Category Archives: Dental Emergencies

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

Greg,

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.

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

Why Has My Tooth Turned Gray After an Emergency Dental Appointment?

I’m a little freaked out here. I had a really bad toothache and I went to the emergency dentist to have it checked out. He said he didn’t see anything wrong with the tooth, but based on my symptoms, he could tell my tooth had a small crack in it. I started the crown that day and then I went back after two weeks and had the new crown placed. None of this really helped to clear it entirely up, but it seemed to feel better. He told me that I could need a root canal on the tooth if the pain didn’t go away. I don’t want to have to have a root canal, so I’ve been nursing it along and taking Tylenol. It’s been about two months with no improvement, but today I noticed that the tooth next to it seems to be turning darker, almost gray. I don’t know if I’m imagining this… maybe the crown is just whiter than my other tooth was? Could the emergency dentist have done something to the other tooth? Anything you can tell me would be helpful.

Sincerely,

Helen

Dear Helen,

For starters,  it sounds like your gray tooth is “dying” or dead. When a tooth dies or is injured, it can become discolored as you’re describing. It’s a lot like a bruise on the skin, but behind your enamel. This needs treatment, which will include a root canal. Until the tooth gets cleaned out and filled from the inside, it can harbor bacteria, which will eventually blow up into an infection. So, this should be addressed sooner rather than later.

As far as the emergency dentist causing it somehow, probably not. There are a few likely culprits here. First, it could have been that tooth hurting you the whole time. Sometimes teeth can refer the pain to neighbor teeth, or even an entire arch. If this is the case, you’re looking at a mistaken diagnosis. The other possibility is that both teeth were somehow injured at the same time. Let’s say you bit down on  something hard, traumatizing the gray tooth and cracking its neighbor. The tooth may not have died right away, but slowly faded over time instead. Lastly, you could be looking at two totally unrelated incidents, which happen to be affecting two neighbor teeth. Unlikely, but possible.

You may never find out if this was a misdiagnosis by the emergency dentist, but if you suspect this to be the case, ask the first doctor for a copy of the x-ray and take it to another dentist and have the gray tooth reevaluated. If he missed a sign that’s visible on the x-ray, you should be able to have him refund the money you paid to have the crown done. If there’s nothing on the x-ray, he probably didn’t miss anything. He operated based on your symptoms, which may or may not have provided the right diagnosis. Best of luck to you.

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

My tooth is loose from an accident. Will an emergency dentist know what to do?

I had a silly accident where  I pulled something on top of me in the garage and it cracked into my face. I iced and took ibuprofen but now it feels like it’s loose. Should I schedule an emergency dentist appointment? Will they know what to do? The tooth feels wiggly now. It’s the weekend (of course) and I don’t know if I should tough it out and wait for my regular dentist or not? If I’m going to lose it anyway, should I just wait?

– Sherry in Nevada

Sherry,

Try not to chew on it and not to mess around wiggling it. The sooner you are into a dentist the better. So, it would be best to try and schedule an emergency dentist appointment, as soon as possible. It is possible that you have injured the ligaments that hold the tooth in place. Think of it like a rubber band being stretched out. If it is stretched or strained too much, it will break.

Try to avoid any unnecessary movements because you run the risk of the tooth eventually falling out if it becomes too lose. The emergency dentist can evaluate the severity of the traumatized tooth and take action right away. He or she will make an effort to stabilize the tooth to stop any movement. It will protect the tooth and the best case scenario is for the tooth to heal without any intervention.

If there is damage to the inside of the tooth where the pulp is located, there is a chance that it may require a root canal treatment to save the tooth and a dental crown.

Until you can get in for your appointment, you should avoid chewing on it and stick to very soft foods so you aren’t tempted to chew with it. Also, feel free to keep up with the ibuprofen to help with any inflammation.

It is hard to give you any further specifics without seeing your case in person. Have you tried contacting your regular dentist? Many times they will have an after-hours or dental emergency system in place for patients of record. So, start there and if you that isn’t an option, try searching for an “emergency dentist” in your town.

Good luck! Hopefully this post encourages you to take action right away.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Does this crown problem sound like a dental emergency?

I have had porcelain crowns on the teeth that show when I smile for years. They are right up front and I have been quite happy with how they look. But, my tongue cannot seem to leave one of them alone. The best way to describe it is that there has always been a divot and I constantly am messing with it. I don’t think there has ever been anything wrong. Then, the last several weeks, I’ve noticed what looks like a dark section on it and it feels a lot more rough. I have always been one that keeps up with regular cleanings, but I am becoming concerned that this is a more serious problem. Do you think I need to schedule an emergency dentist appointment to get it checked out or re-done?

-Beck in Virginia

Beck,

Typically, an emergency dentist appointment is warranted if you are in pain or have some sort of urgent dental need. It doesn’t sound like it is causing you discomfort. Yet, it does sound like it is becoming annoying. So, it would be wise to give your dentist a call to explain what is happening with the porcelain crown. It’s not uncommon for a crown to have an imperfection. But what is alarming is the fact that it has changed over time. It is possible the divot is now picking up stains, which is causing the discoloration that you have described. Or it could be that the integrity of the crown is weakening from this flaw.

It may not require immediate replacement, but your dentist may decide to have that one porcelain crown that is bothering you replaced. It all depends on the condition and age of the restoration. Since it is in such a highly visible area, you may want to consider seeing a cosmetic dentist. If the dentist suggests redoing all the crowns so they match, that is a signal that they may not have the necessary cosmetic dentistry experience to make them look beautiful. So, take note of that cue. The only reason the other crowns should be replaced is if they are showing ware.

Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is a cracked crown an emergency?

My front teeth have had porcelain crowns on each of them for over a decade. I have noticed a very thin crack. It’s not very noticeable and it doesn’t seem to be an issue. But I am nervous that it will break when I least expecting it. Is it a dental emergency or potential dental emergency? The crown runs horizontally.

-Jay in Colorado

Jay,

Since you are aware of the crack, it would be wise to have the porcelain crown replaced. It wouldn’t necessarily be considered a dental emergency, but it could turn into one if you leave it alone.

Since the crack is visible, it does mean the integrity and structure of the crown is compromised. Porcelain restorations sometimes have tiny lines through them which dentist refer to as craze lines which are not visible with the naked eye. But if you can see it, then the crown is at risk.

If you can also feel the crack, this adds concern to the situation. This would indicate that there is some movement that has occurred.

A cosmetic dentist that has an eye for aesthetics may be able to replace the cracked dental crown. And you should be prepared that even an expert cosmetic dentist may recommend having both of the front teeth crowns replaced. This is so that there is no differentiation in the uniformity and coloration with such a highly visible area.

Be careful if a dentist tells you that it is not possible to replace a single crown. That may indicate that they are not confident in their cosmetic dentistry abilities.

This post is sponsored by Cleveland dentist Hylan Dental Care.

The treatment done at the emergency dentist doesn’t look good.

My tooth was killing me and I was out of town for an extended time. So I made an emergency dentist appointment to get it taken care of. I thought the emergency dentist did okay. I don’t mean to complain but I honestly don’t think the crown blends in. Can it be fixed? Is it rude to go back to him to see if it can be done better?

-Paul in Minnesota

Paul,

Most emergency dentists exceed in making patients comfortable and getting them out of pain. It sounds like that was accomplished, yet their skill-set may not involve cosmetic dentistry.

Sorry to tell you that once a porcelain crown has been placed, the color cannot be altered. The only way to correct the color would be to have the crown redone. It is quite possible that the emergency dentist that you saw was a general dentist and didn’t have extensive training in cosmetic dentistry. Sometimes patients don’t realize this but cosmetic dentistry is like an art. General dentistry is much more focused on fixing a functional problem. Although your crown is likely quite functional, it sounds like it is lacking in aesthetics. It is also worth mentioning that emergency dentistry and cosmetic dentistry are not recognized specialty areas with the industry. So, this means any dentist can claim to offer services and may not excel in them.

If it doesn’t show when you smile and you can live with it, you can have it replaced down the road. If it’s bugging you and you don’t want to deal with the discoloration for the next 10-20 years, it sounds like it’s time to see a cosmetic dentist.

Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

 

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.

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.

Can I Self-Medicate with Marijuana Before Visiting the Emergency Dentist?

I have a prescription for medical marijuana which I use for anxiety. I broke a tooth and will be booking with an emergency dentist in a couple of days and will be utilizing my prescription in the meantime. I am curious to know if this will matter to the emergency dentist. Can he refuse to treat me? If so, is there harm in not telling him? I know many people are progressive these days, but there is still stigma with some.

Thanks,

Tom in Washington

Dear Tom,

The situation will likely be handled differently from one emergency dentist to another. From a medical standpoint, there can be complications if you have marijuana in your system during your appointment. Because marijuana varies in strength and there’s no way to know how much you’re taking in, nor how much will be in your system at the time of the appointment, it can be a recipe for disaster. Some studies have shown that marijuana use before receiving epinephrine can make your heart beat abnormally fast or cause peripheral vasodilation. If you already have anxiety, it can create a dangerous, if not deadly situation. Most of the time, the dentist will use a local anesthetic with epinephrine, though if he is aware that it is contraindicated, he will use something else.

Moreover, if your tooth needs an extraction and the dentist wants to give you pain medication for afterwards, your existing prescriptions and over-the-counter medications will be taken into account. Because everything works together differently, he will need to take great care to insure anything he gives you is safe.

Yes, there is still some stigma in certain circles, but that is something you’ll have to tackle head-on for the sake of your health and safety. You can always call more than one emergency dentist and let them know what medications you are taking in advance, just to see how they react. Bear in mind, dentists treat patients from all walks of life, and most doctors have had a patient or two who used marijuana before it legalized in any fashion. Typically, it is treated as any other medication, though you’re still likely to hear about some of the dental side-effects of marijuana use, such as dry mouth and an increased risk for cavities. Take heart when you hear these messages, because you may learn how to prevent some dental woes, even if you continue to make use of your prescription.

This post is sponsored by Cleveland dentist Hylan Dental Care.

What do I do about this dental emergency while I’m pregnant?

I am pretty far along in my pregnancy, almost 34 weeks. I woke up with an absolutely horrendous toothache. I was trying to wait it out until after my baby is born, but I cannot take it anymore. So I went into an emergency dentist. He wants to do a root canal. But I am nervous it is not safe while I’m pregnant. He said it was safe, but I need to be sure even though I’m in pain! I could never live with myself if something happened to my baby because I made the wrong decision.

-Loretta in Texas

Loretta,

It is a good idea to put off any kind of cosmetic or elective dental treatment during pregnancy. But a dental emergency should not be put off! A root canal needs to be done as soon as possible because it is possible that the infection could spread. If that happens it could cause serious risk to you and your unborn child.

Generally speaking, the later you are in your pregnancy, it is better for invasive dental treatment. This is because the vital organs, etc. have already been developed. But since you are in your third trimester, you may have some issue with laying down on your back for extended periods of time. Discuss it further with your dentist to determine the urgency of your individual situation. It is possible some sort of temporary treatment may help if you cannot tolerate the root canal or you simply aren’t comfortable.

The biggest concern of having a root canal performed during pregnancy is that often times an antibiotic is prescribed to help eliminate the infection. That said, there are safe antibiotics like penicillin, amoxicillin, and clindamycin. Have your dentist and OB collaborate with one another to figure out the best medications, if they are required. Also, x-rays are not encouraged during pregnancy. In some cases an x-ray is advised when getting a root canal treatment. This will give the dentist a more complete picture of what is going on. You may find comfort in the fact that the American College of Radiology has endorsed that there is not enough radiation in a single x-ray to cause a fetus any harm.

The bottom line is that it is your call. If you are still unsure, it would be wise to discuss your options with your doctor before moving forward. But you need to get that pain under control or that alone may caused increased stress and cause issues. Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.