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Premium Home Whitening Versus the Dentist

I want to whiten my teeth but I’ve been avoiding going anywhere with the surge of covid cases. I just feel like I need something to cheer me up. Looking online, one kit I see that has some positive reviews is Premium Home Whitening. How does this rank with what I’d get from my dentist? Will it actually whiten my teeth?

Gina

Dear Gina,

teeth whitening trays
Professional teeth whitening trays

I’ll start with the positive about this kit. The teeth whitening ingredient is valid and will whiten your teeth. So, if you decide to use this product and really stick with it, you could get some good results. That being said, I have some concerns.

Disadvantages to Premium Home Whitening

This first one I would not call a disadvantage as much as a red flag. The light they provide does nothing. It is simply a marketing ploy. Why not just sell the kit without it and lower the price. To me, that calls into question the integrity of the company and I’d wonder if the rest of what they list is true. For instance, is the whitening ingredient really the percentage they say it is?

The second is the whitening trays. These are not custom fit the way you would get with your dentist. Instead, you DIY them at home. This causes two problems with the whitening gel. Your saliva can get into the tray, which will weaken the strength of the gel. Now it will take more kits to do the same amount of work. In addition to that, your gel can leak from the tray. Not only does this further weaken the gel, but it puts your gums at risk of irritation. There have been cases where patients needed a root canal treatment as a result of an over-the-counter whitening kit because of this type of leakage.

My Recommendation

I would get your teeth whitening done with your dentist. In the long run, you should save money and it is safer. You mentioned concerns about COVID for not wanting to go in. Dentists are all taking extra precautions to ensure the safety of their patients, especially at this time. Something you could request is to ask to come at a time when they have fewer patients, that way you are not surrounded by as many people. Also, some patients have even requested they wait in their car and the receptionist just texts them when it is time to go back.

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

Using a Cheap Alloy Instead of a Gold Crown

I have some sensitivities to metals and other dental materials. When I needed a root canal treatment and dental crown, I specifically asked my dentist to provide me with a gold alloy crown so I would have less to worry about. The root canal treatment turned out fine, but I’ve been having some swelling around the tooth. I asked to see the dental certificate and my dentist told me the lab did not send one. I requested him to get one and it turned out the materials were not what I requested. There was only 2% Gold. The rest was 35% Palladium, 30% Indium, 30% Silver, and 3% Zinc. I suspect this is why I am having some swelling, though my dentist insists there are never allergies to these materials. Am I wrong for being upset about this? I’m beginning not to trust him as the cost for the crown was in line with a gold alloy but I received something quite different. Where do I go from here?

Benjamin

Dear Benjamin,

identalloy certificate

I’m going to say up front that I do not believe your dentist did not receive the certificate. By law, the labs are required to send them and the dentist is supposed to place that in the patient’s chart. It appears he wanted to increase his profits by giving you a cheap substitute believing that you wouldn’t have a reaction. I have learned not to say there are NO allergies to something. Each human body is remarkably unique and there is always the possibility that someone will have an allergy to something, even if very rare.

For a dental crown to be considered a gold alloy, it has to meet two qualifications. First, it must be made of at least 60% of a combination of gold, platinum, palladium, and silver. Yours was above that number and meets the first qualification. Second, it must be at least 40% Gold. Yours was only 2%, which is well below the qualification.

I’m going to suggest you ask him to re-do the dental crown with the materials you requested. If he refuses, tell him you will report him to the dental board. He violated the standard of care in two ways. One by misrepresenting what he provided you and two by not having the certificate (or pretending not to). Then, I want you to find a different dentist. One you can trust.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
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My Husband is Being Tortured By Our Dentist

My husband had an accident that caused some damage to his chin and teeth, as well as gave him a concussion. We took him to the ER, then the dentist the next morning. The dentist said everything needed some time to calm down. When it did, one of his teeth started turning dark. Fortunately, he wasn’t in pain. Our dentist said she didn’t see anything and only felt dried blood. From there, she gave him a dental crown. Fast forward a couple of months and he was in severe pain. Our dentist then gave him an emergency root canal treatment. She prescribed him 5 days worth of antibiotics then finished up his root canal treatment a week later. Even after the root canal treatment, the pain continued. The dentist provided him with no pain relief medication. After another week she decided to root canal the tooth next to the one she previously treated. That also did nothing. My husband is in absolute agony and I feel like her lack of caring is border line torture. What should we do to get him the help he needs?

Lisa

Dear Lisa,

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

Your husband has been through so much and I can tell how much you care about him. Your dentist has made a couple of big mistakes here. First, when the tooth first started to discolor, it needed a root canal treatment right then. I don’t know why your dentist didn’t do one. It makes no sense to me. The dried blood should have been a giant hint that the tooth was dead, even if the discoloration didn’t tell her that.

Next is the way she handled the root canal treatment itself. The way she provided only five days of antibiotics, but waited seven days to close the root canal tells me that she doesn’t understand how these infections work at all. By allowing the antibiotics to run out, she also allowed the infection to flair back up, then she closed the tooth. No wonder your husband was in pain. She never got rid of the infection and closed it up inside the tooth. Then, she did a useless treatment on the adjacent tooth.

Your husband is not being served well by this dentist. I highly recommend that you call an endodontist first thing in the morning. They are root canal specialists and can get this treated correctly. When you call, let them know what has happened so they can get him some antibiotics and pain relief while they get his appointment ready. I’m certain they’ll schedule him an emergency appointment.

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

How to Know if a Tooth is Infected?

I am really confused and wondering if one dentist is incompetent or maybe one is just taking me for a ride? I went to the dentist and he told me I had a small cavity. He told me it would only need a small filling. We did the filling and then a few days later the tooth was very sensitive, especially to cold. I went back in and now he is telling me I need a root canal treatment. How can it go from small filling to root canal in such a short time? Is this tooth really infected or am I being taken for a ride?

Connie

Dear Connie,

toothache

I am suspicious of this and think you need a second opinion from someone who can examine you. If there is a tooth infection, an x-ray should show that pretty clearly. Sensitivity to cold could also be the result of a poorly done dental filling. I’m assuming you had a composite filling done. These can sometimes be tricky. If a dentist is used to placing silver fillings, he may not yet have the skills to place a composite filling yet.

One thing to notice is the senstivity. If it starts to happen even when you don’t have anything cold, that would be a concerning sign. In that case, I would get the root canal treatment. It is better to nip these things in the bud before an infection can spread.

If it is just the filling, just having that re-done by someone who understands the procedure for composites will solve the issue.

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

Dentist Wants to Crown All My Teeth

I haven’t been to the dentist is seven years because of anxiety. I finally plucked up the courage because I was tired of being embarrassed by my yellow smile. I told him I wanted to clean them, make sure they’re healthy, and improve how they look. After the exam, which was discouragingly painful, he told me I have 5 cavities. In order to treat the cavities and improve my smile he wants to crown all my teeth. I feel weird about that because not only are the other teeth healthy, but this is quite an expense he is recommending. I don’t have much experience with dentistry. Is this my only option?

Cal

Dear Cal,

woman asleep in the dental chair from dental sedation

The short answer is no, this is not your only option. You are wise to be concerned. The first thing I want to do is address your anxiety and then we’ll talk about your options. It took a great deal of courage for you to go to the dentist. After such a long period, it would be easy to just find excuses not to go. You are certainly not alone in your dental anxiety.

There is dental sedation available for patients in your situation. They can give you a pill that will completely relax you. In fact, some people call it sleep dentistry because patients almost always just sleep through their procedure. This will not only give you pain-free appointments, but it will also allow you to catch up on your dental work much quicker.

As for crowning every tooth, while I have not examined you, nothing you mentioned indicates the need for such a drastic treatment. You have five cavities and you want whiter teeth, is the way I understood what you wrote. If that is the case, all you need to do is have fillings placed on the teeth with the five cavities. Make sure your dentist gives you mercury-free composite fillings, and then get your teeth whitened.

That is faster, cheaper, and much more conservative with your tooth structure.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Angry with Pediatric Dentist

I am so upset right now I am shaking. I had my daughter in for a checkup and he told me there is a cavity on a back tooth and he’ll need to do a pulpotomy. I had some questions. First, what is a pulpotomy? Second, why can’t we just do a filling? Third, if it is a baby tooth, why can’t we just extract it and let the adult one come in? Rather than answer ANY of my questions he said, “Do you ever get tired of questioning experts all the time? Maybe you should trust I am the dentist and know what I’m doing.” I don’t think my questions were unreasonable. AND this is MY child. Not his. Would you mind answering the questions for me so I can decide what to do?

Jennifer

Dear Jennifer,

Four Smiling Children

I am sorry that you were treated this way. I will be happy to answer your questions. Before I do, I am going to suggest you find another dentist for your daughter. You need someone who is on your side and willing to answer every single question and concern you have. It does not have to be a pediatric dentist. There are family dentists who treat both adults and children. Now for your questions.

A pulpotomy is a child’s version of a root canal treatment. They are less involved than the adult versions. It is typically reserved for back teeth and is a last resort at saving the tooth that is infected. This leads to your second question.

If it is a matter of a simple cavity, then a filling will be all she needs. I recommend mercury-free composite fillings as the safest option. Once the cavity spreads to about 30% of the tooth, then a filling will not be enough and you would have to get her a dental crown.

Only if the tooth is infected would you do a pulpotomy. You did not mention that your daughter had an infection in the tooth, just a cavity, so that makes me wonder. It may be in her best interest to get a second opinion.

Your final question was a good one as well. In some cases, it is fine to just extract a baby tooth and wait for the adult tooth to make its appearance. Back molars are different. They have to last until your child is around twelve years of age. Otherwise, that space is left open for too long waiting on the adult molars. The adjacent teeth drift or tip into the spot. When the adult teeth finally do arrive, there is not enough room for them, which leads to crowding and the need for orthodontics.

If a back tooth does have to be extracted, her dentist would need to put a space maintainer there in order to keep the rest of the teeth in place until her adult tooth arises.

I hope this helps.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
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Affordable Crown Costing Me a Fortune

I needed a dental crown and my dentist was going to charge $1000. I found another dentist about twenty minutes away who only charges half of that, which was much more affordable for me. Initially, that was great news, but it has fallen off six times since I got it, two months ago. Each time, the dentist puts it on again free of charge, but I still lose a minimum of two to four hours at work, depending on how long I am there. I get paid hourly, so this is cutting into my income quite a bit. Plus, my boss is not too pleased. Now, the stupid thing has broken and we have to start over. He said, I would only have to pay half price since I haven’t had it that long, but still, that is another $250 on top of MORE time lost at work. Is this normal?

Kelly

Dear Kelly,

Gilbert CEREC Crown

I’m sorry, let me understand something. He’s offering you a half-price crown because it didn’t last that long? Really? I believe you said you have had this crown a little over two MONTHS, right? A dentist crown at a MINIMUM should last five YEARS! Most go much longer than that. Do not pay him any more money or go back to this dentist. Instead, I want you to get a refund on the original crown. He does not know what he is doing.

Aside from the crown breaking years before it should even begin to show signs of wear, there is the issue of the bonding failing over and over again. Most dentists go their entire careers without a dental crown falling out. This dentist can’t seem to go much more than a week, and that is just with one patient. I probably sound harsh, but you are getting poor quality care and I don’t want you to go through any more with this dentist.

Cheap Versus Affordable Dental Care

There is a huge difference between a cheap and an affordable dentist. Let’s say, for argument’s sake that you go ahead and have the crown redone at half price. Now you are up to $750 not including lost income and time away from work. This time, the crown lasts two years before you need another one. That’s another $500. Now you’re up to $1250. The next crown lasts a generous 5 years (woohoo!). That’s another $500 and you’re up to $1750. If you’d gotten the original crown for $1000, you could have had a hassle-free crown that lasted up between 10-15 years, assuming your current dentist does good, standard work. As you can see the “cheap dentist” was much more expensive.

While there are good affordable dentists, you won’t usually see their prices so dramatically lower than everyone else. When a dentist is that much lower it is usually a red flag. Often that happens for one of two reasons. Either they are terrible at their job and have to keep their prices low enough to constantly draw in new patients, because he has no patient retention. Another possibility is they are new dentists and need to get patients. That’s fine. We all start somewhere. For a price that low, they’d have to cut corners to keep profits reasonable enough to stay in business. Those cut corners could negatively impact your outcome.

I would go back to your dentist, tell him your financial situation and ask if he or she would be willing to allow you to make payments toward your new crown.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
We offer dental sedation.

Dentist Can’t Match My Crown

I need some advice. I don’t know if the problem is the dentist or the lab, but my dentist cannot get my dental crown white enough to match my teeth. I’m new to the state and am using a different dentist than I normally would. However, this is my first dental crown so I don’t really know what to expect. I only came to him because of a dental emergency and he was available. I was in a car accident and had serious damage to a canine tooth as a result. He says he is using the whitest shade possible. I do whiten my teeth, but they don’t look unnaturally white. Just whiter than what he’s offering. It’s a noticeable difference though. Is it worth it for me to drive to my old state to get this to match or am I asking for the impossible?

Brooke

Dear Brooke,

I don’t think you’ll have to do anything as drastic as going to another state. I think I know what the problem may be here. Understand that this is mostly guess work, but I feel fairly confident with it. This dentist is probably a great bread and butter general dentist. He knows how to fix teeth and he does it well. However, he is more interested in the engineering factor than cosmetic work. He probably doesn’t really do any cosmetic work. This is the problem.

Old Vita Shade Guide
Old Vita Shade Guide

General dentists use a shade guide to help them match the crown they are making to your current shade of teeth (see above). He is probably using the same shade guide he’s always used. The problem with that is the popularity teeth whitening gained in the 90s. Teeth whitening does not just remove stains. It can also make your teeth whiter than even their original shade. That means the old shade guides were no longer as useful. Dental supply companies realized this and soon came out with an updated guide that included shades for whiter teeth (see below).

New Vita Shade Guide
New Vita Shade Guide

I would ask this dentist for a refund and then go to a dentist who does more cosmetic work. They will have the updated guide and can match your teeth.

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

How Long Can I Put Off a Root Canal Treatment?

I have a tooth that needs a root canal treatment. My wife thinks it is urgent and I need to get it checked right away. There is absolutely no pain from this and I think it can wait, especially since I’ve been laid off. If I absolutely had to, I could take money out of savings and deal with this, but I would rather wait until I had some income again. Is that possible? My wife is absolutely certain I am going to die from this if I don’t see a dentist.

David

Dear David,

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

I cannot give you hard and fast numbers, but there are some general guidelines that apply here. First, though, let me explain why your wife is so worried. Believe it or not, there are still people who die from tooth infections. There was a fairly recent case that made the news about a truck driver who died from his tooth. He’d planned on getting an appointment but was too late. That being said, not every infected tooth has to be seen right away. It depends on if it is an active or latent tooth infection.

Signs of an active tooth infection:

  • Current or recent pain
  • Drainage by the infected tooth
  • A pimple on your gums

Any of the above tells me you need to be seen by your dentist and have the root canal treatment done. On the other hand, if your tooth has no pain at all and has not for a while, then you have a latent infection and can afford to put off your root canal treatment for a bit. If the pain returns, call your dentist right away to schedule an emergency appointment.

Is there a risk in waiting?

There are a couple of risks here. One is that the tooth infection blows up quickly causing you to need a more invasive treatment than would have been necessary. A second issue is that your tooth doesn’t hurt for years, but because of what was going on in the background you end up with root absorption and your tooth can no longer be saved. Then, instead of a simple root canal treatment, you end up with a tooth extraction and the cost of a tooth replacement, such as a dental implant.

If you’re in no pain whatsoever, wait and see if the job situation turns around. If it looks like this may be a long-term problem, go ahead and get the treatment while it is simple.

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

How Much Do I Need for a Smile Makeover?

I am a tad confused about something and hope you can help clear some things up. I want to get porcelain veneers but in order to do that, my dentist is insisting I also get teeth whitening and Invisalign first. I was under the impression that porcelain veneers can make your teeth look white and straight. My teeth aren’t really crooked enough to justify a full orthodontic case. I just have one front tooth that crosses over the adjacent tooth. Have I misunderstood this completely?

Theodora

Hi Theodora,

Porcelain veneer being added to a tooth

Let’s start with the teeth whitening. Whether or not this is useful to you depends on how many veneers you are getting. Very few people can afford to get a porcelain veneer placed on every tooth. That means the other teeth may need some whitening done in order to match your porcelain veneers. Most smiles are 8-10 teeth wide. If you’re only getting four or six veneers, you’ll want to whiten your teeth first to have everything blend naturally. The same goes for your bottom teeth. I doubt you want to spend money to veneer your bottom arch. In most cases, people get enough veneers on their top arch to have a beautiful smile and only whiten the bottom arch.

The Invisalign is a completely different story. Given the scenario you described to me, I don’t think you need orthodontics. Porcelain veneers done well can take care of that issue. The fact that your dentist is suggesting Invisalign tells me that he or she is not comfortable reshaping your teeth for the procedure. Don’t force his hand. Instead, find a cosmetic dentist who has done this lots of times and will be skilled getting it done.

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