out. I know my teeth are really bad, but I was sure many of them could still be saved and that the dentist could work with them. Instead, they want to pull all of my remaining teeth and charge me what a modest home in my area costs, to do it. My teeth are important, but it’s not like I can live in them. I’m on a budget and they jumped straight into financing. That’s all well and good, but I can’t afford that kind of money- financed or not. I’m really put off by the whole thing. Is this the best I can hope for? Should I get a second opinion, even though I’ve already heard what Clear Choice has said or just scrap the whole thing for now?


Joel in Washington

Dear Joel,

In short, get a second opinion. Clear Choice is not the end-all. They tend to specialize in only a handful of treatments and use cookie-cutter techniques. So, even if you want a specialized treatment, they’re not likely to recommend one. Their platform and business model depends on them performing the same service repeatedly.

If you have a lot of work that needs to be done, it’s often a good idea to get a second opinion, whether the first came from Clear Choice or another dentist. When there are numerous teeth to restore, there will be multiple ways to do so. Each doctor will evaluate and provide his thoughts on what the optimal method is. Many will give you a few options and tell you which they think is best and why, then allow you to select based on preference and finances. You might even be able to do the work in stages. For instance, if your remaining teeth can be saved, you’d probably want to complete those first. Working in this manner won’t correct your whole smile in a day, but it can keep you within budget and help you hold onto your natural teeth for longer.

If you’re not satisfied with what you were told by Clear Choice, a second opinion is a reasonable and prudent decision.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Sick of canker soures. Looking for a gentle dentist.

I have continuous canker sores in mouth. Therefore, I despise going into the dentist and getting my cheeks and lips tugged at. How do I go about finding a gentle dentist? I know I should probably get my teeth checked, it’s been years.

– Ted in Michigan


Canker sores are the worst. It is understandable that you are on the hunt for a gentle dentist. Whether you realize it or not, if the canker sores are reoccurring ,it is likely that you have some level of anxiety that is keeping you away too. So it would be wise to look for a “cater to cowards dentist” in your area. Yes, the terminology is funny but a dentist that advertises in this manner is likely going to be very gentle. They will take the time to listen and take things slow.

More importantly, have you figured out what is causing these ongoing canker sores? You may have heard that acidic foods like tomatoes, oranges, and grapefruit tend to cause them. This is true. But what you may not realize is that your toothpaste could be a contributing factor to those annoying sores. Common in many toothpastes is an ingredient called Sodium Lauryl Sulfate. This is one of the ingredients that makes toothpaste foam and it can be harsh on soft tissues. That irritation can lead to canker sores. Unfortunately, it is found in nearly 99.9% of toothpastes. It is also found in shampoos and soaps.

It may be difficult to find toothpaste without Sodium Lauryl Sulfate, if you don’t know where to look. But there are products out there that do not contain it. Start by checking out a natural, health food store in your area that also carries hygiene products.

Here are several for your consideration:

  • Squigle Enamel Saver Toothpaste
  • Rembrandt Gentle White Toothpaste
  • Auromere Ayurvedic Toothpaste  (found on-line)
  • Biotene Dry Mouth Toothpaste Fresh Mint Original Flavor
  • Tom’s of Maine Natural Clean and Gentle Care, SLS-Free Antiplaque plus Whitening Spearmint Toothpaste
  • Herbal Toothpaste Cardamon-Fennel
  • JASON Natural Cosmetics Powersmile Toothpaste Peppermint

You can’t expect that these toothpastes will foam like you may be used to, but they can still be used to effectively clean your teeth and gums. Hopefully, this will help get the canker sores under control. then you can get back on track with regular preventative dental cleanings and exams.

This post is sponsored by Cleveland dentist Hylan Dental Care.


Is Incontinence a Reason Not to Have Sedation Dentistry?

My dentist says I need to have a crown done, but I’ve been putting it off for a little over a year. I wouldn’t say I have anxiety, but I do dislike dental work enough that I avoid it at all costs. Last time I went in for my cleaning, they suggested I have sedation dentistry so I can avoid any unpleasantness. The problem is, I have some mobility issues and I usually use a walker to get around. I’m also a little embarrassed to say that I have some incontinence as well. I would prefer not to mention this to the doctor and his staff, but if I’m sedated, I won’t be able to manage myself as well as I normally do. Any suggestions?


Jane in Illinois

Dear Jane,

Sedation dentistry is still an option for you if you’d like to try it, but there will have to be some accommodations made. First off, you should talk to your doctor about your concerns. While it may not be a fun topic to discuss, he needs to know so he can give you the best possible care. Moreover, you’re managing health issues and there’s no shame in that. Your doctor will understand this and you won’t be telling him anything he hasn’t heard from another patient before.

Although your doctor will give you his own guidelines for sedation dentistry, there are a few things that are universal. You will need someone to be in the office with you who can help you in the restroom if you need to be excused during the procedure. It’s a good idea to choose a friend or family member who can devote the whole day to assisting you as needed. You’ll also want to pack a bag with any items you’ll need for hygiene and clean clothes. Using your walker after dental sedation is not recommended. The office should have a wheel chair on hand to get you to the car afterwards, while you’re still medicated, but you should have one on hand at home as well.

It’s normal for the doctor to insist that your helper stay with you all day to ensure your safety. Due to your mobility concerns, it is absolutely essential. The medication will likely take the rest of the day to leave your system, so you will be groggy and unstable. It’s also a good idea to have a “nest” set up at home, with any comforts you’ll want close at hand, so that when you arrive there after the procedure, you can settle in for the day.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is it Safe to Go to a Dental School for a Dental Implant?

I want to have a dental implant done and went to my doctor for a quote. Their estimate was way out of my budget. One of my friends suggested I should go to the local dental school and have it done instead. If it saves me a lot of money, I’m all for it, but I worry about having a dental implant done by someone with little experience. Is it safe to go there or should I keep saving until I can afford to have my regular doctor complete the work?


Patty in Texas

Dear Patty,

This is really a matter of your own personal preference. You’ll have to decide if the risk is worth the tradeoff for reduced costs.

On one hand, dental schools are very meticulous. Your dental implant would be completed by someone with extensive training, as well as hands-on application of that training. Additionally, there will always be a teacher checking the student’s work to ensure that it’s done properly.

On the other hand, dental implants are a skill that must be finely-tuned. There’s a lot that can go wrong, and in the hands of a specialist, they can occasionally fail. Even if it’s a straightforward one, with no bone grafting or other special treatments needed, it still requires surgery. The student will embed the implant into your jawbone and, over a period of months, it will integrate with the bone. Then, you will have a piece added to the top and a crown made custom to fit in place.

If each of these steps is not expertly performed, the implant may not adhere to the bone, it may fail, or you may face recurring infections which ultimately could lead to dental implant failure. Any of these issues sets you back to square one. In order to increase your odds of success, you’ll have to have a student who has a natural gift for placing dental implants and he will have to have a teacher who is an expert in catching issues before they become a problem. Not all dentists have a keen enough eye to do that.

Overall, entrusting a student with a procedure as delicate as an implant might increase your risk of failure and you’ll want to be sure what the protocol is in the event that happens. Most people would prefer to have a highly-skilled dentist do the restoration for those reasons. If, however, you decide to go forward, it’s a good idea to ask lots of questions so you know what experience the student and the teacher have. It is a bit risky.

This post is sponsored by Cleveland implant dentist Hylan Dental Care.

Over-the-counter filling material.

I have a cavity and now my tooth is really starting to bother me. But the problem is that I cannot afford dental care. When I went to the drug store, I found a product that said you can do your filling at home. Do you think this will help reduce the pain?

– Jordan in Wisconsin


The biggest problem with your plan to purchase store-bought filling material is that this product is designed to be a temporary fix. At most, it can be used for a couple of weeks to fill the decay in your tooth until you can get into the dentist office. Unfortunately, this will not help with the toothache you are experiencing either. It is the decay in the tooth that is causing you pain.

If you did go this route and opted to use the temporary filling material, you may actually be doing more harm than good because you will be trapping the harmful bacteria underneath it. This means that the cavity could become even larger. You should get in for an emergency dentist appointment right away. Or call your dentist and get in as soon as possible. The sooner you get this taken care of, there is a better chance you can get the tooth taken care of more economically too.

If the bacteria and decay has reached the inside of the tooth where the pulp is, then you may require a root canal. Symptoms of an infected are tooth pain that radiates into your jaw, pain that keeps you up at night, or sensitivity to hot or cold. This situation also warrants immediate care because the infected tooth will not get better on its own. Not only can the infection spread to other areas of the body, but you may be at risk to lose the tooth if it is not addressed. So if you aren’t dealing with a dental emergency situation just yet, it would be highly recommended that you get in asap to avoid expensive treatment!

It is understandable that you are concerned about the cost. But you may not realize that there are affordable dentists out there that are ready to help people like you. Just be upfront about your situation. Sometimes they can phase treatment, work with you on payment options, or offer low or no-interest payment plans so you can get the care you need. The least expensive treatment is to have the tooth extracted. But this isn’t the best way to handle the problem in the long run. The teeth around the missing tooth may shift around and begin to cause other problems.

Again, it cannot be expressed how serious an infected tooth actually is. If dental care is neglected for any length of time, the infection has the potential to become life threatening.

Lastly, check out dental schools in your area. Sometimes they have less expensive clinics for students that are training. That may be another option you may be interested in.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Can a serious smoker get dental implants?

I have really bad gum disease and I am a heavy smoker. A couple of my teeth have fallen out and I hate the way I look now. I think it would actually look better if I get the other bad teeth pulled and replaced with either a denture or dental implants. I think dental implants will look better but I want to know if that is a good idea because I’m a serious smoker.

– Bart in Washington


Well, it’s likely you know how terrible smoking is for your physical health. But what you may not realize is smoking also has a negative affect on your oral health, especially gum disease. As you are experiencing, gum disease is terrible and will eventually be a cause of tooth loss.

You have also mentioned the fact that dental implants look more aesthetically pleasing than dentures. They are also a permanent solution to missing teeth. They look, feel, and function just like your natural teeth. But the downside to implants is that smoking will negatively affect your implants, just like it negatively affects your gums. Specifically, smoking will complicate the healing and post-operative period after the implants have been surgically placed.

Therefore, if the implant sites do not heal properly, the end result may be loose dental implants, an increased risk for infection, and overall will increase the risk of dental implant failure.

In regard to dentures, many patients are not happy with the way them. Not only do they not like the look of them, other denture problems are that they aren’t ideal for chewing, and eventually you will be dealing with a bone loss condition called facial collapse the occurs when you are missing teeth. The bone is resorbed to be used elsewhere which in turn causes your jawbone to shrink.

So the elephant in the room is that first thing first – quit smoking! Since dental implants are a large investment, it would be wise to invest your money in quitting smoking. Then, you will have a much better chance of being a dental implant candidate.

This post is sponsored by Cleveland dentist Hylan Dental Care.