Tag Archives: Emergency Dentist

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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.

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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.

CEREC

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.

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.

Porcelain Veneers

Dentist Refuses to Fix Son’s Tooth with Veneers or Crowns

I’m really frustrated. My 9-year-old took a bad fall. When he did, he lost half his front tooth. I want his repair to be stable. My first thought was a porcelain veneer but my dentist said no. Then I suggested a crown. The dentist said no. I don’t know what to do. Why won’t they treat him?

Laura K.

Dear Laura,

Porcelain Veneer being placed on a tooth

I know you’re frustrated. You want the absolute best for your son and it seems like your pediatric dentist isn’t cooperating. He may not be explaining things well, but he’s not wrong. Though, he should have told you what solutions would work.

With a child, their jaws and bite are in an almost constant state of flux. He will outgrow both the porcelain veneers and dental crowns so fast it could mess up a lot of things about his bite. Not to mention the fact that it would cost you a fortune to constantly replace them.

Alternative to Porcelain Veneers for a Child

The best solution at this point would be to have dental bonding done to make the tooth look completely natural. It’s much less expensive than veneers or crowns anyway. Then, when his jaw has fully developed you can look for a more permanent solution.

I’m assuming at this point the dentist checked for trauma to his nerves and such and that the tooth is safe. If he hadn’t, I’d go see an emergency dentist just to have his teeth looked at and make sure no permanent damage is done where he’ll need a root canal treatment.

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

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Are infections in your teeth dangerous?

I don’t have any dental insurance, or medical insurance either. I am writing to ask about a problem I am having, so I don’t waste my very limited resources in going to see the wrong professional.

Here is what has happened: Last week I broke one of my molars. It is the very back molar on the left side, right ahead of where my wisdom tooth used to be, in my lower jaw. Ever since I did that, I have a lot of pain in my cheek and jaw. In the last couple of days, the pain seems to be in my sinuses and nose, too. Basically right now my hold head and face just hurt!

I had some antibiotics left over from a recent infection (they are not expired), so I’ve been taking those but that doesn’t seem to be helping at all. Does all of this sound like it could be caused from that broken tooth, or is this more likely to be sinus issues? I know I need to see someone, but like I said I don’t want to waste my money on a visit to someone who is just going to tell me to go see someone different.

One of my co-workers said today that infections in your teeth can get in your brain?! Is that even true? She said that it can be really dangerous and that has me kind of freaked out. Any advice you can offer would be really helpful.

Thanks,

Eleanor in Ludington, MI

Dear Eleanor,

Your friend is correct–an infection in your tooth is dangerous, and can indeed spread to your brain. You must get this taken care of right away. The infection is spreading, and this will not get better on its own.

Call your dentist and see if he or she will work out some kind of payment plan. Very few dentists will turn away a patient in an emergency situation like this. If by some chance your dentist will not help you, keep calling around until you find one that will, or contact the local dental society (look in the yellow pages for a listing) and see if they maintain a list of emergency dentists in your area that can help patients without insurance or funds. You can also go into the emergency room and they will help you.

You should also discontinue the antibiotics immediately. If you take antibiotics for a tooth infection without treating the source of the infection within the tooth (and oral antibiotics do not touch it), then you simply strengthen the bacteria that remain and make them antibiotic-resistant. Only a root canal treatment or an extraction will reach the source of the infection. If you have to have an extraction, talk to your dentist about a dental bridge to replace the tooth. The location of the infected tooth means that a dental implant would be the best choice to replace the tooth, but dental implants are quite expensive and never covered by dental insurance.

Please do not delay. Get this taken care of right away, before the infection spreads further. Wishing you the best of health.

This blog post brought to you as a courtesy by the office of Lafayette Louisiana cosmetic dentist Dr. Malone.

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Should I wait to fix my child’s broken tooth?

Last evening at t-ball practice my youngest daughter was hit in the mouth with a bat. One of her front teeth on the top broke right off, and the other one has a crack all the way across it. We took her to our family dentist first thing this morning, and he said he won’t have time to fix it for three weeks. Three weeks! That just seems crazy to me. Everything I’ve ever heard or read about damage to teeth says that you should “get to a dentist right away”. Well, what is the point of that if they aren’t going to fix it?

One of the reasons our dentist gave for the delay is that the root of the broken tooth needs time to “desensitize”. Is that customary? If it is, then I guess we will wait, but my instinct is to take her to a different dentist, one who will treat this with some urgency.

I hope you can answer this quickly. I don’t want to wait, but I’d like some expert advice about what to do.

Nora in Bar Harbor, Maine

Dear Nora,

Your instincts are correct – there is no reason to wait to address this.

If you have the piece of the tooth that broke off (and see this response promptly!), an expert cosmetic dentist might be able to reattach that portion of the tooth. If you don’t have the piece or it is too badly damaged, a likely procedure to repair both teeth is direct dental bonding.

For this reason, I strongly suggest you chose an expert cosmetic dentist for this procedure. Direct dental bonding requires more than excellent technical skills and training. It requires artistry. The bonding material must be color matched and placed with an eye to the gradients of color that comprise her natural teeth. Only truly gifted cosmetic dentists can do really beautiful direct bonding work.

You don’t say how old your daughter is, but because of your reference to t-ball I am guessing that she is under 10. Direct bonding is a great solution for younger patients. When she is older, she will probably need a single dental crown for the tooth that was broken, but your dentist will have to make that decision when the time comes. If the other tooth is severely damaged, both front teeth may need crowns.