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Pediatric Dentist

Why Fill a Baby Tooth?

Can you tell me why my dentist wants to fill a baby tooth? My son has a cavity on one of his back teeth, but this isn’t his adult tooth. As it is just going to fall out anyway, why should I spend this money and put him through the procedure?

Callie

Dear Callie,

boy smiling with a toothbrush

Nobody wants unnecessary medical or dental procedures so I completely understand your question. While some baby teeth will start to fall out soon, his back molars need to stay in until he is around 12 years of age. You don’t want this cavity to turn into a dental infection. A simple cavity is easy to treat, with little trauma. If the tooth gets infected, you will need a child’s version of a root canal treatment, called a pulpotomy.

In most cases, you will want to prepare ahead of time and possibly even arrange to have oral conscious sedation used during this procedure, so he is as comfortable as possible. If you let the tooth go, it could go downhill fast, which will mean a dental emergency. In that case, oral conscious sedation may not be an option for him which would make the appointment more traumatic for him.

What If He Loses This Tooth?

Another problem with letting the decay continue is that the tooth may become unsaveable. If that happens and it has to be extracted, you will need your pediatric dentist to place a space maintainer in that spot. This will prevent the other teeth from shifting and tipping into that spot.

Without that, the other teeth will drift. This will mean there is not correct placement left for his twelve-year-old molars and will lead to crowding. Crowding means crooked teeth and expensive orthodontics.

A little prevention now by getting this tooth filled can save you and your son a lot of expense and hassle.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Emergency Dentist

Perforated Sinus with Tooth Extractions

Can you help advise me? I had ten teeth extracted by an emergency dentist. With one of the upper molars, he perforated the sinus cavity. He placed a compound in it to increase the clotting, but I can feel air flowing through it even when I am at rest. There is air blowing into my mouth and it feels quite weird. He also gave me a ten day course of antibiotics. Should I be concerned about this?

Emilio

Dear Emilio,

Man holding his jaw in pain

Usually, when a patient sees an emergency dentist they just get the patient out of pain and do the minimal procedure necessary than have you reschedule with your normal dentist. I am a little surprised that this dentist removed ten of your teeth in one appointment. While he was right to get the clotting started, he should also have closed the hole. Will it heal without that? Possibly, but it will take a long time and you are at risk for infection while you are waiting for the healing. In your place, I would see an oral surgeon to have them graft some bone there to close and heal the area.

Another issue I am concerned about is the number of teeth you’ve had removed. It is important that they are replaced as soon as possible. Otherwise, you will begin to lose your bone structure in those areas as well. Without that, you could end up with a condition known as facial collapse. I’m going to recommend that you have them replaced with dental implants because these will preserve your bone.

Sometimes we have found that patients who end up with dental emergencies have a fear of the dentist that keeps them away until they are in too much pain to avoid it anymore. I want you to know, just in case that is a situation you find yourself in that there is a solution. I’d like you to see a sedation dentist. They have medication they can give you which will allow for you to have a pain-free/anxiety-free appointment. Dentists who offer sedation are used to patients with anxiety and can help put you at ease.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Dentures

Can I Get Gold Teeth on Dentures?

I’m only 49 but I’m about to get dentures. I’m tired of these teeth hurting me, I’m ready to be rid of them! I’ve never had dentures before, so I’m kind of excited at the thought of looking good. I was wondering though, do they ever make them with gold-outlined teeth on the front? I just want the upper front two done. I love how that looks but I haven’t seen anyone with that in their dentures yet. So I didn’t know if it was something I could even have done.

Sasha

Dear Sasha,

Dentures

I’m glad you wrote. The short answer is yes, you can have gold teeth set in your new denture. There are a number of variations, from full gold crowns to small amounts that hardly show at all. It will be important that you are very specific with your dentist regarding exactly what your expectations are. The safest option would be to bring in a photo of what you want the teeth to look like to avoid any miscommunication.

As you might guess, adding gold to the denture teeth adds extra expense and your fee will be higher than that of a typical denture. This fee will vary according to the amount of teeth involved and the gold required to cover them.

Understanding Dentures

Before and after facial collapse
Before and After Facial Collapse

I know your teeth are killing you and you are ready to be rid of them, but I want to make sure you understand what you are getting into with dentures. Even the best-fitting dentures will reduce your chewing capacity by 50%.

However, the bigger issue is bone resorption. When your teeth are removed your body recognizes that and immediately begins to resorb the minerals in your body in order to use your resources most effectively. While great stewardship for our body’s resources, it will have the unfortunate effect of shrinking your jawbone. After ten or so years, you will not have enough jawbone left to retain your dentures. Plus, the loss of bone makes you look a couple of decades older than you are.

There is a Way to Prevent Facial Collapse

If you have dental implants placed then your body will interpret that as you still having tooth roots there which need the bone to keep them secure. This will prevent the bone loss from occuring. You can have implant supported dentures placed. This uses a minimum of four dental implants and then when the bone has had time to integrate with the implants a denture can be anchored to them. Not only does this prevent facial collapse, but it is completely secure. You will have no slipping or falling out. You can eat anything you want.

If you absolutely cannot save your teeth. This is what I’d recommend. Because of how young you are, completely removable dentures will be a disaster for you long term.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Dental Implants

Trying to Get Answers About Beautiful Restorative Work

I am having a hard time finding the right information just by looking online on the internet so I am hoping you can help me sort through some things. I need a bunch of restorative work including ten dental implants on my upper arch and five on my lower. I’m not as worried about what my lower arch will look like, but I do want my upper arch to look natural. Here are some of my questions.

1. Which brand of implants is best?

2. Would I be better off with zirconium of porcelain crowns?

3. I had one dentist tell me that white colored metal fused to porcelain, or gold fused to porcelain, will not show a black line, Is this true?

4. Are zirconium abutments for my implants, more aesthetically pleasing than all white abutments?

Kevin

Dear Kevin,

Implant overdentures illustation

I can tell you are working hard to do your research and you have some great questions. I’d like to steer your questions in a slightly different direction. All of your questions are about the materials. What you should be asking, if you are looking for great aesthetic work, is whether the dentist has the post-doctoral training and accuracy to provide you with solid, yet beautiful work.

If you wanted to commission a beautiful portrait of your family, you probably would not be asking about which type of canvas or paint brushes should be used, but rather who would be the best artist to do the work. It is the same with cosmetic dentistry.

First, I would look for someone with post-doctoral training in dental implants. It won’t matter how beautiful they are if they don’t end up failing. After you have narrowed down some implant dentists, I would then look for their cosmetic qualifications. Have they done post-doctoral training in cosmetic work. Smile makeovers and other types of cosmetic work are not taught in dental school. Have you looked at their smile gallery to see if they produce beautiful work? Even better, do they have someone on staff that is AACD accredited?

These are the questions you need to look into. I will correct one piece of bad advice you were given. Any dental crown that is fused to metal will eventually show that black line. Additionally, it will end up looking more opaque because of the metal base that needs to be covered.

I hope this helps you.
This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

CEREC

Matching My CEREC Crown

I needed a dental crown and thought this would be a good chance to try my dentist’s new CEREC machine. I knew it would save me some time. At the appointment, we never really discussed the color. It felt fine and I assumed everything else would be as well. It was not until I got home that I saw the color discrepancy. Now, it is all I notice about my smile and I feel like the tooth looks fake. I don’t know what to do. I have tried using over the counter whitening products in order to get my other teeth as white as the CEREC crown, but thus far, no luck. Is it crazy to ask my dentist to darken it?

Sandra

Dear Sandra,

Block of porcelain for a CEREC crown

I do not think it is crazy at all to want your teeth to match one another. I can already tell you that your dentist has no real expertise in cosmetic dentistry. A true cosmetic dentist would have let you get a good look at the crown to make certain you approved of them before permanently bonding them on. It is possible that he noticed the color difference and didn’t want to have to redo them.

CEREC crowns are very convenient, but if you are having one placed on a front tooth, it will be important that the dentist have real cosmetic expertise. CERECs are milled from a single block of porcelain. This makes them look rather flat and bright. However, there are stains and tints a skilled cosmetic dentist can use in order to make them blend in well with the remainder of your teeth. Unfortunately, these have to be baked into the crowns before they are completed.

You have a couple of choices here. You can give your dentist another opportunity to get these right or you can ask for a refund and get this done properly elsewhere. Whichever you decide, make certain they let you see the crown with a temporary try-in paste first so you can get a good look at them in several lights and give your approval or disapproval to get it permanently bonded on.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Zoom Whitening

Zoom Whitening and a Date on the Same Day

I finally talked my parents into letting me get Zoom Whitening done on my teeth. The appointment is for February 13. I did that in the hopes that if Brandon asked me out for Valentine’s Day that I’d have a beautiful smile for our date. I’ve been waiting for him to ask me out for weeks. Well, today he asked me out for Valentine’s Day, but wouldn’t you know it, he needs us to go out on the 13th because his parents are making him babysit his siblings so THEY can go out on the 14th. Will it be okay to go out with him on the same day? My aunt had Zoom done and she said her teeth hurt afterward. She does have sensitive teeth though and I don’t think I do.

Brianna

Dear Brianna,

Patient under a Zoom Whitening light
Zoom Whitening Light

Congratulations on the Zoom Whitening and the dream date! I don’t know if your aunt told you what the procedure entails, but I’ll give you a quick rundown. They will put some retractors in your mouth to isolate your teeth and gums. That is not nearly as scary as it sounds. It is mostly so you don’t have to hold your mouth open and still yourself the whole time, which would be crazy hard.

After that they’ll put this material on your gums. It is designed to protect your gums from both the whitening material and the light that will be used on your teeth. From there, the Zoom Whitening gel is applied to your teeth and you sit under the light in small installments. The whole process takes about an hour. It’s usually easy enough where people don’t even need a local anesthetic.

That being said, some people have more sensitive teeth than others. One way around this is to ask your dentist for a fluoride varnish to help lessen the sensitivity. It is also appropriate to take some over the counter pain killers, such as acetaminophen.

You know, you could even make this a two night date. At the end of your outing, you could offer to help him babysit his siblings the next day. It’s always a good idea to see what a guy is like around kids.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Invisalign

Will Invisalign Trays Stain My Teeth?

I’ll be using the Invisalign system soon to straighten my teeth. My friend is getting great results with hers, but I have a question: since the trays are worn all day every day for as many hours as possible, will I develop decay or staining from where the trays collect moisture and stuff? I’m trying to keep my teeth as white as possible, and I may want to professionally whiten them once I’m done with treatment. So I really don’t want stains. Is there any danger of this?

Thanks so much,
Jasmine

Hi Jasmine,

Invisalign aligners
Invisalign Aligner

Great question–it sounds like you’ve thought this through. It is exciting to look forward to having a beautifully straight smile.

Invisalign Is A Great Choice

Instead of metal brackets, bands, and wires, Invisalign trays use clear aligners, which is obviously what so many people love about them. They are thin, clear and flexible, and comfortable enough to wear all day and they are invisible even at a conversational distance. Yes, they do have to be worn against the teeth for many hours a day, and even at night.

The good news is that the Invisalign system promotes much less staining than traditional “old fashioned” metal brackets do, which collected plaque around the edges and were more difficult to keep clean. The plastic material that the aligners are formed from does not pick up stains.

That being said, if the trays are not cleaned properly and regularly they can collect plaque, bacteria, and food debris, all of which can then collect stains. If allowed to rest against the teeth for many hours a day, this could transfer the stains to the enamel, or worse, demineralize the enamel and lead to decay. This is especially true if highly-staining foods are regularly eaten without frequent cleansing: foods such as beets, red wines, coffee, black tea, and the like. Use a straw, and rinse right after eating if you do take in these foods.

It Is Simple

You will not have this problem as long as you cultivate the habit of brushing and flossing well each time before placing clean trays into your mouth. Also, be sure to change your aligners as directed, ensuring a fresh start. If you do notice stained, white, or discolored areas on your teeth despite these measures, let your doctor know right away.

You Can Whiten Right Now

I have some more good news for you as well. Your Invisalign aligners can double as teeth whitening trays. This will allow you to straighten and whiten your teeth at the same time. All you need is some professional strength whitening gel that your dentist can provide for you. Simply wear the gel in your aligners at a time that is convenient for you and you will soon be sporting not just a straight smile, but a white one.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Pediatric Dentist

Will a Pediatric Dentist Cost Me More Money?

I have been taking my son to my dentist. He’s four years old and isn’t doing well with them. They are not doing anything wrong, but seem to not be used to children. I’ve never really seen other children at their office either. I noticed that they get frustrated when he fidgets, but it is not excessive, just normal kid fidgeting. It takes everything I have to be able to afford the dentist as it is. I feel like my son may need a pediatric dentist, but I don’t know if they are more expensive. I’m not sure I can afford it if it is.

Miranda

Dear Miranda,

boy smiling with a toothbrush

Dental prices vary and are set by the dentists themselves. That being said, there are some general “rules of thumb” that could be helpful to you.

Pediatric Dentists are Specialists

Pediatric dentists have to spend a bit more time in school in order to specialize in children. As a result, their fees are often at least a little higher. That being said, location often has a greater impact on their fees than whether or not they specialize. If you go to a pediatric dentist in a wealthy area of town, their prices will be a bit higher. However, if you go to one just a few miles away from that area, you may see a drop in the fees.

Leverage Dental Insurance

If you have dental insurance, going in-network will often save you a lot of money. In many cases, regular checkups are completely covered or only have a small fee attached to them. In many cases, the insurance companies dictate the fees, which is why they will be lower than if you go out of network.

There are General Dentists Who are Great with Children

Though your dentist may not be great with children, there are many general dentists who are and love treating them as well. One way to know how good they are with children is to ask them which age they prefer to start treating them. If they say 2 years old (or around there) you can know they enjoy treating children. If they prefer to wait until they are around 5-8 years old, they don’t really enjoy treating children. They tolerate it.

Also, to put your mind at ease regarding qualifications, every general dentist has done a pediatric rotation so they are perfectly qualified to treat children. If anything tricky comes up, they will then refer you to a specialist.

I hope this helps.
This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Invisalign

Will Snap on Smile Help with Crooked Teeth?

I am an adult with crooked teeth and I am trying to re-enter the workforce. It has been hard to clean my teeth because they are so crooked. I am wondering if the snap on smile I have read about would be able to make my teeth look straight and white so I have a better chance of getting a job? My dentist is suggesting porcelain veneers but that is a bit out of my budget. I have had several interviews for which I am more than qualified for but can’t seem to get the job. I asked a friend what she thinks is holding me back and she suggested my teeth could be a problem. So, would this snap on smile option work for me?

Patricia

Dear Patricia,

Invisalign aligners
Invisalign Aligner

Your friend is probably onto something regarding your teeth having an impact on the way the interviewer perceives you. Our smile is the first thing people notice about us so we want to put our best teeth forward.

While it is possible that Snap-on Smile could make your teeth look straighter, it is very likely that it will also look fake and bulky. This is made of acrylic, which often ends up looking flat and dull. That will not be a natural look. Another issue is you are placing it on top of already crooked teeth. This adds bulk and will make your smile stick out a bit more. The bulk can also affect the way you speak, which can also negatively impact your performance and impression with the interviewer.

Instead of Snap-on Smile, I am going to suggest you do Invisalign. These will straighten your teeth without anyone knowing you have orthodontics on. Instead of the metal wires and brackets you get with traditional braces, Invisalign uses clear aligners that straighten your teeth in about half the time of braces. These aligners are invisible even at a conversation distance. This is done at a fraction of the cost of the porcelain veneers procedure your dentist suggested to you.

You can also ask your dentist to provide you with some professional strength teeth whitening gel. You can wear these in your aligners, which can double as teeth whitening trays, at a time convenient to you. This will give you a mini smile makeover by straightening and whitening your teeth simultaneously. Plus, whiter teeth give you a more youthful appearance which can also help you if you are re-entering the workforce after a period of time away.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Zoom Whitening

Zoom Whitening and Blood Thinners

I have been wanting to whiten my teeth for some time now. I think I want to do it quickly with that in office procedure that uses the lights. The one thing that is holding me back is that I am on blood thinners because of a heart attack. I have been stable for a while on the same dose and my heart is healthier. Is there a risk for people on blood thinners with this procedure? If so, do I have any options?

Annie

Dear Annie,

Patient under a Zoom Whitening light
Zoom Whitening Light

When you are on blood thinners is important to avoid invasive procedures because the medicine is designed to stop blood clotting in order to protect you from another cardiac event. If you needed an invasive procedure, your doctor would ask you to stop the medications for a while.

The procedure you are referring to is Zoom Whitening and it is an effective way to whiten your teeth quickly. It is not an invasive procedure and as such will not generally cause any bleeding.

That being said, your oral health is a big factor in that. If you have gum disease, your gums will bleed much more easily, even at the slightest pressure on them. I would want to make sure your oral hygiene is in top shape for two months before proceeding. You will need to brush twice a day and floss once a day. Make certain there is no blood on your floss every time before even considering moving forward.

You will also want to have a thorough professional cleaning done as well. Otherwise, your results will be splotchy because there will be a film over parts of your teeth.

I hope this helps you make a decision. Consult with your dentist and see about the health of your gums. If there is any periodontal disease present, that will need to be addressed before moving forward.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.