Tag Archives: dental anxiety

Sedation Dentistry

My 5 Year Old’s Teeth are Rotting

I have a difficult 5-year-old. I do brush her teeth, but she is a nightmare when I do it. Actually, she’s a bit of a Tasmanian devil. This is especially true in the dental chair where she refuses to cooperate any time they try to do work on her. She now has one molar with a cavity, two that the dentist is saying need to come out, and decay on several other teeth. What is your recommendation for something like this? I don’t know how to get the work done for her.

Patty

Dear Patty,

Young girl in a dental chair smiling

I can tell you are worried and want the best for your daughter. I do have a way for your daughter to get the dental care she needs with minimal fuss, but I am also going to suggest some tough love to help in the long run with her oral health care. The extensive amount of decay you are describing at her age is almost always a result of constant snacking and drinking.

Our saliva is a big help in the fight against decay. It contains minerals that help fight bacteria between meals. But, when we are snacking or drinking (with the exception of water) too often, it doesn’t give our saliva time to do its job. This leads to extensive decay, even when we have good oral hygiene.

I’m going to strongly recommend you don’t let your daughter eat between meals for a while. She won’t starve and it will help her be hungry for the nutritious meals you make rather than snack throughout the day and not get the value out of the healthy food you make. Juice and soda should also be limited because of the citric acid and sugar contained in both of them.

When you have a child who will not cooperate with their pediatric dentist but there is important work that needs to be done, you may have to use dental sedation. This is sometimes called sleep dentistry because even adults are so relaxed when they use this aid that they can sleep through their entire procedure.

What you don’t want to do is put off this treatment at all. Tooth infections are considered dental emergencies. This is because our jaws are close to our hearts, lungs, and brains. A dental infection can turn life-threatening quickly.

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

CEREC crowns

CEREC Crown Disaster

I was told getting a CEREC crown would be a snap and fit better than other crowns. Not only was I in the chair for over three hours, but the crown didn’t fit properly. She said it was because my tooth was in really bad shape so she had to take a general model from the database. It doesn’t fit at all like my normal teeth or even my other crowns. In fact, she had to grind it down because it didn’t fit in properly. Now it hurts. What do I do?

Carol

Dear Carol,

porcelain block for CEREC crowns

Something is wrong here. Let’s start with your dentist’s statement that she had to use a general model from the database. Her reasoning that the tooth was in too bad of shape doesn’t make much sense to me. Of course the tooth was in bad shape. That is the whole point of needing a dental crown! Why would you put a crown on a healthy intact tooth?

CEREC crowns should fit better than other crowns because they are designed and milled using precision software. However, computer software is only as good as the person programming it. Though, this software is pretty user friendly. For instance, let’s say you were missing your lower left molar. Your dentist would program that in and the software would give her a basic shape to use for that type of tooth to start the design. From there, images of your surrounding and opposing teeth give her the remainder of the information she needs to input into the software. Then it designs the crown.

Your crown is uncomfortable and she had to do grinding on the tooth, so clearly this didn’t happen properly. There are so many things that can go wrong with a dental crown. Here are just three:

  • Open margins. If the crown does not fit the tooth perfectly around the complete circumference of the tooth, then you will have a gap where bacteria can get in leading to decay under your crown.
  • Bite Design. When a bite isn’t designed properly, it throws off occlusion and you will end up with painful TMJ Disorder issues.
  • Poor Contouring. If the tooth is not contoured properly, you will have gum inflammation, which will lead to gum disease.

What this boils down to is you need to have this tooth looked at by another dentist. If they can tell you what is wrong with it, you can get either ask her to re-do the crown or ask for a refund and have it redone by another dentist.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
We help patients with dental anxiety.

Sedation Dentistry

Dental Care for Addication Recovery Patients

I am on methadone treatments while I am in addiction recovery. I have a lot of dental needs as a result of neglect during my years of addiction. I’m in a lot of pain, but the last time I went to a dentist he refused to give me any pain meds for after the treatment. It was excruciating. I don’t know if I can go through that again. Is there any dentist who will understand my situation? I am willing to allow them to talk to both my doctor and counselor. I’m hiding nothing. I just need to get my teeth tended to without having to face agony afterward.

Paul

Dear Paul,

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

I am sorry for all that you are facing. You show remarkable courage for both your ability to face your addiction as well as your desire to get your oral health under control. One of the things you are facing is that many dentists are afraid of the Drug Enforcement Administration (DEA) which sometimes cracks down without considering the individual case.

What you need is a dentist who is willing to put his compassion above his fear. You may be better served looking for a sedation dentist. They are already compassionate and treat patients with dental anxiety. You may have to do some calling around, but I am convinced you will be able to find one who will be willing to work with you. Be upfront before scheduling and ask to talk to the dentist directly, explaining you have a unique situation.

One other suggestion. With a sedation dentist, you should have the option of using oral conscious sedation(OCS). This will allow you to get more work done in each sitting than would otherwise be possible, enabling you to catch up on your work much sooner. Plus, it is strong enough that if you wanted to, you’d be able to sleep through your dental appointment.

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

Emergency Dentist

Can a Tooth Infection Spread to My Brain?

I’m worried about this tooth infection I have. I went to the dentist and he provided me with an antibiotic but told me not to take it until two weeks before my procedure, which isn’t for another month. I read somewhere that a tooth infection can spread to my brain, but he is insisting there is nothing to worry about. What do I do?

Miranda

Dear Miranda,

toothache

While it is true that a tooth infection can spread to your brain, as well as your heart and lungs, there are some dental infections that are so small, you’d have time before you had to worry about that type of spread. Starting the antibiotic in two weeks, will help prevent it from spreading as well.

The danger often comes when there are patients who avoid the dentist out of fear. By the time they see a dentist, if they do at all, the infection has progressed so far that it is a dental emergency and they need treatment right away or they can put their lives in danger.

This doesn’t sound like you. However, I’m sure you know someone in your life who suffers from dental anxiety. For the benefit of those who do struggle getting to the dentist I want to post here that dental sedation can change their life. By using something like nitrous oxide or oral conscious sedation, which is even stronger, you can have an anxiety-free dental appointment.

Not only will that prevent them from waiting until they need a painful emergency procedure, but it will also allow them to get caught up on their dental care, giving them a healthy smile for the first time in a long time. In turn, this makes the remainder of their appointments easier.

When You May Have a Problem

Though I said this infection likely won’t be a problem, sometimes a dental infection will surprise us and take off suddenly. If your pain worsens or you develop a fever, call your dentist and have him move up your appointment.

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

Sedation Dentistry

12 Shots of Novocain to Get Me Numb

I recently had a tooth extracted. The whole procedure was a nightmare. It took twelve shots to get me numb. I don’t know how a dentist can miss a spot that many times! Have you heard of this happening before? Is there a way for a dentist to find the right spot the first time so I don’t have to go through that again?

Paula

Dear Paula,

woman wearing nitrous oxide nose piece

While it is possible that your dentist missed the spot to numb your tooth over and over again, it is much more likely that you had some dental anxiety in the beginning which worked against your numbing medication. Then, as you were still in pain, your anxiety went up even more, creating a vicious cycle. There are too many dentists who do not realize the link between anxiety and the inability to get numb in the dental chair.

The simplest solution to this is to find a dentist who offers dental sedation options. It may be all you need is some nitrous oxide, which is administered with a nose piece, as in the image above. This can relax you enough to enable the Novocain to do its job properly. However, if your level of anxiety is super high, you will be better served with oral conscious sedation. This is significantly stronger, in fact, you will likely sleep through the entire appointment. Be aware though, that it is so strong you will need someone to drive you to and from your dental appointment. You will not be able to do this on your own.

Those who have dental anxiety have found that by using the appropriate level of sedation for stressful dental procedures, they are able to have stress-free as well as pain-free dental appointments.

Dealing with a Missing Tooth

You didn’t mention what tooth was extracted. In most cases, it will be very important to replace the tooth. This isn’t just for appearances sake, though that is important. Without that space being filled, the adjacent teeth will start to drift or tip into the empty space. This will throw off your bite, which can lead to painful jaw problems and even daily migraines.

The best option for replacing a single tooth is a dental implant. This is what I would recommend to a patient of mine.

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

Sedation Dentistry

Must I Go to an Oral Surgeon to Get Dental Work Done?

My dentist tried to numb me for two different procedures. Neither time worked. I’ve always ended up having to go to an oral surgeon and have my work done with an I.V. that knocks me out. That makes getting any dental care quite expensive. Am I condemned to spending a fortune and still not having healthy teeth? Have you heard of someone in my situation before? Is there a different solution?

Matt

Hi Matt,

Someone asleep from dental sedation

Yes, I think I know exactly what is going on here. The great news for you is there is a solution. One thing I’ve found is that patients with dental anxiety have trouble getting numb. Sometimes it will seem like the numbing medication is working but once the work starts, they can feel pain. However, if they can be relaxed with something like nitrous oxide before the Novocain is administered, then when they are relaxed give them the numbing medicine, it works almost every time.

Some patients have such a high level of anxiety that they need a stronger level of sedation. For those patients, I recommend oral conscious sedation.

For either of these, you will not have to see an oral surgeon. Just do an internet search for a “Sedation Dentist”. They are able to help you in the office, saving you a good amount of money. You will also find that if you use oral conscious sedation, your dentist will be able to do a lot more work in each sitting. This will allow you to catch up on your work more efficiently. In fact, you’ll probably sleep through all the work.

One thing to be aware of, however, is oral conscious sedation, though administered with a simple pill, is so strong you will need someone to drive you to and from your appointment.

Once you’ve caught up with your work, if you’re looking for a quick, inexpensive way to improve the appearance of your smile quickly, I’d consider teeth whitening. That one procedure takes years off the appearance of your smile.

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

Sedation Dentistry

How Much Dental Work Can be Done at Once?

I will be honest and admit that I have neglected going to the dentist for many years now. However, it has gotten to the point that I need to do something. I can see decay and a couple of broken teeth. I’m sure I need even more work than I think I do. In order to get this over with fairly quickly (you can probably tell dentists aren’t my favorite thing), how much work can be done in one sitting, so I can minimize the appointments?

Kirk

Dear Kirk,

Someone asleep from dental sedation

While each dentist varies from office to office in how much they’ll do at each appointment, you will find the dentists who are willing to do the most in one sitting are sedation dentists. There is a procedure, oral conscious sedation (OCS), that enables both the patient and the dentist to get through more work at a time. Some people have dubbed it sleep dentistry because they are so relaxed they end up sleeping through the entire procedure.

There are many reasons patients avoid the dentist. One of the leading causes is dental anxiety, which can usually be traced back to a traumatic dental appointment. Having a means to experience stress-free and pain-free appointments with OCS has changed many lives.

Avoiding a Dental Emergency

Hopefully, you’ll find a sedation dentist fairly soon. I am especially concerned about the broken and decayed teeth. These can quickly turn into a dental emergency if the pulp of the tooth becomes infected. When you think about how close your jaw is to your heart, lungs, and brain, you can see how a simple tooth infection can turn life-threatening.

People tend to underestimate the seriousness of toothaches, which is why even in the twenty-first century we still have people who die from a tooth infection.

I’m not saying this to frighten you. I just want you to recognize, if the tooth starts to feel pain or if a pimple develops on your gums, both are signs of an infected tooth and you will need to be seen as soon as possible.

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

Dental Emergency

This Dentist Doesn’t Understand Tooth Infections

I had a tooth infection and went to see a dentist. It’s my first time with this dentist. To be honest, I usually avoid dentists but this one couldn’t be helped I was in so much pain. He gave me and antibiotic and I started to get better, but now I’m worse again. Do I need a second round or did I have the wrong antibiotic?

Leslie

Dear Leslie,

A woman grabbing her jaw in need of an emergency dentist

Either there is some miscommunication between you and your dentist or he has a profound lack of understanding of how dental infections work. An antibiotic is only useful to hold off a dental infection. It won’t cure it. In order for a tooth infection to be completely treated, a dentist has to get in there and physically remove the infected pulp. This can be done by a root canal treatment or by extracting the tooth completely.

It is always better to try and save a tooth, so a root canal would be my first recommendation. If your dentist didn’t tell you this would be necessary and just prescribed you antibiotics and sent you on your way, I would consider this gross negligence on his part.

Yes, you would start to feel better after taking the antibiotics, because they were doing their job. Once they ran out, however, because the infected pulp is still there, it rears its ugly head again. This will continue to spread and what was a dental emergency can turn into a life-threatening emergency rather quickly. This is because your heart, lungs, and brain are all close to your jaw. This needs to be treated.

Dealing with Dental Anxiety

I noticed you said you usually avoid dentists. That is a common issue, especially with patients who suffer from some dental anxiety. If that is you., one step you can take that will help is to see a sedation dentist when you go in for your treatment. They can provide you with a pill that will completely relax you, allowing you to get the dental care you need in an anxiety-free and pain-free way.

Please don’t put this treatment off. It’s important. Sadly, people still die from tooth infections.

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

Dentist

How Much is Too Much Dental Work to Get at One Time?

Hello,

My dentist recommended I get a lot of dental work – both cosmetic and general work. I need some cavities filled, one tooth filed down, and several root canals done. I’d also like to get my teeth whitened at this time. Can I get all of this done at once? Or will it take multiple visits?

Tammy, from Mesa, Arizona.

 

Hi Tammy,

To get the most work done at once, you’ll need a sedation dentist. The dentist will put you under oral conscious sedation. Without the sedation, it varies from dentist to dentist how much they will do at one time.

The procedures you need done are not complicated. However, it depends on where in your mouth you need the root canals done. It will take double the time if the root canals are needed in the back of your mouth, versus the front. Your best bet may be to see an endodontist for the root canals, as they are the most experienced and can work fastest.

If you have an experienced root canal dentist or endodontist that can work quickly, your appointment can be completed in about four hours. However, this also depends on your endurance. Without sedation, it may be best to break up the appointments.

This blog post is brought to you by Gilbert dentist, Dr. Roper, of Vista Dorada Dental.

 

Sedation Dentistry

How Can I Get My Dentist to be More Gentle?

Hello,

I’ve been seeing my dentist for a few years now, and I’m happy with him, but he is the worst at giving shots. My last dentist gave me shots and they didn’t hurt this badly. I had to get numbed to get a cavity filled, and worked up the courage to ask him to be more gentle. He brushed off my concerns, saying that shots are supposed to hurt. The shots he gives are unbearable. I need another filling, and I’m dreading going back to this dentist. Is there anything I can do?

Jirard in Los Angeles

 

Hi Jirard,

The truth is, numbing a patient with minimal discomfort takes skill, time, and patience. If your dentist leaves the numbing gel on for some time, or delivers the injection slowly, this will lessen the discomfort. This gives your body time to adjust to the numbing agent. Injecting it quickly can cause the skin to stretch from too much liquid, and can increase pain.

Your dentist is placing the numbing agent as close to the affected area as possible, but trying to avoid the nerve. Everyone’s bodies are different, so it’s possible he came too close to your nerve, or even hit it. Hitting a nerve sends a shockwave of pain through your mouth.

You did the right thing by speaking up. However, your dentist not only dismissed your concerns, he refused to try. This is a major red flag, and shows he lacks in bedside manner.

There is something you can do to minimize pain. Make sure you are hydrated, as this can make getting numb easier. Also, feeling anxiety before numbing can cause a counter effect, where it’s harder to get numb. You can try relaxing techniques before going to the dentist, or ask for nitrous oxide to relax in place of the shot.

Since you are dreading going back to this particular dentist, it may be time to look for a sedation dentist in your area. Sedation dentists focus on gentle dentistry, which can reduce dental anxiety and pain. It may be worthwhile to find a dentist that listens to your needs.

This blog post is brought to you by Gilbert gentle dentist, Dr. Matthew Roper, of Vista Dorada Dental.