All posts by Smile More

Going to a sedation dentist because of anxiety is giving me anxiety!

I really don’t like the dentist, like really, really don’t like going to the dentist. My mom has suggested that I find a sedation dentist, but the thought of going to a dentist appointment and sleeping through the whole thing while a dentist I don’t know is working in my mouth is almost as scary to me as being awake.  With my anxiety, I just don’t understand how sedation is going to make it easier for me.

Alana, West Virginia

Dear Alana,

pleasant dentistrySedation dentistry was started with people like you in mind. It doesn’t matter whether your anxiety stems from a bad experience in the past with another dentist or it has just developed for another reason, sedation dentists are trained to help you have a good experience while taking care of your teeth.

What can a sedation dentist do for you?

To address your concerns about sleeping through the appointment, let’s paint you a picture of what the different options for sedation look like.

  • For someone who is a little nervous in the dentist’s chair, sometimes nitrous oxide (better known as laughing gas) is the perfect solution. Nitrous oxide is great because it works quickly and wear off quickly. The sedative is breathed in through a mask and you are awake throughout the appointment, but feel relaxed. There is no lasting effect that carries over after the appointment. You are alert and able to drive home.
  • For someone whose anxiety is more intense, oral conscious sedation is an option. With this route, an oral medication is taken before your appointment.  This medication allows you to be very relaxed. You are so relaxed that, although you are awake, you may feel like you were asleep. Because you are awake, you still respond to the dentist and can understand his instructions. Many patients have no recollection of the time in the chair. Because this medication has longer reaching effects, someone has to accompany you so they can take you home afterwards.
  • Most patients fit into the first two categories, so not every sedation dentist even offers the third option, which is sedation using an IV. This is for extreme cases of anxiety or other factors.

Visiting with a sedation dentist, sharing your concerns, and asking questions is a great first step. You can develop a plan that you are comfortable with so you can get the care you need for a great smile.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

My dentist won’t fix my bite after getting a crown!

I had to get a root canal because I broke my bottom molar in the back about a month ago eating a hard popcorn kernal.  After I got the crown, I knew immediately that it didn’t feel like my usual bite. The dentist ground it down a little, but I left that day with it still being off.  He said it would get better. I let it got for a week, but every time I would bite or clench my teeth together, they just didn’t fit. So I went back in to have him fix it, but he was really hesitant to grind much more, saying I just need to get used to “my new bite.” Does it weaken the crown to grind it down? I just can’t figure out why my dentist won’t fix how my teeth fit together.

Preston, Branson, Missouri

Dear Preston,

It’s not fun to have to get a root canal and crown, but it’s even more frustrating to have your occlusion, or bite, feel off.  Because eating is essential, it’s not like you can just avoid biting and chewing. Correcting the bite is a routine part of placing a crown. If your dentist is hesitating, it may mean that either he doesn’t know how to fix it or is uncomfortable to do so.

How dentists correct the bite on your crown

Your bite will never feel exactly the way it did with your original tooth. The dentist can shape the contour to match it as closely as possible. Dentists use a special registration paper to have you “tap tap” your teeth together. This helps them see what parts of the tooth are hitting before the other parts. They can then grind down those spots. It’s doesn’t weaken the crown to fix those small spots.

You can give yourself some more time to try to adjust to your crown. If you continue to  experience discomfort, you will need to do something. It’s not good for your jaw to have your bite off. You could try to see your dentist again, but if he was uncomfortable or not knowledgable to do it right the first time, it may not end well . You may need to see another dentist to fix it.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

 

Should I see an emergency dentist if my jaw hurts?

My jaw has been popping for a long time. Sometimes it also seems to need to open at an angle or to the side a little, not just straight down.  I don’t know why, but now whenever I open my jaw wide, it’s like it is grinding. This week it has started to hurt and I wonder if I have dislocated my jaw. Should I see an emergency dentist?

Cynthia, Columbus, OH

Dear Cynthia,

Jaw pain from TMDFrom the list of your symptoms, you may be suffering from Temporomandibular Disorder, or TMD. Sometimes this is also know as TMJ and includes a number of problems associated with the jaw. Some patients with TMD just feel uncomfortable and others experience severe pain.

Symptoms of TMD

When you do suffer from TMD, you may experience that grinding sound, also known as Crepitus. That occurs when you have bone grinding on bone. You may also experience headaches, clicking sounds, restricted motion, and/or pain. You may be further on the spectrum, but unless your jaw is locked closed and your jaw can’t be manipulated open, it probably doesn’t warrant a trip to the emergency dentist.

There are several factors  that can affect TMD. If you grind your teeth at night or clench your jaw, especially if you are stressed, it can aggrevate it. Your jaw can be affected if your bite is off. Arthritis may play a part. There are many reasons why your joint hurts or the muscles around that joint aren’t working well together.

To help ease your discomfort associated with TMD, you can use a moist heating pad on your jaw for 20 minutes a day. If you know you are stressed and it is making your symptoms worse, try to find ways to alleviate it. This may include exercise, meditation, relaxation techniques–whatever works for you. Also, avoid chewing gum and clenching your teeth.

Because TMD can get worse if left unchecked, you will want to see a dentist who is experienced in TMD.  You will most likely be given an appliance to help you with your symptoms.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

What are CEREC crowns and are they best?

I haven’t visited the dentist like I should over the past ten years. Because I had a toothache,  I finally went. I knew my teeth weren’t in the best shape and the dentist told me I would need a tooth fixed with a root canal, along with some other cavities filled.  I don’t know if I was just overwhelmed by all the dentist was suggesting I needed done, but I swear he started talking another language. He started talking about getting a serk crown. I have looked on the internet and can’t find anything. Can you please translate? What is it and is it the best thing for a mouth like mine?

JB in Wyoming

Dear JB,

We are assuming, based on the work you need done, that your dentist was recommending getting a CEREC crown. There certainly are words that are dentist lingo and do require some translation and CEREC crowns fit that category as they are a newer treatment option.

What are CEREC crowns?

CEREC machineCerec crowns are porcelain crowns that a dentist can create in the office the same day as your visit for the root canal. The dentist uses computer technology and his expertise to make them. The dentist matches the shade of your teeth to the color of porcelain. Using the computer images of your tooth, a special machine cuts the porcelain to fit your tooth. It is bonded on once the root canal is finished.

As to whether it is best for your mouth, again we are just going by your brief history, but CEREC crowns created by dentists who know what they are doing can be very successful. If they are bonded well and you don’t grind your teeth, they will last as well as other crowns. The only time CEREC crowns aren’t usually preferred is when you need a crown on a front tooth. This is for esthetic reasons. They may not look as natural as other crowns created in a lab for the front teeth.

Since you have questions, it wouldn’t hurt to ask the dental office to see pictures of others who have had CEREC crowns placed or about the dentist’s experience.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

 

How long will I sleep after sedation at the dentist?

I hate going to the dentist. I haven’t had any one particular bad experience, but I get anxious just thinking about going. My fear of getting cavities is what has kept me going in for my cleanings every six months. Unfortunately, when I went in this week for my cleaning, they found a cavity I need to get filled. Now I’m freaking out. My mom suggests that I get sedated for the appointment, but how long will I sleep? Is it like the recovery room after surgery? I don’t have anyone who can take me home.

Jay, Fayetteville, AR

Dear Jay,

You are not alone in your fear of having cavities filled. Doctors who offer sedation dentistry understand that fear.  They can help you keep your mouth healthy while keeping you comfortable.

Understanding sedation dentistry

There is a notion that when you use sedation to get your dental work done that you are asleep for the visit. This isn’t usually the case. Your doctor will use medication to help you be relaxed and calm during the visit, but you will likely still be awake. It’s as if you are aware of what the dentist is doing, but you don’t care. You may not remember anything after the procedure. Because you are still awake for the work to be done, you can understand instructions from your dentist.

When the dentist is done, you may still feel a little groggy. That’s why it is required that you have someone there with you at your appointment to drive you home after. If you don’t have someone who can be with you, using nitrous oxide for your cavity may be a better option.

Nitrous oxide, or laughing gas, will give you a similar feeling of comfort for your appointment, but as soon as your procedure is done, the sleepy, groggy feeling goes away. Instead of being a pill you take, you breathe it in. This may be a better option for you to get your dental work done without being stranded at the dentist’s office.

Your best place to start is to speak to you dentist’s office about your options. That way you can understand before you go what to expect, what that appointment will look like for you, as well as costs. You’ll be able to ask any questions you have.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

 

 

Why do I have stains between my front teeth when I have porcelain veneers?

I am so sad about my porcelain veneers. I got them a little over a year ago and they were a dream come true.  My smile was exactly what I wanted.  My problem is I’m getting some dark spots in between my front teeth, almost like a line. Have I somehow ruined my new teeth?

Terry in Honolulu

Dear Terry,

Porcelain veneers are nice because they can not only make your smile more beautiful, but they are pretty stain resistant.  Teeth whitening is not needed or suggested when you have porcelain veneers.

So why are there stains on your porcelain veneers?

There is a glaze that is applied to your new porcelain veneers when they are made. The glaze determines the shine of your teeth so they look natural, not dull.  That glaze is also a big factor in the stain resistance of your veneers. Your teeth shouldn’t stain unless that glaze is somehow compromised. This can happen if your dentist uses a power polishing machine at the office or an inappropriate fluoride treatment.

There are several foods that cause stains on teeth. Coffee and juices are just a couple, not to mention how smoking stains your teeth.  If your porcelain veneers were absorbing stain because of a problem with the glaze, it would be more across the surface of the tooth, not just in one line between the teeth.

Porcelain veneer being added to a toothBecause of the area of stain you describe, it’s likely that your problem is where the veneer meets your tooth. This could be caused by a gap between your tooth and the porcelain veneer that wasn’t bonded well and has allowed the stain to enter there.

It could also be that there was some bonding composite on that line that wasn’t polished well. The stains may just be on that bonding agent. If that’s the case, it’s just a matter of repolishing that area.

In either case, a return visit to the dentist who put on your porcelain veneers would be a good place to start.  Hopefully, it’s just a simple polishing issue. Really, it’s a good idea to schedule regular maintenance appointments for your veneers. It will help maintain their stain-resistance and increase their lifespan.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

Should I replace silver fillings even if they are fine?

We just moved to a new town and I had my first checkup with a new dentist. I have some older silver fillings in my mouth and this new dentist was talking to me about replacing all of them with white fillings. They have never bothered me, but now I’ve been researching and wondering if I should do it. What do you think?

Allie, Charlottesville

Dear Allie,

There are situations when dentists recommend replacing silver or mercury fillings.

When should you replace silver or mercury fillings?

If the fillings start to leak, bacteria can get under them and lead to tooth decay. Sometimes those fillings will corrode. Sometimes they deteriorate or crack and have to be replaced. If your fillings are falling into one of these categories and there is something wrong with them, it may be worth considering.  Especially if your filling is leaking, that needs to be replaced.

It’s not cheap to replace your silver fillings with white fillings, though. If you are interested in replacing your old fillings because you like the look of it, that’s your choice to spend the money on them. If there is nothing wrong with your current fillings, though, it just comes down to what you prefer.

Most dentists, especially seeing a patient for the first time, will mention silver fillings, and the option to fill them with white amalgam. It let’s the patient know that option is available. That doesn’t necessarily mean it is necessary.

If your dentist spoke to you about your fillings because there is a problem, you could speak to the dentist about having just that one tooth fixed, or if you want to pay for all of them to be white, that’s your choice. There’s no rush to fix all of them.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

 

Can I whiten a bonded area on my tooth?

I had a little black space near my gums covered with dental bonding a few weeks ago. I love having that space filled because I really self-conscious about it. It looks like my bonding is turning yellow, though. My husband says it’s not, but I swear it’s more yellow than it was when I got it put on. I typically brush with baking soda and that’s not helping.  I have a tooth whitening tray from my dentist a year ago. Should I try it on my bonding?

Amelia, Four Corners area

Amelia,

Baking soda is not your best option on dental bonding or porcelain veneers. It is very abrasive and can cause damage to the glaze on the bonding or veneers. The baking soda may be what has made your bonding turn yellow. If the polish has been compromised, that area may be more susceptible to stains from food or drinks, such as berries, coffee, or tea.

The problem could just be the bonding material itself.  If your dentist wasn’t experienced in cosmetic dentistry, there’s a chance that the materials he used weren’t quality materials. It may have caused the area to yellow.

How do I fix my yellowed bonding?

As you said you had this bonding done a few weeks ago, you should return to your dentist and ask about the coloration of your bonding.  Ask if they can repolish that area. Unfortunately, as with porcelain veneers, no whitening will work. Actually, with bonding, whitening can actually make that area look worse because it will whiten the tooth around the bonding and leave the bonded area the color it is.

If you can resolve the coloring issue with your bonding with your dentist, look for a specialty toothpaste designed specifically for bonded areas or porcelain veneers, such as Supersmile toothpaste. If your dentist can’t remedy this, you may need to see another cosmetic dentist. That area may not need to be completely redone, but may be corrected with just better materials.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

 

Should I whiten and straighten before porcelain veneers?

I am thinking about getting porcelain veneers since I don’t love my front teeth, especially my top ones.  I have looked a little and know it’s expensive to get porcelain veneers, so if I’m going to get them, I want them to look the best they can.  Should I do teeth whitening and invisalign before I get veneers so my teeth will be perfect when I’m done?

Thanks,
KC, San Diego

Dear KC,

Someone's "perfect" smileYou mentioned you wanted perfect teeth. “Perfect” for you may mean something different than another patient. “Perfect” may be dazzling white and perfectly straight teeth.  Maybe “perfect”  is whiter, straighter, natural-looking teeth that are better than what they are now. No matter what your definition of perfect is, it is important to consider your answers before spending the money on porcelain veneers, whitening, or invisalign.

Should I whiten before getting porcelain veneers?

If you are unhappy with the general color of your teeth before veneers, whitening is a step that needs to happen before you start the porcelain veneers. Veneers themselves do not whiten. Good cosmetic dentists will match the color of your porcelain veneers to your regular teeth so they look more natural. If you want the new veneers to be matched to whiter teeth, complete this step before you start the porcelain veneers.

Should I straighten my teeth before porcelain veneers?

It is not necessary to straighten  crooked teeth before you start. That’s one of the beauties of porcelain veneers. They can make your teeth look straight. Invisalign isn’t necessary.  It won’t affect the placement of the veneers and will save you a lot of money, especially if your teeth aren’t too crooked. If you are generally not happy that several of your teeth, top or bottom, are crooked and you are only planning to get a couple of veneers, it may be something to consider.

The best path for you to take to get the smile you want is to discuss your “perfect” teeth with a cosmetic dentist. Ask for his or her opinion about your treatment plan. Discuss your options so you are comfortable and happy with what the outcome will be before you start anything.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.

 

 

Can you get more than one root canal on a tooth?

I had a root canal two years ago from my dentist. I trust him and he usually does a great job. Recently, though, I have been feeling some pain on that same tooth.  I’ve been told before about pain in the teeth being projected (I think it was called) from another hurting tooth. I’m pretty sure that must be it because you can’t get a root canal twice in the same tooth, right?

Pat

Dear Pat,

toothacheThere are times when pain from a tooth is projected, or referred, from another tooth. In your case, though, it truly may be that you are feeling pain from the same tooth that had the root canal.

In most instances where a root canal is completed, the tissue, or pulp, in the tooth is completely cleaned out of the spaces and canals. Then the canals are sealed so bacteria can’t reenter. A crown is put on top and the patient goes home without another thought about the infection in the tooth.

So how come you may need another root canal?

Unfortunately, not all teeth are created equally. Most molars, for example, have three canals leading down to the roots. Every once in a while, those molars either have a fourth canal leading down or the canals are twisted and at angles that make it difficult for a dentist, even a good, competent dentist, to completely clean out the pulp. If that infected area isn’t completely cleaned out or properly sealed, it may cause pain again as infection grows. If that happens, a second or maybe even a third root canal may be necessary.

These scenarios of root canals aren’t common, but they do happen. If your pain continues, you may want to revisit your dentist to check your tooth. He may retreat it or may refer you to an endodontist, a dentist who specializes in root canal treatment.

This post is sponsored by Vista Dorada Dental in Gilbert, AZ.