Dental care for a recovering addict.

I am a recovering drug addict. I need a lot of work on my teeth but the last time the dentist refused to give me any pain medication because of my addiction. I am now on methadone and I tried to tell that to this dentist but he was a jerk. I provided the contact information for the clinic I go to and gave them permission to discuss the matter with my doctor and counselor.

I guess it’s time to try a different dentist but I have to say it was a major accomplishment getting me to talk to the first dentist because I get really freaked about going to the dentist. The last time I went in years ago, I almost had a panic attack in the chair.  Do you have any advice about how I can get my teeth taken care of and move forward. I don’t want to be in pain any longer so I need to make this happen soon.

– Bethany in Texas


Sorry you had a negative experience with the dentist you saw. Many health care professionals steer clear of any issue that would be connected to the Drug Enforcement Administration. There have been instances where the dentist has gotten in trouble with the DEA which has created this negative dynamic. That may or may not be what happened here, but unfortunately, like in your case, it is the patient that  is neglected.

It may be wise to search for a dentist in your area that offers sedation dentistry. Try searching for a “cater to cowards dentist” with your city name. This will likely turn up some dentists that tend to be compassionate about helping fearful patients.

It’s good that you were upfront about your addiction recovery process. It is imperative that you don’t hide anything that would hinder your progress. So be sure to communicate the post-operative plan for pain control, given that you are currently on medication. Don’t give up. You may run into another one or two that are timid and not interested in your case. But you will find the right match for your unique needs. Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Can I just get dental implants instead of braces?

I have some crowding on one side of my mouth and the last thing I want to do is be a brace face. I saw a Clear Choice commercial and I was wondering if I can just get my teeth pulled and replaced with dental implants?

– Darrel in New Jersey


Although Clear Choice Dental Implant Centers may look appealing in their commercial, please think this plan through before taking any action.

Based on what you have described, it doesn’t really sound like you are dental implant candidate. There may be some alternative treatments that will work better for you. Most reputable dentists will do absolutely everything possible to preserve healthy tooth structure. So, having crooked teeth extracted because you don’t like braces doesn’t sound like a logical decision.

Although dental implants are a permanent solution to missing teeth, the process is quite invasive and the procedure is highly complex. It is difficult to say what other options are best for you without having that much information about your specific case, but you need to meet with a reputable implant dentist in addition to Clear Choice if you decide to get a consultation from them.

It is possible you may be able to get crowns, have only a tooth or two removed and have a successful bridge, or possibly a partial denture? Or maybe you it would be best to incorporate dental implants into your treatment plan. But please don’t pull healthy teeth. Once they are gone, there is not getting them back.

If crowding is the main issue here, it is possible Invisalign may work for you. Don’t make any rash decisions based on some bias about orthodontics. You need to make the best decision for your long-term oral health. It’s time to see a respected implant dentist and go from there.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Why does my baby need tooth extractions?

I have an 18 month old that just went into the pediatric dentist for the first time. We decided to take him in because his front teeth didn’t look like they were the same color. We thought maybe he had a lack of vitamins or minerals or something. Well, we were stunned when the dentist told us the discoloration was from decay and he wants to extract them. This was shocking to me? We waiting so long for these little teeth to finally break through and now he wants to pull them? Have you ever heard of this?

Also, he isn’t old enough to get sedation dentistry apparently so they are recommending he be put under with general anesthesia. Here, I was hoping for a fun photo op of my son’s first dental appointment and I leave mortified.

Is this normal? My son is a breastfed baby so I have no idea how he would have such extreme decay. Any insight is welcome. Thank you!

– Paulette in Michigan


Breastfeeding is definitely the most nutritious way to go for your baby’s first year of life. Unfortunately, it has been known to cause tooth decay in infants. This is because the sugars in breast milk ferment and they are amplified by the bacteria inside a baby’s mouth. For example, streptococcus mutans is a bacteria that metabolizes different carbohydrates. This particular bacteria creates an acidic environment which can cause decay.  Your son may have a higher level of this bacteria present causing him to be more prone to problems with his oral health.

It may be wise to try to wean your son from nighttime feedings. In the early months, these feedings are imperative for nutrition and development, but as your son gets older, they are more out of habit and comfort. If your son falls asleep while nursing, the milk has a tendency to pool up in their mouth and sit on front teeth over night. Also, our saliva subsides at night so it doesn’t clean the teeth like it normally would during the day. These factors or a combination of them likely lead to your son’s decay.

It may be wise to take yous son into the pediatric dentist every six to twelve months to monitor the decay, especially if your family has a history. Also, dental hygiene should begin as soon as your child’s teeth erupt.

Unfortunately, if the teeth cannot be restored than they will need to be extracted. The good news is, as you know, these are his baby teeth. You wouldn’t want to leave the decayed teeth in place because it would leave your son to be prone to pain and possible infection. Permanent teeth will erupt between six and eight years old. It sounds like your pediatric dentist is making the right recommendations. Sorry, that you had to learn the hard way.

Thank you for your question. Hopefully it will help other mothers.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Dental implants Groupon deal?

I was told that I need to get a dental implant to replace my missing tooth. So I set out on a hunt to find the best price quote around. Well, my searching must have told my computer I was interested by some ad-ware program, because it was just a couple days before I came across a Groupon deal from a dentist in my city. His quote is much more affordable than any dental implant fee I have found. In fact, it was literally half price. How can this dentist offer such low fees? Should I steer clear or take a chance? I have been known to be cheap, but realize sometimes you get what you pay for.

– Cindy in Tennessee


Unfortunately, this may be one of those instances where you get what you pay for. Dental implants are expensive. And there is absolutely nothing wrong with seeking a second or third opinion or fee quote. But half-price is pushing it.

Dental implants require two phases, the surgical phase and the restorative phase. The oral surgery and placement of the titanium post are critical to the success of the implant. If you end up with a lesser experienced implant dentist or one that is cutting corners in some other way, your good deal will end up costing you much more than it’s worth in the long run when it needs to be re-done.

Trust is the most important factor in selecting the right implant dentist. Check their credentials, ask about their success rate, ask to see cases similar to yours. And don’t be afraid to be upfront about looking for ways to making dental implants more affordable. Often times the right dentist will work with you on payment plans, pay as you go, or low or no financing options. So it is probably wise to avoid discount sites like Groupon, Living Social, and Amazon Local for dental implants.

These services are a fantastic way for new dentists to advertise to potential new patients in the area. But be sure to check them out before moving forward. Good luck and go with your gut on this!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is a broken tooth a dental emergency?

I moved to a new town so I don’t have a dentist yet. Wouldn’t you know, I’m out to dinner with my new boss when part of my tooth crumbles while I was eating lunch. The front part of the tooth is still there. It feels really jagged but doesn’t hurt too much, as long as I chew on the other side. Is this a dental emergency? Or can I take awhile to find a new dentist. The one emergency dentist I googled in town received terrible reviews.

– Sal in New Hampshire


It is good news that you are not in pain, but you don’t want to put off dental treatment for very long. You probably don’t want to go to the emergency dentist that received terrible reviews. Ask your co-workers for a local recommendation. The dentist that you see now to treat the broken tooth doesn’t necessarily mean it will be your long-term dentist, but your situation needs urgent attention.

Since part of the tooth crumbled away, that likely means severe decay on the tooth. So even though you aren’t in pain, this still needs to be treated like a dental emergency. There is a reason the tooth broke and if you want to salvage the tooth, the sooner you get in – the better.  It may require a root canal or crown. Most reputable dentists leave time in their daily schedules to accommodate dental emergencies.

So if you can’t find a recommendation of someone you know, call around and see who can get you in.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Pain after a filling.

I had a filling done in my tooth. It was one of those mercury-free, white fillings. Well today when I bite down, it really hurts. My jaw even feels like it hurts. It feels like the back part of my jaw is hitting the top part of the tooth. It’s a left canine tooth. I hurts so much I don’t really feel like eating. Any idea what’s up? It’s my first white filling.

– Pamela in Kansas

It is always difficult to give you any specific recommendations with such little information. So whenever you are having an issue or pain, it is always important to contact the dentist that did the work right away. You mention that is is a white composite filling, but you failed to mention how large it is. Sometimes, when you get a new filling it can be a little high for your bite. The dentist likely tried to adjust it while you were in the office, but you were probably numb. So sometimes you will need to return to have it adjusted.

The adjustment won’t hurt. It will only take a couple of minutes. That is most likely what is going on here. It isn’t a dental emergency, but give them a call right away to get it take care of. Or if you are having any throbbing pain or pulsing, you may need to have more treatment done.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I feel like I have old person dentures.

I have had an upper denture for many years now. When I first had it done, I really like the end result. Well, I have moved across the country and so I asked my new dentist about the denture. It seemed like he knew what he was doing, but I am so unhappy with the appearance of it. I kept asking them to make more of the tooth visible, but I feel like I look much older than I am with this new denture. I started looking into the dental implants option, but I simply cannot afford them. Do you have any advice on how I can find a skilled dentist to replicate the look of my original denture?

Also, this new dentist mentioned all-on-four implants to me. They are very expensive, but not as expensive as getting all dental implants. Any insight on that treatment would be very helpful too.

– Paulina in Georgia


It sounds like your new dentist wasn’t very aesthetically-minded in creation of your replacement upper denture. Dentists fundamentally are trained to think functionally and only a small percentage excel in cosmetic dentistry.

Many excellent cosmetic dentists will create beautiful, life-like dentures with that aesthetic vision that you desire. The key is to find a cosmetic dentist versus a general dentist.

You are correct that dental implants are much more expensive then dentures or all-on-fours for that matter. But you really need to proceed with caution with all-on-four dental implants. The treatment is quite risky and although more affordable, has a much higher failure rate. There are other options beyond a complete denture. Focus on finding the best cosmetic dentist that also places implants and dentures, then have an honest, open discussion with him or her about what you are after. At the very least they will be able to replicate the look of your previous appliance. The right dentist may also have some other tooth replacement options that work for your budget.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Does My Husband Need an Emergency Dentist for a Gum Injury? His gums are oozing!

My husband just told me that he’s had a sore spot on his gums for a couple of days. He swears he just caught a spot with a sharp chip or something, but I’m really worried. Supposedly, it was just a little tender, but when he massaged it, it oozed a little. He says he’s been using mouth wash to help keep it disinfected and that it’s healing and going away. However, he also says he’s had to “drain” it a few times and is seeing less come out of the spot. I think it’s an urgent need, and he needs to go in and be seen by the emergency dentist right away. He won’t listen to me, though. Does this sound like something that will heal up on its own or is it likely to get worse?


Betty in Texas

Dear Betty,

It sure sounds like he needs to see an emergency dentist. In fact, it sounds like your husband has an abscess. Trauma to the gums doesn’t usually manifest itself this way. You may wind up with a cut or a sore spot, but it doesn’t usually blister up like this and ooze.

More than likely, one of his teeth has become infected and has caused a pocket of pus to form. A disinfecting agent isn’t going to help, because the infection is inside the tooth, but is spreading outwards. Unless he has the infection properly cleaned out and the empty space filled (via a root canal), the infection will grow and can spread even more. He may wake up one morning and find half of his face is swollen. In extreme cases, the infection can travel to his brain or heart. We still see deaths from this in the United States today.

The fact that he’s still experiencing swelling and exudate is very worrisome. Any signs of infection inside the mouth is cause for concern and should be examined by an emergency dentist right away. Even if it was simply trauma, he’s definitely exhibiting signs of a serious infection and should have it medically treated right away. The long-term prognosis of the tooth involved, and perhaps even his life, are dependent on swift treatment.

This post is sponsored by Cleveland dentist Hylan Dental Care.