My Child’s Orthodontist and General Dentist are Giving Conflicting Advice

Hi,

My daughter is missing one of her upper teeth. The orthodontist left a space for an implant when she’s older. In the meantime, our options were a retainer made by the orthodontist or a Maryland Bridge made by our general dentist. However, the Maryland Bridge keeps falling out. He offered to remake it with metal clasps instead of cement, but I’m worried it’ll fall out again. The orthodontist suggested a flipper, and isn’t sure why the family dentist made the Maryland Bridge in the first place. Should we get the flipper from the orthodontist, or try the bridge again? Did our dentist make a mistake? Should we switch dentists entirely?

Thanks,

Yuko from Pennsylvania

 

Hi Yuko,

Maryland Bridges have a false tooth attached metal wings that attach to the backs of the teeth surrounding the empty space. To stay properly, the back of the teeth and metal both need to be etched to bond securely. The etches may not have been made deep enough, which is why the bridge keeps falling out. However, if the surrounding teeth are healthy, roughening them may not be the best option. This process permanently alters the tooth’s structure.

Your dentist didn’t make a mistake, just chose a less obvious solution to the problem of a missing tooth. A flipper would be a better choice going forward, so opt for one from your orthodontist. If you no longer trust your general dentist, you can ask your orthodontist who they would recommend.

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

 

 

Why Won’t Novocain Make Me Numb?

Hi,

I need a root canal on two front teeth on my lower jaw. Despite an infection and nerve damage, my dentist cannot get these teeth numb enough for a root canal. He did over 5 injections in my gums and even used a numbing paste, but it still wasn’t enough! He didn’t charge me, but I’m tired of living off pain killers. I need this root canal, but can’t unless I get numb. What can I do?

Miranda, from Mexico

 

Hi Miranda,

Your problem sounds like it’s related to dental anxiety. Research has shown that each time the tooth fails to get numb, anxiety increases substantially. Anxiety counteracts novocain; the higher your anxiety, the more difficult it is to numb your mouth.

Unfortunately, your dentist did not understand the correlation between increased anxiety and the need for more novocain. The dentist needs to write you a script for anti-anxiety medication. You will be instructed to take the medication before your appointment, about 30 minutes to an hour before. No matter the medication, you will need someone to take you to and from the appointment.

Another option is to find a sedation dentist that offers nitrous oxide. The difference between taking anti-anxiety medication prior to your appointment or getting nitrous oxide is that nitrous oxide will wear off shortly after the appointment. Gentle dentists offer sedation dentistry, as they understand how anxiety-inducing going to the dentist can be.

If your dentist does not offer sedation dentistry, try to find one, and hopefully under their guidance, you can be numb enough to finally get your root canal.

This blog post is brought to you by Gilbert sedation dentist, Dr. Matthew Roper, of Vista Dorada Dental. Dr. Roper offers both nitrous oxide sedation or a prescription for Triazolam for dental anxiety.