Tag Archives: dental implants

Dentist or Oral Surgeon for Denture Surgery

I have always had a fear of the dentist. This really kept me from getting my teeth taken care of. I generally only ended up going in when there was a dental emergency. I know that wasn’t the best way to handle things, but what is done is done. I am now to the point that I need dentures. Most of my teeth are either missing, broken, or decayed. In that case, should I go to an oral surgeon or a dentist to have the remainder of my teeth extracted?

Bruce

Dear Bruce,

Image of dentures

I would go to a dentist who can do both the tooth extractions and the dentures. Most general dentists do pre-denture surgery. It is not a difficult thing to do. I would call to several offices and ask them what the dentist’s normal procedure is. Do not hint to them what you are looking for, just ask about their denture procedure.

Because you struggle with dental anxiety, I am going to suggest that you see a dentist who offers oral conscious sedation. This is sometimes called sleep dentistry because most patients are so relaxed they just sleep through the entire procedure. This will ensure you do not have to have any fear or pain during your procedure.

The reason for using a dentist instead of oral surgeon is to get the best fit possible for your denture. An oral surgeon won’t be as familiar with designing and fitting dentures, as a result they don’t know the things that can be done during the extractions to make this work better.

You should be aware that even the best fitting dentures will reduce your chewing capacity by 50%. There are also long-term consequences, including shrinking of the jawbone. Dental implants can help with both of these issues and I recommend discussing this with your dentist before making any final decisions on your treatment plan.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

High tolerance for Novocain

I have always had a high tolerance for Novocain, which has made all of my dental appointments a living nightmare. I’ve been avoiding the dentist for quite a few years as a result. I am in a position now where I cannot put it off any longer. I feel certain at least two of my teeth will need to be extracted. I just need to grab the bull by the horns. Do you have any recommendations for how to do this with the least amount of pain possible? Also, I’ve been reading up on tooth replacement options. Are dental implants as good as they are advertised to be?

Carla

Dear Carla,

woman smiling in the dental chair with her dentist standing nearby

I can actually help you on both counts here. Your dentist may not have been aware that when a person has a high resistance to Novocain, it is usually a sign that they have dental anxiety. The higher the anxiety, the greater the resistance to the numbing medication. This is because your metabolism kicks in and burns the medication off.

What you need for the numbing medication to actually work is a way to deal with the anxiety. Most people can’t just turn it on and off at will. Instead, you need a dentist who offers dental sedation options. I recommend oral conscious sedation for you. It is sometimes called sleep dentistry because it is so strong that you can sleep through the procedure. You will need someone to drive you to and from your appointment as well as stay with you for a few hours after your appontment until you are lucid and steady on your feet. You will have an anxiety-free/pain-free dental appointment.

As for dental implants, yes, they are the top tooth replacement available. Once completed, it will be like having healthy, natural teeth in your mouth again. Just make sure you see an experienced implant dentist. It is an advanced procedure. Ask them how many dental implant procedures they have done as well as what their success rate is. Don’t settle for anyting under 95%.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

How Long Can I Put Off a Root Canal Treatment?

I have a tooth that needs a root canal treatment. My wife thinks it is urgent and I need to get it checked right away. There is absolutely no pain from this and I think it can wait, especially since I’ve been laid off. If I absolutely had to, I could take money out of savings and deal with this, but I would rather wait until I had some income again. Is that possible? My wife is absolutely certain I am going to die from this if I don’t see a dentist.

David

Dear David,

Man in pain, grabbing his cheek in need of emergency dental care.

I cannot give you hard and fast numbers, but there are some general guidelines that apply here. First, though, let me explain why your wife is so worried. Believe it or not, there are still people who die from tooth infections. There was a fairly recent case that made the news about a truck driver who died from his tooth. He’d planned on getting an appointment but was too late. That being said, not every infected tooth has to be seen right away. It depends on if it is an active or latent tooth infection.

Signs of an active tooth infection:

  • Current or recent pain
  • Drainage by the infected tooth
  • A pimple on your gums

Any of the above tells me you need to be seen by your dentist and have the root canal treatment done. On the other hand, if your tooth has no pain at all and has not for a while, then you have a latent infection and can afford to put off your root canal treatment for a bit. If the pain returns, call your dentist right away to schedule an emergency appointment.

Is there a risk in waiting?

There are a couple of risks here. One is that the tooth infection blows up quickly causing you to need a more invasive treatment than would have been necessary. A second issue is that your tooth doesn’t hurt for years, but because of what was going on in the background you end up with root absorption and your tooth can no longer be saved. Then, instead of a simple root canal treatment, you end up with a tooth extraction and the cost of a tooth replacement, such as a dental implant.

If you’re in no pain whatsoever, wait and see if the job situation turns around. If it looks like this may be a long-term problem, go ahead and get the treatment while it is simple.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Discouraged About My Teeth

I stumbled across your website and am hoping you can help me. I’ve never been so discouraged in my life. I grew up in a very poor family and we could not afford the dentist. They were good parents who worked hard, but dentistry is expensive. I have always had bucked teeth and braces were a wild dream. I spent most of my childhood being teased. Then in high school, I developed a tooth infection. I had a root canal treatment done, but we could not afford the follow-up treatment so I was left with a hole in the back of my tooth. Then, my first year in college the tooth broke in half. It was a front tooth! I was a freshman in college with no resources. One of my professors noticed I always put my hand over my mouth when I was talking and offered to get me a dental crown. I literally cried. Fast forward seven years. I’m married and we have dental insurance. The problem I am facing is my teeth need so much work I just can’t seem to keep up. My dentist seems to have given up as well. He even suggested we just extract them and get dentures. I’m barely 26 years old! Is there any way to save my teeth?

Carol

Dear Carol,

Woman covering her mouth with her hand

You have had a rough go of things and I am sorry. I did love the story about your caring professor. The compassionate people in this world give us hope, don’t they? While you have a tough situation with your teeth. It doesn’t sound like you have anything unfixable. The first thing I would do is look for a dentist who is willing to work to save your teeth. It sounds like they one you are currently with may not be the best fit for you.

Whatever you do, don’t let him extract all your teeth and give you dentures. When teeth are removed, your body begins to resorb all the minerals in your jawbone, the result of that is the shrinking of your jaw. In about twenty years, you won’t even have enough bone left in your jaw to retain your dentures. There is a way to preserve that bone, using dental implants, but it is very expensive and I don’t think you truly need your teeth extracted.

There are two things you can do to get a handle on this quicker. The first is at home. Most people think brushing is what keeps their teeth healthy. While it is a major contributor, if you are someone who snacks throughout the day, you are inadvertently sabotaging your efforts. Your saliva is a tremendous weapon against oral bacteria because of the minerals contained in it. If you limit your snacking, then you will give those minerals their best chance of fighting decay.

The second thing is to get as much work done as possible at each visit to try to get ahead of this situation. As I am recommending you find a new dentist anyway, look for one who offers dental sedation, specifically something like oral conscious sedation. This will completely relax you and even allow you to sleep if need be. Patients who use this are able to get significantly more work done at each visit.

Before you know it, you’ll be caught up on that dental work.
Hopefully, this helped.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

My Mother’s Teeth are Just Falling Out

I took my mother in for a filling a couple of weeks ago. She is 87 years old. Today she called me and told me a tooth just fell out. I called her dentist and they want her to come in and they’ll do a dental bridge for her. I’m a bit concerned, though. They didn’t even seem to wonder why her tooth fell out. Will this keep happening? Is there an affordable way to help her?

Presley

Dear Presley,

elderly woman smiling

It is wonderful that you are doing your best for your mother like this. Like you, I am concerned about some of what I am hearing. I want to make sure I understand that you said her tooth just fell out. Is that right? For that to happen, it would mean your mother has very advanced periodontitis (gum disease). It would have to be as advanced as it gets. If this is the case, there should have been intervention quite some time ago. I don’t know what your mother’s dentist has been waiting for.

I don’t like the idea of a dental bridge if this is her situation. A bridge is made by suspending a false tooth between two dental crowns that are anchored to the adjacent teeth. This will put additional stress on those teeth, causing them to fail sooner.

I want you to take her to a different dentist and have her evaluated before moving forward. If it is periodontitis, as I suspect, she is going to lose all of her teeth. Ideally, you’d replace teeth with dental implants. However, she is 87 years old and you asked for an affordable dental solution. In her case, I would suggest extracting the teeth and getting her completely removable dentures.

Normally, I do not like to recommend removable dentures because of the bone resorption. However, at your mother’s age it will not have much of an impact on her.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Can a Root Canal Infect a Salivary Gland?

My daughter has had two salivary gland infections and they are both on the same side where she had a root canal treatment done. Is it possible the root-canaled tooth is infecting her salivary gland?

Kerrie

Dear Kerrie,

A woman grabbing her jaw in need of an emergency dentist

I’m sorry about the ordeal your daughter has been facing. That must be painful. The first thing I would suggest is that you have some x-rays done for her tooth with the root canal treatment. In order for the salivary gland to get infected from the root canal, there would have to be an active infection in the tooth.

Root canal failure is fairly common so I wouldn’t be completely surprised if there was an active infection. You should be aware that the chances of a successful procedure go down with each root canal retreatment. If it turns out your daughter does have an active infection, you will have a better chance of success with the follow-up treatment if you go to an endodontist. It isn’t a guarantee, but they specialize in these treatments and will have more experience. Don’t put off the re-treatment. These type of infections are considered dental emergencies.

When a Tooth Cannot Be Saved

Sometimes, a tooth cannot be saved. When that happens, the tooth needs to be extracted and replaced. The best tooth replacement is a dental implant. You didn’t mention how old your daughter is. For her to get a dental implant, she would need to have a fully developed jaw. Until then, a temporary replacement (like a dental flipper) will keep the space open and will cost you less than other replacement options.

If the x-ray determines there is not an active infection, then whatever is going on with her salivary gland will have nothing to do with her dental health. I would suggest further investigation.

This blog is brought to you by Gilbert, AZ Dentist Dr. Matt Roper.

Dentist or Oral Surgeon?

I’m going to honest and just admit I avoid the dentist. I had a filling fall out. I avoided the dentist. Then I needed a root canal treatment. I did get that, but it was rather traumatic. So, I didn’t go back for the crown. Now my tooth was hurting so badly that I had to go to a dentist again. Though I did go to a different dentist. He told me the tooth is too far gone and needs to be removed. However, he said it’s extensive enough that I may consider an oral surgeon because he’d have to cut through both gum and bone. I like the idea of it not costing as much going to the local dentist, but wonder if it’s not safe and that’s why he mentioned an oral surgeon.

Patty

Dear Patty,

Someone asleep from dental sedation

I hate it when dentists say stuff like this. It makes patients uneasy. They wonder if they’re being unsafe choosing the more financially feasible option for them. I don’t know if your dentist phrased it that way because he’s uncomfortable with the procedure and he was trying to steer you another direction or if he’s perfectly comfortable doing it and just giving you non-opinioned options.

I’d ask your dentist a few questions before making a decision:

  • How comfortable does he feel with the procedure?
  • Has he done this type of extraction before?
  • What type of sedation does he offer?
  • What are the roots like? Straight and tapered or twisted with knobs?

The Importance of a Sedation Dentist for You

Based on what you’ve described of your oral hygiene habits, you have dental anxiety. It’s not uncommon. However, it wreaks havoc on your oral health, as you’ve discovered. If you were comfortable going to the dentist when your filling first came out, you wouldn’t be facing this difficult extraction and then facing pricey tooth replacement options.

Dental Sedation will change your life. However, at your level of anxiety (and especially for your extraction procedure), you will need something stronger than just nitrous oxide. You will need oral conscious sedation. This is strong enough to allow you to sleep through the procedure.

You will be able to have stress-free dental appointments from now on and even get all your teeth back in shape.

This blog is brought to you by Dr. Matt Roper.

Affordable Dentist for a Full-Mouth Reconstruction?

I never got to go to the dentist as a child. I saved up for two years to go now that I’m in college, just to see what I’m dealing with. He said my mouth was in horrible shape and I needed something called a full mouth reconstruction. I knew there’d be some problems because I’d never been, but I was surprised with how dire my outlook was, especially since my teeth have never bothered me (except for how they look). The way he described the reconstruction sounded like I’d really benefit and my teeth would be pretty, but the price is way above anything I can afford. My roommate said I should ask about affordable dentists. She said that’s what her parents always used. They have less frills but you still get care. Can I get one of those for the reconstruction I need?

Mindy L.

Dear Mindy,

Dollar sgn hatching out of an egg

How admirable that you’ve made such an effort to see a dentist. I wish more older adults were as conscientious as you are. Before we get into a reconstruction I want to caution you. Something feels off about this to me.

While I’m sure there were some issues, if you’ve experienced no pain at all, I doubt you really even need a full mouth reconstruction. You should have been in massive pain. I’d love to hear more specifics of why he said you needed one. I don’t want to see you taken advantage of by someone disreputable.

I’d like you to get a second opinion from another dentist in the area. Some dentists will even give you a free second opinion.

Getting a Second Opinion for Affordable Dental Care

When you go in, don’t tell them who the first dentist was or what his diagnosis was. Just go in and tell him you’re looking for a second opinion on a diagnosis you received that seems questionable to you. Tell him you’ll be happy to tell them the dentist and diagnosis after they give their unbiased opinion.

If it turns out he misled you, please turn the dentist into the ethics board. Most dentists are honest and it’s the bad apples that make life harder for the rest of us.

However, if it turns out you do need a full-mouth reconstruction, that’s not something you price shop for. It is one of the most technically advanced procedures a dentist can do. You don’t want it to simply go to the lowest bidder. There are other ways of making this more affordable.

Instead, talk about ways of phasing out treatments. If planned correctly, it doesn’t have to be done all at once. Get the work done on a schedule of most urgent to least. Also, be clear you want to save as much natural tooth structure as possible.

Fillings before crowns. Crowns before extractions. If you need an extraction, dental implants are the ideal replacement but are pricey. However, it’s worth it to get a temporary cheaper one while you save up the good one, especially as young as you are.

This blog is brought to you by Dr. Matt Roper.

CEREC Crown Disaster

Everything I’ve read about CEREC crowns and their procedure leads me to think my dentist was way off on how she handled my particular case. What’s done is done, but I just need to make sure the sensitivity I’m feeling is normal and will go away after some healing or if I have a problem. When the dentist did my crown, she said my tooth was in too bad a shape to get a good image so she was just going to pull one from a CEREC database. I wasn’t too worried because the advertisements all talk about how perfectly these crowns fit. Well, it didn’t. It was too big all around. She spent well over an hour grinding down all the sides of it. Not only was that remarkably uncomfortable, but it doesn’t even look like a real tooth anymore. It looks more like a box. Plus, every time I eat or drink something cold it zings me. Will that end after a period of time or do I have a problem on my hands?

Dirk B.

Dear Dirk,

Gilbert CEREC Crowns
A CEREC Machine

You have a problem. You’re also right that this seems to be a disaster. CEREC crowns should be able to be placed in minutes. I have no idea what your dentist meant by your tooth was in too bad a shape to get a good image. It’s only teeth which are in bad shape that need a dental crown to begin with. I have no idea why she couldn’t get a clear image.

The only thing I can think of with an image database is when she input into the CEREC machine which tooth she was going to crown. It will give her a basic image to work from, then she’ll put images of the surrounding and opposing teeth so the computer can design a crown with a perfect fit. It sounds like your dentist had absolutely no idea what she was doing.

Get a New CEREC Crown

The sensitivity to cold concerns me. It sounds like your dentist left an open margin. That not only causes some pain when you drink something cold, but it also allows food and drinks to get trapped in there. You don’t want to leave any opening for decay. A mistake like this can cost you your tooth. Then, you won’t be trying to get a crown, but a complete tooth replacement.

You need to get a new CEREC crown made. But, you’ll want to go about this in a way that won’t cost you any more money. You’ll first need to get a second opinion from a dentist verifying everything I’ve said so you have ammunition. Do NOT tell the second opinion dentist the story you told me. Just tell them you want them to look at your crown. Also, do NOT tell them who your dentist is. You don’t want any friendship or misplaced sense of loyalty to cause them to waver in their true opinion. If they pressure you to know, tell them you’ll let them know AFTER they give their opinion. Tell them you just want their pure, untainted thoughts.

Once what I suspect is confirmed, don’t just ask for a refund. Your dentist should also pay for any expenses you incur to fix her botched job.

I hope this helps.
This blog is brought to you by Dr. Matt Roper.

Does Affordable Dentistry Mean Slow Results?

I’m curious if affordable dentists take longer to get results than other dentists. I’ve always had bad teeth. I kept thinking I’d be able to afford more dental care as I got older. But, I’m 40 now and still have horrible teeth. Realizing it’s now or never, I searched for an affordable dentist so I could get started. I’ve been going monthly for almost two years and still see no difference in my teeth. My teeth are stained and crooked. Every time I bring up braces he just says, “Let’s get those teeth and gums healthy first.” I’m discouraged. After two years, I figured I’d see a difference. Am I being ripped off? Would it go faster with a more costly dentist?

Nell M.

Dear Nell,

Affordable Dentist

There are a few things going on here. But, first, I will say that an affordable dentist should work equally as effectively as the highest priced dentists. The two things you’re concerned about, the color and crookedness of your teeth are cosmetic issues. Generally, you get the teeth healthy, then start on the cosmetics. However, you should already be noticing a brighter smile. Your teeth are being regularly cleaned, so they should be at least a tad whiter.

If you do the cosmetics too soon it can be detrimental to your goals. For instance, if you have gum disease (and it sounds like you do), getting braces to straighten your teeth before your gums are healthy will cause your teeth to come loose and fall out. Then instead of straightening your teeth, you’re stuck replacing them.

Because you’re going to the dentist monthly instead of twice a year leads me to believe you have advanced gum disease. That’s your first priority. When that’s in check, there’s much more you can do cosmetically with your teeth.

One proactive step you can do on the cosmetic end, even while you have gum disease, is teeth whitening. I will warn you, the exposed areas where your gums have receded will be sensitive to the whitening gel. Though, with professional teeth whitening, it’s common for the dentist to custom design the trays to your bite. He can try to avoid those areas, while simultaneously making sure the coverage is such that you’ll have an even tooth color.

All of that being said, two years seem excessive with monthly visits. You should be able to spread them out more by now if he’s doing everything he can to help with your gum disease and you’re keeping up with your oral hygiene. You may consider getting a second opinion. Some dentists even give free second opinions so it may not even cost you anything.

This blog is brought to you by Dr. Matt Roper.