Tag Archives: Dental Anxiety

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.

Dental Implants

Implant Bridge Does Not Match My Bite

I had a dental implant bridge placed, but it does not match up with the rest of my bite. Now the side of my teeth with the dental bridge hits first when I bite down, which hurts a LOT. I am wondering if the surgeon did something wrong. He insisted that he was in charge of the whole thing, but when I went to see an implant dentist after my surgery and he said that he would have recommended a different placement. I don’t know what to do here.

Kate

Dear Kate,

implant bridge
An example of a full arch implant bridge

I am glad that you wrote. It sounds like the surgeon threw off your bite with improper placement of the dental implants. This needs to be fixed. If it does not get fixed, it could very likely lead to TMJ Disorder.

It is a basic principle of implant dentistry that it is the restorative dentist who plans the placement, not the surgeon. Yet, your oral surgeon assured you he was in charge. If you can get your dentist to admit that the oral surgeon placed them in the wrong place then you can get a refund from him. I would also ask him to pay for the bone grafting you are now going to need.

Replacing dental implants is not as simple as taking out dental implants and then putting in new ones. When the implants are removed, they will take bone with them. That bone is necessary in order to retain the dental implants. Because of that, you will need a bone grafting procedure to build back up the lost bone.

Then, once the bone grafting is healed, you will be able to have the new implants placed for your implant bridge. Just make certain that your dentist plans the treatment and NOT the surgeon.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.
Do you have dental anxiety? Click here to learn more about sedation dentistry.

Sedation Dentist

Sensitive to Novocain

I have a high sensitivity to Novocain and any type of numbing medication, but want to get porcelain veneers. A friend of mine with a similar condition said that when they put the numbing medication on her she became very shaky and had a hard time calming down. I don’t want that to happen to me so was wondering if there was a way around this.

Callie

Dear Callie,

a porcelain veneer being held up to a tooth

I think you are going to be okay to get the porcelain veneers. Your friend’s reaction is unlikely to be from the Novocain. There’s a very slight possibility that it would be in the epinephrine that is often present in Novocain, but I find that unlikely. The reason for that is the amount of epinephrin in Novocain would be significantly less than what is present in your body when you become fearful.

It is more likely that your friend has dental anxiety which made her shaky. If you have dental anxiety as well, then I would recommend you have your cosmetic dentist provide you with nitrous oxide. Don’t let a dentist talk you into a stronger sedation for your porcelain veneers procedure. It is not a painful procedure at all. This will relax you enough that you won’t have anxiety.

With nitrous, your dentist can switch it back to oxygen and you will be back to normal in just a couple of minutes and can approve or disapprove your smile makeover. If you use anything stronger, then you will be way too groggy to approve anything. You could end up with a smile you hate.

You also want to make sure whoever is doing your smile makeover has extensive post doctoral training in cosmetic dentistry. It would be ideal if they were AACD accredited. These are the top cosmetic dentists in the country and will give you a stunning smile makeover. At the very least, make sure that they have a beautiful smile guarantee which allows you to approve the smile. If you don’t love it, then they should be willing to go back to the lab and make any changes you want.

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

Sedation Dentist

Can I Use Sedation for a Smile Makeover?

I want to get a smile makeover but I am a nervous dental patient. Would I be better off getting dental sedation so they can just knock me out, do the work, and I wake up with a beautiful smile?

Candy

Candy,

Woman resting in dental chair from dental sedation

I am sorry for your dental anxiety. I want you to know that you are not alone in feeling this way. Hopefully, you go to a dentist who is understanding about your fears. It can be very helpful to go to a dentist who is compassionate with patients who are anxious.

While I am a big proponent of using dental sedation, the one concern I have about using it for your smile makeover is that, depending on the type of sedation you use, you won’t get to approve the smile before it is bonded on permanently.

If you are getting porcelain veneers, very little shaving needs to be done on your teeth. The dentist will give you something like Novocain, which will make you completely numb. If that still scares you, then you could have some nitrous oxide. Unlike oral conscious sedation, which will make you too sleepy/loopy to make an informed decision in approving the porcelain veneers, your dentist can switch the nitrous to oxygen once the porcelain veneers have been placed with a temporary try-in paste. This will enable you to be lucid enough to decide if they are to your satisfaction and ready to permanently bond on.

Never allow a cosmetic dentist to bond on your veneers without your getting to see them and approve them. If you don’t absolutely love how they look, the dentist should make the changes needed.

Unfortunately, smile makeovers are not adequately taught in dental school. In order to develop the technical skill and artistry necessary to create beautiful smiles, they will need post-doctoral training. I would look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the best cosmetic dentists in the world. You can feel confident that they will give you a stunning smile.

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

Sedation Dentist

Zirconia Allergy or Burning Mouth Syndrome?

I had two zirconia crowns placed. I’m never a great dental patient because I have a bit of anxiety, but I do my best. Getting these crowns was a big deal for me, though you might find it silly. Since then, I have had this burning and itching in my mouth since getting the crowns. I went back in to see the dentist and asked if I was allergic to the zirconia in the dental crowns. He told me that no one is allergic to zirconia. I felt like he was blowing me off so bucked up and went to see another dentist. He said that he felt it was burning mouth syndrome. I don’t know what to think. Does this sound more like an allergy or the burning mouth syndrome?

Amy

Dear Amy,

An image of a woman resting in a dental chair with dental sedation to relax her

Thank you for reaching out. Let me say right off the bat that I do not think you are being silly. Dental anxiety is real. When you struggle with that and still go to the dentist, it takes a lot of courage. I would never minimize that.

Any advice I give will have to be general because we have not examined you. However, I think I can be of some help. While a zirconia allergy would be extraordinarily rare, I do not think it is wise to say that no one is allergic. The human body is vastly complex and each person is completely unique. The easiest way to find out if you have an zirconia allergy is to get tested for one.

As for burning mouth syndrome, that is a possibility as well. While there is no “official” cause for burning mouth syndrome, several dentists have seen a direct connection between patients with dental anxiety and the development of these symptoms.

Dealing with Dental Anxiety

As you’ve experienced in your own life, our teeth do not care if we are anxious. They’re going to continue to need care whether we are ready for it or not. I want you to have positive dental experiences that will help alleviate the anxiety you have endured all of these years.

My recommendation is that you only see dentists who offer dental sedation. These dentists are not only more compassionate toward patient with your fears, but they can also offer you a medication which will completely relax you. Not only can you have a pain-free/anxiety-free appointment, but if you use something like oral conscious sedation, you are very likely to sleep through your entire procedure.

Patients, who for years only went in for treatment when they had a dental emergency, have found that using dental sedation changed their lives. Not only were they able to get much needed work done without fear, but they were also able to completely get on top of their oral health care and no longer have to worry about their teeth falling apart.

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

Sedation Dentist

Who Removes Teeth for Dentures?

I have always had a problem with going to the dentist, ever since I was a child. This has led to me having some pretty severe problems with my teeth. I was pretty much only going when there was a dental emergency. I’m really tired of it because every appointment is a nightmare. I’m considering getting my teeth extracted and getting dentures to replace them. Would the dentist do that, or do I need to go to an oral surgeon?

Stanley

Dear Stanley,

An image of a woman resting in a dental chair with dental sedation to relax her

You are not alone in having a hard time with the dentist. Many people struggle, especially when they had a traumatic experience when they were younger. Before you have your teeth removed, I want to make sure you understand what the results will be and that you know all of your options.

Once your teeth are removed, your body will immediately begin to resorb the minerals in your jawbone. It does this because it is trying to be as efficient with your body’s resources as possible. The big problem with that is that this has the side effect of slowly shrinking your jawbone. In about ten or so years, you will no longer have enough jawbone left to retain your dentures. This will make you a dental cripple able only to eat soft foods. Dentists call this facial collapse.

The Solution to Facial Collapse

There is a way to prevent the shrinking of your jawbone. It will mean having dental implants surgically implanted in your jawbone. Then, when there has been time for your bone to integrate with the implants, your denture can anchor your dentures to them. The implants signal to your body that you have teeth roots there, so it does not try to resorb the minerals in your jawbone.

This will also increase your quality of life. Even the best fitting removable dentures will reduce your chewing capacity by 50%. Having them anchored means you will be able to eat anything you want. There will be no slipping or sliding.

Getting Pain-free Dental Care

However, the best solution is to keep your teeth in place. Many people who have dental anxiety find that going to a sedation dentist completely changes their experience with dental care for the better. A sedation dentist can offer you a pill that you can take. This pill will completely relax you during your appointment. In fact, you’ll be so relaxed that you will be able to sleep through your entire appointment if you want to. This form of dental sedation is known as oral conscious sedation. The only downside is that the medicine is so strong that you will need someone to drive you to and from your dental appointment as well as stay with you for a few hours until the medication wears off and you are more lucid and steady on your feet.

This would be a better solution for you in the long term than removing your teeth. However, if you still want to get rid of them, I want to answer your original question. Pre-denture surgery can be done by most dentists and is not complicated. You will want someone who can do your surgery and the dentures. I would ask what their normal procedure is, though, and not tell them what you are looking for. You want someone who does this often and is comfortable with the procedure.

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

Sedation Dentist

Dealing with a High Resistance to Novocaine

I am 27 years old and have horrible teeth. Dental work is almost impossible for me because I have a high resistance to Novocain which makes it almost impossible to get numb. I’m thinking my only option is to remove my teeth and get dentures. I want to move up in my career and feel my smile is really holding me back. I am assuming that I can get the teeth removed with anesthesia, right?

Amelia

Dear Amelia,

Woman with beautiful smile

Before you do anything drastic, like remove all your teeth, I want togive you a solution that will allow you to keep your natural teeth, have a beautiful smile, and not get tortured at the dentist because of your high resistance to Novocain.

There is a huge connection between the inability to get numb and dental anxiety. Given your traumatizing experiences with dental care, I would not be surprised if you had a very high anxiety level.

This anxiety amps up your metabolism, which burns off the numbing medication before it can do anything. I recommend you see a sedation dentist who offers oral conscious sedation.

This is administered by a pill which will completely relax you. In fact, it is so strong that it has been dubbed sleep dentistry because most patients just snooze through their entire procedure. You will need someone to drive you to and from your appointment as well as stay with you for a few hours until you are lucid and steady on your feet again. But, this will change your life and you’ll be able to get that work done on your teeth without pain or anxiety.

Why You Don’t Want Dentures

images of before and after facial collapse
The result of facial collapse

When your teeth are removed,  your body recognizes that and immediately begins to resorb the minerals in your jawbone to use elsewhere in your body. In about ten or so years, you will no longer have enough of your jawbone left to retain your dentures. Dentists call this facial collapse. You are only 27 years old, this is NOT what you want.

While there is a way to prevent this, it is expensive. You could have dental implants placed that your dentures would anchor to. The implants are like prosthetic tooth roots, so your body recognizes that you have teeth there and leaves your jawbone intact.

Before you go this route, I think trying dental sedation will truly solve your issue.

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

Sedation Dentist

Need Advice about a Tooth Extraction

Years ago I had an infected tooth. I avoided the dentist because I have never had a good experience with one. When I could not take the pain anymore, I schedule an appointment. He said the tooth was infected and performed a root canal treatment. I was supposed to schedule a follow-up appointment for the cap, but never did. I probably should have because it seems like the tooth got reinfected. It hurt again and pieces started falling off. I went to another dentist who confirmed the infection. I received quite a lecture about the state of my teeth and not getting regular care. He told me it would be a tough extraction. The best he could offer me was nitrous oxide. If I didn’t think I was able to handle the procedure, he could refer me to an oral surgeon. I was thinking I would go with the oral surgeon. However, it turns out they are a LOT more expensive. Would I be able to get this done with a dentist and it not be an absolute nightmare or do I need to take out a loan and see the oral surgeon?

Imogen

Dear Imogen,

Woman resting in dental chair from dental sedation

I am going to say right off the bat that this dentist you saw will not be the best dentist for you. What you need is compassion and a solution, not a lecture. That does not lend toward helping patients feel comfortable going to the dentist.

You should not have to take out a loan and go to an oral surgeon for this extraction. The right dentist can do this extraction for you. What I think you need is a dentist who offers other, stronger, dental sedations options, such as oral conscious sedation.

They are generally more compassionate with anxious patients than the dentist you just experienced. Let them look at the tooth and tell you whether or not they can do the extraction. My guess is you will find someone. It sounds more like this dentist was out of his comfort level and was trying to push  the blame off on you.

With oral conscious sedation, you are not knocked out, but will be so completely relaxed that you will be able to sleep completely through the procedure if you want to.  Most patients who use dental sedation find it completely changes their life and they are able to get the dental care they have always wanted.

The only downside is, because of its strength, you will need someone to drive you to and from your appointment, as well as stay with you for a few hours after the procedure. They will want to make certain you are lucid and steady on your feet.

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

Sedation Dentist

Dentist Cannot Get Me Numb

My dentist tried a paste and seven injections and still could not get me numb. I am in desperate need of a root canal treatment, but the procedure was too excruciating. He ended the appointment and refunded my money. He told me he’d do some research, but I may need to get this extracted surgically with anesthesia if we can’t do the root canal treatment. I really want to save the tooth if possible. He prescribed me some more antibiotics and said he’d be in touch before the prescription runs out. Do you have any way that I can avoid losing this tooth?

Angela

Dear Angela,

Woman resting in dental chair from dental sedation

I am sorry for the horrible experience you went through. The fact that you still want to try and save your tooth says a lot about your character and perseverance.

The good news is I have a solution for you. It sounds like your dentist may not yet be aware of the connection between dental anxiety and the ability to get numb.

When you have a high level of dental anxiety, which many do, your metabolism can burn off the numbing medication before it can be of any use to you.

While you cannot just will your anxiety away, there is a medication that sedation dentists can provide for you that will do it for you. Not only will the medication completely relax you, but if you wanted to you would be able to completely sleep through your entire appointment.  Because of this, some people have dubbed it sleep dentistry.

My suggestion is you see a dentist who offers oral conscious sedation. This is administered by a pill that you will take before your appointment. Be aware that it is strong. In fact, it is so strong you will need someone to drive you to and from your appointment as well as stay with you for a few hours after your appointment. This will be important because you will still be a bit woozy and unsteady on your feet. I would plan on a day of napping or binge-watching your favorite streaming channel.

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.