Tag Archives: Dental Crown

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

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.

 

Pediatric Dentist

Daughter Broke Her Front Tooth

My daughter fell and broke a chunk off her front tooth. I immediately called our pediatric dentist and he said the soonest he could see her is six months from now. I told him we are pretty anxious to get it fixed and asked him to recommend somewhere. His response was that everyone will tell us that the nerves need time to calm down and then they can see us. For some reason that felt like an excuse to me. If not, why not say that upfront instead of originally saying he’s booked for six weeks? Is there really a necessary time to wait?

Belinda

Dear Belinda,

Your instincts are good. There isn’t really a reason you should have to wait. I’m guessing your pediatric dentist just didn’t want to lose any business. This can be treated right away.

If you have the piece that broke off, a good cosmetic dentist can reattach it. If not, the solution would be to have dental bonding done. This will also need to be done by a good cosmetic dentist. It doesn’t necessarily need to also be a pediatric dentist. There are general dentists who work well with children.

As she ages, the pulp of her tooth will get smaller. At that point, it may be necessary to do a dental crown. Until then, bonding or reattachement are your best options for her.

If she gets nervous at the dentist, look for someone who offers dental sedation. They can give her something to relax her. It doesn’t have to be very strong, even just nitrous oxide will be enough.

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

Pediatric Dentist

Daughter has a Broken Tooth

I have a ten-year-old daughter. Today she fell and broke a front tooth. I am a bit frustrated with my dentist who said that he can fix it but he cannot see her for six weeks. When I told him I did not want to wait that long, he said it was necessary for the tooth to desensitize anyway. If that is the case, I’ll wait. However, I got the impression he was just saying that. If that is the case, I’d rather go somewhere else. What is the right thing for me to do?

Cassie

Dear Cassie,

No, there is not a medical reason to wait. I suggest you take her to another pediatric dentist to be evaluated and treated. If you tell them what happened, they may be able to schedule an emergency appointment for you. It would be ideal if it is a dental practice that also has a highly-trained cosmetic dentist on staff. It’s okay if they don’t, but you’ll want a skilled cosmetic dentist to do the repair.

If you have the piece that broke off they may be able to re-attach it. If that peice is missing, then dental bonding will be the right solution. Both require expert cosmetic dentists as I mentioned above.

As she gets older, the pulp of her teeth will shrink. At that point, she’ll need a single dental crown. Be aware that dental insurance only pays for the cheapest option. For children, that is usually a silver crown. I doubt you’ll want that on her front tooth, so call the office and find out what the price difference will be from what the insurance will cover and what you want for her. If you start saving now when the time comes it won’t be as much of a financial burden.

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

CEREC

cerec crowns on front teeth

I was in a car accident and damaged both my front teeth. I need to get crowns on them. I am trying to decide between regular crowns and CEREC crowns. Is one better than the other?

Benjamin

Dear Benjamin,

porcelain block for CEREC crown

CEREC crowns are made out of single block of porcelain. This will give it a very uniform look. This works fine on most teeth. However, our front teeth are much more visible and exposed to light.

Natural teeth aren’t uniform. Look at this image of a tooth directly below. There are varying levels of translucency and opaqueness depending on where you are on the tooth.

image of a tooth

When a dentist does a traditional crown, it is built in layers with varying shades of porcelain. This can make a crown look more natural. However, even then, you’d need an expert cosmetic dentist because this takes a high level of skill.

If you really want a CEREC crown, then having an expert cosmetic dentist is even more important. They need to have a high level of skill in color theory so they can use various stains to give it that variated look while keeping that natural translucency.

Cosmetic Considerations with Dental Crowns

The dental crown can be made to match your teeth exactly. However, the color is permanent. If you are happy with the color of your teeth, then you do not need to take any further steps. However, if you want your teeth any whiter, the time to take care of that is before having the crowns designed.

In that case, your first step is to have your teeth whitened. You can do that in one appointment if you see a dentist who does Zoom Whitening.

Then, give it a couple of weeks for the color to calm down. That’s when your dentist can match the permanent color for you.

When you’re talking about front teeth, whether you get a traditional or CEREC crown, you will need a dentist capable of the skills required. I suggest you see an AACD accredited dentist.

This blog is brought to you by Louisiana Cosmetic Dentist Dr. Mike Malone.

Lafayette LA Dentist

dental bridge or implant

I have to replace two teeth and get a dental crown on another one. I’m trying to decide between dental implants and a dental bridge. What do you think would best work?

Kevin

Dear Kevin,

Both a dental implant and a dental bridge are good tooth replacement options. Which one you get will depend on a couple of things. First, I’ll go over how both of them work. Then, we’ll discuss which to choose.

An illustration of a dental implant among natural teeth
A Dental Implant

With dental implants, a prosthetic tooth root is surgically placed into your jaw. There is a time of healing after the surgery and to allow the bone to integrate around the implant. After that time period, a dental crown will be placed on it

There are benefits to dental implants. They’re completely secure and the closest thing to having a healthy, natural tooth in your mouth again. Additionally, the root form signals to your brain the jawbone in that area is still necessary, thereby preserving it.

Illustration of a dental bridge
Dental Bridge

With a dental bridge, a false tooth is suspended between two crowns. This is secured by being bonded onto the adjacent teeth. It makes more sense when one of the adjacent teeth already needs a crown. Without that, you’re just grinding down healthy tooth structure.

Implant or Bridge?

If you need a false tooth next to the tooth which needs to be crowned, then it would be a good idea to get the bridge. If the tooth which needs a crown is elsewhere, I’d get the dental implants to replace the tooth and then get the single tooth crowned.

I hope this helps. This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Lafayette LA Dentist

Pimple turning tooth gray

I think I need help fast, but I don’t have a dentist. I have a pimple on my gums which is causing serious pain. I think it’s poisoning a tooth tooth because one of my teeth has turned gray. What do I do if I don’t have a dentist?

Brooke

Dear Brooke,

Woman grabbing her jaw in pain needing an emergency dentist
Tooth pain is a dental emergency

I’m very sorry you are in so much pain. You’ve got two things going on here. One of which is considered a dental emergency.

Pimple on the Gums

Let’s start with the pimple on your gums. This is a sign you have an infected tooth. The pimple is known as an abscess. This happens because the infection is severe. Infected teeth are considered dental emergencies.

These infections will continue to spread. In some cases, they become life threatening quickly. This is a result of where they spread and how long they’re left untreated. Your jaw is very close to your brain and heart. If the infection reaches there, sometimes it is too late to do anything. There were too many people who died from tooth infections last year, given how preventable it is.

I do realize you don’t have a dentist. Because this needs to be seen to right away, I’m going to suggest you do an internet search for an emergency dentist. These are general dentists who are willing to see non-established patients quickly in cases of emergencies such as yours.

Often, they’ll do what they can to get you out of pain, prescribe an antibiotic for hold off the infection and schedule a follow-up appointment to give the tooth the entire treatment it needs.

A Gray Tooth

When a tooth has turned gray, that is a sign it is either dead of dying. This tooth was also infected, which is a definite indicator the infection is spreading.

The dead tooth won’t have any pain, but the infection is still there and will need to be removed by the dentist. Unlike medical infections, you can’t just take an antibiotic and be done. Antibiotics will only keep a dental infection at bay, it won’t rid your body of it.

With dental infections, the dentist has to get in there and physically remove the infection with a procedure called a root canal treatment. This often requires the tooth to be crowned as well.

Don’t put off getting this seen.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Cosmetic Dentist

Cosmetic Dentistry Tourism Disaster

I had porcelain veneers placed on my top teeth and a dental implant and crown on my bottom arch. In the U.S. it would have cost me over $60,0000 but I was able to get it done overseas for around $11,000. At first, I was pleased as punch, but now I’m four months out and the veneers are falling off. I’ve been cutting up the food the way he showed me and not eating with my front teeth at all. In fact, the last one fell off while eating spaghetti. That’s hardly anything to stress about. Three of the veneers have fallen off. They’re all intact. Do I need to have these re-done or can another dentist put them back on?

Catrina

A single porcelain veneer being held up by a dental tool

So, here’s the thing. Those instructions your dentist gave you about eating are a huge red flag to me. There is absolutely no reason why you should have any restrictions at all on what or how you eat. When properly bonded on, porcelain veneers will allow you to eat anything.

This dentist doesn’t know proper bonding technique. That alone, makes me question the skill of the rest of his work. For health and safety reasons, I’d like you to get a second opinion on the dental implant and crown you had done. This is especially important about the implant. If an infection develops it can lead to serious consequences.

Regarding your fallen porcelain veneers. You mentioned they’re still intact. In that case, it is possible an expert cosmetic dentist could clean them up and get them bonded back on properly. However, this is beyond the skill of almost all cosmetic dentists. You will need someone in the top 2%.

Finding an Expert Cosmetic Dentist

Cosmetic dentistry isn’t really taught in dental school so you’ll need to look for someone who invested the time and training into doing it well. In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are in the top 1% of dentists. You can find them listed on aacd.com. Just make sure they’re accredited. They will know the right procedure to help you with your porcelain veneers.

The cost to get them bonded back on properly shouldn’t be too bad, if they can be saved. If they can’t be, these dentists will give you a list of options and let you determine which way you want to go.

This blog is brought to you by Louisiana Cosmetic Dentist Dr. Mike Malone.

Uncategorized

Should I Call an Emergency Dentist for a Lost Filling?

Is it a dental emergency if I lost a filling? It’s the New Years Weekend and I don’t really fancy spending it in the dentist’s office.

Mark C.

Dear Mark,

A man holding his jaw in pain in need of a dentist

What??? You don’t want to ring in 2018 from a dental chair? I can’t imagine why not. What could be more invigorating?

In the case of a lost dental filling, you have a couple of good options. Before I give you those, let me tell you what not to do…ignore it. If you don’t do anything bacteria will get into the newly created space and blow up into a tooth infection. Depending on how fast-moving everything is, you could spend the beginning of the New Year in the hospital.

Besides, having a hole in your tooth will not allow you to enjoy all the New Year’s Eve goodies the way you could if it were filled.

You do have a couple of good options:

Ask Your Dentist for an Emergency Visit

I know. I know. You said you didn’t want to go in. But, seriously, a filling takes hardly any time and you’d be back to normal without this weight on your back of having to go to the dentist’s office at some very near date. Who wants to spend New Years dreading the New Year?

Replacing a filling is normally quick and painless. However, the dentist will want to investigate to find out why the filling came out in the first place. You’ll especially want to make sure there’s no new decay developing which could sabotage your weekend plans.

Get Temporary Filling Material

Some pharmacies stock a temporary dental filling material. This will NOT actually replace your filling and is designed to be temporary— a few days at most. But, it could hold you over through your parties, etc. Then, first thing January 2nd, you’ll really need to get in to see your dentist. No excuses.

If you put it off, you won’t be looking at a filling, but rather a dental crown or tooth extraction. That is definitely not how you want to start the year.

This blog is brought to you by Dr. Mike Malone.

Lafayette LA Dentist

Is It Normal to Get a Pimple on Your Gums?

I’ve got a pimple on my gums. I’m worried about it. My husband says I’m overreacting, that it’s just a pimple. But, I’ve never heard of a pimple on gums and it hurts. Is this normal?

Danya L.

Dear Danya,

Emergency Dental Care

You’re right to be concerned. This is more serious than a simple pimple. It’s likely one of two things. First, it could be the beginnings of a canker sore and just resembles a pimple. This won’t be very large, but it will “open up” and start to resemble a canker sore rather soon.

This is not an emergency, but you will want to attend to it. Salt water rinses will help, along with over the counter pain relievers. It should clear up within two weeks. If it doesn’t, see your dentist for an oral tissue exam. Sometimes oral cancer resembles a canker sore. Your dentist examines you for this at every check-up. If you’re diligent with your check ups, the canker sore is the more likely scenario.

If it truly resembles a full-sized pimple, then it is most likely a fistula. This is filled with puss, so don’t pop it. You won’t like the taste. A fistula means you have an active tooth infection. This needs to be seen right away. In fact, if you don’t have a regular dentist, you need to see an emergency dentist. They’ll work you in sooner than most dentists even if you’re not an established patient.

There are a number of possible treatment options here depending on why the bacteria is pooling. If the tooth is cracked and leaking bacteria into the gums, then you’ll need a dental crown. If it’s in a visible place then you’ll want to be sure to get an all-porcelain crown. They look completely natural. If there’s an infection, it’s possible to need a root canal treatment.

Either way, you don’t want to put off treatment. The infection will spread. The quicker it’s treated, the less invasive the procedure will need to be.

This blog is brought to you by Dr. Mike Malone.