Category Archives: 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.

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.

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.

Gross Negligence Caused Serious Problems

I had pain and sensitivity to my back left 1st molar. I don’t have a regular dentist so I went to see a dentist who recently sent out advertisements. I told him about the sensitivity to cold and that the tooth was also painful to touch. He did an exam and x-ray and said the problem was with my wisdom teeth. He felt one was impacted and pressing a nerve. He thought some fillings would help. I agreed to the fillings and we did them right then, which I was grateful for at the time. However, two days later I ended up in massive pain. He adjusted the fillings. That didn’t help, so I called back and he prescribed me antibiotics and pain killers.

When those ran out, the pain flared back up in a serious way. His suggestion was I extract that wisdom tooth. I mentioned the pain felt in a different place, but he said it was probably referred pain. I went ahead and had the teeth extracted and started another course of antibiotics. Everything felt fine until the antibiotics ran out. He prescribed me another one, but by morning I was so miserable that I went to the emergency room.

They said I had an abscessed tooth at the left first molar I originally went to the dentist for. I called the dentist again and he referred me to an endodontist. The endodontist couldn’t see me for several weeks. I was in too much pain to wait so I went back to the oral surgeon who took out the wisdom tooth. He thought the molar needed to be removed as well, so I went ahead and had that taken out. I’m quite frustrated because I felt like I went through quite a few unnecessary appointments and procedures that were very expensive. Do I have any recourse for this?

Benjamin

Dear Benjamin,

Man holding his jaw in pain

This is gross negligence on the part of your dentist. There are so many things he did wrong here it is hard to know where to start. My suggestion is you tell him you would like him to cover the cost of the additional appointments and procedures you needed, in addition to a dental implant and crown which will be necessary to replace the first molar.

There is a good possibility this tooth could have been saved if he’d done his job properly to begin with. Plus, when he finally was told you had a dental emergency, he referred you to an endodontist that couldn’t see you for weeks, which put you at greater risk. Now that you’ve lost that tooth, if you don’t replace the tooth, the other teeth will begin to shift and tip into that space. That will throw off your bite and lead to expensive and painful TMJ disorder. You could go straight to a lawyer and I think you’d get everything you ask for, but I believe in giving a dentist a chance to make things right.

The things he did wrong are so basic, that I almost find it hard to believe that he actually graduated from dental school. That might be worth looking into. When you talk to them about the costs, ask one of the staff where he graduated from. I’d check to see if that is true.

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

Is My Sinus Infection Healing

I had a tooth extracted. Apparently, when that happened he perforated my sinus. We didn’t discover that until a few days after the extraction when I developed a nasty discharge, as well as some nasty swelling and pain. My dentist put me on augmentin for a week. That did help with the swelling. When that was done, my dentist did a CT scan to check everything and it showed that I have a horrible infection in my sinus cavity. So, he put me on azithromycin. That seemed to improve things, but it is finished now and I am worried that I need to see an ENT or something. Is this being handled okay?

Tina

Dear Tina,

Man holding his jaw in pain

You have been very helpful in describing this. You have had two infections which is why they had to treat you twice. You did not mention if they closed up the sinus perforation. If it is a small perforation it will not take much to close it up. However, the infection will need to be completely gone and it sounds like you still have some of your infection left.

I’m going to suggest two things. This is not a dental emergency, but it does need to be dealt with. First, You would probably do well to get some Flonase as well, if you still have any inflammation. This is a cortical steroid that will help reduce the inflammation. Secondly, you need to call your dentist back and tell him the infection is still there. You need a second round of your antibiotic. You’ll want the infection completely gone. If you leave it untreated, it will become an emergency situation.

Your dentist hasn’t done anything wrong, but he still needs to be aware of the situation.

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

Is Needing a Root Canal a Dental Emergency?

If a tooth needs a root canal treatment but doesn’t have any pain, is it a dental emergency or can it wait? On that note, if it can wait, how long can it wait?

Tyson

Dear Tyson,

Root Canal Treatment

This is kind of tricky to answer because I have not examined your tooth. I think, however, I can give you some general guidelines. If the tooth is hurting in any way (which you say yours is not) then, I would consider it a dental emergency and you would need to get treatment as soon as possible. You would not necessarily need to schedule it for that day, but as soon as they can.

I would say that if it starts hurting again, go in fairly soon as well. Both of those scenarios indicate that you have an active tooth infection that needs to be treated. Dental infections spread and can blow up pretty quickly. You do not want it spreading to your heart, lungs, or brain, all of which are close to your jaw.

If it is not hurting and has not for a while, you should be able to wait. I had a colleague who had a patient with a tooth that needed a root canal that waited several years. This was only possible because the infection was not active.

What was interesting to me about this case is that apparently, even though the infection wasn’t active, the fact that it had been infected was having an impact on his health. The patient felt unexplainably worn down all the time, even though he was getting enough sleep and his thyroid levels were good. The cause turned out to be the tooth. After he had his root canal treatment, he told my colleague that he felt better than he had in a while.

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

Is a Crack in a Dental Crown an Emergency?

I have had six porcelain crowns for close to twelve years. One of them, on a front tooth, has always had a slight defect. It never really bothered me because you couldn’t really see it. If I rubbed my tongue against it, there would be a slight depression but that is all. Now, it feels like there is a crack and I can see a horizontal line. I am afraid the crown will break. Would this be considered a dental emergency?

Pamela

Dear Pamela,

Porcelain crown being placed on a tooth

While I would not say that you have a dental emergency on your hands that you have to try and get in today, I would schedule an appointment with an excellent cosmetic dentist and have them look at it. Based on your description, there has been a substantial change on the structure of your tooth. It is likely to break at some point in the near future.

You have a couple of options. Your porcelain crowns are aging. Because of that more of them may start failing. You can either replace all of them at once or one at a time as they fail.

What to beware of is a dentist who says that you have to replace all of them to get them to match. A single crown can be matched to the other teeth. However, it takes a highly skilled cosmetic dentist to do it.

Whichever dentist you end up with, make certain they are willing to do a temporary try-in and allow you to approve the crown before it is permanently bonded on. They need to be willing to re-do the crown if you are not 100% satisfied with it.

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

Do I REALLY Need a Root Canal Treatment?

I want some advice from you. I am six months pregnant. A few weeks ago, I went to see the dentist for a normal cleaning and check-up. I didn’t do any x-rays because of the baby. He said he found a small cavity, but not to worry, it was so small that I wouldn’t need any Novocaine. He was going to do a silver filling, but I heard those have mercury in them so I told him I would only do the white fillings that don’t have mercury. He said the danger of silver fillings was overblown, but I insisted so he gave in. Now, I’m having sensitivity to that tooth, especially to cold. I went back in for him to look at it and he said that it needs a root canal treatment. How can it go from being such a small filling it doesn’t need Novocaine to now needing a root canal in just a few short weeks? Obviously, if I have an infection I need to deal with it, but I don’t want any unnecessary procedures while I am pregnant. How would you advise me?

Kelsey

Dear Kelsey,

Pregnant woman at the dentist before treatment

You have a right to be suspicious of the advice you are getting for several reasons. If there is a cavity, it means the decay is in the dentin. That would need Novocaine. Then, all of a sudden this super small cavity needs a root canal treatment? Yeah, you need a second opinion.

While you are correct that if the tooth is infected you will need treatment, based on what you have said, I think the most likely culprit is the filling itself.

You mentioned your dentist generally does silver amalgam fillings. The procedure for white composite fillings is completely different. My guess is that filling was not properly placed and that is what is causing your sensitivity.

I would like you to see a mercury-free dentist to have this looked at and done correctly. They will be amply skilled with composite fillings. By the way, I do not think this is the best dentist for you. He is not keeping up in his field. Composite fillings should be the standard at this point. I think it is time you look for a new dentist.

On the off chance it turns out you do need a root canal treatment, you can ask for Lidocaine instead of Novocaine. This is used safely during both pregnancy and delivery, which will put your mind at each about any medication going into your body during the procedure.

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

Dental Emergency Disaster

I need some help for my poor husband who is suffering and in great pain. He had an injury which caused some pretty bad damage to teeth number eight and nine, as well as his head. He was treated at the ER and then we went to a dentist. The dentist wanted to wait two weeks for everything to calm down before doing anything. When we returned, the number eight tooth had turned dark but the dentist said there was only dried blood there and she didn’t think it needed a root canal treatment. She did a temporary crown. Then, a couple of weeks later the permanent one was bonded on. Barely a month later he was in excruciating pain. We went back to our dentist who gave him five days’ worth of amoxicillin and did the root canal treatment a week later. The pain did not go away so she root-canaled the tooth next to it, which I think was a totally unnecessary treatment. HIs pain still hasn’t gone away. He is still in pain. I don’t feel like he is getting good treatment. What do I do for him now?

Angela

Dear Angela,

Man in pain in need of an emergency dentist

You obviously know this already, but your husband has received quite poor care from your dentist. Let’s start with the original, “It doesn’t need anything.” What did she think was going on when the tooth turned dark?

The second real issue I see is the way the root canal treatment itself was handled. First, she didn’t give him enough antibiotics to make it through to the treatment, which means the infection will flare back up. Then she did the treatment itself which risks closing the infection in.

Finally, when the pain didn’t go away, instead of thinking maybe the root canal treatment failed, she treats the tooth next to it that had no pain. That is incompetence on a whole new level.

My recommendation is you call an endodontist. They are root canal specialists. Let them know what has been going on so you can get an emergency appointment.

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

Can an Infected Tooth Cause a Fever?

My daughter has a fever and thought it might have to do with a tooth that was bothering her. I asked her pediatric dentist if we could come in for an urgent appointment and he told me he would schedule a regular one, which would take two weeks, but that a dental infection does not cause a fever. I’m confused by that. Am I misunderstanding something?

Lisa

Dear Lisa,

Mom holding her two children

Raising children is hard, isn’t it? We worry about them all the time.

I wonder if there was some miscommunication here. Of course a dental infection can cause a fever. Any infection can cause a fever. Maybe he meant to say that it does not always cause a fever.

If your daughter is in pain, then I think she needs to be seen sooner. I would find a pediatric dentist who would be willing to schedule an emergency appointment.

If she is not in pain, then you are safe to wait for the appointment your dentist is offering.

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