Emergency Dentist Said My Dentist Perforated My Sinus

I can’t believe what is happening to me and don’t know if I can trust my dentist. I went in for an extraction. A few days later I started feeling poorly and feeling “pops” in my nose. I called the dentist worried it had something to do with the extraction. They told me to get a decongestant. No mention of anything else. Then I developed a fever. My dentist’s office was closed, but I was in pain and called an emergency dentist. He had me come in and examined me. He feels my dentist perforated my sinus. He prescribed me an antibiotic and said I should be feeling better within a few days. He wants me to follow up with my regular dentist to get this treated properly. I’m not sure I trust my dentist anymore. Is there anyone else I could follow up with this? Could I just go back to the emergency dentist?

Liv T. – Mississippi


I understand your concern with your dentist. It sounds like he did several things wrong. Though it sometimes happens that a sinus is perforated, the patient should be notified right away as well as given instructions on how to aid its healing, including things like being extra careful not to blow your nose.

When you called, they should have had you come in to check for signs of infection. Thankfully, you went to see this emergency dentist. He sounds very thorough and competent and likely saved you from a serious infection.

You can follow up with the emergency dentist. Many sinus perforations heal well on their own. Occasionally, one will need help with surgery. If that’s they case, the dentist will refer you to an ENT surgeon.

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Want an Inexpensive Smile Makeover

I want an inexpensive smile makeover. I know that is kind of like saying I want an affordable mansion, but I have a friend who goes to your office and she says you’re a miracle worker with finding affordable ways to do things. So, miracle worker…hit me up. What’s an affordable way to get a smile makeover? I need to stay under $1000.

Stacey M. – Georgia


Wow! You really are asking for a miracle. Hmm… for under a $1000, the only thing I can think of would be teeth whitening. While you may think that isn’t much, it actually is the fastest way to make a huge difference in your appearance, plus it’s extremely affordable.

Teeth whitening takes years off your appearance. You don’t need a special, expensive cosmetic dentist to do it either. Any general dentist, even your family dentist, can do the teeth whitening procedure.

If you want it done fast, look for a dentist who has in-office whitening. If you want more control over the level of whitening, do the take-home trays. Plus, you have the added benefit of those being less expensive, yet equally effective. They’ll just take a week or two longer.

Also, tell your friend “thank you” for the compliment.

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Got Ripped off By the ER and I’m Still in Pain

I had a massive toothache. I don’t have a dentist because I just moved to the area. I went to an ER, thinking they could at least get me some help. Instead, they gave me some over-the-counter pain relievers, charged me $400.00 and sent me on my way. I’m still in massive pain and have no idea what to do.

Greg – Tennessee


I’m sorry for your experience. Most people don’t know that emergency rooms won’t treat dental conditions. That doesn’t mean you’re stuck. If I were in your place, I’d call an emergency dentist. These are general dentists who don’t mind treating non-established patients in emergency situations.

Depending on the cause of your pain, they may be able to take care of the situation right then. If it’s more involved then they have time to deal with at the moment, like a root canal treatment, they will take measures to get you out of pain, then schedule a follow-up visit with you to care for the “root” of the issue.

Who knows? You may even like the dentist so much you end up finding who’ll be your next family dentist.

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Are Dental Implants the Only way to Get Pretty Teeth?

I went to a consultation for replacing my teeth. I asked for prices first. It was obvious from that my only option was dentures. I wasn’t thrilled, but I learned long ago not to get too upset about things which can’t be changed. However, it was quite an additional blow when he told me there is no way to get dentures to look natural. He told me that if I wanted natural looking teeth it had to be dental implants. I truly can’t afford implants. Is there anything kind of in between the two? Maybe it won’t look as good as dental implants, but won’t look as bad as dentures?

Ashley S. – Ohio


I don’t say this often, but I want you to get as far away from this dentist as possible. I don’t want to discourage you or make you feel like you can’t trust your healthcare providers in general. However, this dentist isn’t honest. He’s lying to pressure you into the more expensive treatment. I HATE that. There are plenty of legitimate reasons why implants are superior to dentures. He doesn’t need to make something up. Plus, it’s unfair to guilt someone into something they can’t afford.

If the dentist is skilled, dentures can look not just natural, but gorgeous. If your dentist says otherwise it’s more a commentary on his ability.

The stronger reasons to get implants is to protect your jawbone. If you can’t afford implants, that’s understandable. See if snap-on dentures are within your budget. It will give you some of the benefits of the ideal procedure without the huge price tag. If not, dentures are perfectly acceptable teeth replacement option.

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Can I Get Braces with Dental Implants?

I’m a bit frustrated with my dentist. We were talking about why I needed to have my pre-molars removed. He said my tooth spacing likely had a lot to do with it. I have crowding in the back and spaces in the front. Then he mentioned braces would have helped. He tells me this now…after I’ve had the teeth removed and replaced with dental implants. Is it too late? Can I remove the implants and fix my teeth?

Cynthia – Denver, CO


While you could have the dental implants removed, I wouldn’t recommend it unless absolutely necessary. The implants, if done properly, will have integrated with the surrounding bone. This is important because it keeps the implants in place. If you remove them, you’ll have to start over. But, you won’t be able to just do the procedure over again. You’ll need to have bone grafting done to build up the bone structure. Then you can start over.

There’s a chance braces are possible even with the implants in place. Given the lack of foresight and communication from your dentist, I’d work with someone else for this. Talk to several orthodontists in the area. See if they think it’s possible with the implants.

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Will Sedation Dentist Let Me Stay Until Meds Wear Off?

I’m planning to schedule an appointment with a sedation dentist to have some work done. I know I need at least three crowns and probably have four or five fillings as well. From what I understand of it, the dentist can do all the work at once this way, but the medications will make me very groggy and unable to drive right after. How long will the medicine stay in my system? Will the sedation dentist allow me to stay in the office and sleep until they wear off? Normally my wife can help with stuff like this but she’s away helping our daughter who just had her first baby.

Don – Little Rock, AR

Dear Don,

Congratulations on becoming a grandpa! There’s no telling what your sedation dentist will prescribe unless you talk directly to him. There is a number of possible medications he might use and each one has a different lifespan and affects the body differently. Most people feel groggy for the rest of the day after being medicated, so driving is not allowed on the same day as treatment.

When you choose a sedation dentist, your first appointment will be a consultation to go over the diagnosis and treatment options. No treatment will be performed that day. As part of the consultation, they’ll go over what medications they use and how they’ll affect you. As a general rule, sedation dentists require you to have an adult bring you to the office, take you home, and stay with you for the rest of the day on the day of treatment. There’s a good chance you’ll probably sleep some in the office anyway, but you won’t be able to sleep off the medications and drive later. In fact, most offices suggest that you plan to spend the rest of the day at home; preferably in bed or on the sofa, so you don’t have a fall.

As far as having all the work done at once goes, you may or may not be able to. One of the main benefits is that doctors can accomplish more because you’re relaxed, but if the work is extensive or is in different areas of the mouth, you may still need to come back for multiple appointments.

However, depending on the doctor and the treatments that are necessary, you may also feel comfortable going without medication for some of the quicker visits, such as fillings. If not, then each visit would require you to have a driver and helper for the rest of the day. Your office will go over all your necessary treatment with you and will work with you to develop a plan that’s manageable, so be sure to express any concerns you have about timing and the number of visits during your consultation.

This blog is brought to you by Dr. Brad Hylan.

Terrified to Go to the Dentist

I’m sure I have a cavity. The tooth is aching and I see a spot on it. I know I need to do something about it, but I’m terrified of the dentist. Why can’t dentists be gentle?

Kate – New Jersey


It’s normal for people to be uncomfortable with the dentist. Our mouths are both sensitive and personal. Having someone messing around there feels invasive and can make you feel a little helpless. Let me assure you, though, there are gentle dentists.

However, based on what you’ve said above you’ll need a gentle dentist who also uses sedation. This procedure will be extra intimidating to a patient who hasn’t been to the dentist in a while. Plus, the area is already tender and the dentist will need to poke at it a bit.

Using sedation, will give you a pain free experience while getting your dental needs dealt with. Depending on the level of sedation you choose, you’ll need to have someone drive you to and from your appointment.

Don’t put this off. A cavity can quickly turn into an abscess and spread.

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Why I Backed Out of Clear Choice?

One woman’s experience with Clear Choice:

I was considering doing a dental implant procedure. I really wanted the best tooth replacement. However, my dentist indicated this procedure could take months. I saw an advertisement for Clear Choice. It talked about how much faster their procedure was. In fact, they said I could get it all over with in one day. That sounded appealing.

When I called, however, the sales tactic was pretty hard. While they gave me a price compatible with my dentists, they insisted I place a $1000 deposit down to hold that guaranteed price. Then I find out they expect me to remove healthy teeth in order to do their procedure. That worried me. I did some more research and discovered their procedure isn’t the “normal” dental implant procedure. Instead, Clear Choice does some kind of short-cut, which does save time, but will likely cost me in the long run–including some healthy teeth. No thanks.

Glad I did some more research.

Helen – Virginia

I Ticked Off the Best Implant Dentist. Is There a Way to Right Things?

I’m afraid I made a horrible mistake and ticked off the best implant dentist in my whole city. I’ve been trying to take a practical approach to my treatment and visited several offices for consultations. Overall, I need to replace four missing teeth, have at least two crowns done, and perhaps a root canal. I also needed four fillings, but those are done now. Due to the extensiveness of my situation, I really wanted to hear what all the options were and make sure I was getting the right thing for me.

It came down to two different doctors. Both have good reputations, but their recommendations were different. The first one wanted me to get four independent implants and the second one wanted to do three, with two of them supporting a bridge. There were other differences in their plans, but that was the biggest difference, and it made a difference in costs, too. I’m trying to be practical about this, and both options seemed good, so I decided to go with the less expensive doctor. Well, I scheduled with him to start on the fillings and it was a horrible experience. He was really rough on me and I’ve now been back three times for adjustments. Each time I go back, he tells me it’s all in my head, but he makes some changes anyway. The last time, he told me he was done making adjustments- that if I wasn’t happy, there was nothing more he could do.

I don’t feel comfortable with him anymore and I don’t trust him to treat me well or do a good job on the more important work. However, I’m really afraid that I’ve upset who I think is the best implant dentist now. He knows I went to the other guy and he’s going to see that I’ve had those fillings done, which, by the way, are still not right. What’s the best way to approach the first doctor and ask him to take me back?

Yasmine E. – San Antonio, TX

Dear Yasmine,

It sounds like you’ve been through the wringer with the second doctor and it’s good that you’ve chosen to work with a different practice. It’s especially good that you discovered this before your dental implant procedure. You really want the best implant dentist possible. If that procedure is botched it could cause serious problems.

The good news is, it’s highly doubtful the first doctor has any ill feelings toward you. This kind of thing happens all the time. It’s very difficult for patients to know what they’re getting into until they’ve worked with a doctor. He knows this. In fact, he’ll probably be flattered (or very proud, at the least), that you’ve chosen to come back to him after seeing someone else.

Let him know why you chose the other doctor over him. There’s no reason why this doctor couldn’t do the treatment with the bridge as well, though he could have mentioned it in passing and then only done up the estimate to show the top choice. Don’t feel anxious about calling the office and going back. They’ll probably welcome you with open arms.

This blog is brought to you by Dr. Brad Hylan.

Affordable Dental Implant Doctor Insists I Get Veneers Too

I lost my two front teeth in an accident when I was a teenager and, for the past ten years, I’ve been wearing a flipper. Lately, I’ve been shopping around for some affordable dental implants, and I came across someone who comes highly-regarded for his cosmetic work, even though his rates are supposedly cheaper. During the consult, he told me that we could go ahead and do the implants to replace my missing teeth, but he wants me to get two veneers placed on each side of them, so I’d have work done on a total of six teeth. He says this is important if I want everything to match well. Now, I know my flipper isn’t perfect, but it matches ok and my prior dentist never said anything about needing veneers later. He just suggested I get the implants done when I was an adult. To be blunt, there was a reason I was shopping for affordable dental implants. I’m not made of money and the veneers aren’t cheap. If I need them, I guess I need them, but it seems odd to me that my prior dentist never mentioned this. Is this standard in cases like mine?


Xavier W. – Kansas

Dear Xavier,

I’m glad you wrote before following through on this treatment. No, this isn’t a normal course of treatment. Unless there’s something cosmetically wrong with the other teeth that you want to correct, there’s no need to have anything done to them.

Even if there was something wrong with your other teeth, I’d suggest you go to a different dentist to have your porcelain veneers done. This dentist may give you affordable dental implants, but he can not give you a gorgeous smile. If he can’t make the implants look nice next to your natural teeth, he is not a very good cosmetic dentist.

It takes a high degree of skill, as well as knowledge of materials and shading, to make everything come together right. The fact that he insists this is the only way he can make it work for you suggests that he’s either not skilled with cosmetic work or that he’s trying to increase your bill. Neither scenario gives me any confidence in him.

You can find affordable implants without doctors inflating their prices AND get quality work, but focus on quality first. If need be, you may be able to break the costs up or finance them. Implants are generally done and paid for in stages anyway, which makes budgeting for them easier. Get a second (and maybe a third) opinion before you begin any work and skip the veneers unless it’s something you want for cosmetic reasons.

This blog is brought to you by Dr. Brad Hylan.