Tag Archives: sedation 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.

Should I Wait to Extract an Impacted Wisdom Tooth If It Isn’t Bothering Me?

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,

An illustration with four examples of impacted wisdom teeth.

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.

Can a Toothache Cause Chestpain?

My mother is in her 80s and absolutely hates going to the doctor and dentist. The other day when I went by to see her, she was chewing weirdly. When I asked her about it she said her tooth has been hurting. She said the pain comes and goes and that it makes her chest hurt sometimes. I went into a mild panic and she got snippy and told me to stop worrying that her chest hurts every time her tooth hurts and it is nothing. Ignoring the fact that I need to get her to see a dentist for her tooth, is chest pain a normal side effect of a toothache?

Selena

Dear Selena,

elderly woman smiling

Both Toothaches and Chest Pain Can Indicate a Heart Attack

I would like you to take your mother to the doctor right away. Chest pain should always be investigated. Although tooth pain is not one of the more common signs of a heart attack, it does occur in about 10% of cases. Rather than localized, this type of tooth pain seems to be more across the entirety of the jaw, though it often starts in the lower left.

Some additional signs of a heart attack are:

  • A squeezing feeling in your chest and/or arms
  • Nausea, heartburn, stomach pains
  • Shortness of breath
  • Dizziness and Lightheadedness
  • Cold sweats

Dental Health and Cardiovascular Health are Linked

Your mother implied that she has had several toothaches, which makes me wonder about her oral health. When you take her to the dentist, have him look at her gum health. People with periodontal disease are more likely to suffer a heart attack or diabetes. Getting her heart checked is priority one. Then, if that is clear, then I’d like you to schedule a dental appointment for her as soon as possible. You should be able to get an emergency dental appointment.

If Dental Anxiety Keeps Her Away

You mentioned that your mother does not like doctors and dentists. It is possible that she, like many people, suffers from dental anxiety. If that is the case, then having her see a sedation dentist will make her much more likely to agree to regular treatments. It will enable her to have pain-free/anxiety-free dental appointments.

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

Are All Dentists Sadists?

I am just going to be blunt. I have never had a pleasant dental experience. Here is the pattern. I go in. I get tortured and even have blood all over my dental bib. Not even numbing medication helps. I am too disgusted to go back again for a while and put it off. Then, I start feeling guilty for missing appointments and go in, this time to a different dentist. I get tortured… ad nauseum.

Here is my question. I need a bunch of work but don’t want to go to more appointments than is necessary. How much work can I get in during just one appointment? I figure I can just bring a flask of whiskey with me or something to steady my nerves and just grin and bear it.

Louis

Dear Louis,

Gilbert dental anxiety
Dental work can be intimidating…but there is a solution.

I’m sorry you have spent a lifetime having this trouble with dentists. Believe it or not, most dentists went into their field because they wanted to help people, not because they enjoy causing pain. My guess is there is a three-fold problem that is causing this cycle. We can go into that in a moment. First, I want you to know that there is a solution, so as I am going through this cycle, know there is hope.

First, early trauma. There is likely some point in your childhood where you had a frightening or painful dental appointment.

Second, anxiety. That early trauma set up a pattern of dental anxiety. This is a big deal because when a patient is anxious, it is actually harder for the numbing medication to work. The higher the anxiety, the faster the medication burns off.

Third, avoidance. The trauma and anxiety you’ve experienced keep you away from the dentist, which in turn allows for more buildup and problems with your teeth. This can lead to gum disease, which is painful to deal with and will bleed during your appointments, as well as large deposits that are harder to remove.

The solution is to get you relaxed enough for the numbing medication to effectively do its job. My recommendation, because of the severity of the experiences you’ve had, is to look for a dentist who offers dental sedation. You can do an internet search for one of the following terms to locate them:

In your case, I am going to recommend you find someone who specifically uses oral conscious sedation (OCS). Oral Conscious Sedation is administered by a pill. Don’t let that fool you, though. This pill is so strong that you will need someone to drive you to and from your appointment, as well as, stay with you for a few hours while you get lucid and steady on your feet again. Because you are so comfortable and relaxed, you are most likely to sleep through your entire appointment. This works in your favor when you need a lot of work done because it allows you to get more work done in each appointment than you would normally be able to. This will help you catch up faster with oral health care.

I think you’ll find this simple step will completely change your experience with dentists.
This blog is brought to you by Gilbert, AZ 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.

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.

This Dentist Doesn’t Understand Tooth Infections

I had a tooth infection and went to see a dentist. It’s my first time with this dentist. To be honest, I usually avoid dentists but this one couldn’t be helped I was in so much pain. He gave me and antibiotic and I started to get better, but now I’m worse again. Do I need a second round or did I have the wrong antibiotic?

Leslie

Dear Leslie,

A woman grabbing her jaw in need of an emergency dentist

Either there is some miscommunication between you and your dentist or he has a profound lack of understanding of how dental infections work. An antibiotic is only useful to hold off a dental infection. It won’t cure it. In order for a tooth infection to be completely treated, a dentist has to get in there and physically remove the infected pulp. This can be done by a root canal treatment or by extracting the tooth completely.

It is always better to try and save a tooth, so a root canal would be my first recommendation. If your dentist didn’t tell you this would be necessary and just prescribed you antibiotics and sent you on your way, I would consider this gross negligence on his part.

Yes, you would start to feel better after taking the antibiotics, because they were doing their job. Once they ran out, however, because the infected pulp is still there, it rears its ugly head again. This will continue to spread and what was a dental emergency can turn into a life-threatening emergency rather quickly. This is because your heart, lungs, and brain are all close to your jaw. This needs to be treated.

Dealing with Dental Anxiety

I noticed you said you usually avoid dentists. That is a common issue, especially with patients who suffer from some dental anxiety. If that is you., one step you can take that will help is to see a sedation dentist when you go in for your treatment. They can provide you with a pill that will completely relax you, allowing you to get the dental care you need in an anxiety-free and pain-free way.

Please don’t put this treatment off. It’s important. Sadly, people still die from tooth infections.

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

How Can I Get My Dentist to be More Gentle?

Hello,

I’ve been seeing my dentist for a few years now, and I’m happy with him, but he is the worst at giving shots. My last dentist gave me shots and they didn’t hurt this badly. I had to get numbed to get a cavity filled, and worked up the courage to ask him to be more gentle. He brushed off my concerns, saying that shots are supposed to hurt. The shots he gives are unbearable. I need another filling, and I’m dreading going back to this dentist. Is there anything I can do?

Jirard in Los Angeles

 

Hi Jirard,

The truth is, numbing a patient with minimal discomfort takes skill, time, and patience. If your dentist leaves the numbing gel on for some time, or delivers the injection slowly, this will lessen the discomfort. This gives your body time to adjust to the numbing agent. Injecting it quickly can cause the skin to stretch from too much liquid, and can increase pain.

Your dentist is placing the numbing agent as close to the affected area as possible, but trying to avoid the nerve. Everyone’s bodies are different, so it’s possible he came too close to your nerve, or even hit it. Hitting a nerve sends a shockwave of pain through your mouth.

You did the right thing by speaking up. However, your dentist not only dismissed your concerns, he refused to try. This is a major red flag, and shows he lacks in bedside manner.

There is something you can do to minimize pain. Make sure you are hydrated, as this can make getting numb easier. Also, feeling anxiety before numbing can cause a counter effect, where it’s harder to get numb. You can try relaxing techniques before going to the dentist, or ask for nitrous oxide to relax in place of the shot.

Since you are dreading going back to this particular dentist, it may be time to look for a sedation dentist in your area. Sedation dentists focus on gentle dentistry, which can reduce dental anxiety and pain. It may be worthwhile to find a dentist that listens to your needs.

This blog post is brought to you by Gilbert gentle dentist, Dr. Matthew Roper, of Vista Dorada Dental.

 

 

Can You Get Sick from Dental Sedation?

Hi,

I started seeing a gentle dentist for my dental anxiety. Sedation is supposed to calm your nerves, but I’m worried about getting it at my upcoming dentist’s appointment. I’ve heard it causes nausea, and the painkillers you get afterwards can cause drowsiness. Those two side-effects mixed together is a recipe for disaster. I’ve never had any adverse reactions to medications before, but I’m still worried. Is choking on your own vomit a risk after dental sedation? Or am I overthinking this?

Samira, Sterling, Colorado

 

Hi there Samira,

There are different levels of sedation and medication a dentist can provide.

The first is nitrous oxide, Also known as laughing gas. This is the sedation of choice for gentle dentists, because it works fast and wears off quickly afterwards, before you even leave the office. You may experience some nausea afterwards, but not necessarily vomiting. Most procedures using nitrous are relatively short, but the longer you are under sedation, however, the amount of nausea you may experience increases. To reduce this risk, don’t eat before your appointment.

The second is oral conscious sedation (OCS): This method uses nitrous oxide and an oral medication (like a sedative, anti-anxiety medication, or anti-histamine) prescribed by your dentist. The type of medication prescribed will depend on your dentist’s personal preference and which one best suits your needs; for instance, at Dr. Roper’s office, he prescribes Triazolam, a safe method of oral sedation.

It’s also recommended you have someone take you to your appointment and check in with you for a few hours after the appointment. Again, to combat nausea, your dentist will schedule you for a morning appointment, and instruct you to not eat the night before or morning of your appointment. Even with this stronger sedation, no cases of asphyxiation during sleep have occurred, so please do not worry.

In summation, nausea is a common side-effect of sedation, but vomiting is not. Talk to your doctor about your fears, and they should be able to give you advice on how to minimize your experience with side-effects.

This blog post is brought to you by Gilbert sedation dentist, Dr. Matthew Roper.

Do i have to see an oral surgeon for my tooth extraction?

I have a strong apprehension to dentist offices. Therefore, I have not maintained a practice of attending regular dental check-ups. Then, a few years ago I lost a filling. I put off taking care of this and later that tooth broke. I prolonged having this looked at until the pain from the broken tooth became too much to bear.

When I finally saw the dentist, I learned that I needed a root canal. Following the root canal, the dentist did not follow up with me. However, because the pain had decreased for the most part, I did not follow-up either. I also did not have a cap put on the temporary filling. Therefore the temporary filling later fell out and an infection developed.

When I saw a different dentist about this, I learned the remaining part of the tooth needed extracted. In addition, because of the tooth’s poor condition, it was going to be quite invasive, involving the gums down to the bone. The dentist recommended I see an oral surgeon for the procedure and be under anesthesia. This is not something I can afford. Is an oral surgeon my only option, or can a general dentist conduct the procedure?

Thank you,
Jessica

Dear Jessica,

Your dilemma is an understandable one. First, it is important that you understand the reasons to see an oral surgeon for a procedure like this one. It would also be a good idea for you to develop questions to ask your dentist, to help you determine if an oral surgeon is the best route for you, even considering the cost.

Reasons to See an Oral Surgeon for Tooth Extraction

It could be that the dentist you say is not comfortable doing such an invasive extraction. He may be suggesting you seek out an oral surgeon to prevent himself from getting into trouble by taking on a procedure like this if it is outside his realm of experience.

Secondly, the procedure may be a traumatic experience for you, the patient. Therefore, he is suggesting seeing an oral surgeon in order for you to be under anesthesia, in order for the procedure to be easier on you.

Dental Anxiety Can Be Costly

As you are learning, the anxiety that sometimes accompanies dental visits and procedures can be quite expensive. If you had immediately replaced your filling after it fell out, there would not have been a need for the root canal you had. In addition, if the dental crown would have been placed quickly following the root canal, the tooth would not have needed extracted. And, if the tooth does get extracted, you may later need it replaced in order to keep your bite from collapsing.

Therefore, the idea of moving forward with the extraction procedure being done by an oral surgeon will prevent you from having a traumatic experience, which would just further amplify your dental anxiety and cause future dental issues for yourself.

Questions to Ask Dentist About Tooth Extraction

It is important to develop specific questions for your dentist, in order to help yourself better answer your question. Try asking how comfortable your dentist feels doing performing a procedure like this. Also consider asking if he has performed extractions like this before. It would be a good idea to find out if there is nitrous oxide available to help with your comfort level. Understanding if your roots are straight or tapered, or twisted with knobs on the end, would also be helpful.

From what you’re describing, it does sound like your dentist is sharing his fair and honest opinion with you, so place significant value in that while making your decision.

This blog post is sponsored by the office of Gilbert sedation dentist, Dr. Matthew Roper.