Category Archives: General Dentistry

I Want to Extract My Tooth. My Dentist Wants to “Save” It

I’m so tired of messing with one of my stupid teeth. First, I was a toothache. My dentist thought it was fine. Then, a few months later, I developed a cavity. We filled the cavity. A few months later, it got a completely different cavity. My dentist wants to do a crown. I’m so tired of this tooth. I want to just take it out, but my dentist thinks it’s better to “save” it. Why is that so important? It’s not like the tooth people see is going to be real anymore.

Phil – Washington

Phil,

I’m going to side with your dentist. Let’s say you extract the tooth. Then what? Are you just going to leave a gap there? Even if the tooth isn’t a front tooth, which would affect your appearance, that gap will cause your other teeth to shift. This will cause bite problems and may even lead to TMJ.

But what if you replace it instead of leaving a gap? Okay, the best replacement is a dental implant. It will require surgery and months of healing. Then a crown. Not to mention the thousands of dollars it costs. If you decide to get a removable partial denture instead, that’s easier–initially. But, it’s removable. You have a tooth that moves, comes out, gets food under it, and is uncomfortable. Fun, huh?

Neither of those options sound better than getting one crown. If you talk to patients who’ve had their teeth extracted, they’d tell you they wish they could have saved the tooth.

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

Is My Dentist Cheating Me?

I went in for a check-up. The dentist said I had a cavity and needed a filling. I haven’t had any pain, but went ahead and scheduled the appointment anyway. Then, in the middle of the procedure he announces, there’s more decay than he originally thought and he wants me to get a dental crown. That’s a lot more money. Is he just ripping me off? I made him wait until I got a second opinion.

Danusha L. – Detroit

Danusha,

Though it’s rarely a bad idea to get a second opinion, I don’t think your dentist is trying to cheat you. You don’t always feel a cavity. If it spreads and becomes an infection, that’s when the real pain starts. It’s also quite possible he couldn’t see the extent of the decay until he got in there.

If that’s the case, he’s right about recommending a dental crown. Once a cavity reaches a certain size, you risk the tooth breaking. That causes even more expensive problems.

It’s best to nip this in the bud before it does become an infection. You don’t want a root canal treatment on top of everything else.

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

Jaw is killing me after my dentist was not gentle.

I recently had fillings done and the doctor who did it was not a gentle dentist at all. I don’t normally have jaw pain, but today, 24 hours after treatment my whole jaw is in agony. It hurts to even open my mouth to talk. The shot he gave me hurt and I can still feel something like a bruise back there where he did it. I also have pain in my jaw joint. He was pretty rough during the filling. He made me keep my mouth open forever and he kept pressing on my lower jaw throughout. By the end of it, it was hurting, but then he started to “finish” the filling and he literally shook my whole head with the force. He said it was because my cavity was between my teeth, too, and that he had to get in there to smooth it out. He just kept going back in and telling me to hold still, but I couldn’t. He was pulling on me that hard. I’d call them to find out what to do, but I don’t want to get called back in. I don’t want to see him again. How can I treat the pain at home?

Thanks,

Glenn in Nevada

Dear Glenn,

It sounds like he wasn’t a gentle dentist at all. You’re dealing with two different “injury” types. In all fairness, some people have pain from an injection for a couple of days, no matter how careful the doctor is, but there are ways to administer one to minimize it. For instance, entering the tissue slow certainly helps, as does administering the medication very gradually. Afterward, this kind of discomfort is usually quieted by cold. You can drink some cold water with a straw and let it rest in the area or have a Popsicle. Within a day or so, it should feel better.

The jaw joint pain is different. This usually comes about when the muscles and tissues are inflamed. The trick is to get the inflammation to go down so it can rest again. Take ibuprofen or another an anti-inflammatory medication and use warm compresses to soothe it. You’ll also want to be very gentle on your jaw until it feels better, so go for soft foods and use a straw to drink. If these remedies don’t settle it down within a week or the pain gets worse, contact another dental office or see your primary care physician. It’s not likely any permanent damage was done, but a prescription medication might be necessary to calm the inflammation. Next time around, you may want to do some research to find a gentle dentist in your area.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I am scared of the dentist!

When I think of the dentist, I see a horror film going through my head. I hate it! The drill, the noise, the stuff hanging out of my mouth. I get myself entirely too worked up, but I cannot help it. I don’t want to set this terrible example for my kids. Is there any hope for me to get the care I need?

-Jess in New Jersey

Jess,

If it makes you feel any better, millions of people hate going to the dentist. Whether it’s fear or possibly a negative experience, there is good news. There are many dentists out there that focus on gentle dentistry techniques and take a cater to cowards approach. They genuinely love seeing fearful patients.

It sounds like you understand the importance of going to the dentist, to avoid those expensive, invasive dental appointments. And it’s great that you want to set a better example for your children. The dentists that love treating fearful patients will work with you and will not make you feel bad, even if it has been years since you were in. They will take it slow and do everything possible to ease your anxiety. Many practices of this nature practice sedation dentistry. Based on what you have talked about, it sounds like you may be an ideal candidate for sedation dentistry.

Nitrous oxide is a form of sedation that uses a relaxant gas that is administered by breathing through a mask. It is easy to adjust and you are still able to communicate with the dentist during treatment. It will make you feel relaxed in the chair and the effects wear off in only a couple minutes. This option is an ideal choice for patients that tend to get a little nervous and have mild anxiety.

If you are scared or extremely fearful, oral sedation may work best. This option simply involves taking a prescribed medication prior to your appointment. Although, you will technically still be conscious and your protective reflexes will function normally, you will remember very little if anything about the visit. Pretty much, it will feel like no time has passed and that you fell asleep. This form of sedation dentistry is perfect for the petrified dental patient. It allows the dentist to get a lot of work done in one sitting. You will be required to have someone accompany you to the appointment, because it will be unsafe for your to drive yourself home.

Hopefully this post gives you some hope. You aren’t alone! Sedation dentistry has helped countless patients get back on track with regular dental care. Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Have Dental Anxiety: Need Help Finding the Best Implant Dentist

I haven’t always taken the best care of my teeth, but I’ve gotten much better over the years. I really hate going to the dental office and get terrible anxiety- not your average anxiety either. I pace in the waiting room, I can’t bear to sit in the chair and wait for the dentist, and I even sweat up a storm. Somehow, I made it through most of my reconstructive work, which included a deep cleaning, a couple of crowns, and some fillings. However, my avoidance of the dental office cost me two teeth- one towards the front and one all the way in back. I want to replace them, but I’m not sure how to go about looking for the best implant dentist for patients with anxiety. It seems to me that most doctors offer one service or the other, but not both together. Is there a trick to finding the best implant dentist for someone in my situation, or do I have to choose between someone who is either great with anxious patients or someone who is truly the best implant dentist?

Thanks,

Martin in Connecticut

Dear Martin,

Let’s start with the basics. There are only nine specialties recognized by the American Dental Association, and none of them relate to dental implants or treating anxious patients. This is actually a good thing, because it means that any general dentist can go through additional training, and become experts in either (or both!) types of treatment.

In terms of finding the best implant dentist, you’ll want to look for someone who has lots of experience, and who has a successful track record. Naturally, those who have the most training and practical experience will have a very high success rate- as high as 98-99%. You can also ask for before and after photos of their real patients, so you can see firsthand what their finished restorations look like. This way, you’re able to evaluate his cosmetic and mechanical skill levels.

It takes a special kind of doctor to treat anxious patients. Generally, if you see that an office provides “sedation dentistry” services, it’s a sign that the doctor is familiar with the psychology behind anxiety, and that he takes extra steps to set his patients at ease. You don’t necessarily have to take advantage of to it, but seeing “caters to cowards,” “gentle dentistry,” or “sleep dentistry” alongside his traditional services, should indicate that the doctor will go the extra mile to set the right atmosphere for you and will be understanding if you need time to settle in.

Before you book an appointment, have a look around the websites of prospective offices and look for the signs that he’s the best implant dentist around (experience, skills, photos) and also that he provides additional services for those who suffer from dental anxiety. Don’t hesitate to call and ask questions if you’re not sure, and take advantage of consultations to make sure that you mesh well with the doctor you choose.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Can an aggressive cleaning chip my teeth?

I had a dental cleaning today after two years of not going. I brush my teeth twice a day and had no issues, so I thought it was no problem. I had the cleaning done by the hygienist and boy was she rough! Or maybe I was used to the gentle dentistry of the previous office I went to.  Not to mention, there was so much blood and my gums were super sore after she was done.  I noticed a small space now between my two front teeth that wasn’t there before my cleaning. It’s the tiniest gap, but I’m thinking the hygienist was too rough with the scaler and chipped something. Can that happen when a cleaning is so aggressive?

– Sarah in Montana

I’m sorry you felt your experience was rough.  It is very likely that your previous “gentle dentist” missed a buildup of plaque or tarter in between your two front teeth, seemingly making it looked closed, or no gap. Unfortunately, your current hygienist probably had her work cut out for her where she had to really get in there and remove what was left behind from your previous appointment. In addition, you accumulated two year worth of buildup on top of that. The removal of the calculus would make a gap visible. Be assured that your hygienist could not remove enamel by scaling, and that is likely what it was. Next time, do let the hygienist know you are in so much discomfort, and perhaps they can apply a topical anesthetic to help ease the discomfort.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Sick of bleeding gums, I need a gentle dentist!

I have always struggled with gums that bleed at the dentist. Ever since I was a kid I hated going into the dentist because my gums would be bloody and I was embarrassed. Over 10 years ago I had my wisdom teeth removed because they were impacted. Now the gums near that lower wisdom tooth area are extremely sensitive. Even if I brush super light in the back, I get blood. The last time I was in for an exam, the dentist took a look and told me there is no pocket or anything unusual with the gum tissue. I think I need a gentle dentist that truly understands how I feel when I sit in the chair.

Also, I sometimes see a little bi t of sticky saliva present when I run my fingers over my gums. Does that sound normal? I have been told I have an abnormal bite and I am supposed to wear a night guard, but I’m not sure that has anything to do with my sensitive gums.

– Rhonda in North Carolina

Rhonda,

There are gentle dentists that go out of their way to help you with patients that are uncomfortable in the chair. Communication is essential in how your appointment goes. If you have any dental anxiety or have a history of bleeding gums, bring this up right away. You have nothing to be embarrassed about.

As for the answer to what is causing your bleeding gums, it probably has nothing to do with wisdom teeth that were removed over 10 years ago or an abnormal bite. It is probably more connected to your daily hygiene. Maybe you are not brushing that area consistently? Or maybe you avoid that area because you are afraid you will get bloody gums? Keep it up to strengthen that sensitive gum tissue.

You may not realize it but when you avoid brushing an area, you are leaving bacteria-filled plaque to adhere to your teeth and gums. The bacteria can cause inflammation in your gums which can make them very sensitive, even to a soft touch. So proceed gently, but don’t put off or avoid brushing.

The wisdom tooth area should be re-shaped by now. In fact, your body and tissues have likely re-developed and consider it like they were never there.

This post is sponsored by Cleveland dentist Hylan Dental Care.

How teeth can be affected by bulimia.

I was a bulimic for over 10 years and my teeth are in terrible shape. Any advice to give to others that are going through it now? I’m helping out with a support group and want to help others through it.

– Sandy in Alabama

Sandy,

As you know bulimia is a potentially life threatening eating disorder, with ramifications to an individual’s physical, emotional, and dental health. Dehydration from the excessive vomiting can negatively impact vital organs like your hear and kidneys. But in regard to your dental health, all of the purging can cause teeth to erode. Sometimes patients with severe erosion will have issues with the way their teeth come together, which could negatively impact the TMJ over time as well. But the most common issues are with the erosion of the tooth enamel, typically on the back of the upper teeth. This is the area that is the most affected from excessive purging and patients that have recovered or are still bulimic also complain about tooth sensitivity.

Another issue is that the swollen salivary glands cause the mouth to be extremely dry which increases and progresses tooth decay. Over time if this disease isn’t cured, patients may sadly end up dealing with tooth loss. And at that point if the teeth are not salvageable, dental implants will be the way to go to replace the missing teeth. But first and foremost a patient needs to get the bulimia under control.

Here are some helpful tips you can pass along to those you are working with in your support group:

  • Do whatever it takes to stay hydrated. A dentist can even prescribe a saliva replacement if an individual suffers from an extremely dry mouth. Gum chewing (sugarless) can also help produce more saliva.
  • Fluoride can also be prescribed by your dentist to help prevent the common tooth decay and erosion from bulimia.
  • Drink as much water as possible after purging. This will help to keep the harmful acid under control. Brushing right after is also helpful in minimizing the damage to the tooth enamel.
  • Brush and floss normally, and keep up your regular preventive maintenance at the dentist. Find a dentist that wants to partner and help you overcome this condition versus one that will make you feel guilty.

Most importantly encourage those you are supporting to seek professional help. You are a testament to one that can break this cycle. Congratulations and thank you for reaching out and being willing to be vulnerable. You will make a difference. The more bulimics know about the long-term damage to their overall health may help more than you know.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Scared about going to the dentist for my gray tooth.

So the last time I went into the dentist (about a year ago) my dentist was watching my gray tooth. I have never even had a cavity so so I must say that it kind of made me nervous that she wanted to watch this tooth. I’m not sure if it will need a filling or if she was thinking a root canal was needed? Anyway, she wants to see me again but I have been putting it off. It is one of my big molars in the back of my mouth. And I guess it is gray. How serious is this? I actually have an appointment but I have cancelled it two times because I’m scared!

– Lola in Colorado

Lola,

The gray color may be a good indicator that the tooth is actually dying. If the dentist didn’t make it clear to you that it was a cavity is is likely that it didn’t show up on the x-ray as a cavity. I know it is hard to believe but sometimes teeth can die for no real reason. Most often there is some kind of issue, like extensive tooth decay or a trauma to the tooth. But in those cases you would be experiencing some kind of toothache, sensitivity, or throbbing. So if you haven’t dealt with any of those symptoms, then the tooth could be dead. This means that the nerve tissue inside the pulp of the tooth has died. Sometimes even hard chewing can negatively impact the tooth and cause this too. But if it is actually dead than then you may be at risk for the tooth to become infected. There could be bacteria inside the tooth and your dentist will not want your tooth to become infected. If it is infected a root canal treatment may be the way to go.

So don’t be scared. At this point, your dentist needs to take a new x-ray to see if there is anything else going on with the tooth. An Endodondist specializes in root canal treatments. But some general dentists also perform this service. And if you are really scared about the dentist, you may want to talk to your dentist about any gentle dentistry techniques that they offer. Or maybe even sedation dentistry if you do end up needing a root canal. Your dentist can’t help you if she doesn’t know how you feel though. So be open and honest about your anxiety so together you can put a plan together that you are comfortable with. If you don’t get the feeling that your dentist will work with you on this, there are many dentists in your area that cater to cowards. You are not alone! Millions of people deal with dental fear.

Best of luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

 

Is having sensitive teeth an emergency?

I was wondering what causes tooth sensitivity? Also, is this an urgent issue? Do I need an emergency dentist appointment?

– Hope in Virginia

Hope,

Tooth sensitivity is one of the most common concerns people have. The sensitivity varies from person to person and is wide-ranging in terms of urgency and seeking out emergency dentist care.

The main reason that an individual deals with sensitivity is because some of the underlying tooth tissue called the dentin is exposed. When the tooth’s enamel wears away or decays you may notice some irritation, sensitivity, and in some cases a toothache. Another issue that leads to increased tooth sensitivity is when the gums have receded. Many are more prone to the effects of sensitivity when eating or drinking something hot or cold. The change in temperature sometimes sends a zing. Others have sensitivity to breathing in cold air, or from dental tools at an exam where air is used to dry or clear a particular area.

Causes may include brushing the teeth too hard. Over time hard brushing can break down tooth enamel. Or consumption of highly acidic foods and drinks like soda, sugary energy drinks, or citrus fruits can wear down the tooth’s enamel. A chip or crack can expose the dentin too. Some patients may not realize it but they may grind or clench the teeth during sleep. This can add to the stress that teeth endure. Another culprit are those whitening toothpastes or abrasive toothpastes. These can also add to your tooth sensitivity.

If your sensitivity progresses into pain or a dull ache or throbbing, you may be in need of a root canal treatment to save the tooth. This may mean that the decay has reached the inside of the tooth and the nerve endings are dying in the pulp of the tooth. Don’t put this off. Schedule an emergency dentist appointment today if you are experiencing any of these symptoms or notice a small abscess or pimple on your gums near the aching tooth.

This post is sponsored by Cleveland dentist Hylan Dental Care.