Tag Archives: sleep dentistry

Dental Emergency

Should I Wait to Extract an Impacted Wisdom Tooth If It Isn’t Bothering Me?

I have four wisdom teeth. Two are impacted. The one on the top right is bothering me. The one on the bottom left does not. I’m having the one on the top right extracted. My dentist asked if I wanted to extract the other impacted tooth, but warned me the root went past the nerve. He said we could leave the root and that way there’d be less chance of a problem. I can’t decide what to do. That bottom tooth does not bother me so I wonder if I am borrowing trouble by removing it. Is there a standard for this situation?

Miles

Dear Miles,

An illustration with four examples of impacted wisdom teeth.

The most important rule of thumb is to take an impacted wisdom tooth out when you are young. When you are in your late teens to twenties, everything is relatively pliable. The older you get, the greater the risk of complications. By the time you are thirty years old, your risk of complications doubles. Then it doubles again every few years after that.

An impacted tooth almost always becomes a problem at some point. What you don’t want is to wait until there is a dental emergency to have to deal with it. You will have far less control over the circumstances at that point. Leaving the tooth root is not a bad idea. However, I am not in favor of leaving the entire root. I would suggest you just have him leave the root tip that is near the nerve. You’ll reduce the chances of having trouble with it if the root tip is small.

For dental procedures such as yours, where the patient can feel very anxious, I recommend using oral conscious sedation. This will allow you to get the needed work done in an anxiety free/pain free way. In fact, you will be so relaxed that you could sleep through the entire procedure if you wanted to.

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

Sedation Dentistry

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.

Sedation Dentistry

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.

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.

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.

Dental Implants

I Can Smell My Husband’s Dental Implants

My husband just received six dental implants for his implant overdenture. He is currently wearing a temporary acrylic denture while we have the porcelain ones made. The big problem is that I can literally smell his dental implants and it is making me gag. It almost smells like vomit. I’ve even had to start sleeping on the couch. I would like him to trade out the metal implants he has for the metal-free zirconia implants, but his dentist says there is no way what I am smelling is his implants. I think this dentist just does not want to admit the metal implants are outdated because he does not offer the zirconia ones and we’d have to go elsewhere to get them replaced. What can I tell my husband that will help him understand how far superior the newer ones are so he will be willing to replace them?

Jade

Dear Jade,

metal and zircomia dental implants

I can sense you are frustrated. The truth is, while there is something causing that smell, I don’t believe it is his dental implants. Titanium is inert, so it will not have a smell. I bet if you asked his dentist to allow you to smell one that he has in his office, he would let you. My guess is the smell is coming from something not getting completely cleaned out of his acrylic dentures. He’s probably got some food or bacteria trapped in there. There are a couple of options for dealing with this. He can get something like a Waterpik that will help him get more of the food out. He can also rinse with peroxide, which kills bacteria and debris. I do not recommend using the peroxide more than that or he could get a yeast infection. The peroxide will not distinguish between good and bad bacteria.

I also don’t think you want him to replace your husband’s dental implants unnecessarily. Here’s why. The implants will have to be surgically removed. When they are removed, they will take some bone structure with them. In order to replace them with new implants, he’ll need to first get new bone grafted into that area with a bone grafting procedure. Then, after that heals, he will need another surgery to have new implants placed. Then, another waiting period for the osseointegration to take place and finally his dentures.

That is a lot of unnecessary extra surgeries for your husband. Plus, you take a huge risk of the second group of implants not being successful. These are working. Get to the real cause of the smell and don’t go through all those unnecessary procedures.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Click here to read about sleep dentistry.

Sedation Dentistry

Should an Oral Surgeon Do This Extraction?

I had a tooth that I neglected years ago because of a phobia I have with dentists. When the pain became too much to bear I went to see somoene who did a root canal treatment. As expected, the appointment was a nightmare. I did not follow through with the dental crown and neither did the dentist. At the time, I considered that a blessing. Now, the tooth is so far gone that it broke. I went to see a different dentist and he said it is infected and needs to be extracted. He gave me two options because of the state of the tooth. I could do it with him using a local or with an oral surgeon using anesthesia. I was tempted to go with the anesthesia because at least it would be pain free. But, the cost is way more than I can do and the oral surgeon wants payment up front. Here is my question. Am I putting myself at risk by doing this with the dentist? If so, I guess I could try to get a loan to use the oral surgeon.

Dennis

Dear Dennis,

woman asleep in the dental chair from dental sedation

There should not be a reason that a dentist could not do this extraction for you in complete safety. However, that does not mean the dentist you saw is qualified or comfortable doing it. The fact that he suggested an oral surgeon tells me he is not. Plus, given your dental anxiety I do not think a local alone will be enough.

My suggestion is that you see a sedation dentist. They can provide you with oral conscious sedation. This is administered by a pill but strong enough where you can sleep through the entire procedure pain-free. Be aware that you will need someone to drive you to and from your appointment.

The really great news is people in your situation, with anxiety of the dentist, have found that using dental sedation has changed their lives. They’re not only able to get the help they need without fear, but are able to stay on top of their dental care from then forward.

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

Sedation Dentistry

Dental Sedation with Wisdom Tooth Extraction

My 20 year old has an impacted wisdom tooth. The dentist thinks they will have to remove some of the bone. He wants her to go under general anesthesia for the procedure. Is this necessary because of the bone? I’m uncomfortable with using anesthesia unnecessarily. There are so many risks and we have a relative with serious complications to anesthesia. What would your recommendation be?

Kelly

Dear Kelly,

Someone asleep from dental sedation

Bear in mind I haven’t examined your daughter. However, at her age I would be very surprised if general anesthesia was warranted. With a twenty year old, the bone is still very pliable because there is not really any cementum accumulation at the roots. She is in the ideal age range to have her wisdom teeth extracted. As she ages, that cementum builds up and makes the procedure more difficult with a greater risk of complications.

My recommendation would be oral conscious sedation. This is sometimes called sleep dentistry. However, don’t push your dentist into that. His suggestion signals to me he is not completely comfortable with the procedure. Your daughter would be much better served finding a dentist who is experienced and confident. To find that dentist, simply do an internet search for “Sedation Dentist”, find out if they do wisdom tooth extractions, then schedule a consult with them.

If they recommend general anesthesia as well, there may be some complicating issues the first dentist did not explain to you. My guess is your second dentist will think oral conscious sedation will be perfectly sufficient.

There are always additional risks with general anesthesia. With your family history, it seems like that risk is higher. I’m with you on this one and would not want to jump into that unless it were absolutely necessary.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Click here to learn about our emergency dental services.

Sedation Dentistry

Traumatic Tooth Injury and Dental Anxiety

I took a pretty bad fall and now two of my teeth are starting to turn black. Is there something that can be done to help this? I have to tell you I haven’t been to the dentist in two years because I have horrible dental anxiety. The last time I went the teeth were healthy.

Brooke

Dear Brooke,

woman asleep in the dental chair from dental sedation

When a tooth turns black after an injury, it means the nerve inside the tissue of your teeth has died. The treatment for this will be a root canal treatment. Then a dental crown can be placed over the tooth to both protect the tooth and to improve its appearance.

I do understand that you are not comfortable at the dentist and have some dental anxiety you are dealing with. I want to make sure you know there are dentists who work with anxious patients. By seeing a sedation dentist, you can have a completely anxiety-free and pain-free dental experience.

Most dentists offer two levels of dental sedation: nitrous oxide and oral conscious sedation. Nitrous is sometimes called laughing gas. It doesn’t actually make you silly as it does give you a relaxed, floaty feeling. This is often enough for some patients to have an easier dental experience. It has the additional benefit of allowing you to get on with your day immediately following your appointment.

If your anxiety is stronger, and for some it is debilitating, then I would suggest oral conscious sedation. This is so strong that some call it sleep dentistry because you are so relaxed you can sleep through your appointment. The only real downside is that, because of its strength, you will need someone to drive you to and from your appointment as well as stay with you for a few hours after your appointment until you are lucid and steady on your feet.

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

Teeth Whitening

Luster Premium At-Home Teeth Whitening

I don’t really feel comfortable with dentists but want to whiten my teeth. I saw an advertisement for a DIY kit call Luster Premium At-Home Teeth Whitening. It seems to have one of those light things that dentists use with teeth whitening. Do you know if it is safe? There are some good reviews, but these days it is hard to tell if they are legitimate.

Kristen

Dear Kristen,

teeth whitening trays
Professional teeth whitening trays

Looking at this particular whitening kit, I am glad you wrote before purchasing it. It won’t harm you, but you won’t be getting the whitening you think you are. True teeth whitening kits use a special peroxide gel to get your pearly whites looking youthful and bright again. Many over-the-counter kits have a legitimate ingredient, such as Crest Whitestrips. Though, by law, they are significantly weaker than what you would get with a dentist’s office.

Unfortunately, this kit doesn’t use a legitimate whitening ingredient. The whitening effect they achieve appears to be from a pigment in the zinc oxide. The pigment will stick to your teeth and make them look whiter, but only temporarily. The pigment will only last a few days. My suspicion is many of these positive reviews were written before the pigment wore off.

The light is another issue altogether. It is too weak to be of any effect even if they had a valid teeth whitening ingredient. It appears to be there for psychological effect. So, you essentially have a company using a bogus lamp that is supposed to aid the whitening, with an ingredient that merely colors your teeth.

If you are absolutely committed to doing this without a dentist, I suggest you use Crest Whitestrips. At least their product will work. It will cost you more in the long run to get the same results you would with a dentist, but it will work.

Dealing with Dental Anxiety

You mentioned being uncomfortable with the dentist. I wanted to make sure you knew dental anxiety is a pretty common thing and there are dentists equipped to help. Most dentists who enjoy working with and helping anxious patients will have a way to locate them on the internet by doing a search for a sedation dentist.

There are medicines available that will relax you in the dental chair and give you an anxiety-free and pain-free experience. I’ve found this has changed the lives of patients who were afraid to go to the dentist. Now they are able to get regular dental care and get the work done they’ve been avoiding for years.

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