Category Archives: 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.

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.

Surgeon Won’t Take OUt Both My Teeth

I am very frustrated. I had a root canal treatment that I think has failed and the tooth needs to be removed. Near that, I have an impacted wisdom tooth that my dentist says is infected and he thinks needs to be removed. I am fine with that, but he refuses to remove the tooth on which I had the root canal treatment. Shouldn’t I be the one to decide that? I’m refusing the procedure because I do not want to do them separately and I am certain the other needs to be removed. What do you recommend I say to convince him to do both teeth?

Linda

Dear Linda,

I want you to be very careful here. An infected tooth is nothing to mess around with. It appears your dentist feels very strongly that this wisdom tooth IS, in fact, infected. If you think about how close your jaw is to your throat (which could swell up and close), heart, and brain, you definitely do not want this infection to spread. This is one of the reasons we consider tooth infection a dental emergency.

So, if your dentist is trying to get you to remove one tooth, why not two? He’d certainly make more money if he did. The only reason I can think of is that your dentist does not believe the tooth with the root canal treatment is infected and he has too much integrity to take your money on a tooth that is saveable.

I am sure if you searched you would find a dentist willing to remove both. While you do not have to replace an extracted wisdom tooth. The other tooth will need to be replaced. This will give the dentist even more money, especially if you choose to get the best tooth replacement option, a dental implant.

If you choose not to replace it, the other adjacent teeth will either shift or tip into the tooth’s empty space. This will throw your bite off and can lead to painful TMJ Disorder.

The fact that your dentist is not wanting to remove this tooth and gain all this extra money tells me your tooth is healthy and you have a dentist of great integrity. I’d stick with him.

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

Can’t Afford My Wisdom Tooth Extraction

I have an infected wisdom tooth. It has been bad for a while and the teeth around it are starting to get holes in them. Tonight I noticed I have pressure and a yellow streak leading up to my eye on the same side as the tooth. Now there is pressure behind my eye. I really can’t afford a dentist right now. Can I just visit the ER to get an antibiotic to treat this and then get to the dentist later when I can afford it? I’m starting to get concerned.

Brad L.

Man in pain holding his jaw

Dear Brad,

I want you to understand how serious this is. Your infection has already reached your eye. Your brain is not that far away and this can turn life threatening quickly. Believe it or not, people still die from tooth infections.

An antiobiotic will not solve your problem. What it can do is slow down the infection, but once you are out of the medication (and this is assuming they prescribe the right antibiotic for this particular infection to begin with) it will flare right back up and continue to spread.

The only way to deal with this is to have the tooth extracted…and soon. I would consider this a dental emergency.

Most dentists went into their field because they wanted to help people and make a difference. I would call around and see if there is a dentist who is willing to work with you on payments.

Whatever you do, take it seriously. The good news is a wisdom tooth does not have to be replaced. However, if you delay and the other teeth get so far decayed that they can’t be saved, you’ll also need a tooth replacement for them or your teeth will shift, throwing off your bite. This can lead to painful TMJ disorder.

Call around. There is bound to be a dentist in your area willing to help.

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

Is My Dentist Trying to Scare Me?

I went to my dentist after saving up for a while because I don’t have dental insurance. During the appointment, he told me I had a tooth infection. I knew my tooth had been hurting which is why I started saving to begin with, but the tooth stopped hurting. He wanted to schedule a follow-up appointment right away, but I don’t have money for two appointments. I told him I’d have to get back with him. That’s when he told me if I put it off, that the infection could kill me by getting to my heart, brain, or lungs. Is this true or is he just trying to scare me to get me to come back?

Amy

Dear Amy,

Let’s start with why your tooth stopped hurting. When your infection first set in, there was pain. As the infection progressed, however, the pulp of your tooth died so it stopped hurting. Unfortunately, that didn’t end the infection. It is continuing to spread.

As to your dentist trying to scare you, I can’t tell you exactly how urgent your particular infection is because I haven’t examined you. What your dentist said is true. Tooth infections can spread to your heart, lungs, and brain. Believe it or not, people still die from dental infections. This is why tooth infections are considered dental emergencies.

As I said earlier, I didn’t examine you so I can’t tell you how advanced your infection is. It may be that he felt you weren’t taking the situation seriously enough so he wanted to impress upon you not to just ignore this.

I understand that money is a challenge. COVID has made it nearly impossible for many people to keep up with their dental care. One thing I know about dentists is that many of them are compassionate and went into their field with a desire to help people.

The first thing I would do is explain to your dentist your financial situation and how long it took you to save up for your appointment. Make sure he understands that you are taking it seriously but that you are in a difficult financial situation. He may offer to give you the treatment you need and then allow you to pay off the cost of treatment over time. If he doesn’t, there are dentists that will. Just call around. You will find someone.

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

Is Every Toothache a Dental Emergency?

I’ve been reading about toothaches online because my daughter is complaining about a back tooth. Everyone seems to indicate that any time there is a toothache, it means a dental infection. Is that ALWAYS the case? I’m in a tough spot. At the moment there is only $35 dollars in my bank account. I don’t want to leave my daughter in danger, but I don’t know how to pay for the appointment. The tooth she is complaining about is in the back of her mouth. I would be surprised if it developed an infection because I had those teeth sealed and her last checkup had an all-clear.

Cassie

Dear Cassie,

child getting teeth attended to

While in most cases a toothache can indicate a tooth infection, it is not so in EVERY case. You didn’t mention how long it had been since her last check-up. So it is hard to tell if it was close enough where you should not be too concerned.

I recently spoke with someone in a situation such as yours. Her daughter was complaining about a back tooth. Like you, this mother was responsibile and caring, so she worried about the potential of an infection. However, when she took her daughter in, the tooth was perfectly clear. The conclusion was that her daughter, who struggles with anxiety, had been clenching her teeth. This lead to the pain her daughter was experiencing.

In her case, the solution was to get a mouth guard. She couldn’t afford a custom one at the time. So, as a temporary solution, they purchased a one-sized fits all one at their local pharmacy for just a few dollars. While not ideal, it will do in a pinch while she saves up for the better device.

Because there is no way to know without checking, I would simply recommend calling your dentist and explaining the situation. Most dentists are compassionate and went into their field because they wanted a job that allowed them to help people. As you already have a working relationship with this dentist, they may be willing to just take an x-ray and peak in order to see what is going on and allow you to pay off the appointment a little at a time. This is especially true of dentists who see children.

At least this way you will know what your daughter is dealing with. If it is a tooth infection, then it would be considered a dental emergency. This is simply because these infections will continue to spread until the infected pulp is physically removed by the dentist.

Many people don’t realize that these infections can become life-threatening because of their proximity to the brain, heart, and lungs.

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