Does the emergency dentist think I’m crazy?

My tooth hurts, again. I had it taken care of (or so I thought) about a month ago when I visited an emergency dentist. He decided to do a root canal. But I don’t feel like the pain ever let up. So, I decided to go back into the same emergency dentist because the pain was interrupting my daily life. Well, he did x-rays and examined the tooth. Honestly, the entire time I felt like he as humoring me. He basically told me I need to see a neurologist. Is he implying that the pain is in my head or something? Does he think I’m crazy? I feel like he was just trying to get me to leave. But my tooth still hurts!

-Jess in Maryland

Although your emergency dentist doesn’t sound like he had the most welcoming demeanor, he may be onto something. No, the pain isn’t inside your head and that’s not what he was implying by referring you to schedule an appointment with a neurologist.

If an x-ray and exam was performed and everything checked out, it is quite possible that your pain is being caused by nerve damage. This isn’t a common occurrence, but it does happen. This may explain why you feel like you have a toothache. If this is indeed the case, it would be in your best interest to schedule a neurological appointment.

Other issues that may be influencing your pain may be from your sinuses since the nerves are all intertwined in that area. A recent cold or even allergies, may also contribute to tooth pain. It is difficult to pinpoint precisely what is causing your discomfort. If indeed it turns out to be cold or sinus related, you will likely need a decongestant or possibly an antibiotic to clear up any infection. A general physician will be able to better diagnose this possibility.

All that to be said, the emergency dentist should have been able to provide you with additional information to steer you in the right direction. Sometimes root canals are not successful, but that should have been identifiable by an x-ray. It is also possible that the pain is from a nearby tooth that is referring pain to that same general area.

So, don’t settle if you are in pain. You are not crazy. It may be in your best interest to schedule a second opinion with a different dentist to see if they can continue to rule out any problems with the tooth and make proper recommendations on who you need to see next. Sometimes, tooth pain can be difficult to diagnose.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I couldn’t afford dental implants. Now I’m having problems with my denture.

I should have trusted my gut. I really wanted to get dental implants to replace my missing teeth. But I honestly couldn’t afford them. So, I went with more affordable dentures. I knew from the beginning that they wouldn’t look natural. But I had no idea how terrible my quality of life would be. I have had so many denture problems, I don’t even know where to begin. They don’t fit right. I can’t eat normally or even talk normally. And they hurt! Am I doomed or do I have any other options?

-Bart in Florida

Bart,

Your situation is unfortunate. Don’t be so hard on yourself in choosing to move forward with dentures. You made the best decision you could at the time. Many dentists don’t always effectively communicate the possibility of ill-fitting dentures that can cause many problems.

It is possible that you will continue to adjust to them and your day-to-day quality of life will improve. Your first option would be to go back into the dentist to see if there are any adjustments that can be done to improve your comfort. Contact the dentist again and have an evaluation done. Sometimes even the smallest adjustment makes a world of difference to remedy denture problems.

It sounds like budget is an important factor for your treatment plan. Although, dental implants may not be an option for your financially, ask your dentist about a snap-on denture. This treatment will help stabilize your denture and keep it from slipping around. It is a lot less expensive than getting dental implants to replace every missing tooth. Depending on the budget you have available, dental implants will be placed to secure the denture. The more dental implants you have placed, the better.

Dentures can be made to look life-like and beautiful. So if you don’t like the way you look, you may want to see another dentist that is more experienced in the aesthetics versus purely functionality or lack of functionality, in your case. Sorry you have had to endure so many denture problems. Don’t settle with being unhappy. You deserve to have a better fitting set or to move forward with an improved treatment plan. Best of luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

I’ve decided that my implant dentist was incompetent.

I have determined that my implant dentist is incompetent. I went through the entire dental implant process and was so excited to put it behind me. Well, it was less than a month before the crown felt loose. When I went back into the implant dentist, he told me that the dental implants looked fine after doing an x-ray. He determined it was the crown that was the problem. When he tried to remove the crown and it wouldn’t budge. He returned with some special tool. Then, when he removed it, the implant came out with it. Help! I’m freaked out now. Where did he go wrong, in placing it or in yanking on it with too much force?

-Rebecka in Rhode Island

Rebecka,

Based on what you have described, one thing is clear. The crown was not the problem. It was the dental implant that was loose the entire time. When a crown isn’t placed properly and is loose, it is simple to remove. In fact, it may end up falling off on it’s own. There would never be a “special” tool required to remove a loose crown. The problem with implant dentistry is that it is not a regulated specialty area within dentistry. Therefore, any dentist can claim to place dental implants without adequate training and expertise that is required for success. A loose dental implant is very serious.

There are a few possibilities to explain why your dental implant was loose. It is possible that the crown was placed onto the implant too early, prior to the necessary healing time that is required. The implant fuses to the bone in a process called osseointegration. If too much stress is placed on the implant too early, it will fail because it doesn’t have enough bone support. Or it may have been an issue of substandard materials.

Infection is another possible cause. But you didn’t mention being in pain and typically when there is an infected dental implant, there is intense pain.

Unfortunately, repairing the dental implant at this point isn’t an easy or straightforward process. The bone will need to be prepared again and you will need to have surgery again. Bone grafting may also be required to build up enough density at the implant site. The possibility exists that there wasn’t enough bone density to begin with.

It would be in your best interest to find a new implant dentist. Be sure to research their credentials and experience, as well.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Help an implant broke off my All-on-Four!

I feel helpless and angry. It’s not a good combination. I knew it was time to replace my teeth and I went into my dentist for a denture. He totally talked me into dental implants and further pushed be into an All-on-4. He told me there were many benefits over dentures, like they would be stronger and get me feeling back to my old self again. I spent a lot of money on this treatment and had every confidence it would do what I was told it would. Well, it’s only been a couple of weeks and one already broke off! When I called in irate, he agreed to fix it. But now he’s trying to convince me I need bone grafting before getting the new dental implant. Am I stuck? I honestly wish I never did it. I wish I could go back in time and have stayed with my original denture plan. Do I have any grounds for a refund?

-Gerald in Nebraska

Gerald,

Well, let’s first apologize on behalf of the dentist. It sure doesn’t sound like the dentist that placed the All-on-4 has done that at least. Some dentists have a high success rate with the All-on-4 technique, while others will never use it.

There could be a couple factors at play. One of which is that the dentist simply didn’t have the skill required to be successful. Dental implants take extensive training beyond dental school. If an All-on-4 is placed incorrectly, the pressure that it endures will simply not hold up. The angle, the surgery, the quality of the products all come into play too. This may be one reason for the failed All-on-4.

Another reason it may have failed is due to the quality of the product. Some implant dentists try to cut corners on cost and utilize sub-standard materials. Now, this is in no way accusing the dentist of using faulty materials. Simply put, some are much higher quality than others. Others feel very strongly that the All-on-4 technique isn’t strong enough.

Bone grafting  from the same dentist doesn’t sound like the best plan either. If bone grafting was required, you should have known prior to the treatment being done. You may be best served by visiting another more experienced implant dentist or at least seeking a second opinion on the matter. A refund is not likely. Although, it never hurt to ask. If, in the second opinion with a new dentist there is anything that is abnormal, he may be able to support you in your quest for a refund. Best of luck! And again, sorry that you are having to deal with this.

This post is sponsored by Cleveland dentist Hylan Dental Care.

My tooth is not fine. Could my dentist be wrong?

No one is perfect. So, does that mean a dentist can be wrong? Let me back up. It was over a month ago that I had a terrible toothache. The tooth needed a root canal treatment. The pain in the tooth did improve, but it never really went away. This past week, I have been in terrible pain once again. I couldn’t tell if it was the same molar or the tooth adjacent to it. So when I went into the dentist, he did x-rays to see which tooth was giving me pain. The x-rays didn’t reveal anything out of the ordinary and he told me I’d be fine. I don’t feel fine. He then proceeded to tell me to schedule a consultation with a neurologist. Question – if I’m, “fine,” why on earth do I need a consultation with a neurologist? What is going on?

-Becca in Texas

Becca,

This is a tough one to respond to having not seen your case in person. As strange as it may sound, especially after your recent troubles with one of your molars, it is possible for a tooth to be fine even if it is hurting.

One possibility is called referred pain. For example, sometimes patients will come in complaining of a severe toothache on one of their upper teeth. After an examination, the tooth that requires treatment actually has turned out to be located on the bottom. Other times, the pain may be coming from an adjacent tooth. When a tooth is infected in the same quadrant, the pain sometimes isn’t pinpointed.

Neuralgia is another nerve issue that feels like a toothache. But the pain is caused by the nerves and technically the tooth is fine. That would be when you visit a neurologist.

Still another possibility for tooth pain is caused by a sinus infection. When the sinus cavities are infected they can affect the roots of the teeth since they are located in such close proximity to them. Other health problems may cause toothaches, as well.

So to answer your question, your dentist may be correct that you do not need another root canal treatment. You did the right thing by going back into the office and having an examination. And he did the right thing by performing an x-ray. So this isn’t necessarily an issue of who is wrong. It is more ruling out the possibilities that may be causing it.

If you are convinced it is indeed a tooth, than it may be in your best interest to schedule a second opinion with an endodontist. These doctors specialize in root canal treatments and would be able to confirm your dentist’s findings or possibly make a different diagnosis. If you decide to get a second opinion, don’t tell the endodontist that you have already been in to see someone else. Don’t give them any preconceived notions. Just let them diagnose and make recommendations based on what they are see in their examination. You do need to inform the new doctor that you had a recent root canal and now you are experiencing pain again. If they ask you more about who you saw, etc. simply state that you would like a blind second opinion. If the new dentist knows your old dentist or contacts him to get more details, they could be trying to protect one another. So, having an independent examination is very important.

Good luck! Hopefully your pain is taken care of as soon as possible.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Did my dentist mess up?

My dentist has been “watching” one of my teeth for years. Finally it got to the point where it was infected and when I went into the emergency dentist that referred me to an endodontist. The root canal was done. But no one was really sure if all would work out since my roots were oddly shaped. It seemed like it was getting better, so I went back to my normal dentist for the crown to finish it off. Then, weeks later I ended up in agony with my entire face swollen. The emergency dentist extracted it immediately. I thought it was finally all said and done, but I still have lingering pain. My sinuses bother me now and I always have this nasty taste in my mouth. The jaw on the side of my face with the infection still aches on and off too. Did the emergency dentist mess up when he pulled it? I was on antibiotics to treat the infection. So, I’m wondering if it’s possible he didn’t get all of the tooth out when it was extracted?

-Sondra in South Carolina

Sondra,

Oh no! Well, it’s too late to tell you this at this point. But if you ever encounter a failed root canal treatment, go back to the endodontist. It isn’t common, but sometimes a root canal must be done twice. Having the tooth re-treated may have saved the tooth.

Anyway, the symptoms you are describing does sound like there is still something that isn’t right in the area. It doesn’t mean the dentist messed up and it also doesn’t mean that there was any portion of the tooth left behind. On the off chance that there was, it wouldn’t be the culprit. It is time to go back into the dentist as more of a precautionary measure. The issues that are bothering now, shouldn’t be associated with the emergency tooth extraction. But if you don’t feel normal, it’s worth getting checked out. You don’t have to treat it like a dental emergency if you aren’t in pain. So go ahead and schedule a normal dentist appointment to get checked out. Although, you may end up needing another course of antibiotics if the infection is still present.

That said, if you are in pain or notice swelling, get in right away for an emergency dentist appointment.

Good luck! Hopefully, this will all be behind you soon enough.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Will the emergency dentist’s treatment last?

I broke my tooth a week ago. A portion of one of my front teeth was broken off. I went to the emergency dentist because it happened over the weekend and my regular dentist wasn’t available. The x-rays showed that underneath the gums everything looked okay. So, he fixed it up with dental bonding and told me to follow up with my regular dentist. Well, the emergency visit was a bit expensive. So I don’t want to have to go back into my regular dentist, if I don’t have to. It looks fine to me? Do I really need to schedule another appointment?

-Jeff in Minnesota

Jeff,

The emergency dentist likely used a composite material used to patch up the broken piece of your tooth. This is the same bonding material that is used for fillings. Used in this manner, the dental bonding work should last for a couple years. In some cases, it may last longer.

That said, the emergency dentist encouraged you to follow-up with your regular dentist for other reasons too. Although the bonding looks good to you, when a tooth is traumatized there can be delayed symptoms or issues. For example, the x-ray may not reveal if the blood flow has been altered. If it has, the tooth may end up dying and may end up requiring a root canal treatment. It would be in your best interest to schedule the follow-up appointment to avoid more issues in the future. Symptoms that the tooth is dying or has become infected will be discoloration, tooth pain, or an abscess. It is typical protocol to refer you back to your normal dentist.

There is also a possibility that the tooth may require a crown and the work he did may be more of a temporary fix.

Thank you for your question. Hopefully, the follow up appointment will reveal that all is well.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I have two implant crowns, will a Maryland bridge still work?

I am trying to find out if it’s possible to have a Maryland bridge placed between two crowns. The crowns are actually part of dental implants. The place where the bridge would be is a molar and I currently have a tooth there. But it needs to be extracted and replaced.

Does that make sense?

-Jim in Iowa

Jim,

Yes, it is possible to place the Maryland bridge in a location between two dental implant crowns. The bigger issue at play is, how long will it last?

Maryland bridges have a short track record among many dentists. Although they seem easy to place, the force that will be endured with normal chewing and daily activities, presents some complications. Typically, to place a Maryland bridge, the adjacent teeth are ground down a bit and the framework is installed, then the bridge is bonded. But there needs to be small indentations or grooves implemented for success. Not every dentist will get this right. And the Maryland bridge may be at risk for popping out unexpectedly even if it is properly done.

Since you already have crowns on the adjacent teeth, that means that the bridge would not be bonded to natural tooth enamel. When bonding is done to porcelain, it simply isn’t as strong, even if it is well placed. Not too many dentists know how to bond directly to porcelain.

For an extremely skilled implant dentist, the possibility exists to bond the Maryland bridge to the metal framework. This alternative would be better than bonding to porcelain. But it’s a high risk treatment plan. So, although it is possible, it is definitely not ideal.

Hindsight is twenty-twenty. If the dentist would have originally anticipated the fact that the middle tooth would need to be replaced down the road, the implants could have been surgically implanted in such a way that the crowns could have been unscrewed and replaced with a bridge. But that’s neither here nor there.

At this point, the best permanent solution will be to have a third dental implant placed. As long as there is enough bone present at the implant site, this solution would give the the best outcome. The result would look, feel, and function, just like your natural teeth.

This post is sponsored by Cleveland dentist Hylan Dental Care.

 

What are my options if I’m allergic to dentures?

I have had bad teeth all my life. The last one was removed several months ago. When I heard about how great dental implants are to replace my missing teeth, I was ready to sign on the line. That is, until I found out how terribly expensive they are. So, I moved forward with the lesser expensive treatment option, complete dentures. That experience was a nightmare because I ended up being allergic to the dentures. My mouth hurt and burned like you wouldn’t believe. When I talked to my dentist he kept telling me that I was probably still getting used to them and that my mouth was likely still healing. After several months of only being able to keep them in for less than 10 minutes at a time, I realize they will not work for me. What am I going to do? I cannot afford dental implants. Are they my only option?

– Pamela in Kentucky

Pamela,

Your dentist doesn’t sound like he is taking you seriously. Yes, an allergy to dentures is very rare. But, if you cannot tolerate to have them in your mouth for longer than a few minutes at a time, there is a major problem. Acrylic is the main material used in dentures. This material  rarely causes an adverse reaction. But there are a few cases of this occurring in medical journals. Often times, it turns out that it is the nickel, metal, or maybe even the adhesive that you are reacting to.

That said, have you tried eliminating the dental adhesive? The dentures should fit pretty well at this point, so try going without it. If indeed, it turns out to be the adhesive, you can try another brand with a different formulation of ingredients.

Do you have a metal allergy? If so, investigate if there is any metal used in your denture. If so, you may be able to have a new set of dentures manufactured for you that doesn’t contain the trigger material. If you are unable to pinpoint the metal allergy, it may be in your best interest to meet with an allergist so you can avoid those materials. Then, a new denture can be made.

As you mentioned, dental implants are becoming the standard of care for missing teeth. But, they will not likely be covered by dental insurance. Don’t rule that option out completely. If your dental insurance covers the cost of even just the restorative phase, that could help make them more affordable.

The bottom line is, do not feel like you have to suffer. If your dentist isn’t proactive in helping you through this, it may be time to seek out a second opinion. Best of luck and thanks for sharing your story.

This post is sponsored by Cleveland dentist Hylan Dental Care.

 

Is sedation dentistry what you get in the hospital?

I suffer from dental fear. I’m not really sure that’s a “condition” but it may as well be, because I avoid the dentist at all costs. Is sedation dentistry the same as getting an IV at the hospital for surgery. I have had that done and am out completely. But when I saw this ad for sedation dentistry they were calling it conscious sedation. Either you are knocked out or you’re not – right? Is it the same? I don’t want to remember anything about the appointment!

-Jake in Maryland

Jake,

Different sedation dentists offer different techniques. In the hospital when an IV is administered prior to a surgery, you are correct in that you are completely knocked out. For example, it is required that a machine breathes on your behalf. Sedation dentistry in the dentist’s office is different.

Nitrous oxide is a form of sedation dentistry that is used for mild anxiety. It simply involves breathing in a relaxant gas to help take the edge off. This doesn’t sound like the best fit for you because you mention not wanting to remember anything about the visit.

Oral sedation which is also called conscious sedation may be a better fit for you. Now, technically you are not “out” because your protective reflexes like coughing and breathing function normally. But it will feel like you went to sleep. It will also feel like no time has passed and you will not be aware what is going on. This is an excellent option among patients that have severe dental anxiety. Your vitals will be monitored throughout the procedure as a safety precaution. Also, you will need to have someone drive you home from the appointment.

Every dentist has different requirements for administering sedation dentistry. You may be required to have an initial consultation which involves review of your dental and health history to make sure you are a candidate. If it’s been some time since you were in, you may be relieved that most dentists can get a lot more work done in one sitting with sedation.

Thank you for your question. Sedation dentistry can commonly be confused with general anesthesia that is provided in the hospital setting.

This post is sponsored by Cleveland dentist Hylan Dental Care.