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Sedation Dentistry

Problems with novacain

I have had dental problems my whole life, because novacain doesn’t always work for me. This has caused some really painful dental appointments. After a while I just stopped going. I realize now that I’m older that I made a bad decision, because that has made for a ton of dental issues. I need to get at least five teeth pulled. However, I’ll want to immediately get dental implants. I’m not worried about the implants because I know they’ll knock me out for that. What terrifies me is the pulling. Do I have any other options than novacain?

Brenda P.- from Idaho

Brenda,

Yes, there is a really good solution for you. Many dentists aren’t aware of this, but dental anxiety can lead to Novocaine resistance. I think the anxiety tends to “burn off” the Novocaine. Look for a dentist who uses either nitrous oxide or oral sedatives. The nitrous oxide will relax you enough that the Novocaine will work. An oral sedative will put you in a sleep like state to relax you throughout the appointment. At our office we call this sleep dentistry. Our fearful patients have found this to be a fantastic solution for them.

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

Dental Crowns

How to tell if you need crowns

My dentist wants to replace my silver fillings in #3,4,5 with crowns. How can I tell if that is necessary?

Madeline J. from Wisconsin.

Madeline,

In dental school we are taught a few guidelines that can make a dental crown desirable.  Two of the main ones are: 1. The width of the filling: Once a filling gets to to a certain width it weakens the tooth and makes it prone to fracture. 2. There may be fracture lines showing.  Amalgam (silver) fillings tend to weaken a tooth.

Other than this it is really a judgment call on the part of your dentist. That is why it is so important to have a dentist you feel you can trust. Most dentists are trustworthy, but there are a few out there that use pressure sales tactics or try to rush you into a treatment option. If you’re feeling uncomfortable with the decision you can get a second opinion. Just make sure the second dentist doesn’t know who the first dentist is or what treatment recommendation you were giving. It is always best to get a blind second opinion.

You may also be interested in a Mercury-free dentist.

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

Dental Emergency

Gum bump with puss

Below my gum there is a pimple kind of bump with puss in it. What should I do?

Kevin J. from Philadelphia

Kevin,

It sounds like you have a fistula. You may have an abscessed tooth. It is common for people to have a tooth infection without realizing it because the infection is draining in the mouth and there is little or no pain coming from the tooth. Sometimes you’ll have pain upon chewing, a mild ache, or sensitivity to hot/cold temperatures, but not always. I advise you go see your dentist. He can evaluate whether your tooth is infected. If it is, you’ll need antibiotics, a root canal, and a dental crown. At our office we can do one appointment CEREC crowns.

Sometimes you can have an infected tooth that causes a lot of pain. If that happens to you, it is perfectly acceptable to get a same day appointment with an emergency dentist. They’ll be able to get you out of pain right then, but may need to schedule the permanent fix for a later date.

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

Invisalign

Teeth maintenance with invisalign

I am thinking about getting Invisalign and wondered if you could tell me what kind of maintenance is required. How often will they have to be worked on? How do I clean them? Is it hard to eat?

Franny- Indiana

Franny,

Invisalign is very low maintenance. You’ll need to switch out your aligners every two weeks, but you wouldn’t necessarily need to see your dentist that often. To clean them, you would just rinse them out. They pop in and out quite easily. You would just take them out to eat, so there are no dietary restrictions, nor do you have to worry about any food getting caught like in traditional braces. Then, just brush your teeth after eating and pop the aligners back in. It is remarkably simple and pain free. I feel they are a great advancement in orthodontics.

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

Invisalign

Invisalign

I keep seeing these TV ads for invisalign and wondered if they are the real deal. Do they really straighten your teeth like braces and are they really invisible? I’ve wanted to get my crooked teeth fixed for a while, but I put it off for so long that I’d feel kind of dumb wearing braces at my age. I kind of got excited when I saw the commercial, but wanted to make sure it wasn’t bogus first.

Robert N.- Benton, AR

Robert,

You can be assured that Invisalign is quite legitimate. In fact, they are more effective than traditional braces and can straighten your teeth in half the time. No one will be able to tell you are wearing them at a conversational distance. We’ve even had patients tell us that their family never even knew they were wearing them.

You may also be interested in Teeth Whitening, and have a kind of smile makeover. This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Dental Emergency, Tooth Infections

Blood infection from tooth

I have a really infected tooth that is rotted all the way down to my gumline. I’ve known for over a year that this tooth needs to be taken care of, but I just don’t have the money. Now I’m afraid I’ve caught a blood infection from this. The whole side of my face, down into my neck hurts. What would the symptoms be if this has spread into my bloodstream? What can I do about it?

Patty L.- Benton, AR

Patty,

Pain in the side of the face is quite common with a tooth infection, so I wouldn’t panic yet. However, a severe tooth infection left untreated can lead to sepsis, though it is not very common. This is sometimes called blood poisoning.

Some early signs of sepsis are flu like symptoms, dehydration, a racing heart rate, and shallow breathing. If it becomes severe you can also experience difficulty swallowing, infrequent urination, and mood swings.

Due to the fact that this tooth has been left untreated along with the symptoms you’re experiencing we highly recommend you see a dentist as soon as possible.  Ask the dental office about financial options they may offer and see if they are willing to work with you on making payments.

This blog is brought to you by Gilbert emergency dentist Dr. Roper.

Invisalign

Fixing a large gap

I have a gap between my two front teeth that his about 10 mm. I’ve already been told I am not a candidate for Snap-on Smile, so my next route is to get Lumineers. I know I should probably get braces, but I’m 42 and would just feel silly wearing them. Am I going to have the same candidate problem with Lumieers that I did with snap-on smile?

Jerry R.- Utah

Jerry,

You didn’t say why you were not a candidate for Snap-on Smile, so I don’t know how to comment on whether you’d have the same problem with the Lumineers. However, I do want to recommend you NOT get Lumineers to solve this problem. 10 mm is a huge gap. That is big enough to put another tooth in. I think you’d be unhappy with the results of the Lumineers.

I know you said you didn’t want to wear braces, but have you considered Invisalign? They truly are invisible so none of your friends would know you were wearing them. As an added bonus they straighten your teeth a lot faster than traditional braces do. This could close your gap, without you having to try to manipulate covering the space of an extra tooth.

Hope I’ve helped.

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

CEREC crowns

Crown keeps falling off

I had an all porcelain crown placed about five years ago. Since then it has fallen out at least three times, that I can recall. My dentist has always re-cemented them for free. However, this last time, I didn’t realize it had fallen out while I was eating. I bit down again and shattered most of it.  Because he has to make a new crown now, he wants to charge me an additional $1400.00. Is it common for crowns to fall out this much? I wondered if it was because I got a CEREC porcelain crown.

Susan- Lehi, Utah

Susan,

No, it is not normal for CEREC crowns to fall out. In fact, if they’re done correctly, they will never fall out. You said your dentist keeps cementing the crown. If he did an all porcelain CEREC crown, then he should have bonded the crown instead of cemented it. Maybe that is what you meant and you didn’t know there was a difference.

One of the things that holds crowns is the parallelism of the way the tooth is prepared. The more parallel the tooth is prepared, the stronger the retention. However, it doesn’t take much retention in their design if they are bonded in properly.

My suspicion is your dentist doesn’t have sufficient training in the bonding procedure and that is why your crown keeps falling out.

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