Tag Archives: Dental Implants

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.

Is She Allergic to Her Dentures?

Can you help me? I recently received dentures. When I first wore them, I started getting some redness around my eyes and swollen glands. I continued wearing them and went back for a fitting. I am really pleased with how they fit, but the awful symptoms got worse. After a few days, I started having trouble breathing and my entire face was swollen. I discontinued the dentures for a week and the symptoms subsided. When I started them back, within one day the symptoms had returned. I don’t want to give up these dentures because they fit so well. Is there anything that can be done?

Miranda

Dear Miranda,

Dentures

You are definitely allergic to these dentures. I would stop wearing them until you can figure out exactly what you are allergic to. You can go to an allergist and have this evaluated.

Do not mess around with an allergy. You have already had some difficulty breathing. You do not want this to turn life threatening.

There are a couple of possibilities here. One is that you are allergic to the monomer used in the acryllic. This can be dealth with.  The acryllic begins in the liquid form when it is being used in dentures. That is a monomer. Then, a chemical reaction is used to harden it into a solid polymer. Some of the monomer is always leftover in the chemical reaction. You may remember about leftover reactants from your chemistry study days in high school or college.

If that is what you are allergic to, then you can immerse the denture in very hot water for several hours to complete the process from monomer to polymer.

If you are allergic to something else used to build the denture, then there are other materials that can be used, including other resins.  Though, in those cases the denture will have to be remade. Hopefully, if it comes to that your dentist can make sure it fits as well as the first one.

I want to give an additional word of caution. I don’t know if your dentist warned you about facial collapse when wearing completely removable dentures, but I would take this time when you are at a crossroads with your denture to learn about that so you can make as informed a decision as possible. The solution to that would be dental implants combined with dentures.

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

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.

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

Can I Get Gold Teeth on Dentures?

I’m only 49 but I’m about to get dentures. I’m tired of these teeth hurting me, I’m ready to be rid of them! I’ve never had dentures before, so I’m kind of excited at the thought of looking good. I was wondering though, do they ever make them with gold-outlined teeth on the front? I just want the upper front two done. I love how that looks but I haven’t seen anyone with that in their dentures yet. So I didn’t know if it was something I could even have done.

Sasha

Dear Sasha,

Dentures

I’m glad you wrote. The short answer is yes, you can have gold teeth set in your new denture. There are a number of variations, from full gold crowns to small amounts that hardly show at all. It will be important that you are very specific with your dentist regarding exactly what your expectations are. The safest option would be to bring in a photo of what you want the teeth to look like to avoid any miscommunication.

As you might guess, adding gold to the denture teeth adds extra expense and your fee will be higher than that of a typical denture. This fee will vary according to the amount of teeth involved and the gold required to cover them.

Understanding Dentures

Before and after facial collapse
Before and After Facial Collapse

I know your teeth are killing you and you are ready to be rid of them, but I want to make sure you understand what you are getting into with dentures. Even the best-fitting dentures will reduce your chewing capacity by 50%.

However, the bigger issue is bone resorption. When your teeth are removed your body recognizes that and immediately begins to resorb the minerals in your body in order to use your resources most effectively. While great stewardship for our body’s resources, it will have the unfortunate effect of shrinking your jawbone. After ten or so years, you will not have enough jawbone left to retain your dentures. Plus, the loss of bone makes you look a couple of decades older than you are.

There is a Way to Prevent Facial Collapse

If you have dental implants placed then your body will interpret that as you still having tooth roots there which need the bone to keep them secure. This will prevent the bone loss from occuring. You can have implant supported dentures placed. This uses a minimum of four dental implants and then when the bone has had time to integrate with the implants a denture can be anchored to them. Not only does this prevent facial collapse, but it is completely secure. You will have no slipping or falling out. You can eat anything you want.

If you absolutely cannot save your teeth. This is what I’d recommend. Because of how young you are, completely removable dentures will be a disaster for you long term.

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

Help! I Look Like a Chipmunk!

Can you advise me? I’m looking for a second opinion. My two front teeth are long and stick out a bit from the rest of my teeth. I always feel like my teeth make me look like a chipmunk. My dentist is suggesting I extract them and get dental implants, but I want to make sure there is not another option before I go that route.

Avery

Dear Avery,

Invisalign aligners
Invisalign Aligner

Whatever you do, please do not have your teeth extracted. That is way too drastic a solution. I suspect your dentist said that because he doesn’t have any training or familiarity with cosmetic dentistry options for people in your place.

Bear in mind that I have not examined you. However, I do have some general advice. Though, I’d like you to see an expert cosmetic dentist and get his or her opinion. Look for someone who is AACD accredited.

One thing you can do is trim down the protruding teeth. This can be done with diamond burrs and diamond strips. A dentist skilled in this procedure can file them on the sides and bottom to make them match the remainder of your smile more appropriately.

The next step would be to move the front teeth back into place. You have a couple of options for this. The first is to get a retainer to move them back. The second would be to use Invisalign. That would be my suggestion.

If a lot of the tooth structure has to be removed in the trimming process, you may need porcelain veneers to cover the exposed dentin. The key to all this will be a great cosmetic dentist who looks at your specific case and makes recommendations. However, at least now you know you have good options and don’t have to remove your teeth and replace them with dental implants.

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

Will Invisalign Correct Misalignment?

I have some misaligned teeth but feel too old for traditional braces. I asked my dentist about Invisalign and he said it does not correct misaligned teeth. I sort of have my doubts and felt like he just wanted to refer me to an orthodontist friend of his. So, I thought I would double-check with you guys whether it would be possible for me to use Invisalign.

Karen

Dear Karen,

Invisalign aligners
Invisalign Aligner

It sounds to me like either your theory is correct or possibly your dentist is just not open to new treatment options. As such, he may be completely unaware of what Invisalign is capable of.

My suggestion is that you get a second opinion from a dentist who has experience with Invisalign and let them look at your case. When Invisalign first came out, many years ago, it was only able to do the more ideal cases. These days, however, they can fix all but the most complicated cases.

If your dentist isn’t willing to keep up with the latest technologies in his field, he may not be the best dentist for you. You want the top treatment possible. Let’s say you lose a tooth and need to replace it. Will your dentist only offer removable partial dentures or does he know about dental implants, which give you a permanent, secure tooth?

I’m not telling you to switch dentists. However, I would advise you to take a good look at what your dentist offers and see if he is keeping up in his field.

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.

Invisalign and Missing Teeth

If I have a missing tooth and want to replace it, but have a crooked tooth too, how do I fix that? I was thinking of replacing the lost tooth with a dental implant and straightening my teeth with Invisalign. If so, would I do Invisalign before or after? If I have to do it after does Invisalign work with missing teeth or do I replace my teeth with something else?

Theodora

Dear Theodora,

Invisalign aligner

You have picked two wonderful procedures. Nice work! Dental implants will be a great tooth replacement and Invisalign has one of the highest patient satisfaction rates of any dental procedure.

Between the two, you will want to straighten the teeth before replacing the tooth.

Invisalign does a great job of working around missing teeth. It uses a sophisticated software program to design the ideal treatment plan for you.

Aside from being comfortable, allowing you to straighten your teeth invisibly, and working in a fraction of the time of traditional braces, the aligners can also double as teeth whitening trays. This means you can straighten and whiten your teeth at the same time, giving you a mini smile makeover at a fraction of the cost.

Then, once all your teeth are in place it will be time to get your dental implant. You will want to go to a dentist who has post-doctoral training in placing dental implants. It is not something taught in dental school.

When you are done, you will have a beautiful straight smile.

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

Adult Teeth Behind Baby Teeth

Can you help me? I am 16 years old. I’m with a new foster family who wants to help me with my dental care and we’re trying to figure out what to do. I asked my foster mom if I could research. She agreed so I thought I’d start here. I have both baby teeth and adult teeth but my adult teeth all came in behind my baby teeth. It’s been like this for a long time and it is very embarrassing. Is there a good way to fix this?

Celia

Dear Celia,

Young woman smiling

I am glad to hear you have a foster mom that is being proactive with your oral health care. I’m sorry you had to wait this long for it to happen. Had you been under the care of a good pediatric dentist this would not have happened to you. The good news is all of this is repairable.

The first thing they’ll want to do is extract all of your baby teeth. I know you had no control over this, but for the sake of parents out there reading this, I want to discuss what to do when you have adult teeth ready to erupt when the baby teeth are not coming loose.

The best thing to do in that case is to simply extract them, as I am suggesting to you. However, sometimes you have retained baby teeth when there is no adult tooth to come in. This is called a cogenitally missing tooth. In that case, there is a different plan of attack.

In that case, there are two scenarios. If it a molar or premolar. It is helpful to maintain those as long as possible and then when they finally fall out, you can replace them with a dental implant.

If they are not molars, we usually will extract the baby teeth and separate them with orthodontics in order to make the appropriate space. Then, depending on your age, you can replace it with a dental flipper (which is removable and inexpensive). Then, when your jaw is fully developed replace those with a dental implant as well.

Once Your Baby Teeth are Extracted

Now, back to your case. Once you have your baby teeth removed you will want to straighten the adult teeth. You sound like a very responsible young woman. With teens like yourself, I tend to recommend Invisalign teen. It can straighten your teeth comfortably and invisibly. It is removable so it requires patient compliance. I don’t think that will be a problem for you.

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

Root Canal FAilure

I’m a bit worried about something. I had a root canal treatment done about 3 years ago. About a month ago it started hurting. My dentist did a retreatment. A week later the pain increased quite a bit. I called him and he prescribed an antibiotic. It started to feel a bit better but now it is worse again. I called his office again and he said to give it time, some people take longer to heal than others. I am in tremendous pain. Is he right about this? If so, how much is a reasonable amount of time to give it?

Nicole

Dear Nicole,

Something isn’t right with how your dentist is handling this. It appeared like you said that your pain went down and then started back up. This is a clear signal you still have an infected tooth.

Though root canal treatments are successful about 95% of the time, when it does fail, the chances of a re-treatment being successful go down with each successive try.

That doesn’t mean it isn’t worth trying. It is always better to save a tooth whenever possible. I would consider your situation a dental emergency. This infection will continue to spread. Dental infections can turn life-threatening because they are so close to your heart, brain, and lungs.

Because of the severity of your situation, I am going to suggest that you call a prosthodontist. These are root canal experts. Explain the situation when you call. They will likely try to get you in right away. If they can’t, make sure they call in a new, different antibiotic for you.

If it turns out the prosthodontist tells you the tooth can’t be saved, then extraction will be the only option. When that happens, you will need replace the tooth. Ideally, you’d get a dental implant for that as it will help preserve the underlying bone structure.

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