Tag Archives: Gum Disease

Invisalign

Problem with Black Triangle

I used one of those mail order Invisaligns to straighten my teeth. It did straighten my teeth but I developed some gum disease and black triangles. I was brushing and didn’t notice any problems until it was too late. My dentist is treating the gum disease and I asked what would fix the black triangles. He said dental bonding should do it. But, it made things worse. It looks like white blobs between my teeth and I can’t even floss. What do I do?

Ellie,

Dear Ellie,

Treatment of black triangles

I am sorry this happened to you. Those mail order invisible braces, are fake Invisalign substitutes, but nothing like the real thing. One of the big problems with those mail order kits, even if they work by straightening your teeth, is that you are not under the supervision of a dentist during treatment. Had you been, they would have caught the gum disease before it became this big of an issue.

I’m glad your dentist is working on the gum disease. That will be very important. The first thing I want you to do is have the dentist remove the dental bonding. If you cannot floss then your new bonding has become a trap for bacteria.

Once you are sure that the gum disease is completely under control then you will be safe to have the dental bonding done again. This time, though, you will need to have it done by an expert cosmetic dentist. This is one of the more advanced applications of dental bonding.

Look for a dental practice that has an AACD accredited dentist on staff. These are the best cosmetic dentists. Plus, they will be more likely to stock the composites that you’ll need for the bonding to blend naturally.

Down by your gums the color of your teeth is darker.  Most dentists don’t keep a large variety of composites. Those who do a lot of cosmetic work, do.

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

Emergency Dentist

Does She Need to Remove All Her Teeth?

I had not had dental care for most of my life. My parents didn’t have dental insurance or money. I was equally in poverty as an adult. I finally was able to improve my circumstances and was able to get to the dentist. As expected, my teeth and gums are a mess. I had two scaling and root planing appointments, where the hygienist saw improvement. Her suggestion was that I follow up that work with a periodontist, and they would focus on the crowns and fillings I need. I thought that was a good idea. It has not turned out that way. The periodontist was very condescending about my lack of dental care over the years. She also found that my deepest pocket was 3 mm deeper than the hygienist said. It had only been a couple of weeks, so that surprised me. The most distressing thing, is that she suggested I just extract all my teeth because I was fighting a losing battle. I don’t want to lose all my teeth. I’m willing to work hard to save them and I thought I was making great progress. Is it really hopeless?

Florence

Dear Florence,

Woman covering her mouth with her hand

I am glad you wrote. First, though, a huge congratulations on all the improvements you’ve been making in your life. That takes a lot of hard work and courage.

The discrepancy in the pockets is fairly easy to explain. While there wouldn’t have been that much of a difference in such a short period of time. It is more likely that either one dentist poked through and thought the pocket was deeper or the other dentist hit a piece of tartar and thought they’d reached the end of the pocket. Without another examination there is no way to know which it was.

The other issue, about removing your teeth, is much more clear cut. You have all your teeth, as far as I know based on my you’ve said. Your dental hygienist saw improvement and they were planning on working on your teeth. I don’t think they’d be willing to do that if the situation were hopeless.

If the teeth were that bad, they’d be falling out. You never mentioned that.

Your periodontist however, was insensitive and didn’t appear to give you any time for treatments to see what improvements could be done. Normally, they are experts at saving teeth. Maybe she was having a bad day. Maybe she’s grown tired of her field. What I will tell you is not to remove all your teeth without being absolutely sure there is nothing that can be done for them.

Look for a different periodontist in your area. Check their reviews. Then, go and see what they say. Do not tell them what the last periodontist said. Get their unbiased diagnosis first.

I get the feeling you are going to be able to save your teeth. On the off-chance that you cannot, look into dental implants for their replacement. They are the top tooth replacement option, and the closest thing to having natural teeth in your mouth.

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

Deep Cleaning has Left Me in Terrible Pain

I’m 53 years old and never had a problem with my teeth until I had a deep cleaning done because I was told I have deep gap pockets. The procedure itself was nightmarish and I never want to go through that again. However, ever since the cleaning my teeth are sensitive and hurt all the time. I think I made a mistake in having this done. Is there anything I can do?

Pamela

Dear Pamela,

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

It sounds like you have advanced periodontal disease. If it does not get taken care of soon, you could lose your teeth. The disease will eat away at the bone that supports your teeth. Most deep cleanings are done with an anesthetic so that the patient does not experience the pain you described during the procedure. I would recommend you see another dentist to have this completed. Call a periodontist. These are gum specialists. Tell them about your situation and they can probably get you an urgent care appointment.

The post-operative pain tells me you have an active infection. One way to deal with this is by having a course of antibiotics during the duration of your treatment. This will help keep the infection at least in check while the periodontist gets everything cleaned out. Let them know about the pain you experienced in your last deep cleaning so they can be sure to give you the right amount of anesthetic so this doesn’t happen to you again.

I know you are probably leery of any treatment right now after your last experience, but I cannot emphasize enough how important this is. I wasn’t kidding when I said you could lose your teeth. Please see that periodontist as soon as possible.

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

Zoom Whitening

Zoom Whitening and Blood Thinners

I have been wanting to whiten my teeth for some time now. I think I want to do it quickly with that in office procedure that uses the lights. The one thing that is holding me back is that I am on blood thinners because of a heart attack. I have been stable for a while on the same dose and my heart is healthier. Is there a risk for people on blood thinners with this procedure? If so, do I have any options?

Annie

Dear Annie,

Patient under a Zoom Whitening light
Zoom Whitening Light

When you are on blood thinners is important to avoid invasive procedures because the medicine is designed to stop blood clotting in order to protect you from another cardiac event. If you needed an invasive procedure, your doctor would ask you to stop the medications for a while.

The procedure you are referring to is Zoom Whitening and it is an effective way to whiten your teeth quickly. It is not an invasive procedure and as such will not generally cause any bleeding.

That being said, your oral health is a big factor in that. If you have gum disease, your gums will bleed much more easily, even at the slightest pressure on them. I would want to make sure your oral hygiene is in top shape for two months before proceeding. You will need to brush twice a day and floss once a day. Make certain there is no blood on your floss every time before even considering moving forward.

You will also want to have a thorough professional cleaning done as well. Otherwise, your results will be splotchy because there will be a film over parts of your teeth.

I hope this helps you make a decision. Consult with your dentist and see about the health of your gums. If there is any periodontal disease present, that will need to be addressed before moving forward.

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

Zoom Whitening

Zoom Whitening After Gum Surgery

I had gum surgery to fix some recessive areas. I love the results, but now am wanting to improve my smile even more. Is it possible to get zoom whitening done or do I need to wait for a period of time?

Kelly

Dear Kelly,

Zoom Whitening Logo

Congrats on the gum procedure and feeling good about your smile! That is exciting. I can understand the desire to keep improving the appearance. Once you get a taste of beauty, you just want to do what you can.

You did not mention which gum grafting procedure you had done. Different ones have a varied amount of healing requirements because of the differences in invasiveness. Typically, you need between four to eight weeks of healing before you are ready for any other oral procedure.

With teeth whitening, such as Zoom Whitening, it is important that you pass the following checkpoints:

  • No missing fillings or even damaged fillings
  • No active, untreated decay
  • No gum issues, including periodontal disease and gum injury

Additionally, you will have wanted to have a recent cleaning. Otherwise, you risk splotchy results from calculus being on the surface of the teeth.

I would simply have a consultation appointment with your dentist to see if your oral health is ready for the next step. You’ll find your smile’s appearance improves dramatically once you have them whitened, taking years off your appearance.

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

Dental Implants

Dentist Said I Have to Get Dentures

I have dental insurance for the first time and just started going to the dentist. My teeth are pretty bad and some of them have started coming out. My dentist said I have advanced gum disease and will need to extract my teeth and get dentures. Is it at all possible that I could get dental implants instead?

Susan A.

Dear Susan,

Implant Overdentures
Implant Overdentures

You are in a tough position. At some point, dental implants will be possible, but you are going to have to get that periodontal (gum) disease under control first. That will be imperative. After that, I would make sure your dentist does adequate diagnostics. That would need to include a CT for two reasons. First, you want to make sure you have enough bone structure left to retain your dental implants. Second, dental implants are a 3D procedure and you need 3-Dimensional images in order to ensure proper placement.

If you don’t have enough bone structure, you will need to have a bone grafting procedure done first. Then, after a time of healing, it will be okay for you to go forward with your dental implants.

What you will want to get is called implant overdentures or implant supported dentures. With this, you will have between four to eight dental implants placed and then, after a period necessary for osseointegration (meaning bone integrating with the implants), have a denture anchored to them.

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

Invisalign

Invisalign Versus Smile Care Club

I’ve been wanting to straighten my teeth for some time. I’ve been looking at Invisalign and was pretty excited about it. I almost have enough money. Today, I received an advertisement for Smile Care Club. This is less money and I could get it right away. Are there big differences between the two? Is it worth it to wait for the Invisalign?

Callista

Dear Callista,

Smile Care Club is a do-it-yourself copy of Invisalign that was founded in 2013. They operate under the same concept as Invisalign, though they switch aligners every three weeks, where Invisalign switches every two.

For some people, this works fine, but when it doesn’t there can be rather serious consequences. Even starting out there is a danger. Before you get Invisalign, your dentist will give you a complete examination to make sure your teeth and gums are healthy enough to make it safely through the treatment. The biggest concern is gum disease. If your teeth are being shifted with orthodontics while you have gum disease, you risk them coming loose.

The only examination you get with Smile Care Club is done through photographs you send in. That is not adequate enough for the dentist to get a true sense of your oral health. Plus, there will be no x-rays which will be important as well.

There are other things to consider. The human body is unpredictable and that includes our teeth. Sometimes teeth need some aditional room to get into their proper position. If there is a lot of crowding then the dentist may remove a couple of back teeth. If there is minor crowding, then there would only need to be some mild shaving of the sides of your teeth. While they will send you to one of their dentists if that is necessary, I would not want someone doing that who is not really invested in my case. They could mess up the look of your smile quite a bit.

Bottom line: While for many this will work out fine and they can save some money, when things do not go well, there can be pretty serious consequences.

One thing I might recommend is you talk to your dentist about your desire. He may let you pay out your Invisalign and allow you to get started right away.

There is a hidden benefit too. Your dentist can provide you with some teeth whitening gel. Your aligners can double as whitening trays. This will allow you to straighten and whiten your teeth at the same time, giving you a mini smile makeover at a fraction of the cost.

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

Invisalign

Smile direct Club Safety

I’ve been wanting to straighten my teeth for years, but wasn’t able to invest the amount of money into it required. I’d run across Smile Direct Club on Facebook. They are significantly cheaper than Invisalign.I did wonder in the back of my mind whether they were too good to be true. Is it okay to use this? I was especially interested because we can’t go in to see a dentist at the moment for routine care because of COVID-19. This seems like a quick, easy way to get my teeth straightened while still social distancing.

Mercy

Dear Mercy,

Invisalign aligner
Invisalign aligner

Smile Direct Club advertises as a more affordable way to invisibly straightening people’s teeth by comparing themselves to Invisalign. While there are some similarities, the differences are the most striking. First, how they’re similar:

  • They use clear aligners
  • You switch your aligners out as your treatment progresses.

That’s about it.

The Shortcomings of Smile Direct Club

It’s the ways in which Invisalign is different that create my biggest concerns.

The Pre-Exam

With orthodontics under the care of a dentist, you get a thorough pre-exam. This is important. You need a dentist to look for things like decay, failing fillings, gum disease, and signs of TMJ Disorder. Ignoring these can have serious consequences. For instance, if you do orthotdontics with untreated gum diease, you could end up with you teeth coming loose.

With Smile Direct, there is no real exam, putting you and your teeth at risk.

The Impression

An accurate impression of your bite is essential for a proper treatment plan. It’s so imperative it’s done right that many dentists won’t even let their hygienists do it.

What you’ll get with Smile Direct is a do it yourself kit. If that impression isn’t free of imperfections, it will throw off your treatment.

The Treatment

Though many cases go as planned, not all of them do. Sometimes teeth don’t turn the way they should or you need more space opened up than originally planned. In that case, a dentist will need to carefully shave some of the sides to your teeth.

I honestly think you are safer waiting for COVID-19 to calm down. This will be the safest way to straighten your teeth.

An Added Benefit with Invisalign

In addition to being able to safely straighten your teeth, the Invisalign aligners can double as teeth whitening trays enabling you to straighten and whiten your teeth simultaneously. It’s like getting a mini smile makeover.

This blog is brought to you by Lafayette, LA 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.

Invisalign

Is Orthly Equal to Invisalign?

I told a friend the other day that I wish I could afford Invisalign. I’ve spent a lifetime embarrassed about my teeth. She sent me this link to a company called Orthly. It looks like Invisalign, but it’s 70% cheaper. I just want to make sure it’s safe to do it and it’s similar to Invisalign.

Ellen

Dear Ellen,

Image top: A woman putting on her Invisalign aligners. Image bottom: a woman smiling with Invisalign on her teeth

It sounds like you have a friend who cares about you. It’s lovely to have friends like that. If you won’t hate me, I’m going to help you understand the differences taking you back to High School. Do you remember geometry class where you had similar triangles versus congruent triangles? As you recall, congruent triangles were completely equal to one another in both sides and angles. But, similar triangles were only that, similar but not equal. They had the same angles but not the same lengths.

That’s how I would describe Orthly to Invisalign. Similar but not equal. It will save you money. Unfortunately, it could also cost you some teeth.

The first thing you should know is it wasn’t founded by dentists or anyone with dental knowledge. The idea came to two students who wanted to get Invisalign but couldn’t afford it. Their company is very straightforward about that. They say, “Orthly does not practice dentistry nor do any employees in the company.” That alone wouldn’t make it dangerous. I’m sure they consulted with dentists and orthodontists as they followed through on their idea.

Where Does Orthly Fall Short of Invisalign?

The way Orthly saves money is by avoiding orthodontic appointments. You see a dentist a total of two times. They can request photos through the app, but that’s the extent of the “looking after” you get. You may think that’s no big deal, but here’s what worries me about that.

The reason dentists keep an eye on you throughout the treatment is to measure things like mobility, root absorption, periodontal disease, and oral hygiene. None of these can be tracked through a photo. If they don’t catch any one of these problems in time, it could lead to the patient losing their teeth.

Then you’re talking about a much greater expense then they’d have had if they’d done the best treatment to begin with. They’ll need to replace their teeth.

So, in your place, I’d weigh the benefits with the risks before you decide.

You could always talk to your dentist about your desire and ask if there’s a way he’d let you pay out “the real deal” in installments you can afford.

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