Tag Archives: dental emergencies

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.

Pediatric Dentist

Can tooth decay Affect the Salivary Gland?

I am trying to find a solution for my daughter. She’s had two salivary gland infections and the doctor can’t figure out why. I know the molar above the salivary gland has decay. It is a baby tooth, though, so I haven’t messed with it. It’s going to fall out anyway. Now, I am wondering if maybe that decay is causing her salivary gland problems.

Andrea

Dear Andrea,

Some baby teeth have to stay for many years.

There are a couple of separate issues here. First, let’s talk about that molar with decay. While baby teeth do fall out, your daughter’s molars need to stay until she is around twelve years old. That is when her adult molars will come in. If the molars fall out pre-maturely, then the adjacent teeth will shift or tip into the open space. This will lead to crowding and expensive orthodontics later in life.

You’ll want to preserve that back molar. I would start by getting that decay looked at and filled as quickly as possible. It’s possible at this point that the molar has become infected. If that is the case, then she will need a pulpotomy to keep the tooth viable until it is safe to come out. A pulpotomy is simply a child’s version of a root canal treatment.

I’m concerned your pediatric dentist hasn’t addressed this. Additionally, she should have had her molars sealed to prevent decay to begin with.

Now, regarding her salivary gland. Tooth infections do spread to other parts of the body, which is why they are considered dental emergencies. Because of that, if her tooth is infected, it is possible that it has spread to her salivary gland. Some dental x-rays can let you know either way. You don’t want to leave this any longer because it can also spread to her heart, lungs, or brain. All of those are close to her jaw.

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

Emergency Dentist

She Shouldn’t Trust This Dentist

I am going to be honest and up front with you that I am not the best dental patient. Being in the dental chair makes me nervous in the best of circumstances so I tend to avoid dental work as much as possible. This is likely why this happened to me. I was in a lot of pain for about a week and finally caved to see a dentist. He did some x-rays and found a problem with a tooth that already had a filling. He told me there is very little chance that he can save the tooth and I should expect him to have to extract the tooth. From there, he wants to provide a dental implant. I’ll be honest that this whole thing sort of terrifies me. Is there another option?

Kelly

Dear Kelly,

A woman grabbing her jaw in pain, in need of emergency dental care

Please bear in mind that I haven’t examined your tooth so I can only go on what you’ve described. However, based on what you’ve said, I have my doubts about this dentist’s diagnosis.

If a tooth was truly that far gone, I don’t think your dentist would have even needed to take an x-ray. The decay would have been evident to the naked eye.

Even if it was under the filling, that extensive amount of an infection means the filling would have caved in or fallen out at that point.

Another issue is that type of dental infection takes a LONG time to develop. You would have been in a significant amount of pain for substantially longer than a week.

Before moving forward, I would like you to get a second opinion from another dentist. It could save you some unnecessary dental work. I do realize the idea of seeing another dentist probably doesn’t sound much better to you, but I believe I have a solution to that as well.

Your fears of the dentist are not at all uncommon. There are many people who struggle with fear of the dentist. Those who visit a dentist who offers some type of sedation tend to have an easier go of things.

When you get your second opinion, I’d like you to not tell the dentist what your first diagnosis was. Just allow him to look at your tooth and form his own opinion.

If Your Tooth Cannot Be Saved

Hopefully, your tooth is saveable. However, if it isn’t, the one thing I agree with the dentist you saw was his choice of tooth replacement. If you do have to replace a tooth, dental implants are the absolute best replacement. This surgically implants a prosthetic tooth root then attaches a crown to it. It is the closest thing to having a healthy natural tooth again.

Another option is a dental bridge. This suspends a false tooth between two dental crowns. It doesn’t require surgery. However, it does mean you have to crown the two adjacent teeth. Unless those teeth already need a crown then I don’t recommend grinding down healthy tooth structure.

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

Porcelain Veneers

Root Canal with a Porcelain Veneer

I have eight porcelain veneers that I love. I recently found out that one of the teeth needs a root canal treatment. I am a bit worried the procedure will damage my porcelain veneer. Is this safe or will I need to replace the veneer?

Maggie

Dear Maggie,

A single porcelain veneer being placed on a tooth

If your tooth needs a root canal treatment, you don’t want to leave the infection untreated. That would be quite dangerous. Dental emergencies have a way of turning into life-threatening medical emergencies when you don’t get timely care.

To put your mind at ease about your porcelain veneer, though, it shouldn’t have any impact on the porcelain veneer itself. One thing that does become an issue is the underlying tooth turning dark, which in turn will cause your porcelain veneer to turn dark. There is a way to forestall this, however.

Have your dentist carefully follow these instructions if they don’t already know this procedure.

The most important step is to make sure they get all the underlying material out of the canals from the root tip all the way to the crown of the tooth.

Once that is done, your dentist will want to put in a white fiberglass post. From there, he or she will fill the remainder of space with white composite material.

Doing this will keep the tooth white much longer than would otherwise be possible. It works even better when the tooth has a porcelain veneer, as yours does.

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

Porcelain Veneers

Smile Makeover Disaster

I need some advise. I had porcelain veneers done. The first time they came back they were way too thick. Even my dentist knew that by looking. I asked him to send them back, which he did. When they came back again, they didn’t really let me see them. They did tell me they could make any adjustments necessary after they were bonded on. That turned out not to be true. They ended up very bulky looking and, though I did ask for a white smile, they ended up chalky and fake looking . I absolutely hate them, but my dentist isn’t returning my calls. Do you have a recomendation of how I can get this fixed?

Carla

Dear Carla,

A single porcelain veneer being placed on a tooth

I think you’re suffering from having a decent family who is trying to do cosmetic dentistry he’s not qualified to do. Believe it or not, smile makeovers aren’t taught in dental school. A dentist has to invest in a significant amount of post-doctoral training in order to develop the skills necessary to create beautiful smile makeovers. My guess is your dentist didn’t invest in that.

True cosmetic dentists also know that it is the patient’s perception of their smile that matters most. Because of that, they will use a temporary try-in paste so you can get a good look at your porcelain veneers in a variety of lightings before they are bonded on. You have a legal advantage. He misled you regarding the ability to make changes to your porcelain veneers after they were placed, bonding them on without your official permission.

Getting Your Porcelain Veneers Done Right!

Normally, I would say insist on a refund, however, you mentioned he’s not returning your calls. That may be because he is avoiding you or, if we want to be generous, maybe he’s not checking messages as much if his office is closed during the COVID-19 quarantine. Though, they should be open for emergency procedures.

Leave him another message letting him know if you don’t hear back from him this time, you’ll be contacting a lawyer. That will kick him into gear. If you do end up having to get a lawyer involved, you have a pretty solid case. I’m sure his insurance holders will advice him to settle quickly.

When you go to have these re-done, I want you to be certain you use a dentist with both training and artistry.. Ideally, you’d see an AACD accredited dentist (which is different from just being a member). Accredited dentists are in the top 1% of dentists in the country. If you can’t find one of them within a reasonable distance to you, contact me again and we’ll help you find someone.

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

Uncategorized

Popcorn Kernel Leads to open Heart surgery

Adam Martin in recovery. Photo courtesy of SWNS

I saw an article yesterday that emphasized how quickly things can turn dangerous with a dental issue. You can read the article in its entirety here, but I will sum it up.

Adam Martin, a 41-year-old man in the United Kingdom, had a popcorn kernel stuck in his tooth. He’d tried various ways to remove it with no success. Soon afterward, he started feeling sluggish. He thought is he was coming down with something. It quickly escalated and he took a trip to the hospital.

After some diagnostics they realized a tooth infection had quickly spread to his heart and ate away at his valves. He now required emergency open-heart surgery.

When Adam spoke to reporters, he said, “If I had gone to the dentist in the first place, none of this would have happened.”

Dental Infections Can Lead to Death

Your teeth and gums have direct and short pathways to your heart, lungs, and brain. Tooth infections and gum disease can cause serious problems, just as they did for Mr. Martin.

If you have tooth pain, it often means you have a tooth infection. It needs to be checked out as soon as possible. Most dentists reserve time for dental emergencies, such as an abscessed or broken tooth. You simply need to call your office and let them know what is going on.

Preventative Care Saves Money

I know dental care can sometimes seem expensive, but did you know NOT going actually costs you more money? Going to the dentist just twice a year prevents most cavities, especially if you are following up with good home care practices.

If you do happen to get a cavity, it is caught early. A small composite filling costs significantly less than letting it grow and needing a dental crown, which costs hundreds of dollars more. If you let it grow from there, you’re also talking about a root canal treatment or possibly even an extraction and dental implant. That is thousands of dollars more.

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.

Lafayette LA Dentist

Pediatric Dentist Strapped My Child Down

I am absolutely appalled. I took my daughter to the pediatric dentist for the first time. I got a little nervous when they didn’t let me back with her, but I didn’t want to make her worry so I pretended it was no big deal and she’d have a lot of fun. You can imagine how heartbroken I was when she told me that she got scared so they strapped her down. When they brought her out I could tell she’d been crying. I called, thinking I must have misunderstood her or she didn’t know how to explain what actually happened. They told me it’s standard procedure in dealing with an uncooperative child. Please tell me that’s not correct. She doesn’t ever want to go back.

Amy L.

Dear Amy,

Boy smiling and holding a toothbrush
Dental Care for Children Should be All Smiles

I’m heartbroken with you for the trauma your little girl experienced. I believe what you’re referring to is a papoose board. It wraps the child which essentially keeps them from moving during their appointment. It used to be a regular practice in many pediatric offices but has come under fire in recent years. Even the American Academy of Pediatric Dentistry has warned of its drawbacks and said parents have the right to terminate its use at any time.

While some children do better alone, many feel comforted knowing the mother is there to look out for them during their appointment. The goal of pediatric dental care is to give children a positive experience and get them excited about taking care of their teeth. I’d say your pediatric dentist totally failed at that.

Finding a Good Pediatric Dentist

You’ll obviously want to switch to a different practice. You can take your daughter to a pediatric specialist or a general dentist who enjoys treating children. One way to know how good a general dentist is with children is the age they’re willing to first see them. If they say around two years of age, you can feel pretty sure they’re comfortable with the wee set. If they say 8-10, then I’d look elsewhere.

Given your daughter’s experience, you’ll want a dentist who will let you go back with her. She’ll need to feel safe. You may also want to give her some nitrous oxide. It’s commonly called laughing gas and will help relax her. Wherever you end up, be sure to check their reviews ahead of time as well.

Please tell the new dentist what your daughter went through so they’ll be prepared to handle her understandable fear. We want to get her on the right track having positive experiences.

Most adults who end up with dental emergencies do so because they had a traumatic experience as a child and now avoid the dentist until their services become unavoidable.

For those patients, we recommend oral conscious sedation. It’s stronger than nitrous and will allow them to sleep through the appointment. That would be the last resort with a child, though. Let’s see if we can’t get her relaxed and happy without it.

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