Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Archives for December 2016

Does My Orthodontist Have to Pull My Teeth?

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My orthodontist wants to pull a couple of my teeth. He says it’s the only way he can make all my teeth straight and keep them that way. I disagree. I’ve never heard of this and I don’t understand why he would want to remove good teeth. Aren’t dentists supposed to be in the business of saving teeth, not pulling them? What should I do? Is this normal and something I have to go along with or is the guy a little off his rocker?

Jeremiah

Dear Jeremiah,

Yes, orthodontists commonly remove teeth as part of treatment. There are a number of reasons why they do, but a lot of time it comes down to not having enough space. If you have a narrow arch and a full set of teeth, there may not be enough room for them to be straightened out and fit properly. This likely is the cause of you having less than straight teeth to begin with. When an orthodontist catches cases like this early on, before the top of a child’s mouth is fused, a metal expander can be used to gradually widen the arch. At a certain age, usually around age 12 or so, the palate becomes hard and can’t adjust, so the only way to make room for everything is to remove some teeth.

There are other reasons why it might be necessary as well, such as to correct an overbite or to prevent the roots of the teeth from becoming exposed during treatment in some cases, but a lot of the time it simply comes down to making room.

Having straight teeth makes it much easier to keep them clean and to clean between them, which in turn helps prevent decay. So, although those teeth are healthy now, keeping them could indirectly affect the health of all your other teeth in the long run. When an orthodontist considers your treatment plan, he takes time to weigh the value of performing extractions. They’re not the easy way out, but they can help produce the results you need.

Should you go along with it? Only you can decide that. However, If you’re on the fence about it, find another orthodontist and have him provide an assessment. You don’t even need to mention your concerns about the extractions- just ask him what the best way to get the results you want is. If he suggests extractions, then you know it’s probably a solid choice. If he doesn’t, then you can see how he feels about it. Best of luck to you.

The blog is brought to you by Dr. Ryan Noah.

Affordable Dentist in an Emergency for Unemployed

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I need to find an affordable dentist for my dad. He is 63 and has a terrible toothache, but he’s also unemployed and on state insurance, which doesn’t provide dental coverage. Obviously, with the unemployment, he can’t really afford to have the tooth fixed, which is terrible. He keeps trying to live with it, thinking he’ll just fix it when he gets back on his feet again, but I’m really worried that it’s infected and that it’s getting worse. How do I find an affordable dentist who will help him?

Jim

Dear Jim,

There are a lot of ways you can find an affordable dentist and it sounds like your dad needs to get in as soon as possible. Anytime there’s extreme pain, it is a dental emergency. If it’s an infection, it will get worse and spread, so it’s good that you’re looking into options. I’m not trying to scare you, but people still die from tooth infections. I’m only saying that so you’ll have an understanding that it cannot be ignored.

The fastest way to get him treatment is to call around and see who offers payment plans. Some offices will provide in-house financing, but a lot of them are offering things like Care Credit, which is financing through a company that only helps people with medical bills. They usually have a deal where, if you pay off the balance in six months or less, you don’t even have to pay interest on it. If you find an office that does either one of these things, any office can instantly become an affordable dentist and he can get treatment right away.

Depending on the severity of the pain and how long it has been going on, you could look into dental insurance plans as well. When you do self-pay on the policy, it may kick in right away, but be sure that the plan doesn’t have any kinds of waiting periods. These are clauses that some insurance companies stick in there that say the insured party cannot have a specific kind of treatment for a certain number of months after signing up with a policy. You might see waiting periods of 6-12 months or more on “major” services, which generally include extractions and root canals.  Always read the fine print, but you can find him a policy that only runs $30 a month or so and may cut the fees he pays in half or even more, depending on what he needs to have done.

If he’s in a real bind, have him visit his primary care physician. Although a doctor won’t treat dental needs, he can assess it and determine if he thinks it’s infected. If it is, he’ll be able to prescribe antibiotics, which should be covered under his state medical care. This won’t fix the problem, but it will buy him a little bit of time to work out which affordable dentist he’s going to see and how he’ll cover the expenses.

This blog is brought to you by Dr. Ryan Noah.