Tag Archives: Emergency Dentist

Pediatric Dentist

Why Would a Dentist Use Restraints on a Child?

I am expecting my first child and have been getting advice from a friend. One of the things she told me is never to use a dentist who does not allow me to go back with my child. She did that once and they put her son in restraints. Can you tell me why they would do that?

Sally

Dear Sally,

Pediatric Mouth Props
Pediatric Mouth Restraints

 

There are two type of pediatric restrains. The first is pictured up above. These are mouth restraints. They are designed to help keep your child’s mouth open when they are having dental work that includes a drill.

I know of a colleague that didn’t use this once. Unfortunately, the child bit down during his procedure, which caused the drill to go through his tooth and into gums. What should have been a simple filling ended up with the child needing a root canal treatment.  These type of restraints are absolutely essential.

papoose board
Papoose Board

The next type of restraints I would say are only rarely necessary.  Also, a dentist should ask a parent’s permission before using them. If your friend’s dentist didn’t I would say she was right to get rid of him.

Your question about why a dentist would use this is valid. Most pediatric dentists have techniques to keep children calm and cooperative. Every once in a while, however, there is a child who is so terrified that they won’t let the dentist near them and become destructive. If the procedure is not essential, normally you would just send the child home and then schedule another appointment for them, possibly using dental sedation if that is available.

However, sometimes a child has a dental emergency that has to be treated right then for their own safety. In those cases, I would understand a papoose board. Though they have been criticized, they actually feel more like a hug, sort of like a weighted blanket that closes. Every time a child has gotten into one when I have been present, they calmed right down and are able to get the dental work done with no trauma.

You are wise to be planning and learning everything you can now that you are a mother. One thing I would advise is to take your child to see a pediatric dentist as soon their first teeth come in. Don’t wait until they are older and there is a problem. You want their early experiences with a dentist to be positive ones so they are not afraid to go.

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

Sedation Dentist

Help! My Five Year Old’s Teeth are Rotting!

I have a five year old daughter. Three of her molars are decayed. I brush her teeth twice a day and floss. I do take her to the dentist but she is remarkably uncooperative. Every appointment is embarassing. First, what is going on with her teeth? Second, how do I get this necessary work done with her being so difficult?

Edith

Dear Edith,

Little girl smiling in a dental chair

I can tell that you are a caring mother and are doing your best to take care of your child. Let’s start with the most urgent issue first. She needs this work done on her molars for two reasons:

  1. If left untreated, this can turn into a dental emergency. When those are left untreated, it can become life threatening.
  2. Molars need to be kept until the child is about twelve years old. Otherwise, the other teeth will drift and it will lead to crowding when her permanent molars come in. That will mean expensive orthodontics. If a molar is so far gone that it cannot be saved, make sure your pediatric dentist places a space maintainer there in order to prevent that issue.
papoose board
Papoose Board

If she is uncooperative, you will either need to have the dentist use a papoose board or dental sedation. The work has to be done for her own good.

As to the second issue of why. Some of it may be genetics, but you didn’t mention this problem with your teeth. My strong suspicion is that she either snacks a lot or has lots of drinks thoughout the day that are not water.

Most people don’t know that one of your biggest allies in the fight against decay is your saliva. It contains bacteria fighting minerals. However, if someone is snacking often or having lots of sugary/citrusy drinks throughout the day then it doesn’t get the time it needs to do its job.

My suggestion is to limit her to one snack a day and make sure she is drinking lots of water instead of juices and sodas. This may be a tough adjustment for her, but if you hold the line, she’ll adjust to the new rules.

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

Pediatric Dentist

Can Teething Cause a Fever?

Our first-born son is eight months old and seems to run a lot of fevers. A friend told me that it is probably because he is teething and we may need to slit his gums. I can’t imagine doing that! Can you give me some guidance here? We don’t have a pediatric dentist yet.

Melanie

Dear Melanie,

Photo courtesy of St. John’s Pediatric Dentistry, St. John’s, FL

The first thing I am going to say is not to slit your child’s gums. I’ve never even heard of that for teething children. Doing that runs the risk that the roots are not adequately formed and they will erupt prematurely now unable to properly support the tooth. Let nature take its course. The teeth will erupt when the root is ready.

That being said, teething can cause fevers. However, it will only be a mild fever. Teething infants will also be a bit fussy, drool a whole lot more, and eat a bit less. Giving them some infants Tylenol will help some.

There is a slight difference when it comes to adult teeth erupting. If the baby teeth are still in place and you see the adult teeth breaking through, you need to seek some help from a pediatric dentist to remove the baby teeth. If you don’t, the adult teeth will get deflected, which will cause them to come in out of alignment. From there, you will be looking at expensive orthodontics that you might have gotten away with needing.

As your son is approaching a year old soon, I recommend beginning your search for a pediatric dentist. It is always best to acquaint them with a dentist before a problem arises. This way their first experience with a dentist is a positive one and not a scary emergency appointment.

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

 

Pediatric Dentist

Why Fill a Baby Tooth?

Can you tell me why my dentist wants to fill a baby tooth? My son has a cavity on one of his back teeth, but this isn’t his adult tooth. As it is just going to fall out anyway, why should I spend this money and put him through the procedure?

Callie

Dear Callie,

boy smiling with a toothbrush

Nobody wants unnecessary medical or dental procedures so I completely understand your question. While some baby teeth will start to fall out soon, his back molars need to stay in until he is around 12 years of age. You don’t want this cavity to turn into a dental infection. A simple cavity is easy to treat, with little trauma. If the tooth gets infected, you will need a child’s version of a root canal treatment, called a pulpotomy.

In most cases, you will want to prepare ahead of time and possibly even arrange to have oral conscious sedation used during this procedure, so he is as comfortable as possible. If you let the tooth go, it could go downhill fast, which will mean a dental emergency. In that case, oral conscious sedation may not be an option for him which would make the appointment more traumatic for him.

What If He Loses This Tooth?

Another problem with letting the decay continue is that the tooth may become unsaveable. If that happens and it has to be extracted, you will need your pediatric dentist to place a space maintainer in that spot. This will prevent the other teeth from shifting and tipping into that spot.

Without that, the other teeth will drift. This will mean there is not correct placement left for his twelve-year-old molars and will lead to crowding. Crowding means crooked teeth and expensive orthodontics.

A little prevention now by getting this tooth filled can save you and your son a lot of expense and hassle.

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

Pediatric 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.

CEREC

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.

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

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.

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

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.