Category Archives: Emergency Dentist

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.

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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.

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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.

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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.

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Emergency Dentist

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.

Emergency Dentist

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.

Emergency Dentist

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.

Emergency Dentist

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.