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Emergency Dentist

Does a Tooth Infection HAVE to be Treated?

I have a tooth infection and my jaw is a bit swollen. Everyone is saying that I need to go to the dentist, but even though it hurts, I feel confident it will go away. I get sinus infections all the time and they go away with antibiotics. I have some left over that I’m taking, but my sister is driving me crazy about this and keeps telling me what I’m doing is dangerous. Can you tell her that it will be fine and will work itself out?

Murray

Dear Murray,

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

Tooth infections are a bit different because at some point the pulp inside the tooth dies and then the antibiotics can not get to the infected part of the tooth. That infection spills out to other parts of the body. A dentist has to physically remove the infected pulp. There are only two ways to fully treat a tooth infection. The first is with a root canal treatment, which is ideal because it saves your tooth. The second is to extract the tooth.

While the antibiotics may help you feel better for a bit and hold the infection at bay, once they run out the infection will flair back up. People die every year from untreated tooth infections because they mistakenly believe it is no big deal.

If your jaw is swollen then yours is already spreading and you have a dental emergency. I do think that you need to see a dentist. Hopefully, a root canal treatment will be sufficient. If not, then you’ll need to extract the tooth. It will also be important that you replace the tooth as well. Otherwise the adjacent teeth will shift or tip into the empty space, which will end up causing your bite to be thrown off. If you do need to replace the tooth, I recommend a dental implant. It is the closest thing to having a healthy natural tooth.

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

Dental Emergency

Porcelain Veneers Keep Coming Off

My dentist said that I needed porcelain veneers because my teeth were discolored, one was a bit crooked, and I would sometimes grind my teeth. The whole process has been a nightmare. They keep popping off, even if I’m eating something as simple as a banana. I would say not a week goes by when one of them doesn’t come off. It’s crazy embarrassing, especially because the only thing left is a small nub of a tooth under the veneer. He does glue them back on, but I usually have to wait a day or two to get in. I think he should consider it an emergency and glue it back in that day. Is this normal?

Penny

Dear Penny,

Crown versus veneer tooth preparation

No, this is not normal. It also sounds to me like your dentist provided you with dental crowns instead of porcelain veneers. Your teeth only have a minimum amount of surface of the front of the tooth removed for porcelain veneers. When you start talking about nubs, that sounds like dental crowns. You can see in the picture above the comparison of the two preparations.

Porcelain veneers are an advanced cosmetic procedure which requires significant post doctoral training to know how to do. Dental crowns, on the other hand, are taught to every dentist in dental school. Unfortunately, your dentist doesn’t even seem to know how to pull that off. My guess is (and please bear in mind that I haven’t examined you) that your dentist has over contoured these dental crowns and that is why they keep popping off.

If you’re grinding your teeth, you will need to wear a nightguard while you sleep to protect them, but that isn’t the problem with your crowns. When they are properly formed and bonded on they are secure. They certainly wouldn’t fall out from eating a banana. Yes, I agree with you that your dentist should fit you in the same day to bond that back on. Most dentists leave some room in their schedule for dental emergencies.

However, I think you need to have these crowns looked at by an expert cosmetic dentist. I’m concerned about the amount of crowns popping off. It may be you need these completely redone. If that is the case, don’t just ask for a refund. Ask for the dentist to pay to have this repaired by the dentist of your choice.

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

Dental Emergency

Porcelain Veneer Broke

I had porcelain veneers put on my teeth to cover my tetracycline stains. I’d actually gone to another dentist to have it done quite a few years ago. One of them has recently broken horizontally. I went to see my dentist and he fixed it with some glue, but it looks like an obvious fix and feels uncomfortable on my upper lip. He’s said it will be a couple of weeks before we he can get to my temporary crown. I was hoping to get this fixed faster, but he said it isn’t a dental emergency. Do you recommend I try to get in to see someone sooner or will everyone make me wait?

Stephanie

Dear Stephanie,

An image of a porcelain veneer being held up to a tooth.

There are a couple of issues here. While this situation isn’t your typical dental emergency, like an infected tooth, most cosmetic dentists would understand the importance of an aesthetic emergency. A second issue is his idea of giving you a dental crown. Why? Is something wrong with the tooth where it needs a crown? If not, then that would be a major overtreatment and completely unnecessary.

This can be repaired with another porcelain veneer. My guess is that your dentist does not have the training or skill to do porcelain veneers. They are an advanced cosmetic procedure. Instead of telling you that he is out of his depth and recommending a skilled cosmetic dentist, he is steering your toward a procedure that he is comfortable with. Every dentist knows how to do porcelain crowns.

My suggestion is that you go back to the original dentist who did your veneers and have him make you another one. If he is retired, then I would look for another cosmetic dentist in town who has training in porcelain veneers. Just make sure that they show you some examples of their work. They should have a smile gallery of cases they have done. If the results aren’t beautiful, then look for a different dentist.

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

Emergency Dentist

Tooth Trauma Delay

A few years ago, while hiking, I tripped and damaged a tooth by breaking a part of a front tooth. I was out of town when it happened but did get an emergency root canal treatment with a dentist I didn’t really know. Once I returned home, my regular dentist checked it out and thought the work was good, but added a dental crown to it. Fast forward two years and the crowned tooth really started to bother me. It became sensitive to hot and cold. My dentist referred me to an endodontic specialist. He thought the problem was actually coming from the tooth next to the one with the dental crown because I have been clenching it in my sleep. Eventually, it stopped hurting, but now it is hurting again. They say there is nothing on the x-rays. I don’t know what to do. If something happened, is it normal for an adjacent tooth to have a problem a year or two later? What do I do?

Sammie

Dear Sammie,

A woman grabbing her jaw in need of an emergency dentist

I think I can help you here. First, once the root canal treatment was done on your tooth, the nerve was removed. So that means the tooth with the crown could not be the one sensitive to hot or cold unless the root canal wasn’t done or if it failed. This was an upper front tooth, which are the easiest root canals to do, so I don’t think it failed. Plus, your dentist checked it out and said it was fine.

I’m not shocked that they didn’t see anything on the x-ray. Until it progresses to an infection it might not be visible. It is also not unusual for a tooth to have trauma but not show problems for a year or so. I don’t know why your dentists are having trouble with this. My suggestion, if it is no longer bothering you, is to follow up with this and have an x-ray every year or so to check for a developing infection. It may never develop.

If you do have pain blow up before your yearly x-ray, get an emergency dental appointment because you want to stay on top of it.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Click here to learn about one-visit crowns.

Teeth Whitening

Can You Bleach Your Teeth with Clorox?

I want to bleach my teeth so they don’t look so yellow. I know dentists use those trays. Is there a way to keep bleach on your teeth without them? I have a whole jug of bleach at my house and I thought I could use that to bleach my teeth. If there’s not a way to use a homemade type of tray, what about just brushing with it? Will that work?

Stacey A.

Dear Stacey,

Image of teeth whitening trays
Professional teeth whitening trays

I appreciate that you’re trying to find ways to bleach your teeth yourself. Unfortunately, this isn’t the way to do it. When dentists bleach your teeth, they don’t actually use bleach. Instead, they used a specialized peroxide gel.

Bleach is a base, like Lye, which means it is corrosive and can burn living tissue. Ironically, bleach is used in a dental procedure for that very reason. Dentists use it in root canal treatments to clean out and dissolve all the dead debris left.

While you might try something like brushing or rinsing with it, you will damage the tissue in your mouth. There are over the counter whitening kits that will work, such as Crest Whitestrips. It is significantly weaker than what you get at the dentist, but it will work.

While it is less expensive to get a box of Crest Whitestrips, than to do professional teeth whitening, in the long run it will end up costing you significantly more money. You’ll have to use quite a few boxes to do the same thing just one treatment with your dentist will do.

If cost is the only thing keeping you from doing it through your dentist, then I suggest that you shop around. Look for a dentist who advertises as an affordable dentist. Their prices will either be lower or they will be more willing to work with you on payments.

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

Emergency Dentist

A Tooth Infection is Dangerous

I had a molar break about a month and a half ago. I did not have money to deal with it. Recently, I’ve been having pains in my cheeks, sinuses and temple on the side of the mouth with the broken tooth. This morning I woke up with pain in my neck, also on the side of the tooth. Do you think this is related? My sister thinks it is an infection. Is this dangerous? I tend to avoid dentists both because of the cost and the fact that I have never had a pleasant experience at the dentist. So, if there is an antibiotic I can use, I’d rather go that route.

Analisa

Dear Analisa,

Woman holding her jaw from a toothache

I am sorry this is happening to you. Before I talk about your tooth infection, I want to let you know ahead of time that I do have a solution for your negative experiences at the dentist. I want you aware of that so you do not panic.

Yes, you do have a tooth infection and it is spreading. It is dangerous. Yours has already spread up to your temple and your neck. Here are some things that can happen if it is not treated, all of which are life-threatening. It can spread to your brain. Your neck can swell up closing your breathing passage. It can continue past your neck and spread to your heart. I know it sounds crazy, but people die every year from an untreated tooth infection.

Unfortunately, an antibiotic won’t help. The most it can do is temporarily stave off the infection. It will not cure it. This is because it can only reach the part of the infection that has spilled out of your tooth. The only way to treat this is either with a root canal treatment or a tooth extraction.

Both of those probably sound very scary to you. I am going to recommend, especially because of your history, that you see a sedation dentist. They can provide you with a pill that will completely relax you during your treatment. In fact, many people call it sleep dentistry because you can sleep through your treatment if you want to.

Please don’t put off getting this tooth treated. It is a dental emergency and I do not want you turning into another statistic.

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

Teeth Whitening

Tetracycline Stains and No Money

I’ve had tetracycline stains most of my life. When I went to my dentist about ten years ago in order to improve my smile. He told me that porcelain veneers were the only solution. I couldn’t afford them. I still can’t. I’m hoping there are other solutions now. Is there anything else I can do to improve my smile? I’m tired of being embarrassed by my teeth.

Caroline

Dear Caroline,

Image of teeth whitening trays
Professional teeth whitening trays

While porcelain veneers are the best option for smile makeovers, you are correct that they are quite pricey. The good news is that they are not your only option. While it will not make your teeth as absolutely stunning as they could get with veneers, it will improve them remarkably. My suggestion is that you have at-home teeth whitening done. Your dentist can make you custom fit trays. You’ll be able to smile without feeling embarrassed.

It is important to know up front that you will have to be persistent. This won’t happen overnight. But, if you keep wearing the whitening trays, you will eventually make a significant difference. And, it will be much more affordable than porcelain veneers, even after months of whitening.

One precaution. Do not try to use Zoom whitening or laser whitening. While both of those are initially stronger than the at-home whitening trays I suggest you use, it would take too many treatments to do what you need. These two options are more expensive and I do not believe you will find the extra cost worth the minimal amount of time you will save using them.

In the meantime, you can save up for porcelain veneers if you still want to get them eventually. The good news is that, while you need an expert cosmetic dentist to do porcelain veneers and you would not want to price shop for them, pretty much any dentist can do teeth whitening well. It is a basic procedure. So, in this case, you can price shop. Find an affordable dentist and wear the whitening trays as much as you can. You’ll find it the most effective if you wear them overnight.

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

Sedation Dentistry

I Want to Get ALL My Dental Work Done

I have avoided the dentist for years, but my mouth has been hurting so much that I went in. I need a LOT of work done. A LOT. I know it is my own fault, but I’ve never had a pleasant dental appointment in my entire life. I’ve decided it is time to man up. I want to get as much of this done at once as possible. So, give it to me straight. How much can I get done in one day?

Troy

Dear Troy,

woman asleep in the dental chair from dental sedation

You are not alone in your dental anxiety. Many of those anxieties start because they had a horrible experience at the dentist when they were children. This often happens because parents don’t think very young children need a dentist and wait until there is a problem before they bring them to the pediatric dentist. Then, their first experience in the dental chair is a painful and frightening one. That’s enough to keep anyone away!

I have a couple of pieces of good news for you. One, there is a way for you to have an anxiety-free/pain-free dental appointment. Two, there is a way for you to get more work done than would normally be possible in one appointment. Even better, they both have the same solution.

The best thing for you to do is to see a sedation dentist. They can prescribe you a medication that will completely relax you. I recommend that you find a dentist who offers oral conscious sedation. With this medication you will be able to sleep through your appointment if that is what you choose to do. It is so strong. The only real downside is that it’s strength means 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.

Dentists who offer sedation are more compassionate with their patients who have dental anxiety than most other dentists. Plus, because you are so relaxed, or even asleep, you are able to tolerate more work done in each sitting. Though, you need to know up front that dentists vary in the amount of work they are willing to do in each appointment.

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

Teeth Whitening

Can I Whiten My Dental Bonding?

I have two front teeth that have dental bonding on them. The bonding is quite old and probably needs to be replaced. I’m just hoping to wait a couple of more years before doing that. I do realize that dental bonding cannot be whitened to a whiter color than it was created with. What I’m wondering is whether or not I can just whiten them back to their original color.

Amelia

Dear Amelia,

Before and after dental bonding

Unfortunately, all that teeth whitening will do in this case is make your dental bonding look worse. This is because it will whiten your natural teeth but do nothing for the bonding. Now, your teeth will be significantly whiter than the bonded portion.

If your stains are all external, it is possible that your dentist could polish them up to improve their appearance. Another possibility is for you to also use Supersmile Toothpaste. This does a good job of removing surface stains. If, however, the stains are internal neither of those options will help.

In that case, the only thing you can do is replace the dental bonding. Don’t try to save money on this by going to the cheapest dentist. Dental bonding is an advanced procedure and you will want a skilled cosmetic dentist to do it. Though, I am certain you may be able to find a dentist who is willing to work with you on payments. There is also the Care Credit company, which is a type of medical credit card. They will pay for your treatment with your dentist and allow you to pay out the treatment to them.

I hope this helps.

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

Emergency Dentist

Am I Too Old To Remove Wisdom Teeth?

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,

Woman holding her jaw from a toothache

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.