Tag Archives: dental anxiety

Sedation Dentistry

Should an Oral Surgeon Do This Extraction?

I had a tooth that I neglected years ago because of a phobia I have with dentists. When the pain became too much to bear I went to see somoene who did a root canal treatment. As expected, the appointment was a nightmare. I did not follow through with the dental crown and neither did the dentist. At the time, I considered that a blessing. Now, the tooth is so far gone that it broke. I went to see a different dentist and he said it is infected and needs to be extracted. He gave me two options because of the state of the tooth. I could do it with him using a local or with an oral surgeon using anesthesia. I was tempted to go with the anesthesia because at least it would be pain free. But, the cost is way more than I can do and the oral surgeon wants payment up front. Here is my question. Am I putting myself at risk by doing this with the dentist? If so, I guess I could try to get a loan to use the oral surgeon.

Dennis

Dear Dennis,

woman asleep in the dental chair from dental sedation

There should not be a reason that a dentist could not do this extraction for you in complete safety. However, that does not mean the dentist you saw is qualified or comfortable doing it. The fact that he suggested an oral surgeon tells me he is not. Plus, given your dental anxiety I do not think a local alone will be enough.

My suggestion is that you see a sedation dentist. They can provide you with oral conscious sedation. This is administered by a pill but strong enough where you can sleep through the entire procedure pain-free. Be aware that you will need someone to drive you to and from your appointment.

The really great news is people in your situation, with anxiety of the dentist, have found that using dental sedation has changed their lives. They’re not only able to get the help they need without fear, but are able to stay on top of their dental care from then forward.

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

Teeth Whitening

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.

Dental Emergency

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.

Sedation Dentistry

My 5 Year Old’s Teeth are Rotting

I have a difficult 5-year-old. I do brush her teeth, but she is a nightmare when I do it. Actually, she’s a bit of a Tasmanian devil. This is especially true in the dental chair where she refuses to cooperate any time they try to do work on her. She now has one molar with a cavity, two that the dentist is saying need to come out, and decay on several other teeth. What is your recommendation for something like this? I don’t know how to get the work done for her.

Patty

Dear Patty,

Young girl in a dental chair smiling

I can tell you are worried and want the best for your daughter. I do have a way for your daughter to get the dental care she needs with minimal fuss, but I am also going to suggest some tough love to help in the long run with her oral health care. The extensive amount of decay you are describing at her age is almost always a result of constant snacking and drinking.

Our saliva is a big help in the fight against decay. It contains minerals that help fight bacteria between meals. But, when we are snacking or drinking (with the exception of water) too often, it doesn’t give our saliva time to do its job. This leads to extensive decay, even when we have good oral hygiene.

I’m going to strongly recommend you don’t let your daughter eat between meals for a while. She won’t starve and it will help her be hungry for the nutritious meals you make rather than snack throughout the day and not get the value out of the healthy food you make. Juice and soda should also be limited because of the citric acid and sugar contained in both of them.

When you have a child who will not cooperate with their pediatric dentist but there is important work that needs to be done, you may have to use dental sedation. This is sometimes called sleep dentistry because even adults are so relaxed when they use this aid that they can sleep through their entire procedure.

What you don’t want to do is put off this treatment at all. Tooth infections are considered dental emergencies. This is because our jaws are close to our hearts, lungs, and brains. A dental infection can turn life-threatening quickly.

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

CEREC crowns

CEREC Crown Disaster

I was told getting a CEREC crown would be a snap and fit better than other crowns. Not only was I in the chair for over three hours, but the crown didn’t fit properly. She said it was because my tooth was in really bad shape so she had to take a general model from the database. It doesn’t fit at all like my normal teeth or even my other crowns. In fact, she had to grind it down because it didn’t fit in properly. Now it hurts. What do I do?

Carol

Dear Carol,

porcelain block for CEREC crowns

Something is wrong here. Let’s start with your dentist’s statement that she had to use a general model from the database. Her reasoning that the tooth was in too bad of shape doesn’t make much sense to me. Of course the tooth was in bad shape. That is the whole point of needing a dental crown! Why would you put a crown on a healthy intact tooth?

CEREC crowns should fit better than other crowns because they are designed and milled using precision software. However, computer software is only as good as the person programming it. Though, this software is pretty user friendly. For instance, let’s say you were missing your lower left molar. Your dentist would program that in and the software would give her a basic shape to use for that type of tooth to start the design. From there, images of your surrounding and opposing teeth give her the remainder of the information she needs to input into the software. Then it designs the crown.

Your crown is uncomfortable and she had to do grinding on the tooth, so clearly this didn’t happen properly. There are so many things that can go wrong with a dental crown. Here are just three:

  • Open margins. If the crown does not fit the tooth perfectly around the complete circumference of the tooth, then you will have a gap where bacteria can get in leading to decay under your crown.
  • Bite Design. When a bite isn’t designed properly, it throws off occlusion and you will end up with painful TMJ Disorder issues.
  • Poor Contouring. If the tooth is not contoured properly, you will have gum inflammation, which will lead to gum disease.

What this boils down to is you need to have this tooth looked at by another dentist. If they can tell you what is wrong with it, you can get either ask her to re-do the crown or ask for a refund and have it redone by another dentist.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
We help patients with dental anxiety.

Sedation Dentistry

Dental Care for Addication Recovery Patients

I am on methadone treatments while I am in addiction recovery. I have a lot of dental needs as a result of neglect during my years of addiction. I’m in a lot of pain, but the last time I went to a dentist he refused to give me any pain meds for after the treatment. It was excruciating. I don’t know if I can go through that again. Is there any dentist who will understand my situation? I am willing to allow them to talk to both my doctor and counselor. I’m hiding nothing. I just need to get my teeth tended to without having to face agony afterward.

Paul

Dear Paul,

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

I am sorry for all that you are facing. You show remarkable courage for both your ability to face your addiction as well as your desire to get your oral health under control. One of the things you are facing is that many dentists are afraid of the Drug Enforcement Administration (DEA) which sometimes cracks down without considering the individual case.

What you need is a dentist who is willing to put his compassion above his fear. You may be better served looking for a sedation dentist. They are already compassionate and treat patients with dental anxiety. You may have to do some calling around, but I am convinced you will be able to find one who will be willing to work with you. Be upfront before scheduling and ask to talk to the dentist directly, explaining you have a unique situation.

One other suggestion. With a sedation dentist, you should have the option of using oral conscious sedation(OCS). This will allow you to get more work done in each sitting than would otherwise be possible, enabling you to catch up on your work much sooner. Plus, it is strong enough that if you wanted to, you’d be able to sleep through your dental appointment.

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

Emergency Dentist

Can a Tooth Infection Spread to My Brain?

I’m worried about this tooth infection I have. I went to the dentist and he provided me with an antibiotic but told me not to take it until two weeks before my procedure, which isn’t for another month. I read somewhere that a tooth infection can spread to my brain, but he is insisting there is nothing to worry about. What do I do?

Miranda

Dear Miranda,

toothache

While it is true that a tooth infection can spread to your brain, as well as your heart and lungs, there are some dental infections that are so small, you’d have time before you had to worry about that type of spread. Starting the antibiotic in two weeks, will help prevent it from spreading as well.

The danger often comes when there are patients who avoid the dentist out of fear. By the time they see a dentist, if they do at all, the infection has progressed so far that it is a dental emergency and they need treatment right away or they can put their lives in danger.

This doesn’t sound like you. However, I’m sure you know someone in your life who suffers from dental anxiety. For the benefit of those who do struggle getting to the dentist I want to post here that dental sedation can change their life. By using something like nitrous oxide or oral conscious sedation, which is even stronger, you can have an anxiety-free dental appointment.

Not only will that prevent them from waiting until they need a painful emergency procedure, but it will also allow them to get caught up on their dental care, giving them a healthy smile for the first time in a long time. In turn, this makes the remainder of their appointments easier.

When You May Have a Problem

Though I said this infection likely won’t be a problem, sometimes a dental infection will surprise us and take off suddenly. If your pain worsens or you develop a fever, call your dentist and have him move up your appointment.

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

Sedation Dentistry

12 Shots of Novocain to Get Me Numb

I recently had a tooth extracted. The whole procedure was a nightmare. It took twelve shots to get me numb. I don’t know how a dentist can miss a spot that many times! Have you heard of this happening before? Is there a way for a dentist to find the right spot the first time so I don’t have to go through that again?

Paula

Dear Paula,

woman wearing nitrous oxide nose piece

While it is possible that your dentist missed the spot to numb your tooth over and over again, it is much more likely that you had some dental anxiety in the beginning which worked against your numbing medication. Then, as you were still in pain, your anxiety went up even more, creating a vicious cycle. There are too many dentists who do not realize the link between anxiety and the inability to get numb in the dental chair.

The simplest solution to this is to find a dentist who offers dental sedation options. It may be all you need is some nitrous oxide, which is administered with a nose piece, as in the image above. This can relax you enough to enable the Novocain to do its job properly. However, if your level of anxiety is super high, you will be better served with oral conscious sedation. This is significantly stronger, in fact, you will likely sleep through the entire appointment. Be aware though, that it is so strong you will need someone to drive you to and from your dental appointment. You will not be able to do this on your own.

Those who have dental anxiety have found that by using the appropriate level of sedation for stressful dental procedures, they are able to have stress-free as well as pain-free dental appointments.

Dealing with a Missing Tooth

You didn’t mention what tooth was extracted. In most cases, it will be very important to replace the tooth. This isn’t just for appearances sake, though that is important. Without that space being filled, the adjacent teeth will start to drift or tip into the empty space. This will throw off your bite, which can lead to painful jaw problems and even daily migraines.

The best option for replacing a single tooth is a dental implant. This is what I would recommend to a patient of mine.

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

Sedation Dentistry

Must I Go to an Oral Surgeon to Get Dental Work Done?

My dentist tried to numb me for two different procedures. Neither time worked. I’ve always ended up having to go to an oral surgeon and have my work done with an I.V. that knocks me out. That makes getting any dental care quite expensive. Am I condemned to spending a fortune and still not having healthy teeth? Have you heard of someone in my situation before? Is there a different solution?

Matt

Hi Matt,

Someone asleep from dental sedation

Yes, I think I know exactly what is going on here. The great news for you is there is a solution. One thing I’ve found is that patients with dental anxiety have trouble getting numb. Sometimes it will seem like the numbing medication is working but once the work starts, they can feel pain. However, if they can be relaxed with something like nitrous oxide before the Novocain is administered, then when they are relaxed give them the numbing medicine, it works almost every time.

Some patients have such a high level of anxiety that they need a stronger level of sedation. For those patients, I recommend oral conscious sedation.

For either of these, you will not have to see an oral surgeon. Just do an internet search for a “Sedation Dentist”. They are able to help you in the office, saving you a good amount of money. You will also find that if you use oral conscious sedation, your dentist will be able to do a lot more work in each sitting. This will allow you to catch up on your work more efficiently. In fact, you’ll probably sleep through all the work.

One thing to be aware of, however, is oral conscious sedation, though administered with a simple pill, is so strong you will need someone to drive you to and from your appointment.

Once you’ve caught up with your work, if you’re looking for a quick, inexpensive way to improve the appearance of your smile quickly, I’d consider teeth whitening. That one procedure takes years off the appearance of your smile.

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

Sedation Dentistry

How Much Dental Work Can be Done at Once?

I will be honest and admit that I have neglected going to the dentist for many years now. However, it has gotten to the point that I need to do something. I can see decay and a couple of broken teeth. I’m sure I need even more work than I think I do. In order to get this over with fairly quickly (you can probably tell dentists aren’t my favorite thing), how much work can be done in one sitting, so I can minimize the appointments?

Kirk

Dear Kirk,

Someone asleep from dental sedation

While each dentist varies from office to office in how much they’ll do at each appointment, you will find the dentists who are willing to do the most in one sitting are sedation dentists. There is a procedure, oral conscious sedation (OCS), that enables both the patient and the dentist to get through more work at a time. Some people have dubbed it sleep dentistry because they are so relaxed they end up sleeping through the entire procedure.

There are many reasons patients avoid the dentist. One of the leading causes is dental anxiety, which can usually be traced back to a traumatic dental appointment. Having a means to experience stress-free and pain-free appointments with OCS has changed many lives.

Avoiding a Dental Emergency

Hopefully, you’ll find a sedation dentist fairly soon. I am especially concerned about the broken and decayed teeth. These can quickly turn into a dental emergency if the pulp of the tooth becomes infected. When you think about how close your jaw is to your heart, lungs, and brain, you can see how a simple tooth infection can turn life-threatening.

People tend to underestimate the seriousness of toothaches, which is why even in the twenty-first century we still have people who die from a tooth infection.

I’m not saying this to frighten you. I just want you to recognize, if the tooth starts to feel pain or if a pimple develops on your gums, both are signs of an infected tooth and you will need to be seen as soon as possible.

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