Category Archives: Emergency Dentist

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.

Emergency Dentist

A Dental Infection with No Money

I am in misery. I have a couple of missing teeth, which is bad enough. Now I have an infection in one of the teeth I do have. It is making me miserable. My cheek is swollen. The problem is I was laid off and have no medical or dental insurance. Is there anything I can do to deal with this?

Misty

Dear Misty,

Woman holding her jaw in pain

I am sorry for all you are going through. With your cheek swollen, it tells me that your tooth infection is quite advanced. In fact, it is a dental emergency.  Treating this with antibiotics alone will not solve your problem. You will feel better for a short time and then the infection will expand rapidly.

The danger here is that it will spread to your brain. It can even reach your throat and close off your breathing.

I know you do not have money, but there are places that are willing to help you. I would call your local dental society and ask if there are clinics that will see patients in your situation,

If they can’t help you, I suggest you call around to some local dentists. Most dentists went into their field because they wanted to help people. I feel certain if you explain your situation there will be a dentist willing to help.

They can give you the emergency treatment you need and then allow you to pay it out as you are able.

Ideally, you should get a root canal treatment, which could save the tooth. If you can’t then the next option is a tooth extraction. The problem with that is that then you will need to replace the tooth, which is another expense. But, an extracted tooth is better than a serious tooth infection that can kill you.

Please call the dental society.

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

Emergency Dentist

Deep Cleaning has Left Me in Terrible Pain

I’m 53 years old and never had a problem with my teeth until I had a deep cleaning done because I was told I have deep gap pockets. The procedure itself was nightmarish and I never want to go through that again. However, ever since the cleaning my teeth are sensitive and hurt all the time. I think I made a mistake in having this done. Is there anything I can do?

Pamela

Dear Pamela,

A woman grabbing her jaw in pain, in need of emergency dental care

It sounds like you have advanced periodontal disease. If it does not get taken care of soon, you could lose your teeth. The disease will eat away at the bone that supports your teeth. Most deep cleanings are done with an anesthetic so that the patient does not experience the pain you described during the procedure. I would recommend you see another dentist to have this completed. Call a periodontist. These are gum specialists. Tell them about your situation and they can probably get you an urgent care appointment.

The post-operative pain tells me you have an active infection. One way to deal with this is by having a course of antibiotics during the duration of your treatment. This will help keep the infection at least in check while the periodontist gets everything cleaned out. Let them know about the pain you experienced in your last deep cleaning so they can be sure to give you the right amount of anesthetic so this doesn’t happen to you again.

I know you are probably leery of any treatment right now after your last experience, but I cannot emphasize enough how important this is. I wasn’t kidding when I said you could lose your teeth. Please see that periodontist as soon as possible.

This blog is brought to you by Lafayette, LA Dentists 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.

Emergency Dentist

Can I Take Xanax Before My Dental Appointment

I am not being melodramatic when I tell you that I am terrified of the dentist. I haven’t gone in years because of that, but now I have a tooth which is in so much pain that I can’t focus or sleep. I know I need to go see a dentist. Half my face is swollen going all the way up to my eyeballs. I’m worried, but my anxiety about going is still strong. Would it be okay if I took a Xanax before my appointment in order to help relax me?

Greta

Dear Greta,

A woman grabbing her jaw in pain, in need of emergency dental care

I am sorry for your pain as well as the fear you face when thinking about the dentist. Often, when someone has this level of anxiety, it is a result of experiencing some dental trauma earlier in their life. If you have properly prescribed Xanax, you can take it before your appointment. However, you need to let your dentist know ahead of time that you’ve taken it because it will affect what types of numbing medication he or she can give you.

Because you are in so much pain, and especially because of the swelling you are seeing, I would consider this a dental emergency. It doesn’t sound like you have a regular dentist, given your experiences. So I would do an internet search for someone who sees non-established patients in cases of emergencies. Doing a search for for an emergency dentist will help you find them.

While you are searching, I do think you should look for a sedation dentist. This could solve all of your anxiety issues and you would not even need any Xanax.

Whatever you do, please don’t put off getting the treatment you need here. The swelling that has gone up to your eye means that your infection is spreading. You do not want it to reach your brain. Then a simple tooth infection will become life threatening.

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