I am 35 years old. About 8 years ago I had a wisdom tooth removed, but they never told me that the others can be a problem. Now I have another wisdom tooth bothering me. My dentist is saying I need to have it out but is warning me that there are dangers at my age. I looked up some of the complications of wisdom tooth removal and it looks like my jaw can break. Am I too old to have this wisdom tooth removed? Should I just deal with the tooth bothering me? If I have to take the tooth out, should I get all of them done?
Hailey
Dear Hailey,
While it would have been better to have all your wisdom teeth out eight years ago, you are not too old to have them removed now. Yes, these is a slight increased risk of complications at your age, but when I really start worrying about that issue is when someone hits 40 years old.
However, even if you were 40, if your wisdom tooth is bothering you, then there is a good chance it is infected. If the tooth is infected, then you have to have it out regardless of your age.
Yes, your dentist is going to tell you about scary risks. He’ll probably even give you a paper to sign that describes all types of horrible things that can happen. That is because we are a litigious society, so dentists do what they can to protect themselves.
I say get the tooth out now before it becomes a dental emergency. I do recommend you get them all out at the same time. This will prevent what you are dealing with now from happening ten years from now when you will be at a much higher risk for serious complications.
The good news is that this type of procedure is done with dental sedation, so you are not likely to even remember anything. You can sleep through the entire thing if you’d like.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
What do you do if you do not have money but you have a tooth infection? I’ve got a back tooth which has been bothering me and I suspected it was infected, but now my cheek is swollen up to the size of a golf ball. Is there anything I can do at home for this or is there an antibiotic my medical doctor can provide? Though I do not have dental insurance, I do have medical insurance.
Susan
Dear Susan,
I am sorry that you are going through this. It is discouraging when you need basic care and cannot afford it. I want to warn you about the concept of just using antibiotics as a means of dealing with a dental infection. This can actually end up end up placing you in a worse situation than you were in before taking the antibiotics. This is because the antibiotics will temporarily hold the infection at bay. Then, once the antibiotics are completed, the infection will flare back up stronger than before.
There are only two ways to truly get rid of a tooth infection: a root canal treatment or a tooth extraction. With a root canal treatment, you remove all the infected pulp in the tooth. This will enable you to save the tooth. If that is not a possibility, than you can extract the tooth. Ideally, you will want to replace that tooth. Otherwise, the other teeth will shift or tip into the space. This can lead to painful TMJ Disorder.
With your cheek swollen up, you have a dental emergency on your hands and need to be seen as soon as possible. When a tooth infection is left untreated, it will continue to spread, even outside of the tooth. People still die from tooth infections, but only if it is allowed to spread.
Many dentists are sympathetic to patients in your circumstance. I would call around and see who is willing to work with you by treating the infection and allowing your to pay out the treatment. You may want to start by calling around to dentists who advertise as affordable dentists.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
I had two CEREC crowns done and am a bit frustrated. I’ve only had them a few months and they’re already picking up stains. I do drink coffee, but no one told me not to. Is this something I am going to have to give up drinking coffee? If so, I wish they would have told me that. Is there a procedure I can have that will allow me to drink coffee? Will I be able to whiten them back to their original color?
Stan
Dear Stan,
When Should You Get a CEREC Crown? Teeth whitening will only work on natural tooth structure, so I would not count on that to do any good. Sometimes people are told they are getting porcelain crowns, when their dentist actually gives them a composite resin. This will pick up stains very quickly. I would not think that is what happened to you because you mentioned that you had it done with CEREC crowns which mills from blocks of porcelain.
The porcelain has a protective glaze which protects it from staining. In fact, it should be more stain resistant than your natural teeth. If they are picking up stains, then something happened to damage the glazing. Some possibilities are if your hygienist used something like a power prophy jet or acidulated fluoride. If this happened then, they should bear the responsibility of repairing this.
If they didn’t do this, it is possible you used something that caused some damage to your porcelain crowns. Most whitening toothpastes use abrasives to remove the stains on your teeth. While it does remove some surface stains, the abrasives scratch both your tooth enamel as well as any dental work you have. This means they will quickly begin to pick up stains.
As for your coffee drinking, as long as you get the protective glaze back on your dental crowns, you should have no problem drinking coffee. I do recommend you use a safe whitening toothpaste, however, designed specifically for dental work. Supersmile whitening toothpaste will remove all the surface stains without causing any damage to your teeth or dental work.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
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,
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.
I whitened my teeth several years ago and would like to retouch them before I have to get my dental crown. This way I can make it into the color I want. The problem is my dentist can’t tell me how to go about this. I’m hoping you can. My dentist has a 33% of whitening gel. Here are my questions. First, how many weeks should I use the gel? Second, for how many hours each day should I whiten?
Audrey
Dear Audrey,
Professional teeth whitening trays
There are not specifics that work with teeth whitening like that. However, there are general principles. I don’t know exactly how white you want them. The most basic of these principles is that the longer you wear the whitening gel, the faster your teeth will whiten. If you wear them overnight, which is the most effective time to bleach, your teeth will whiten much faster than if you just wear the trays for an hour a day.
As an example, and this is most definitely not exact, if you wear them overnight, you could do in one week, what wearing them an hour a day would take you eight weeks. Again, not exact, and it depends on how white you want them.
The one sure principle, is something you have not asked. You will need to wait two weeks from the time you finish whitening until you match the crown color. This gives the whitening the time to settle to its final color before you start with the porcelain crown.
One thing to bear in mind here. If your dentist was not able to answer these basic cosmetic questions, then how can he or she provide you with a beautiful crown? You may want to at least make sure your dentist is going to do a temporary try-in and let you make sure everything matches in a way that is beautiful before permanently bonding them on. If you’re not happy with the crown, he should be willing to send them back to the lab.
I am on the cusp of getting porcelain veneers. I am a bit concerned about the procedure. I have a sensitivity to Novocaine as well as any drugs which can make your heart race. A friend of mine recently had the porcelain veneers procedure done and said that the green topical agent they put on her teeth made her very shaky and nervous. This went on for almost fifteen minutes. Do you know if there is epinephrine in the medication used in the procedure? If so, would I be better off having this done with dental sedation?
Sally
Dear Sally,
Epinephrine’s function in a Novocaine injection is to restrict the blood flow and keep the medication more effective. However, any epinephrine in a body would have very little effect on the symptoms your friend experienced. It is more likely that she was dealing with anxiety. That would be a much higher amount of epinephrine than what would be in the medication given to you.
My advice would be to use a mild relaxant along with the Novocaine, such as nitrous oxide. This will keep the epinephrine in your body from getting too high and causing the issues you are concerned about. As I mentioned earlier, any epinephrine in the medication would be miniscule compared to a body’s reaction to anxiety.
I do not recommend you use a stronger dental sedation such as oral conscious sedation. Though stronger, you will not be lucid. Your dentist should place your porcelain veneers on with a temporary try-in paste. This is so that you can get a good look at the veneers and approve of them before they are permanently bonded on.
If you are practically asleep, as you would be from oral conscious sedation, then you would have no way to approve or disapprove the smile makeover. That is important.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
I had a dental crown placed on a slightly crooked tooth. A few weeks later, my tooth became sensitive to both hot and cold. He assured me that was normal for the first few weeks. But, a few months later, I ended up in the E.R. from the pain. They told me I needed to see a dentist. I called a couple of dentists but had trouble getting in. Two days later my face swelled up. Luckily, when I called the next dentist and told them, they scheduled an emergency appointment for me. At the appointment they told me there was something called an open margin on my dental crown. Apparently, that led to a tooth infection and I now need a root canal treatment and a new crown. The second dentist said this is because the dental crown wasn’t placed properly.
Here is my problem. I called the first dentist and asked for my money back because I had to get a new grown and root canal treatment. I didn’t think they’d have a problem giving me my money back seeing as they messed up. Man, was I wrong. They told me I am responsible with what happens after they place the crown. But, if the crown was defective, how can that be my fault?
The second dentist showed me the x-ray and it is huge. Should my dentist have taken an x-ray after the crown to see the margin? If so, will that help me get a refund?
Presley
Dear Presley,
I am sorry this happened to you. One of the things I suggest you do is get these x-rays from this second dentist. This will really help you. I don’t think a malpractice suit will be worth the money, but there are some things you can do.
1. Tell them you are going to go to the dental board. It will be serious for this dentist if the board gets involved and that may cause your dentist to think twice about not giving you back your money.
2. While you are not going to get enough from a malpractice suit, that does not mean that that you wouldn’t benefit from having an attorney write a letter to your dentist on official letterhead. Your dentist doesn’t need to know you’re not going to court and it could get him nervous.
3. I would see if your second dentist would be willing to talk to your first dentist. Sometimes a dentist will be willing to listen more to a peer than to a patient.
I am glad you got the emergency dental help you needed. In your place, I would switch to the second dentist permanently, especially if they’re willing to confront your first dentist about shoddy work.
I had a crown placed several years ago. It was done by the computerized machines that do it the same day. Before doing the crown, she used a drill to remove a metal post. When I went back for a checkup this year with a new dentist, she told me that the crown was not fitting well and would need to be redone. She also said the post should have been removed using an ultrasonic to remove the post by vibration. As I am about to replace the crown, I am hoping you can help with with two things. First, did drilling the post damamge the bone structure? Second, are the same day crowns as good as the porcelain ones? I liked the convenience, but want the best crown.
Carol
Dear Carol,
When Should You Get a CEREC Crown?
The drilling will not have damaged the bone. Dentists are drilling on teeth regularly. There is a risk, however. That comes with the fact that the drill could slip while in use and perforate the root of the tooth, which would lead to needing to extract and replace the tooth.
As to whether your other dentist should have used an ultrasonic device or not, that is always the ideal and I hope they tried that first, but there are times that those posts will only come out with a drill.
Before you replace this crown, I would like you to get a second opinion. When she said the crown wasn’t fitting properly that was quite vague. Did she mean the margins were open, and by that I mean gaps? That would be a reason to replace the crowns. But, if that was the issue, why not just say that? If that isn’t an issue than your crown is probably fine. Hence, the second opinion.
You asked a great question about whether the same day crowns are as good as the porcelain ones. The answer is yes. In fact, both are porcelain. The same day crowns are milled by a computer from a single block of porcelain. Traditional crowns are created by a ceramist and may use a variety of blocks of porcelain.
I hope this helps.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
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,
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.
I had a problem where my tooth number 19 became sensitive to cold. I didn’t have a regular dentist because I have a bit of a dental anxiety. Generally, my teeth stay healthy, but this time I could tell something was wrong. I looked online and there was a dentist who called himself an emergency dentist which meant he would see patients who didn’t have a regular dentist. I went in and he did a quick examine and some x-rays. He told me that one of my wisdom teeth is impacted and should probably be extracted, but if I wanted him to do a filling instead, that could fix it as well. I went ahead to have him do the filling. It was just a few days after that when everything blew up. I was in tremendous pain. I went back to the dentist and he adjusted the filling and told me to take over-the-counter pain meds. I mentioned the pain felt deeper and closer to tooth 19, but he said the only other option was to extract the tooth. I asked for a referral to an oral surgeon and went to have the tooth extracted. That seemed to help things and I was relieved. However, when the prescribed antibiotics and pain meds wore off, the pain returned. I could not understand that because there was not tooth left. Eventually, I ended up at the ER in so much pain I didn’t know what to do. They told me that I had an abscess on the tooth which I’d been telling the dentist all along was the problem. I called him and he just told me to give it time. Instead, I went back to the oral surgeon because I didn’t trust the dentist any longer. He said that he didn’t do root canals and I need an endodontist. So, I found an endodontist. I’m out a ton of money and time, not to mention all the pain I’ve been in. To be honest, I’m more likely to avoid the dentist than ever before because of this. Is there any way I can get at least some of this money back from my dentist for all these unnecessary procedures?
Dennis
Dear Dennis,
What a horror story! I am so sorry this happened to you. I would consider this gross malpractice. Here is why:
1. The sensitivity to cold should have told your dentist right away that a root canal treatment was likely needed. If he didn’t like doing root canals, he could have simply refered you elsewhere.
2. The pain didn’t go away with the filling and he is just adjusting your bite? That was another symptom of the need for a root canal treatment.
3. You have an extraction and that doesn’t help the problem, should have told him he had the wrong tooth. Instead he tells you to “give it time.” Time for what? To develop a bigger infection and leave you with a dental emergency?
My suggestion is that you go to the dentist and ask him politely to pay for all the extra, unnecessary procedures. If you end up losing the tooth, he should pay for its replacement as well. If he refuses, you have a good malpractice case.
Help for Your Dental Anxiety
I want to make sure you are aware of dental sedation. This can allow you to get your dental work done without anxiety and without pain. There are different levels of sedation. My suggestion for you would be to use oral conscious sedation until you are comfortable at the dentist again. It is administered by a pill. However, it is so strong you will need someone to stay with you a ride to and from the dentist as well as stay with you for a few hours after your procedure until you are steady on your feet and lucid again.
Patients who use this say it changes their life. In fact, they are so relaxed that most people just sleep through their entire procedure. Give this a try, with a different dentist than the one who was such an incompetent disaster.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Stay Ahead of the Curve with the Latest Dental Trends and Techniques
