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Sedation Dentistry

What is the Fastest Way to Get Caught Up On My Son’s Dental Care?

My son has never been to the dentist even though he is nine years old. We’ve been broke for so many years. Now my husband has been offered a great job and it even has dental insurance. I am certain my son will need a TON of dental work (as will my husband and myself). What is the easiest and fastest way to catch him up on his needed care without traumatizing him. I remember hating the dentist as a child.

Patricia

Dear Patricia,

Happy girl in pediatric dental chair

I am glad you wrote and I can tell you care about your son! It’s always hard when their first experience with the pediatric dentist is to deal with decay, etc.. Ideally, their first visit is in their toddler years before there is a time for any problems to develop. That way they associate the dentist with fun. However, we realize the ideal is not always possible. You were in that situation, but are still trying to do the best you can for your son.

The good news is he may not need as much work as you think. If his genetics are working in his favor and he’s done a good job keeping up with his oral health care at home, you may just get lucky. I once had a woman who wasn’t ever able to go to the dentist growing up. Her first dental visit was when she married. She came in at twenty five years of age very nervous about what she’d find. Would you believe that woman didn’t have even one cavity! The entire office was amazed. It was a combination of superior oral care at home along with fantastic genetics when it came to her teeth.

The first thing I would recommend, because you do not know what type of shape your son’s teeth are in, is that you go to a pediatric dentist that also offers dental sedation. For his first appointment, you may want to have them use nitrous oxide so that he is relaxed. This is very mild sedation. He can be awake the whole time. Let’s say, however, that at your son’s first check up, they find a bunch of things that need to be worked on. Don’t panic. There is a way to do that without him feeling any pain whatsoever.

There is another type of sedation you can use for his treatment appointments called oral conscious sedation. This will make him very sleepy. In fact, he’ll sleep through the entire appointment which will allow dentists to get more work done during each appointment. This is the fastest way to get him caught up.

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

Emergency Dentist

When a Dental Crown Feels Off

I had a root canal and dental crown put on a tooth a couple of years ago, but it has really been bugging me lately. It’s not pain, it just awkward. I know that makes absolutely no sense, but it is distracting. My dentist said he can replace it. I let him, but it did not really make a difference. I am not sure what to do. I feel like I’m going crazy. Have you encountered anything like this?

Andrew

Dear Andrew,

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

When a dental crown is done correctly and nothing else is wrong that has been missed, you won’t notice the crown at all. It will just fit in with the rest of your teeth. That is not happening for you, so obviously, there is something amiss. You are not going crazy.

Believe it or not, I know a colleague, an advanced and experienced dentist himself, that went through something similar. He too was not being listened to by his dentist, so he switched. When he went in for his first appointment, he asked the hygienist to take a periapical x-ray in hopes of getting some more information. Boy did he!

It turned out that the tooth under his crown was halfway eaten from decay from the inside. He didn’t feel pain because that tooth had a root canal treatment done on it, just as yours did. It was a good thing he kept following up on this because that decay could have spread and caused a massive dental emergency with little warning.

The solution in his case was to have the tooth extracted and replaced with a dental implant. In your place, I would suggest that you go back to your dentist and ask for this same type of X-ray. Follow your gut and until you are comfortable, don’t back down. If he won’t follow up, find a different dentist.

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

Dental Bonding

Will Dental Bonding Fix My Peg Lateral?

I have one peg lateral tooth and it really bothers me. I hate the way it makes my smile look so I never smile in pictures. Someone mentioned to me that I might be able to get this fixed with dental bonding and I wanted to know if that was accurate before I get my hopes up too much.

Carly

Dear Carly,

What Are Peg Laterals?

I am going to answer your question, but not many readers will know what a peg lateral is, so I will start with that. Peg laterals are a genetic malformation of the developing tooth, which essentially means the tooth does not fully develop. As a result, the teeth look smaller than the other teeth and sometimes can even be pointy.

Can Dental Bonding Work?

Before and after dental bonding

For those who may not know what dental bonding is I have a picture directly above of one of its most common uses. Dental bonding uses a composite resin in order to replace missing tooth structures. It is used to fix chipped teeth, gapped teeth, divots, and much more.

In answer to your question, yes, dental bonding can fix the peg lateral. Your dentist will fill the area with the composite material that is shaded to match your tooth, then it will be appropriately shaped, adjusted, polished, and smoothed. If done correctly, it will match your bite perfectly.

You Have Options

Another solution for peg laterals is to have dental crowns placed over them. Often there is so much structure missing that you don’t even need a lot of tooth preparation. Because the crowns are made from porcelain, they are more stain resistant than the composite bonding. I’d advise the crown as your first option, but if you are opposed to them, then getting bonding done is a great second choice.

Make sure the dentist you go to have this procedure done is experienced in dental bonding and can show you before and after images of cases he’s done, similar to the photo I posted above. Dental bonding is a tricky procedure that has to be done free hand. There is no try in for the results the way you would get with dental crowns.

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

Pediatric Dentistry

Should My Special Needs Foster Teen Go to a General or Pediatric Dentist?

I’ve recently become a foster parent. I choose to work with special needs children. They give us training, but of course, there is no way to teach us about every single issue that comes up. What I am up against now is that he needs to see a dentist. He is sixteen years old and is pretty much a child in a man’s body because of his special needs. Of course, he doesn’t want to be treated like a child. I am trying to decide whether to take him to a pediatric dentist or a general dentist. My concern is he will be hurt or offended about the idea of a pediatric dentist but that his social skills and compliance issues, which aren’t bad except when his anxiety jumps through the roof, will be an issue with the general dentist. Do you have any recommendations for me?

Pricilla

Dear Pricilla,

Happy girl in pediatric dental chair

First, let me say right off that bat that I admire you for taking on foster children, and especially those with special needs. You are amazing. The first thing I would do is look up some websites of pediatric dentists that are in your insurance network. Show your foster son the pictures they have on the site and see what he thinks. If he gets excited about it, go to a pediatric dentist. If he complains that it is for little kids, you still have a good option.

There are general dentists who like to treat children. However, some are better at working with children than others. If a general dentist recommends bringing in children as young as two years old, then you can know they are good at working with kiddos and really enjoy them. If they want you to wait until the child is about five or six years old, then I would look for someone else.

Whichever you end up with, I have two additional recommendations. First, is that you let the office know ahead of time about his special needs. The second is that you set up a time for him to “tour” the dental office and meet the staff. That way it won’t be a totally new experience for him when he goes in for his dental care.

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

Teeth Whitening

Crest 3D Advanced White Toothpaste Gunk

I don’t quite know how to explain this but will do my best. I’ve been wanting to whiten my teeth but thought I would just try the whitening toothpaste first to see what type of results I can get. It’s leaving this weird white gunk on the inside of my lips about ten minutes after I use it that makes it look like my skin is ready to peel off. Is this common and part of the process?

Kelly

Dear Kelly,

teeth whitening trays
Professional teeth whitening trays

Most whitening toothpaste that you purchase over the counter does not whiten your teeth the way that professional teeth whitening does. Your dentist would provide you with a gel that will penetrate the tooth and oxidize it from the inside out. Whitening toothpaste uses abrasives that scratch the surface of your teeth and scrub the surface stains off. While this can remove the stains temporarily it does damage your enamel which will cause it to pick up more stains at a faster rate.

I think the reason for the peeling skin you are experiencing is sodium lauryl sulfate, an ingredient found in this toothpaste. It has been known to produce side effects such as inflammation, skin irritation, and sloughing of oral tissues. I would stop using this because you are obviously having a reaction to it.

If you want to try a whitening toothpaste, I recommend you use Supersmile Toothpaste. This uses a protein pellicle to remove surface stains and will not damage your teeth. Bear in mind, that it will only remove surface stains, which is all that a toothpaste can do.

If you have years of stains on your teeth, you are better off with professional teeth whitening. Though it costs a little more, the results are massively better than anything else you’d get with an over the counter product, including something like whitestrips. If cost is the main issue, talk to your dentist and he or she may be willing to work with you on payment options.

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

Sedation Dentistry

Sedation Dentistry and Type-2 Diabetes

If I have type-2 diabetes can I still use sedation dentistry? I have to get my wisdom teeth out and I’m a huge baby when it comes to the dentist. He told me not to worry because I can be sedated. It wasn’t until a few minutes ago that I realized my diabetes might be a problem. I haven’t found anything online, but did come across your blog. I have a glucose monitor that keeps my blood sugar steady, but I do need to eat regularly. I just read the pamphlet that said not to eat the morning of the procedure. That will be a problem for me. Will any of this mess up my sedation?

Cassie

Dear Cassie,

woman asleep in the dental chair from dental sedation

I am so sorry you are having to deal with this. Diabetes brings so many worries into a person’s life. The good news is having sedation dentistry done, will not have to be one of them.

It sounds like your diabetes is being well controlled with your glucose monitor and you stay on top of things. That is wonderful and will be very important because of the impact diabetes has on your ability to heal.

My recommendation for you will be oral conscious sedation. This is sometimes called sleep dentistry because you are so relaxed you sleep through your appointment. Unlike general anesthesia, you will be okay to eat before the procedure with this type of sedation. It is administered by a pill. You will need someone to drive you to and from your appointment, as well as to stay with you for several hours after your procedure. Whoever you choose as your caregiver will need to make sure you are completely lucid and steady on your feet before leaving you on your own.

When you arrive at the office, all of your vitals will be recorded. Make sure to let them know your most recent HbA1c levels.

You probably already know this but diabetes can be hard on teeth and gums, so make sure you keep up with your regular check ups and appointments. You mentioned being a baby about the dentist. Don’t feel too bad about that. Dental anxiety is quite common. You could ask for some nitrous oxide for your regular, simple appointments. This is a gas that will relax you and take the edge of the appointment. It’s not as demanding as oral conscious sedation and you will be fine to drive yourself home afterward.

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

Dental Emergency

Can a Toothache Cause Chestpain?

My mother is in her 80s and absolutely hates going to the doctor and dentist. The other day when I went by to see her, she was chewing weirdly. When I asked her about it she said her tooth has been hurting. She said the pain comes and goes and that it makes her chest hurt sometimes. I went into a mild panic and she got snippy and told me to stop worrying that her chest hurts every time her tooth hurts and it is nothing. Ignoring the fact that I need to get her to see a dentist for her tooth, is chest pain a normal side effect of a toothache?

Selena

Dear Selena,

elderly woman smiling

Both Toothaches and Chest Pain Can Indicate a Heart Attack

I would like you to take your mother to the doctor right away. Chest pain should always be investigated. Although tooth pain is not one of the more common signs of a heart attack, it does occur in about 10% of cases. Rather than localized, this type of tooth pain seems to be more across the entirety of the jaw, though it often starts in the lower left.

Some additional signs of a heart attack are:

  • A squeezing feeling in your chest and/or arms
  • Nausea, heartburn, stomach pains
  • Shortness of breath
  • Dizziness and Lightheadedness
  • Cold sweats

Dental Health and Cardiovascular Health are Linked

Your mother implied that she has had several toothaches, which makes me wonder about her oral health. When you take her to the dentist, have him look at her gum health. People with periodontal disease are more likely to suffer a heart attack or diabetes. Getting her heart checked is priority one. Then, if that is clear, then I’d like you to schedule a dental appointment for her as soon as possible. You should be able to get an emergency dental appointment.

If Dental Anxiety Keeps Her Away

You mentioned that your mother does not like doctors and dentists. It is possible that she, like many people, suffers from dental anxiety. If that is the case, then having her see a sedation dentist will make her much more likely to agree to regular treatments. It will enable her to have pain-free/anxiety-free dental appointments.

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

Sedation Dentistry

Can a Diabetic Use Dental Sedation?

I have type-2 diabetes and am about to have my wisdom teeth out. I understand that there is dental sedation available for this procedure. Will my being diabetic be a problem? I have a glucose monitor and my levels have been staying in a healthy range. One of the things I worry about is the ability to eat before a procedure because that affects my levels significantly. Am I a candidate for dental sedation or will I have to tough this thing out the hard way?

Karen

Dear Karen,

woman asleep in the dental chair from dental sedation

I am glad you wrote. Diabetes sure does make life more complicated, doesn’t it? The good news is this should not keep you from having dental sedation. Your levels are staying steady and it sounds like you keep up with your care. My suggestion is you ask for oral conscious sedation. This is administered by a pill but is quite strong. Not only will you be able to eat before your procedure, it will be important for you to do so. Also, don’t skip your insulin dose, though I doubt you would. If you didn’t have a monitor, we’d ask you to bring a glucometer, but your meter will make monitoring your levels during the procedure simple.

With oral conscious sedation, you will need a driver to get you to and from your appointment as well as to stay with you for a few hours afterward until you are lucid and steady on your feet. You may want to pick that person well in advance and make sure to train them in your diabetic care so they are prepared for any eventualities.

Other than that, you will want to keep a close eye on your healing and surgical site. It is harder for diabetics to heal, so stay on top of all your post-operative care.

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

Teeth Whitening

Is Tanda Pearl Teeth Whitening Safe?

I have been doing some teeth whitening with a kit my dentist gave me but the trays hurt my jaw. I saw an advertisement for the Tanda Pearl Teeth Whitening System. They said with their special light that you only have to do the whitening for 5 minutes per day. My dentist has me doing it for an hour. I think only needing 5 minutes would really help my jaw pain. Do you know if this is legitimate?

Sally

Dear Sally,

teeth whitening trays
Professional teeth whitening trays

I am glad you wrote. I think I can help you. First, you should know that the whitening ingredient they use is legitimate. That will whiten your teeth. That being said, their light doesn’t seem like it is anything special and they shroud it in mystery which makes me distrust their claims about it. If it did have anything better than the Zoom light, they’d make a fortune marketing it to dentists. They do not, which makes me think it is more psychological than utilitarian.

There is something important to bear in mind, especially if you are having jaw pain. They do not use two separate trays, the way your dentist likely did. You should have something similar to what is pictured above. With the Tanda Pearl System, there is one tray that you have to hold onto with your teeth in order to keep it in. I believe this is going to cause you more pain than what you are experiencing now.

Some other considerations are the fact that the tray will not be custom fit to your bite. This means that the gel will leak out making the strength less effective. It also means your saliva will mix with the gel in the tray further weakening its effectiveness. Finally, the gel can also irritate your gums as it leaks out. You won’t want that either.

My suggestion for you is to first have your dentist look at your trays to make sure they were properly fit to your bite. If the trays are fine then you can simply whiten for a shorter amount of time. You don’t have to wear them for an hour. You can do a half hour or even fifteen minutes. Try lessening the time. I think that would be more comfortable for you than what this kit offers.

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

CEREC crowns

My CEREC Crown Doesn’t Match

Hi there,

After I got home from my CEREC crowns appointment, I noticed my crown was a different shade from the rest of my teeth. Getting the CEREC crown was quick and convenient, but the result is brighter than the rest of my teeth.

I did not want to bother my dentist again, so I tried to fix the problem by whitening the rest of my mouth. However, this did not work and the crown is still too bright.

Is there a way for my dentist to make my crown a different color? I like my CEREC crown, it fits perfectly, but I want a natural smile.

Max, from Friendship, Pennsylvania

Hi Max,

porcelain block for CEREC crowns

Your dentist can change the color of your crown, but he will have to redo it. If you get the crown redone, be sure to first have them use a temporary try-in paste so you can check it under many different light sources – natural lighting, camera light, bathroom lighting, as much as you can. This will give you the best idea of what your crown will look like when you go home with it.

If the CEREC crown still does not match, you will have to send it to a dental laboratory, which will need to be done through your dentist. A master ceramist can match the color, but it may take several attempts. This will lengthen the time it takes to get your crown, however.

The ceramist will have to cut back part of crown’s ceramic and apply a porcelain overlay. Porcelain is easier to color match. CEREC crowns are milled from a block of porcelain, making them very strong but the block is all the same color. Without any shading, it may look unnatural.

CEREC crowns are some of the newest dental technologies, and cosmetic dentists require skill to work the machine. If you want your crown redone, you may need to see a different cosmetic dentist, one who is more experienced with CEREC.

This blog post is brought to you by Gilbert Dentist CEREC crown provider, Dr. Matthew Roper, of Vista Dorada Dental.