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In Pain After Dental Work in Mexico

I need some advice and am wondering if I have a dental emergency on my hands. I went to Mexico to save some money on my dental care. They gave the three crowns in all. One of the crowns fell off after a few days, so I made the trip back to have it fixed. Then, they told me it needed a root canal treatment in order to have the crown replaced. When I asked why they didn’t do that to begin with they said root canals only work sometimes so aren’t worth it unless there is a problem. It sounded like they were trying to save me money before so I agreed to the root canal treatment. Now I am in massive pain and the tooth is really sensitive. I called them back and they said I would need to come back in. Now they are saying the tooth is cracked and I will need to extract it and get a dental implant. If it wasn’t cracked before does that mean they cracked it when they did the root canal? Do I go ahead with this extraction and replacement? I’m starting to lose confidence in them.

Bryce

Dear Bryce,

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

STARTING to lose confidence in them? I lost confidence back when the dental crown fell off. Properly bonding on a dental crown is a pretty basic dental procedure. Even the worst crowns should last a minimum of five years. Yours did not even last a few days. As for their root canal treatment, the excuse that they don’t always work does not wash with me. While root canal failure is a thing, if your tooth is infected you need a root canal treatment. Period. However, I don’t think you needed one. You gave no indication to me that you were in pain, which is one of the signs of an infected tooth.

I think you were given an unnecessary root canal. Not only that, they didn’t finish it. If they had, you would not be in pain. You can only have sensitivity in a tooth if there is still some viable tissue. A root canal treatment is supposed to remove all the inside tissue. Obviously, they didn’t. Now they are saying the tooth is cracked and you need to replace it. Even if it is true that the tooth is cracked, that does not make it unsavable.

I would not let these people anywhere near your teeth for even a second. I don’t know what the laws are in Mexico for patient recourse in these situations, but you may end up just having to cut your losses. If you are in pain, and it sounds like you are, I’d like you to schedule an urgent dental appointment with a dentist here in the United States. Get a true evaluation of this tooth and see where you stand. Then we’ll have a better idea of how you can get this healed.

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

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.

Is a Cracked Crown a Dental Emergency?

I have five porcelain crowns. They have served me well for just over 15 years. With one, there has been a slight defect in it from the beginning. It was never before visible, but could only be felt by my tongue. Lately, it has changed. I can now see it and it feels more like a crack. I am assuming I have to replace the crown, which I am fine with. I am just wondering if it requires an emergency appointment. I don’t want it to break in public.

Allie

Dear Allie,

Gilbert CEREC Crown

While I would not consider this a dental emergency, I would not put it off either. Based on the changes you described, I would expect it to go sometime soon. It has had a good life. Given the amount of time you’ve had all of these crowns, I would expect that others will start to show their age soon too. You have a couple of choices here. You could replace the dental crowns all at once, or you can just replace them one at a time. There are benefits to both.

If you get them done all at once, you will be done with it. Though, of course that is a bigger chunk of money at once. If you do them one at a time, you can pay a little at a time, but you will be making trips to the dentist more often, possibly at unexpected and inconvenient times. It really is six of one; half a dozen of the other. It’s just which inconvenience is the least problematic for you.

One thing to be aware of is that you don’t want a dentist saying you have to replace them all at the same time in order for them to match. That tells me the dentist does not have adequate cosmetic skill. Speaking of aesthetics. If you want to whiten your teeth, the time to do it is now before you have the new crown made. This way, the crown can be made to match the new whiter color. It is certainly not required. I just wanted you to be aware that teeth whitening only works on natural tooth structure so the crowns themselves will not whiten.

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

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.

Options for a Tooth Gap

I have an 8mm gap in my front teeth. My dentist is suggesting I get Lumineers to fix that but I’m a bit nervous about that. I see the Lumineers have mixed reviews. Are there other options for me that do not include 3 years in metal braces?

Cameron

Dear Cameron,

An image of Invisalign aligners

Whatever you do, please do not allow your dentist to do Lumineers on your teeth. For one, 8mm is enough space for a whole other tooth. This is a very complicated case for any brand of porcelain veneers and you are correct that Lumineers is touch and go at best. This is due to two factors.

1. They are highly advertised to inexperienced cosmetic dentists. You would need one of the top 1% of cosmetic dentists for your particular case.
2. The company that owns Lumineers insists dentists use their lab, which is not known for having excellent results.

My suggestion would be for you to get Invisalign. This can straighten your teeth and close that gap in half the time of traditional braces. Not only that, they can do it invisibly. There are no metal wires and brackets. Instead, Invisalign uses clear aligners. These are much more comfortable and, because they are removable, it is simple for you to brush and floss your teeth.

They have an additional hidden benefit of allowing you to whiten your teeth at the same time. This is because the aligners can double as teeth whitening trays. It is like getting a mini smile makeover at a fraction of the cost.

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

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.

She Should Not Trust This Dentist

I need some advice. I went to the dentist because of a toothache. It was actually hard for me to go because I have a lot of dental anxiety. When I got there he said that there is an infection in a tooth that already had a filling. He said the tooth is too far gone to save and it needs to be extracted then replaced with a dental implant. He gave me some antibiotics and scheduled me to come back in less than a week for the extraction. I’m having serious doubts about this, but it may just be because I don’t like dentists. Should I just move forward with this or are there other options?

Mandy

Dear Mandy,

A woman grabbing her jaw in need of an emergency dentist

I am very glad you wrote. I think you need to get a second opinion before moving forward with this. If the tooth were as far gone as the dentist indicated, he would not have needed an x-ray to see that. Your filling would literally be falling in on the decay. Plus, you would have been having severe pain for a while and that isn’t something you mentioned. You seemed to indicate the pain was fairly new. Have another dentist look at this just to make sure this is what your tooth really needs. It’s better to be safe in cases like this.

It showed real courage and wisdom to go to the dentist when you had a toothache, even with your dental anxiety. Tooth infections are considered dental emergencies and you did the right thing even if I am not sure you should trust this dentist.

I want to address something that can help with your anxiety. When you get your second opinion, try to find a dentist who offers dental sedation options. Doing it that way will enable you to get an anxiety-free and pain-free appointment. Patients with anxiety find dental sedation can change their lives and enable them to finally get all the dental work they’ve been avoiding for years done.

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

CEREC Crown Hurts

I had a CEREC crown done on a tooth. This isn’t my first crown, but it is my first CEREC crown. For some reason, this one hurts when I bite down. Is that something peculiar to this type of crown? I’ve never had that happen before?

Jeff

Dear Jeff,

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

I truly do not believe the pain you are experiencing is because it is a CEREC crown. Most of the time, CEREC crowns fit better because they are precisely milled by a computer. So, what COULD be causing your pain?

The first reason could be that the bite is too high. If it isn’t seated in the correct place, then when you bite down all your biting force is going to that one spot instead of being spread across all your teeth. This can cause some substantial pain. If this is the case, your dentist can adjust the crown and you should have no further problems.

You didn’t mention if you’d already been back to your dentist and this has been done. If the crown has been adjusted and you are still experiencing pain, the next step would be to check for a lingering infection. If you had this crown placed after a root canal treatment, there can be a canal that was missed. Though our teeth only have a limited number of canals, many times they have branches that shoot off into other parts of the tooth. A dentist can do everything right and still not be able to get everything the first go-round. In that case, a re-treatment can be tried. If you do need a re-treatment, I generally recommend you see a root canal specialist to increase your chances of success the second time around.

Even if you didn’t have a root canal treatment, there could still have been an infection there. Sometimes, the infections are small and hard to read, but get easier as the infection grows. A simple diagnostic x-ray should help determine if this is the cause of your pain.

I would start with these two avenues of inquiry as they are the most common.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Learn about our dental sedation options.

Discouraged About My Teeth

I stumbled across your website and am hoping you can help me. I’ve never been so discouraged in my life. I grew up in a very poor family and we could not afford the dentist. They were good parents who worked hard, but dentistry is expensive. I have always had bucked teeth and braces were a wild dream. I spent most of my childhood being teased. Then in high school, I developed a tooth infection. I had a root canal treatment done, but we could not afford the follow-up treatment so I was left with a hole in the back of my tooth. Then, my first year in college the tooth broke in half. It was a front tooth! I was a freshman in college with no resources. One of my professors noticed I always put my hand over my mouth when I was talking and offered to get me a dental crown. I literally cried. Fast forward seven years. I’m married and we have dental insurance. The problem I am facing is my teeth need so much work I just can’t seem to keep up. My dentist seems to have given up as well. He even suggested we just extract them and get dentures. I’m barely 26 years old! Is there any way to save my teeth?

Carol

Dear Carol,

Woman covering her mouth with her hand

You have had a rough go of things and I am sorry. I did love the story about your caring professor. The compassionate people in this world give us hope, don’t they? While you have a tough situation with your teeth. It doesn’t sound like you have anything unfixable. The first thing I would do is look for a dentist who is willing to work to save your teeth. It sounds like they one you are currently with may not be the best fit for you.

Whatever you do, don’t let him extract all your teeth and give you dentures. When teeth are removed, your body begins to resorb all the minerals in your jawbone, the result of that is the shrinking of your jaw. In about twenty years, you won’t even have enough bone left in your jaw to retain your dentures. There is a way to preserve that bone, using dental implants, but it is very expensive and I don’t think you truly need your teeth extracted.

There are two things you can do to get a handle on this quicker. The first is at home. Most people think brushing is what keeps their teeth healthy. While it is a major contributor, if you are someone who snacks throughout the day, you are inadvertently sabotaging your efforts. Your saliva is a tremendous weapon against oral bacteria because of the minerals contained in it. If you limit your snacking, then you will give those minerals their best chance of fighting decay.

The second thing is to get as much work done as possible at each visit to try to get ahead of this situation. As I am recommending you find a new dentist anyway, look for one who offers dental sedation, specifically something like oral conscious sedation. This will completely relax you and even allow you to sleep if need be. Patients who use this are able to get significantly more work done at each visit.

Before you know it, you’ll be caught up on that dental work.
Hopefully, this helped.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

My Mother’s Teeth are Just Falling Out

I took my mother in for a filling a couple of weeks ago. She is 87 years old. Today she called me and told me a tooth just fell out. I called her dentist and they want her to come in and they’ll do a dental bridge for her. I’m a bit concerned, though. They didn’t even seem to wonder why her tooth fell out. Will this keep happening? Is there an affordable way to help her?

Presley

Dear Presley,

elderly woman smiling

It is wonderful that you are doing your best for your mother like this. Like you, I am concerned about some of what I am hearing. I want to make sure I understand that you said her tooth just fell out. Is that right? For that to happen, it would mean your mother has very advanced periodontitis (gum disease). It would have to be as advanced as it gets. If this is the case, there should have been intervention quite some time ago. I don’t know what your mother’s dentist has been waiting for.

I don’t like the idea of a dental bridge if this is her situation. A bridge is made by suspending a false tooth between two dental crowns that are anchored to the adjacent teeth. This will put additional stress on those teeth, causing them to fail sooner.

I want you to take her to a different dentist and have her evaluated before moving forward. If it is periodontitis, as I suspect, she is going to lose all of her teeth. Ideally, you’d replace teeth with dental implants. However, she is 87 years old and you asked for an affordable dental solution. In her case, I would suggest extracting the teeth and getting her completely removable dentures.

Normally, I do not like to recommend removable dentures because of the bone resorption. However, at your mother’s age it will not have much of an impact on her.

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