Tag Archives: Emergency Dentist

Numbing Medicine Doesn’t Work On My Daughter

My seven-year-old daughter developed a cavity on a back tooth, which is weird because they have sealings. I took her in for them to do the filling and they could not get the numbing medicine to work. She is in agony and ended up thrashing about. He did seven shots to no avail. He finally just sent her home without the tooth dealt with. Where do I go from here?

Maggie

Dear Maggie,

Little girl smiling in a dental chair

I am sorry you and your daughter had to go through this. It is agony watching our children suffer. The good news is I have a solution. It appears that your current pediatric dentist is not aware of the connection between anxiety and numbing medication.

If a patient is very anxious, it has the effect of metabolizing the numbing medication very quickly. Sometimes so quickly that the patient gets no benefit out of it. I feel this was what happened to your daughter. Traumatic experiences like this are what keep people away from the dentist in adulthood.

Our goals right now for her are two-fold. First, get the cavity dealt with before it blows up into something more substantial or even a dental emergency. Two, give her a positive experience at the dentist so she can feel good about her oral health care.

I want you to find a dentist who is good with children that also offers dental sedation. It doesn’t have to be a pediatric dentist. There are many general dentists who enjoy treating children and are qualified.

Under normal conditions, she would only need some nitrous oxide to relax her. However, after her recent experience, I am concerned that will not be enough. Look for someone who offers oral conscious sedation. It is so strong that she will sleep through her whole procedure. In fact, some people call it sleep dentistry for that reason. She is still conscious. This is not anesthesia. It just completely relaxes her which will allow that numbing medication to do its job.

Be aware that she will still be woozy for a few hours after that procedure. You might want to set her up a little castle on the couch and let her binge watch something like “A Series of Unfortunate Events,” which will entertain her while simultaneously realizing her life isn’t so bad.

As for her sealants. Sometimes those will come off. Make sure you have the dentist check that the others are still intact.

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

Problem with CEREC Crown

I went to my dentist because of pain with pressure and sensitivity to hot and cold. My dentist suggested a crown and we decided on a CEREC crown for the first time on a back tooth. I’d had other crowns before so I wasn’t new to the gig. I like how fast it went and having the crown that day. A few days later though, I still had the same problem. I went back to see the dentist and he checked to make sure it was on right. He felt it was and told me to give it eight weeks. That was discouraging because I was going on vacation, but what else could I do? I bought some pain meds and left town. I was in so much pain and practically lived on those pain meds. At about the eight-week mark, it did start to get better. That’s a lot of pain to go through with a crown. Normally, I have the pain go away with immediate relief. Is this a pattern with a CEREC crown?

Morgan

Dear Morgan,

Block of porcelain for a CEREC crown

I would like you to see a different dentist and have this looked at, including an x-ray. CEREC crowns are equally effective as traditional crowns. The biggest difference is the same-day service. When there is the type of pain you were having, just crowning the tooth will not necessarily solve the problem on its own. The fact that it was still hurting afterward bears this out in your case.

With it gradually getting better over that length of time, it sounds more to me like the pulp of your tooth was dying. I’d like to know if the original problem was some type of dental infection.

Usually, when there is a sensitive tooth that also needs a crown, the first thing to do is remove any old fillings or decay. Then place some glass isomer or bonded build-up material and give it a bit of time. This is to see if the tooth settles down. If it doesn’t and the pain persists, that is a signal the tooth needs a root canal treatment.

Have this looked at elsewhere so you don’t risk an infection flaring back up.

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

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.

Is a CEREC Crown falling Off an Essential treatment?

I had a CEREC crown placed right before the lockdown for COVID-19.. Today, it just fell out. Our governor said you can only go to the dentist for essential treatment. How do I know if this is essential? Do I go in or wait until the quarantine is over?

Mark

Dear Mark,

porcelain block for CEREC crown
Block of porcelain for a CEREC crown

In most cases, because of COVID-19 and how easily it transmits, the CDC and Governors of many states are asking us to forego routine treatments until we have a handle on the virus. That would mostly include things like cleanings, checkups, and elective cosmetic procedures such as teeth whitening and smile makeovers.

Essential appointments are things like emergency dental care, such as you’d have with a tooth infection or other types of repairs. Your case is one of those. If a dental crown falls off, which by itself should be unusal, it is important it gets re-bonded.

If you wait until the quarantine is over, the adjacent teeth will begin to shift into the space left open. This will mean by the time you are able to contact the dentist for the re-bonding, your CEREC crown will no longer fit and you’ll have to get an entirely new one.

Don’t wait. Call your dentist.

One other thing, as I said earlier, it is highly unusual for a dental crown to fall out, especially a CEREC crown. They are milled by a computer so they are usually a tighter, more accurate fit. If your dentist rebonds this and it falls out again, I’d recommend you see a different dentist.

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

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.

Can I Bill Ex-Husband for Emergency Dental Work?

I’ve been divorced for about ten years. I left my ex-husband because he was abusive. It wasn’t until recently I developed the confidence to start dating again. When my ex-husband found out, he showed up at my apartment after one of my dates and beat me pretty badly. Thankfully, a neighbor noticed what was happening and called the police. He’s been arrested. But, I’ve been left with one chipped tooth and three loose teeth. I’m worried I’m going to lose them if I don’t get seen by a dentist, but I don’t have any money. Would an emergency dentist be willing to bill my ex?

Tanya

Dear Tanya,
Woman covering her mouth

I’m so sorry you had to experience that. You’ve been through a lot. Unless your ex-husband signs something saying he’ll pay for the appointment, there’s no legal way for the dentist to bill him. However, given the situation, I am pretty positive any dentist would be willing to allow you to get the services you need to save your teeth and pay out the bill a little at a time. Even if they don’t offer in-office payment plans, they’re sure to work with Care Credit.

It’s a medical “credit card” of sorts. It’s more financially friendly than your typical credit card, allowing the patient to get a much lower interest rate than would otherwise be possible. There’s also no penalty for an early payoff.

Given your ex-husband has been arrested for the assault, if you took him to small claims court you’ll be quite likely to win your money back.

You Need to See a Dentist Right Away

With you having some loose teeth, you don’t want to put off seeing a dentist. This needs to be dealt with immediately. If you don’t currently have a dentist, do an internet search using the term “emergency dentist“. These are general dentists who are willing to see non-established patients in cases where urgent care is needed.

They can splint your teeth and fix the chip with dental bonding. They’ll also do an x-ray to make sure there’s no internal damage to the teeth. If there is, they’ll do a root canal treatment and provide a dental crown.

You should know, there is a charity called “Give Back a Smile” that does free dental work for those who’ve suffered domestic abuse. After you get this emergency work done, you should apply.

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

Do CEREC Crowns Break Easily?

I’ve had crowns before and have never had any problems. My previous crowns were with a different dentist and were always the result of an infection gone mad which required a root canal treatment. This time, I decided to try to get treatment before an infection developed. Unfortunately, the new dentist said the cavity is too large for a traditional filling and will still need a crown (well, at least I don’t also need a root canal). It’s a step up. He told me he could give me a CEREC crown in just one day. I liked the idea of not missing more work and agreed, but after just two weeks it broke. I called the office and he offered to replace it for free. I’m hesitant to do so if it will just break again. Are CERECs weaker than other crowns?

Olivia

Dear Olivia,

Machine for CEREC Crowns
CEREC Crowns are Milled by Computer

CEREC crowns are just as strong as traditional crowns. What happened in your situation is incredibly unusual. As you’ve had several crowns before, did you notice anything which felt unusual about this one? Maybe your crown hit your teeth before the rest of your teeth or possibly tooth pain when you bit down? I could see a crown breaking if it sat way too high, but even then it would take some flaws in the materials for it to break that soon after it was placed.

In general CEREC crowns have less of a chance of having a problem because they’re designed by a sophisticated software program and milled by machine. They should fit perfectly. You didn’t mention pain, which again makes me wonder about something being off with the materials.

Redoing Your CEREC Crown

Going forward, I’d give your dentist an opportunity to fix this. It’s so unusual for this to happen so I doubt it would again. If it does, the dentist would be the problem. If you happen to look up your dentist’s reviews and see this is a regular thing, then my suggestion would be to find another dentist. It probably wouldn’t matter what type of crown he gave you.

In that case, you may want to see an emergency dentist in your area. They can help you get a crown and get you back on your way. You won’t want to wait too long because your teeth will shift into the open space left by the broken crown.

I’m NOT saying this is what happened, but be careful about dentists whose prices are significantly lower than other dentists in the area. There is a huge difference between an affordable dentist and a cheap dentist. Our area was hit hard economically, so it’s tempting for patients to go for the cheapest. It’s also tempting for some (less ethical) dentists to draw in patients by lowering their prices, then buying subpar materials which helps them make up their profits.

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

Help! My Front Tooth is Loose

I am terrified. I discovered my front tooth is loose. I don’t remember hitting it and I don’t think the other teeth are loose. Can a dentist fix this? What if it can’t be fixed? Do they make dentures for one tooth? Help me!

Samantha

Dear Samantha,

A woman with a gorgeous smile created by cosmetic dentist Dr. Mike Malone
A gorgeous smile created by cosmetic dentist Dr. Mike Malone

First, I want you to take a deep breath. You will not end up with a space where a front tooth should be for the rest of your life. The first thing you need to do is schedule an emergency appointment with your dentist. If the tooth is loose, regardless of the cause, it needs to be splinted to keep it secure.

Next, your dentist will need to determine why it’s loose. Do you have gum disease? Was there trauma? He’ll want to do some x-rays to see if the pulp was damaged. If so, you’ll need a root canal treatment.

Dental Solutions for a Missing Tooth

If you do end up losing this tooth, which would surprise me if this is the first sign of a problem and you don’t remember any trauma, there are solutions. We’ll go over each of them, from the least desirable (and least expensive) to the highest quality replacement, which is also more pricey.

Removable Partial DentureYes, there are “dentures” for a single tooth. It’s called a removable partial denture. It connects onto your other, healthy teeth, with a false tooth attached. It does put pressure on the teeth it hooks to so it’s not the ideal solution, but depending on your budget, you might use it as a temporary solution while you save up for one of the more preferable treatments.

Illustration of a dental bridgeThe next best solution is a dental bridge. This suspends a false tooth between two dental crowns. In reality, this makes more sense if your adjacent teeth (which will receive the crowns) need work anyway. In that case, it’s like knocking out two problems with one. However, if they don’t need work, I wouldn’t want to remove any healthy tooth structure.

Dental Implant DiagramThe top of the line replacement is to get a dental implant. It’s like having a healthy, natural tooth back. If your budget allows, this would be the treatment I’d choose. A prosthetic root is implanted where the natural root was, then a porcelain crown is placed on top. You can eat, brush, and floss just like you normally would. They’re very strong and last for many years.

Getting a Beautiful, Natural-Looking Tooth

You’re talking about replacing a front tooth, so you want to be certain the dentist is also a skilled cosmetic dentist. Whatever crown he creates for your front tooth needs to look just like the adjacent tooth. Above all else, make sure they give you an all-porcelain crown and not a porcelain-fused-to-metal crown.

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

Can an Adult Tooth Be Saved Once it’s Knocked-Out?

At my son’s football game one of the young men had a tooth knocked out. He just tossed it aside and kept playing. I’ve been wondering about that ever since. Could the tooth have been saved? Are there steps that need to be taken?

Arlene

Dear Arlene,

hockey player missing a tooth
How to Save an Adult Tooth

It’s good that you’re asking about this ahead of time because there is very little time to actually save a tooth during the trauma of the event. At max, you have 30 minutes. If a series of unfortunate events take place which causes an adult tooth to get knocked out here are the steps to take:

  • Grab the tooth by the crown only. That’s the visible part of your tooth when you smile. DO NOT touch the roots.
  • The tooth needs to stay moist. If milk is available, place the tooth in a cup of milk.
  • Call your dentist’s office and let them know you have a knocked out tooth and are on your way in. They’ll know time is of the essence and will be ready for you when you arrive.
  • It’s also a good idea to keep a short list of emergency dentist numbers on hand who see non-established patients, even after hours, in case you can’t reach your dentist.

What to Do if the Dentist Can’t Save the Tooth?

Sometimes you and the dentist can do everything right, but the tooth cannot be saved. In that case, you’ll want to know about your tooth replacement options.

Fortunately, the advances in dentistry have been useful. Your best option, if you’re a good candidate is to get dental implants. Depending on the age of your son, he may not be a good candidate. Teenager’s jaws are still developing.

If that’s the case, your dentist will go over temporary options for him that will give him a false tooth and hold the space available for implants in the future. Make sure he knows you son is in a contact sport so he takes that into consideration with any temporary replacement.

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

Could CEREC Crown Have Saved My Tooth?

I needed a root canal treatment and dental crown. I wanted to do a CEREC crown, but my dentist doesn’t have the machine. I considered going elsewhere, but felt guilty about going to another dentist. So, I thought the traditional crown would have to suffice. After he made the temporary, I had to go out of town for work. While I was gone, the temporary crown broke. I called my dentist and he said it would be fine, though to try and eat on the other side of my mouth. I was super careful. When I got back, I immediately went to the dentist but he told me that a crown would no longer work. First, the crown would no longer fit and we’d have to start over. But, that part of my tooth broke and the rest was brittle, so he’d have to do an extraction. Is this really my only option? Now what? I’m over $2000 into this crown which I can’t even have and now I’m losing the tooth. Should I have gone to a CEREC dentist?

Minnie W.

Dear Minnie,

A tooth receiving a CEREC crown

There are some things that bother me about what you’re saying. I’d like you to get a second opinion to see if your tooth can be saved. Preferably to a dentist who does provide CEREC crowns. Some dentists will even do free second opinions. While certainly, a CEREC crown would have saved your tooth, because it would have been protected from day one, there’s more at issue here.

If he’d have suggested you see an emergency dentist when your temporary broke, this would also have protected your tooth. It would also have allowed your permanent crown to fit. When you leave the space empty, it doesn’t always take very long for your teeth to shift leading to the crown not fitting properly. This was your dentist’s fault.

Something else which bothers me is how quickly the tooth became brittle. That’s uncommon.

If You Can’t Get a CEREC Crown and Lose the Tooth, What then?

If it turns out you can’t save the tooth, I’d first ask for a full refund from your first dentist. Then it’s time to decide on a tooth replacement. The two best options are dental implants or a dental bridge. A dental bridge would make more sense if either of the adjacent teeth need to be crowned.

If they don’t, then a dental implant would be a better option. It’s a great tooth replacement, but you don’t want just any dentist to do it. It’s an advanced procedure. Be sure to ask the dentist how many they’ve done and what their success rate is? It needs to be at least 98%.

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