Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Does Professional Whitening Work?

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I would like to know if it’s worth going to the dentist to have professional tooth whitening done?
I looked at using Crest whitening strips and tried them but they didn’t make much of a difference for me. How much does it cost and how often does it have to be done?
– Mike from Oklahoma

Mike,
To answer your question, professional whitening procedures at the dental office do work well and can dramatically lighten your teeth. Any whitening product bought over the counter or a treatment from your dentist can be harmful to your enamel if it is over-used.

The products over the counter may lighten teeth a couple of shades, however this is more of a temporary lightening and the product has to be used over and over again in order to maintain brightness. The reason for this is because over-the-counter bleaching products are not as concentrated as the ones used in dental offices. You could compare the difference to the drugs – Ibuprofen versus Percocet, with Percocet being far stronger.

When you choose to have your teeth whitened at the dental office, you can be sure that your teeth will remain white and bright for several years but this will also depend on your diet. Dark liquids, smoking and other habits can discolor your teeth quicker. However, if you watch what you eat, you should be happy with the results from your dentist.
It is recommended that patients see their dental professional every few years to touch up their teeth if they notice a darkening of the teeth. This is fairly inexpensive.

Most dentists have two types of whitening procedures. One is an in-office procedure where a bleaching agent is applied to your teeth and a light is placed over your teeth to activate the bleaching product. This procedure generally takes about two hours and boosts up the color of your teeth several shades. This may cost several hundred dollars.
Another option is to have bleach trays made and you can bleach your teeth in the comfort of your own home. This procedure is less expensive than the dental office and it works just as well.

It is important that you consult with your dentist to see if you are a good candidate for teeth whitening and what product would be the best fit for you.

This blog brought to you by Dr. Noah of Region Dental

Does Tonsillitis Cause a Bitter Taste in the Mouth?

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I’ve had swollen tonsils for a couple of days and have a bitter taste on my tongue all the time. When I eat food it goes away and then it’s back as soon as I finish eating. I don’t know if it’s from the tonsils, from acid reflux, or a broken tooth?
– Dan from Oklahoma

Dan,
There are many reasons you may have a bitter taste in your mouth. Tonsillitis, acid reflux, and a broken tooth that’s decayed will give you this. It does sound like swollen tonsils are the issue, especially if you have been diagnosed with Tonsillitis.

The main symptom of Tonsillitis is a sore throat but you can also have bad breath, a bad taste in the mouth, a fever, runny nose, headache or you may have trouble swallowing. You should know that symptoms may vary from person to person. An infection of the tonsils may be caused by either a bacteria or virus which causes white spots or pockets of pus to develop on the tonsils. When this occurs, it generally causes a bad taste in the mouth.

Either one of these types of infections is highly contagious and may spread to others through drinking the same glass, talking or coughing. If you believe you have Tonsillitis and haven’t been diagnosed, do see your doctor for a throat culture. If you have Tonsillitis, you will probably receive an antibiotic which will clear up the infection and in turn will alleviate the bad taste in your mouth.

This blog brought to you by Dr. Noah of Region Dental

Great information about porcelain veneers

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We noticed a website that has some great information about porcelain veneers. Click here to read more: https://www.chaldentistry.com/phoenix-cosmetic/porcelain_veneers.htm. It talks about how the veneers are prepared, costs, how to maintain them. The author is Dr. Arthur Chal, a past president of the American Academy of Cosmetic Dentistry.

Dr. Noah also does porcelain veneers, porcelain crowns, and other cosmetic dentistry procedures.

If you are interested in a smile makeover, but would like to save some money, another option could be a Snap-on Smile. Check our page on that subject to learn more. The cost for an entire smile would be about what it would cost for one or two porcelain veneers.

This blog is sponsored by Tulsa dentist Dr. Ryan Noah.

What Should I do about My Gray Tooth?

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I’ve never had any cavities in my life but just over a year and a half ago, my dentist pointed out that I have a gray tooth. She wasn’t certain if I needed a filling or a root canal and said she wanted to see me again. I never went back because I was anxious about the outcome. The gray tooth is my bottom right molar and it’s partially gray. I have an appointment this week but I feel stressed and think the tooth might be dead. What do you think?
– Brad from Oklahoma

Brad,
When teeth begin to turn gray it can be a sign that the tooth is dying. Since your dentist was unsure if it was a cavity, this was probably not observed in the X-ray of the tooth.

Teeth can die for no reason, however usually dental trauma or decay is the main cause. Most patients experience pain and sensitivity when trauma or decay occurs. If you are not experiencing any pain, the nerve in the tooth could be dead. A tooth can die from a heavy biting force and clenching of the teeth because the blood supply to the nerve becomes reduced causing death to the tooth. Sometimes people think that if the tooth doesn’t hurt, don’t do anything but here may be dead nerve tissue in the tooth. Leaving this tissue gives bacteria a feasting ground to grow, which does lead to an infection.

It is recommended to have your dentist take another X-ray to see if there are any changes in the tooth. If you feel like she is unsure if the tooth is dead or not we would recommend you visit an Endodontist. An Endodontist is a dentist that had more schooling then a typical dentist who solely specializes in root canal treatments. They use more equipment and different techniques to determine if the tooth has died.

For more information about Dr. Noah, visit Region Dental.

 

My Temporary Crowns Hurt

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A few weeks ago, I decided to replace two crowns on my upper left side of my mouth. I was getting food trapped between a large space between the two old crowns. My dentist gave me temporary crowns for three weeks while I waited for my permanent crowns to be created.

Unfortunately for me, week three of wearing the temporary crowns was miserable. The temp crowns smelled and I was in pain. My dentist assured me the pain would dissipate once the new crowns were cemented in my mouth.

I did not experience relief from the pain. Instead, the pain only increased in the days following the placement of the permanent crowns. I saw the dentist again and was told that my bite might be ‘off’ a bit. My dentist did a little drilling to fix the bite and I have noticed that I now hurt in that area. The pain comes and goes and it hurts to chew on the side where the dentist drilled to fix the bite. Is this common? I was assured I don’t need a root canal. What are your thoughts?
– Thomas from Oklahoma

Thomas,
You may experience different types of pain when you wear temporary crowns or have a new crown. Some pain is serious and other forms of pain are not. It’s important you know what pain is okay and what pain requires further attention.

Temporary crowns are better when they are worn less than three weeks. You mentioned in week three that they smelled and hurt. The reason for this is that they were starting to leak and microscopic particles were getting between your teeth and the temporary crowns. These trapped particles also cause pain because they are in direct contact with the porous dentin of your teeth and cause irritation.

Your dentist should’ve explained to you what would happen when your crowns were cemented. When cementing is done, this may cause further irritation and sensitivity may increase immediately after the crowns are done. This should gradually subside and wane. However, if the pain doesn’t go away, the tooth may be too irritated and might need a root canal treatment.

If you’re feeling pain when you chew, this is may be a separate issue and your bite might need to be adjusted until your bite is comfortable. There’s a tiny possibility all the work on your teeth may have caused the pulp in one or both of the teeth to die, which would irritate the ligament that holds the tooth in.

It would be wise to have a checkup and ask that the roots of these teeth be X-rayed to ensure everything is okay.

This blog brought to you by Tulsa dentist, Dr. Noah.

Is a Root Canal the Same as a Root Filling?

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I was at the dentist today and I noticed my left front tooth is extremely sensitive to the touch. The dentist gave me an X-ray but didn’t see anything when the X-ray was reviewed. I was given Amoxicillan and I took this an hour ago and was told to take it three times a day, most likely every eight hours. This is supposed to take away my pain but the tooth still hurts a lot.

The dental office recommended I come back in six weeks as my tooth may need a root filling. Is this the same as a root canal? Should I continue to take Amoxillan every eight hours? What is the best protocol for my situation?

– Frank from Oklahoma

 

Dear Frank,

It sounds like the pain in your tooth is caused from a tooth infection. This may not be visible on an X-ray because it may take a couple of weeks before a dental abscess or infection is visible on an X-ray. Even though you have pain in a tooth, an infection may not be visible on a dental X-ray. Sometimes it takes a couple weeks before an infection/dental abscess is visible on an x-ray.

Amoxicillan, the antibiotic your dentist prescribed, is not just used to reduce pain but also to minimize the chance of a tooth infection. If you are in pain, we advise you to take 800 mg of Ibuprofen every four to six hours and not to exceed more than 2400 mg per day. Take your Amoxicillin three times a day, every eight hours. For example, you might take it at 7:00am, 3:00pm, and 11:00pm to make it convenient for you. It’s also important to note that antibiotics often upset the stomach so you may wish to have a small snack with your medication.

Sometimes the tooth infection is only temporarily cleared up when taking medication. This means that when you see your dentist for a follow-up appointment in about six weeks, your dentist might not be able to determine if your tooth is infected. If it’s hard to have a diagnosis, it’s recommended to postpone any treatment.

The common cold or sinus infection may cause your teeth to hurt as well.

If you’re still suffering from tooth pain after a couple of months, you should make another dental appointment.  If an infection is present, your dentist will probably prescribe another antibiotic and recommend a root canal.

To answer your question, a root canal is the same as a root filling. If this is the treatment recommended following your root canal, you will need to have a porcelain crown placed over the root-canalled tooth to prevent it from breaking and decaying.

This blog brought to you by Dr. Noah, Region Dental.

Should You Fill a Cavity in a Baby Tooth?

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My son is nine years-old and has a baby tooth with a cavity in it. The dentist wants to fill the cavity but my son is going to lose the tooth soon. I don’t think it’s necessary to fill it other than the dentist wanting to make some money. What is your opinion?

–  Amanda from Oklahoma

 

Dear Amanda,

There are many considerations with your inquiry. If your son’s tooth is one of the eight teeth in the front, it probably does not need to be filled. You’re right when you consider your son will lose the tooth soon and the adult tooth will come in.

If your son’s tooth is in the back of his mouth, there are many reasons to fill it. If it’s a baby tooth, he’ll keep it for at least three more years. Most baby teeth remain in the mouth until the child is at least twelve years-old. Sometimes, adults have baby teeth because no permanent teeth formed underneath.

If you’re unsure about the direction to take, an X-ray will give you more information. It’s still recommended to have your son’s baby tooth filled to save this tooth and hold space for adult teeth to grow in correctly.

If the tooth isn’t filled, it continues to decay – eventually creating a toothache and then it has to be pulled. This is very traumatic for a child and should be avoided if at all possible. If the tooth is pulled, your son would need a space maintainer placed where the tooth was pulled to maintain the space for a new, adult tooth to erupt. If a tooth comes out too soon and nothing is put in this place, surrounding teeth move into the open space and block the eruption of the adult tooth below.

One more thing to consider is that if this is your son’s last baby tooth, it’s most likely his six-year molar and since this is a permanent tooth, it would need a filling.

This blog is sponsored by Region Dental.

Should I See a Dentist for Professional Whitening?

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I want to whiten my teeth as they’re looking yellowish and dull in tone. I don’t want to use Crest strips as they don’ seem to work that well for me. I’m considering getting professional whitening with a dentist. Does it really work well and how much does it cost? Also, how often does it need to be done?

 – Mark in Oklahoma

Dear Mark,

If you’re looking to effectively whiten your teeth, seeing a dentist is a wise move.  They will give you dramatically whiter teeth without the hassle. Also, it’s important to know that any whitening product bought over the counter or treatment from your dentist, can be harmful to your enamel if it’s over-used. Products that you buy over the counter may lighten teeth a couple of shades, however it’s very temporary and the product must be used over and over to maintain tooth brightness. The reason is because these bleaching products are not as strong as what the dentist uses.

If you opt for professional teeth bleaching at the dental office, teeth tend to remain white and bright for several years. They usually never go back to the original shade but colorful diets, dark liquids and tobacco habits do discolor teeth quicker. We recommend patients touch up every few years if they notice darkening of the teeth. Touching up the teeth is a procedure that’s fairly inexpensive.

Most dentists have two types of whitening procedures available. One is an in-office procedure where a bleaching agent is applied to your teeth and a light is placed over your teeth to activate the bleaching product. This takes approximately two hours and brightens up the color of your teeth several shades. This may cost several hundred dollars.

Another option is to have bleach trays constructed and you can bleach your teeth in the comfort of your own home. This procedure is less expensive than the in-office treatment and works just as well.

We recommend you consult with your dentist to see if you are a good candidate for teeth whitening and which product is most suitable for your teeth.

This blog brought to you by Dr. Noah of Region Dental.

Why do I feel pain after a root canal?

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Around three and half years ago, I had a tooth that needed to have a root canal and crown. Now, I’m experiencing pain with this tooth but my dentist says the root canal looks good. The dentist did not inform me of any cracks in the tooth so I’m not sure if that’s the problem or if I will lose my tooth. Also, the dentist said my tooth might need a new crown. I think the crown looks good and I don’t see any problems. What do you think?
– Brenda from Oklahoma 

Hi Brenda,
There may be many reasons why you’re experiencing discomfort with your tooth that has had a root canal and crown. One possibility for the pain you’re feeling is that the crown may be placed too high and it may need to be adjusted. If you’re biting hard on a crown tooth and it’s seated too high it can cause the tooth to ache even with a root canal. It’s important your bite be checked.

Did your dentist study your bite to see if the tooth needed adjustments? If not, have them check to see if it needs to be adjusted. If this isn’t the problem, it may be that you may grind or clench your teeth at night when you sleep and may not be aware of the issue.

Clenching and grinding can also cause teeth to hurt. Get your dentist to check and see if there are signs of grinding or clenching. If you have this issue, the dentist should create a night guard for you to protect your teeth and gums. There is a possibility the tooth has a crack within the root, however it is difficult to diagnosis. To confirm this, you will want to have a consultation with an endodontist who specializes in root canal treatments and would give you a better indication if the tooth actually has a crack or not. If your tooth has a crack, it would need to be extracted because there is no way to fix the tooth. If your tooth has to be removed, you have the option of getting a dental implant or dental bridge to replace your missing tooth.

Reasons why a root canal procedure may fail and cause discomfort:
■Sealers used to coat the filling material may wash out, creating a gap within the root canal, therefore causing infection
■If gaps are left at the base of the root and not filled properly, the tooth gets contaminated with bacteria which infects the tooth again
■If the tooth had multiple canals and exit points a spot may be missed and infection can set in
■If the root has small fractures the tooth may get contaminated with bacteria, causing infection which will lead to extraction
■If the tooth is not restored with a properly fitted dental crown then contamination may occur
■Inadequate cleaning, reshaping, or a lack of aseptic techniques of the root may cause root canal failure

As was mentioned before, there are multiple reasons why you’re having pain in your tooth. You should consult your dentist to determine if the bite is too high or to see if you have issues with grinding or clenching. These are two very common reasons for root canal pain. If your issue isn’t resolved, we advise you to see an endodentist who will inform you whether  the tooth is re-infected and needs to be retreated or if the root is cracked and the tooth needs extraction.

For more information about Dr. Noah, visit Region Dental.

How do you treat a deep pocket?

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I’m concerned about a problem I have with two back molars. They are spreading apart and the dentist told me a deep pocket now exists in that area. While I had the appointment, deep cleaning was performed and I was told the dentist would review my situation at the next appointment. I’m concerned.
I’m wondering if I can do anything else besides brushing and flossing, to reduce the pocket. Do you have any suggestions?
– Cathy from Oklahoma

Dear Cathy,
It’s quite likely your dentist will schedule you for a three to four month periodontal cleaning schedule to keep your gums healthy and maintain the bone levels around your teeth. Many times, deep cleaning may reduce pockets to the point where a patient can keep the area clean and free from disease. In fact, the disease process may be stopped so no more treatment may be necessary. This is why it’s vitally important to have this cleaning program done regularly and you must also practice proper brushing and flossing as this will help the pocket reduce in size. It sounds like you’re doing all the right things.

If pockets do not reduce enough with periodontal cleaning and other recommended activities, and if the patient is having a challenge keeping the pockets clean, there is another alternative. The dentist will recommend crown lengthening. This procedure is generally performed by a periodontist, a specialist who knows how to treat periodontal disease. There are some dentists who are trained in this procedure as well.  The process of crown lengthening is a fairly simple surgical procedure performed using a local anesthetic. What happens is that excess tissue around the tooth is removed so more tooth structure is exposed and contoured closer to the bone. The procedure minimizes the distance from the top of the gums to the bone, thus reducing the pocket and enabling the patient to keep the area cleaner. When you see your dentist, you’ll be able to get more information on how to proceed.

This blog brought to you by Tulsa dentist, Dr. Noah.