Category Archives: Emergency Dentist

Emergency Dentist

Does She Need to Remove All Her Teeth?

I had not had dental care for most of my life. My parents didn’t have dental insurance or money. I was equally in poverty as an adult. I finally was able to improve my circumstances and was able to get to the dentist. As expected, my teeth and gums are a mess. I had two scaling and root planing appointments, where the hygienist saw improvement. Her suggestion was that I follow up that work with a periodontist, and they would focus on the crowns and fillings I need. I thought that was a good idea. It has not turned out that way. The periodontist was very condescending about my lack of dental care over the years. She also found that my deepest pocket was 3 mm deeper than the hygienist said. It had only been a couple of weeks, so that surprised me. The most distressing thing, is that she suggested I just extract all my teeth because I was fighting a losing battle. I don’t want to lose all my teeth. I’m willing to work hard to save them and I thought I was making great progress. Is it really hopeless?

Florence

Dear Florence,

Woman covering her mouth with her hand

I am glad you wrote. First, though, a huge congratulations on all the improvements you’ve been making in your life. That takes a lot of hard work and courage.

The discrepancy in the pockets is fairly easy to explain. While there wouldn’t have been that much of a difference in such a short period of time. It is more likely that either one dentist poked through and thought the pocket was deeper or the other dentist hit a piece of tartar and thought they’d reached the end of the pocket. Without another examination there is no way to know which it was.

The other issue, about removing your teeth, is much more clear cut. You have all your teeth, as far as I know based on my you’ve said. Your dental hygienist saw improvement and they were planning on working on your teeth. I don’t think they’d be willing to do that if the situation were hopeless.

If the teeth were that bad, they’d be falling out. You never mentioned that.

Your periodontist however, was insensitive and didn’t appear to give you any time for treatments to see what improvements could be done. Normally, they are experts at saving teeth. Maybe she was having a bad day. Maybe she’s grown tired of her field. What I will tell you is not to remove all your teeth without being absolutely sure there is nothing that can be done for them.

Look for a different periodontist in your area. Check their reviews. Then, go and see what they say. Do not tell them what the last periodontist said. Get their unbiased diagnosis first.

I get the feeling you are going to be able to save your teeth. On the off-chance that you cannot, look into dental implants for their replacement. They are the top tooth replacement option, and the closest thing to having natural teeth in your mouth.

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

Am I Too Old To Extract a Wisdom Tooth?

I had a wisdom tooth start to bother me. All of my wisdom teeth are impacted, but this is the first time I’ve had a problem with one of them. The dentist said it is infected and that I need to have it extracted. Here’s my problem. I’m 32 years old and have always heard that you should remove your wisdom teeth in your late teens or early twenties, otherwise there is a risk of complications. What do I do? Am I too old to remove this tooth?

Gina

Dear Gina,

Image of impacted wisdom teeth

There is always a chance for complications with any dental procedure no matter what your age. That being said, you are correct that the ideal time to have your wisdom teeth extracted is in your late teens or early twenties. After that your chances of complications do go up. However, until your are in your forties I would not be too concerned.

Even then, no matter what your age, if the tooth is infected, then you need to extract it. In fact, it can turn into a dental emergency. When they are left untreated, dental infections turn life threatening. In fact, people die every year from untreated tooth infections.

In your place, given your (still very young) age, I would like to suggest that you have your remaining impacted teeth extracted. While they are not a problem now, there is a very good chance that they will be in the future. Better to do it now before the chances of complications increases, which it will every few years.

The good news is that you are removing wisdom teeth. That means they do not have to be replaced. If it were any other tooth, it would be important to replace the tooth. Otherwise, the adjacent teeth will shift or tip into the open space, leading to your bite being thrown off and, likely, TMJ Disorder. If you lose a tooth in the future, the best tooth replacement is a dental implant.

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

Emergency Dentist

Is a Tooth Infection Dangerous?

I had a problem with a tooth, but I will be honest that I ignored it because I have pretty severe dental anxiety. The other day part of my molar broke off. Then, my cheek started hurting. Now the pain has wound its way around my ear and to the front of my neck. A friend of mine says that this is dangerous and I need to be seen right away. Is this an overreaction or does she have a point?

Sheryl

Dear Sheryl,

Woman holding her jaw in pain

I’m glad you wrote. Yes, your friend is correct. You are entering into a dangerous situation. When you have an infected tooth, the only way to treat it is by removing the infected pulp. That can be done by either a root canal treatment, which will save the tooth, or by a tooth extraction.

If the tooth does not get treatment, then the infection will continue to spread. This is what is happening to you now. You don’t want to leave this to continue to spread. Otherwise, what is currently a dental emergency can turn to a life threatening one. You will need to have this tooth treated. Without that, it can spread to your heart, lungs, brain, or even close up your throat to where you can not breathe. Believe it or not, people still die from tooth infections every year. I do not want you to be one of them.

I know you have dental anxiety, which has kept you from getting the care you need. The good news I have a solution for this. I would love you to see a sedation dentist. This can allow you to get your tooth treated the way you need to without any pain or anxiety. In fact, if you use something like oral conscious sedation, then you can actually sleep through your appointment if you want to. You’ll find that sedation will actually change your life.

You will finally be able to get caught up on all that dental care that you’ve needed but your anxiety has kept you from. Your oral health will improve, which you’ll find also improves your general health.

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

Emergency Dentist

Are They Misdiagnosing a Dental Emergency?

I broke a front tooth while on vacation about three years ago. I saw an emergency dentist who did a root canal treatment on the tooth. He did the filling part and said my dentist could do the crown when I returned home from vacation. When I did get home, my dentist removed the filling just to check out the work and said that everything looked fine. He replaced the filling and then provided me with the dental crown. Everything was fine for two years. Now, I’m living in a new state and the tooth starts hurting again out of nowhere. It became sensitive to hot and cold. I went to see my new dentist. He said that he didn’t see anything wrong and nothing showed up on the x-ray either, but did send me to a root canal specialist. That dentist didn’t see a problem with the crowned tooth but thought the problem was coming from the tooth next to the one that is crowned. There was nothing wrong with this tooth up until now so I’m not sure why it would be the problem. Are they overlooking a dental emergency with the tooth that is already crowned?

Amelia

Dear Amelia,

Man holding his jaw in pain

If the root canal treatment was done on your front tooth, then there will be no pain from that area. You had two dentists verify the root canal was done. When it is a back tooth, there can be some hidden canals that can be overlooked, but you are dealing with a front tooth so there would be nothing odd or challenging about that case.

Because of the extent of damage your tooth received, I would be shocked if the adjacent teeth did not also incur some trauma at the same time. It is fairly common for a tooth that underwent trauma to not show any signs of a problem until a few years down the line. When the pulp of a tooth is inflamed, it will not show up on an x-ray. That will only become a visible problem after the tooth develops an infection that starts to leech out into the bone.

If the tooth is no longer hurting, then it is not a dental emergency and you can leave it alone. Then, make sure you do an x-ray at least once a year. If anything changes, such as it develops pain again or something shows up on the x-ray, then you will know it is time to get treatment for the adjacent tooth. It will be a simple matter of having another root canal treatment and crown done.

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

Tooth Hurts and Dentist Can’t Figure Out Why?

I had an accident while I was out of town. I had an emergency emergency dental appointment that resulted from that accident because of trauma to the tooth. I had two teeth hit. One of them was broken. The other was okay. The dentist did an emergency root canal treatment on the broken tooth. When I got home my dentist checked the work and said it was okay, then put a crown on the tooth. Now it’s been a couple of years and the tooth has really started hurting again, but the dentist cannot find anything wrong with it. There’s nothing on the x-ray and it does not hurt when he taps on it. I insisted it was hurting, so he sent me to a specialist. Unfortunately, the specialist can’t find anything wrong with it either. It is not hurting at the moment and I’m at a loss and worried I’ll lose the tooth, especially because it is a front tooth. Have you seen anything like this before?

Christine

 

Dear Christine,

Man holding his jaw in pain

I’m puzzled why both your dentist and the specialist, which I am assuming is an endodontist, are finding this hard to diagnose. While it is true that root canal treatments can fail, I don’t think it is likely that your front tooth did. There aren’t any surprise canals that are hard to reach on a front tooth the way there is on a molar.

You did have trauma to two teeth. My feeling is that you are having referred pain from the adjacent tooth that experienced the trauma but did not break.

Until an infection starts to spill out of the tooth, it is not unusual for nothing to show up on the x-ray with the pulp inflamed. It would not hurt when tapped at that point either.

If it is no longer hurting, that tells me that either the tooth has recovered or it is dying. If it is dying, that will eventually show up on an x-ray. The tooth will eventually start turning darker as well. I would not consider it a dental emergency, but I would keep an eye on it. You may find yourself needing another root canal treatment and dental crown at some future date. I would just keep up with your regular dental appointments and periodically have the tooth x-rayed.

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

Emergency Dentist

Discolored Porcelain Veneer

My daughter is in college and still has several weeks before she gets out for the summer. A couple of years ago she had eight porcelain veneers placed on her upper teeth. Last summer she chipped one in a biking accident. Our dentist decided the solution was to shorten the tooth to even out the chip. That also meant shortening the tooth next to it so they’d match. This was not ideal and changed the character of her smile. A few months later, the tooth began to turn dark. We brought her in over the Christmas break but the dentist insists we’re being too picky and he doesn’t see anything wrong with it. When I pushed back against that a little, he told me that he is the cosmetic specialist and knows color better than I do. I mean, sure, he’s the dentist, but I did learn how to match colors in kindergarten and this tooth looks different. There is  now a weird blue/green tint to the tooth and we’re worried the veneer is going to fall off before she can get home. Of course, I think we’ll need a new dentist to do any thing about it, which is frustrating because I feel certain he’s the one who damaged it and should repair it. Do you have any recommendations for us? Should we get her to a dentist near her school or can it wait until she is home in a few weeks?

Sandy

Dear Sandy,

Leaky porcelain veneers
The bluish color on these temporary porcelain veneers are an example of leaky veneers in their early stages.

The blue/green color to me indicates that the veneer is leaking. Does it look a bit like the ones above? That happens when the bond between the tooth and the porcelain veneers is failing.  While it will fail at some point, it is better to let it fall off than to force it.

If the porcelain veneers falls out while she is at school, I would look for an AACD accredited dentist that can get her in for an emergency appointment and bond her veneer back on safely.  While there is no such thing as a specialty in cosmetic dentistry. AACD accredited dentists have proven expertise and artistry. With you away, this is one way for you to feel confident she is in qualified hands.

I also agree that another dentist is in order for your family. The way he rudely discounted your concerns is unprofessional.

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

 

Emergency Dentist

Do You Remove Wisdom Teeth Before or After They are Bothering You?

I am one of those lucky people with four impacted wisdom teeth. Only one of them is bothering me at the moment and I’m going to get it extracted. My dentist asked if I wanted to extract all of them or just the one and something about my age being an issue. I’m 27.  However, he did mention that one of them has a root that goes past a nerve, which means there is a slight chance of nerve damage.

My dentist gave me three options. I could leave the other wisdom teeth until they started bothering me. I could remove all of them. I could remove all of them, but for the one near the nerve I could remove the tooth part, leaving the root and hope it doesn’t get infected. Then, if it does get infected I will have to go back to get the rest.

Is there a best way to handle this?

Samantha

Dear Samantha,

Image of impacted wisdom teeth
Types of impacted wisdom teeth.

 

I’m glad that you wrote. Your age is a factor in how you handle this. While you are relatively young, as you are currently, it is much easier to remove wisdom teeth. Once you hit thirty, your chances of complications double. They double again every few years after that as well.  This is because the bone becomes less pliable and cementum builds up at the roots.

If your wisdom teeth were not impacted, I would say leave them be. However, when it comes to impacted wisdom teeth, it is not a matter of if they give you a problem, but when. Because of that I recommend doing it now before they become a problem. The last thing you want is a dental emergency while dealing with this, especially when you get a few years older.

I like your dentist’s idea of leaving the root, but don’t have him leave the whole root. Tell him just to leave the very tip. If it is a small piece, your body will often not have an issue with it, therefore you will have less of a chance of developing an infection.

I hope this helps with your decision. Click here to learn about sedation options for your procedure.

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

Emergency Dentist

Getting a Refund from a Dentist Who Made a Mistake

I had a tooth that was slanted from thumb sucking. My dentist put a crown on it in order to fix that. A few weeks later, it became sensitive to both hot and cold. The dentist told me this was a normal condition in the first few weeks and my tooth would adjust. I was in pain for months and the side of my face swelled up so much I ended up in the E.R. That was pretty much was useless, because they just charged me a small fortune and told me I needed to see a dentist. I didn’t want to go back to the same dentist, but needed to see someone. I called around to see who else could get me in and one dentist said they kept some room for emergency patients. Thank the heavens for that! They told me the tooth with the crown was infected and I’d need a root canal treatment. I asked them how in the world that could happen and she told me the crown was not put on properly and left open margins. I don’t know what this means. She did try to explain it and showed me the x-ray, but I was so freaking angry at my other dentist that I wasn’t really paying attention after that. She got me out of pain and we scheduled the root canal. I contacted my other dentist trying to recoup the money I’d paid and they said that once the crown is placed I’m responsible for what happened to the tooth. What they heck? They placed it wrong. How can I be responsible for that? Is there any way I can get my money back? I can’t afford random dental procedures?

Nadia

Dear Nadia,

Man holding his jaw in pain

I’m sorry this happened to you and am frustrated on your behalf! Bear in mind that I have not examined you myself but based on what you’ve described, your dentist owes you that refund.

He violated the standard of care by leaving open margins. After placing the crown, he is supposed to run an explorer around the margins to make sure everything is properly seated for the crown. It sounds like he either didn’t do this or did it and ignored the fact that they were open.

You have a couple of good things going for you here. First, a dentist who is willing to say the first dentist messed up. Second, she took x-rays, which is solid evidence.

One of the problems about this kind of case is there often isn’t enough money involved to make going to court worth it, but you do have some steps you can take to encourage that refund.

First, tell him you will go to the dental board and that you have x-rays to back up your claims. Most dentists want to avoid this. Second, you could ask the new dentist to call your old one. This can be very persuasive. No one likes to look bad in front of their peers. Third, get an attorney to write a threatening letter on an official letterhead. This costs less than an actual lawsuit but can make the dentist think you’re willing to go to court.

You’ve probably already decided this, but if I were in your shoes, I’d switch to the dentist who saw you during your dental emergency from now on. It sounds like you’d get better care there.

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

 

Emergency Dentist

My Crowns Hurt

I had some dental bonding done years ago on my two front teeth because of an accident. Now, about ten years later the bonding is looking pretty rough so I decided to bite the bullet and get the work redone. My dentist thought doing crowns would be better and did four of them so that my teeth would match. The four teeth do match each other, but not quite the other teeth. That’s not why I’m writing, though. The dental crowns feel really weird and heavy. They hit my other teeth in a way that makes it hurt when I chew. Is it possible that I have a cavity or infection under one of them? Is it a dental emergency?

Emma

Dear Emma,

Porcelain crown being placed on a tooth

A simple x-ray will tell you if there is an infection under one of those crowns, However, you said it hurts when you bite down but did not mention it hurting any other time. This make me think that the problem is the fit of the crowns and not what is underneath them.

I’d like you to get a second opinion on the fit of these crowns. I would not consider it a dental emergency, but I would try to get in as soon as possible simply because you are uncomfortable.

The fact that your dentist gave you four dental crowns to replace dental bonding on just two teeth makes me wonder about his ethics. This was a massive overtreatment.

On top of that, he told you that you needed four dental crowns in order to make them match. That is not true. A skilled cosmetic dentist can even match a single crown to the rest of teeth. Even then, he couldn’t match the four crowns to the remainder of your teeth.

I don’t know if you went back to have your dentist look at these, but the pain could be solved by a simple adjustment. If he doesn’t solve the problem or tries to tell you everything is fine, then I would definitely get that second opinion.

Don’t tell them who provided your dental crowns, just that they hurt when you bite down. Dentists know each other and you don’t want them worried about critisizing a friend’s work. If he or she asks, just explain you want an unbiased opinon. They should respect that.

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

Emergency Dentist

My husband Just Broke Off Two of His Teeth

My husband took quite a fall and broke his two front teeth. It appears the roots are still intact. We went to see an emergency dentist and he told us just to have the teeth extracted. Is there any way to save his teeth?

Brenda

Dear Brenda,

A hockey player smiling with a knocked out tooth

I am sorry about your husband’s accident. While it is possible to save these teeth with root canal treatments and dental crowns, there is not a guarantee. It is a bit tricky. A lot will depend on how much of the tooth is broken off, what condition the roots are in, and the comfort level of the dentist.

You may have some difficulty finding a dentist willing to do the procedure. Now that dental implants have grown in popularity and reliability, even fewer dentist will be willing than might have been twenty years ago. It’s easier just to replace them.

Here are some things to be aware of if you do find a dentist willing to try that will increase the chances of a succesful outcome. Whatever dentist you end up going to for this will need to bear in mind that the rotational forces are working against him or her.

Front teeth are rounded and the posts are as well. This does not bring much resistance to the rotational forces. You can increase your chances of the post working loose by putting two posts into the root, which minimizes the complication.

A second issue is that the post can crack at the root. Some dentists think using a rigid post will help this. However, with a front tooth, there are tipping forces to consider. Because of that, they would need to use a flexible post on the front teeth. Two I’d recommend are carbon fiber or fiberglass.

If it turns out that these teeth cannot be saved, don’t despair. He doesn’t have to look like the hockey player pictured above. Dental implants really are the closest thing to having healthy, natural teeth in his mouth again. I highly recommend them. Just make sure he goes to a dentist with post-doctoral training in dental implants.

Try to save these teeth first and then go from there.

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