Tag Archives: tooth replacement

Emergency Dentist

Am I Too Old To Extract a Wisdom Tooth?

I had a wisdom tooth start to bother me. All of my wisdom teeth are impacted, but this is the first time I’ve had a problem with one of them. The dentist said it is infected and that I need to have it extracted. Here’s my problem. I’m 32 years old and have always heard that you should remove your wisdom teeth in your late teens or early twenties, otherwise there is a risk of complications. What do I do? Am I too old to remove this tooth?

Gina

Dear Gina,

Image of impacted wisdom teeth

There is always a chance for complications with any dental procedure no matter what your age. That being said, you are correct that the ideal time to have your wisdom teeth extracted is in your late teens or early twenties. After that your chances of complications do go up. However, until your are in your forties I would not be too concerned.

Even then, no matter what your age, if the tooth is infected, then you need to extract it. In fact, it can turn into a dental emergency. When they are left untreated, dental infections turn life threatening. In fact, people die every year from untreated tooth infections.

In your place, given your (still very young) age, I would like to suggest that you have your remaining impacted teeth extracted. While they are not a problem now, there is a very good chance that they will be in the future. Better to do it now before the chances of complications increases, which it will every few years.

The good news is that you are removing wisdom teeth. That means they do not have to be replaced. If it were any other tooth, it would be important to replace the tooth. Otherwise, the adjacent teeth will shift or tip into the open space, leading to your bite being thrown off and, likely, TMJ Disorder. If you lose a tooth in the future, the best tooth replacement is a dental implant.

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

Dental Implants

Dental Insurance for Dental Implants

I’ve never been a fan of going to the dentist and I am afraid that I have let my dental anxiety get in the way of my dental care. I think I would be a good candidate for dental implants. Do you know if dental insurance will cover this?

Amy N.

Dear Amy,

An image of a woman resting in a dental chair with dental sedation to relax her

I’m glad you wrote. I want to address the dental anxiety issue first, because I’m hoping to give you a solution that will enable you to have positive dental appointments that will allow you to get caught up and not lose any more teeth.

It’s tough when you’re dealing with anxiety and that fear itself can make the appointments feel more painful. For patients in your situation, we have found that going to a sedation dentist changes their lives.

With one level of sedation, oral conscious sedation, you can sleep through your appointment if you want to. It’s that strong, even though it is administered by a pill. The only real downside is that you will need someone to drive you to and from your dental appointment.

As for dental insurance covering your dental implants, that depends. If you already have dental insurance, depending on the plan, they will cover a portion of them, but don’t expect it to be much. In most cases, they’re only willing to pay a significant amount on the least expensive solution for tooth loss, which would be removable partial dentures in your case.

If you don’t have dental insurance, they won’t allow you to sign on and then immediately get an expensive procedure. Most of them will have a waiting period for anything other than basic checkups and cleanings.

If you decide to get the removable first because of the cost, that is fine. I would save up for the implants, though, because you’ll have a better quality of life with something permanent.

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

Sedation Dentist

Family Pressuring Me to See Dentist

I have a toothache. I have for a while. My parents keep telling me that I need to see the dentist. They’ve even offered to pay for it. The money isn’t the problem. My real problem is I am terrified of dentists–like throw up at the thought of going terrified. I keep telling them I’m fine and the pain isn’t too bad, but I think my mom can tell I’m hurting worse than I’m letting on. Plus, my cheek has started swelling. Tonight she sat me down and said that people die from infected teeth and she’s very worried about me. Is that true or is she just saying that to get me to go? My mom tends to think of all the worst case scenarios (that are unlikely) because she’s a worrier. If she’s right, what is the easiest procedure I can have to fix this?

Andrea

Dear Andrea,

Woman resting from dental sedation

I’m very glad you wrote. I’ll start by saying your mother is correct. People die from tooth infections every year. This is because your jaw is close to your throat, heart, lungs, and brain. Once the infection gets out of your tooth and spreads, it becomes very dangerous.

Something that starts as a dental emergency (a tooth infection), can quickly turn life threatening if it spreads to one of those areas. Your cheek is swollen, which tells me it has already begun to spread.

Let’s address the dental anxiety first, because knowing you need to go to the dentist and being able to are two different things. It sounds like you have rather severe anxiety. I’m going to suggest that you see a sedation dentist, specifically one who offers oral conscious sedation.

This is administered by a pill, but it is STRONG. This pill will completely relax you, enabling you to not only get the dental care you desperately, need, but allow you to do so in an anxiety free/pain free way. I think you will find it will change your life.

One thing you need to be aware of is that, because of its strength, you will need someone to drive you to and from your dental appointment as well as stay with you for a few hours at home until you are lucid and steady on your feet. I bet your mother would be willing to do that.

Treatment Options

Ideally, you would be able to save your tooth by having a root canal treatment. If that is no longer possible, then the tooth will have to be extracted and replaced.

The best tooth replacement option is a dental implant. This will be the closest thing to having a healthy natural tooth in your mouth again. There are other options if that is too expensive.

The good news is, once you try dental sedation, it will help you with that anxiety, which will allow you to get the care you need much sooner. You’ll find early intervention means much easier treatments.

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

Dental Implants

Dental Implant Failure Disaster

I had to get a dental implant because of a serious infected tooth. I had a crown but there was another infection, so the dentist said it had to be pulled.  He suggested I get a dental implant. When he gave me the Novocain for the tooth extraction, it felt like the needle went into my brain. Ever since then, I’ve had a burning in my mouth that is driving me crazy. I complained about it on every check up appointment for my dental implants, but he kept saying it was normal and would go away after a few weeks. Then, it came time to place the dental crown on the dental implant. He had trouble getting it on and had to press it super hard. It hurt like mad the entire time. While I was at that appointment, I told him the burning was still happening. He said it was Thrush, which seemed like an excuse to me. He did give me an antibiotic but that didn’t seem to help.

Then, a couple of months later, I was on vacation and the crown just fell off. I went to see a dentist there who told me that the implant was infected and needed to be removed. Now, I’m stuck with no tooth. I don’t think I want to go through everything with a dental implant, so am thinking of getting a dental bridge. Is there a way I can get the dentist to refund me for the failed implant?

Carl

Dear Carl,

illustration of a dental implant

I am sorry this has happened to you. What a disaster! The burning in your mouth that you’re feeling is burning mouth syndrome. It is obvious to both of us that you did not have thrush. He just used that as an excuse. The common denominator  for people with this condition is a traumatic dental appointment, which you certainly had.

As to whether you can get a refund, you can always ask. If the dentist has integrity he will want to do the right thing about a failed implant. I suspect he will not give you the refund. In that case, you have limited options. You could take him to court, but you’d have to prove that he was at fault. It would be helpful to have another dentist on your side for this. I think the failed dental crown is more easily provable.

I have some doubts about the infection because you didn’t mention anything about pain or a fever. Those usually follow an infection.

If you don’t want to start over with a dental implant, a dental bridge is your best second option. I still think an implant is possible, but you’d want to do it with a different dentist.

Given that you’ve had some traumatic dental appointments, I want to suggest  that you see a sedation dentist. This will give you a pain-free/anxiety-free dental appointment.

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

Dental Implants

Can a Maryland Bridge Attach to a Dental Implant

I have two dental implants that had a natural tooth between them. Now that natural tooth needs to be removed and my dentist is recommending a Maryland Bridge. Is it possible to attach a Maryland bridge to the dental implants? I was concerned about attaching the metal to the porcelain. Have you seen this successful?

Charlie

Dear Charlie,

Illustration of a Maryland Bridge

The short answer is yes, it is possible to bond a Maryland Bridge to a dental crown. That being said, it is tricky. The ideal bond is metal against enamel, not metal against porcelain.

It would have been better if your dentist had anticipated that when you have two dental implants on either side of a natural tooth it is very likely that the tooth will eventually need to be replaced. With that foresight, he could have placed the abutments parallel to one another so that you could have changed two screw-retained crowns to a dental bridge with little trouble.

As it is unlikely that your dentist planned ahead, I would suggest your best option will be to place a third dental implant in between the two others, if there is room.

If not, then you can try the Maryland Bridge, but it will take some preparation of the crowns to make it work.

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

Emergency Dentist

Perforated Sinus with Tooth Extractions

Can you help advise me? I had ten teeth extracted by an emergency dentist. With one of the upper molars, he perforated the sinus cavity. He placed a compound in it to increase the clotting, but I can feel air flowing through it even when I am at rest. There is air blowing into my mouth and it feels quite weird. He also gave me a ten day course of antibiotics. Should I be concerned about this?

Emilio

Dear Emilio,

Man holding his jaw in pain

Usually, when a patient sees an emergency dentist they just get the patient out of pain and do the minimal procedure necessary than have you reschedule with your normal dentist. I am a little surprised that this dentist removed ten of your teeth in one appointment. While he was right to get the clotting started, he should also have closed the hole. Will it heal without that? Possibly, but it will take a long time and you are at risk for infection while you are waiting for the healing. In your place, I would see an oral surgeon to have them graft some bone there to close and heal the area.

Another issue I am concerned about is the number of teeth you’ve had removed. It is important that they are replaced as soon as possible. Otherwise, you will begin to lose your bone structure in those areas as well. Without that, you could end up with a condition known as facial collapse. I’m going to recommend that you have them replaced with dental implants because these will preserve your bone.

Sometimes we have found that patients who end up with dental emergencies have a fear of the dentist that keeps them away until they are in too much pain to avoid it anymore. I want you to know, just in case that is a situation you find yourself in that there is a solution. I’d like you to see a sedation dentist. They have medication they can give you which will allow for you to have a pain-free/anxiety-free appointment. Dentists who offer sedation are used to patients with anxiety and can help put you at ease.

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

Sedation Dentist

Twelve Shots to Get Numb?

I recently had a lower second molar extracted. The appointment was a nightmare. First, it took twelve shots for him to get me numb. How he could miss the area that many times is beyond me. Then, I had a bone spur in the area that took the dentist over thirty minutes to get. Now, I seem to have a sharp edge on the extraction site. I’ve sort of lost confidence in this dentist. Can you tell me if this is normal or if I need to have another procedure done to deal with this?

Cassidy

Dear Cassidy,

Woman holding her jaw in pain

I would find it hard to think any dentist would actually miss the spot that many times. The more likely scenario is that you had some dental anxiety going in and, as a result, your body was fighting the local anesthetic.

Unfortunately, not enough dentists currently understand the connection between dental anxiety and the inability to get numb. I am going to recommend for your next appointment where you need any work done you see a sedation dentist. Even just some nitrous oxide will help relax you, which in turn enables the anesthetic to do its work.

For those with a more severe level of anxiety, I recommend oral conscious sedation. While it is administered by a pill, it is so strong that you will need someone to drive you to and from your dental appointment as well as stay with you for a few hours afterward until you are lucid and steady on your feet again. Most people who use oral conscious sedation sleep through their appointment.

As for the bony ridge. sharp edges do show up during the healing process. You don’t notice them at first because your gums are swollen. As the swelling goes down the ridges appear. If it stays a problem, your dentist can clip it.

One thing I want to make sure your dentist addressed is the need to replace that second molar. If you leave the space open, your other teeth can drift or tip into the space, which will throw off your bite. That can lead to painful TMJ Disorder.

If you want the best tooth replacement, I’d look into a dental implant. However, you do have other options.

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

Emergency Dentist

Can’t Afford My Wisdom Tooth Extraction

I have an infected wisdom tooth. It has been bad for a while and the teeth around it are starting to get holes in them. Tonight I noticed I have pressure and a yellow streak leading up to my eye on the same side as the tooth. Now there is pressure behind my eye. I really can’t afford a dentist right now. Can I just visit the ER to get an antibiotic to treat this and then get to the dentist later when I can afford it? I’m starting to get concerned.

Brad L.

Man in pain holding his jaw

Dear Brad,

I want you to understand how serious this is. Your infection has already reached your eye. Your brain is not that far away and this can turn life threatening quickly. Believe it or not, people still die from tooth infections.

An antiobiotic will not solve your problem. What it can do is slow down the infection, but once you are out of the medication (and this is assuming they prescribe the right antibiotic for this particular infection to begin with) it will flare right back up and continue to spread.

The only way to deal with this is to have the tooth extracted…and soon. I would consider this a dental emergency.

Most dentists went into their field because they wanted to help people and make a difference. I would call around and see if there is a dentist who is willing to work with you on payments.

Whatever you do, take it seriously. The good news is a wisdom tooth does not have to be replaced. However, if you delay and the other teeth get so far decayed that they can’t be saved, you’ll also need a tooth replacement for them or your teeth will shift, throwing off your bite. This can lead to painful TMJ disorder.

Call around. There is bound to be a dentist in your area willing to help.

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

Pediatric Dentist

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.

Emergency Dentist

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.