Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

What’s causing the pimple on my husband’s gums?

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My husband recently said that he has a little pimple on him gum on the upper left, above his molar. Is this something that needs an emergency dental appointment? Karen

Dear Karen,

Tulsa emergency dentist

There are a couple of possibilities for a pimple on the gums. If it is near the root tip of your husband’s molar, it is most likely from a tooth abscess. When a tooth gets infected, the pulp eventually dies and the infection festers inside the tooth, spilling out bacteria into the bone. The infection in the bone then looks for a place to escape, and it will often try to drain through the gums.

While this wouldn’t be considered a dental emergency, it would need attention. If untreated, the infection can spread into the surrounding bone. It can also begin to dissolve away the roots of that tooth. It is unlikely that the tooth will be hurting, for two reasons. First, the tissue inside the tooth is dead, so it has no feeling. Second, while an abscess around the end of a tooth can cause the tooth to be painful to biting, since this infection has found a pathway to drain, pressure isn’t building up. Though my guess is that your husband has some mild discomfort to biting on this tooth, assuming that it truly is an infection and not just some little growth on the gum.

It’s Important He Doesn’t Put This Off

The tendency for men is to “tough it out” and hope it goes away. This won’t go away. And while the tooth will need a root canal treatment, I would tell him not to worry about that. Since the tissue inside the tooth is dead, the dentist could probably do a root canal without any novocain, since there is no feeling in it. I expect it will be a completely painless procedure. The dentist may still want to make the tooth numb, and may put your husband on some antibiotics to get the infection completely under control before starting treatment and to help insure that there is no post-operative flare-up.

It’s always better to take care of these things sooner rather than later. Better a root canal treatment and dental crown than to need a tooth extraction and replacement.

If the Tooth Can’t be Saved

There’s always a chance, depending on how long this has gone that the tooth can’t be saved. In that case, you’ll need to look at tooth replacement options.

Two of the best are to get a dental implant or a dental bridge. A dental implant is the better treatment, but it is more costly than the bridge.

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

Sinus Infection after Extraction

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I had a dental emergency a couple of weeks ago and the tooth is beyond repair. The dentist did an extraction. In the process my sinus was perforated. I’ve done some research and this seems to be something that can happen without it being the dentist’s fault. He told me about it after the extraction, cleaned the area, closed it up and then gave me a prescription for antibiotics. I was feeling better and had finished my antibiotics. Today there is drainage and pressure in my sinuses. Could I have developed an infection at the extraction site?

Miranda

Dear Miranda,

blonde woman holding the side of her jaw in need of an emergency dentist

I’m glad you know that a sinus perforation doesn’t necessarily mean your dentist made a mistake. Some roots of teeth are so close to your sinus cavities the only thing separating them is a thin membrane, which will be perforated during an extraction when they’re that close.

It sounds like your dentist followed correct protocol when that happened as well. You’ve got a responsible caregiver and that is something to be grateful for. I can think of three possibilities going on here.

The first is that you just needed to be on your prescribed antibiotic a little longer than you were. Some infections need a little extra oomph to help your body fight it. This may be the case with yours.

A second possibility is you need to be on a different antibiotic. You didn’t mention which antibiotic your dentist prescribed. A good one for this type of situation is clindamycin.

A third possibility is there is some bone in the sinus cavity. This will blow up into an infection and can cause another dental emergency, plus a host of other problems.

I want you to call your dentist and schedule an appointment to be seen again. He’ll likely put you on more of the antibiotic or a different one. He may do an x-ray to see if there is some bone trapped there. If he doesn’t don’t panic. Try the antibiotics. If they don’t work, then it will be time to see an ENT and have this investigated further.

You are doing a good job staying on top of this. I don’t know if you and your dentist have started talking about what you will replace the extracted tooth with, but once you have this infection settled, I’d like you to discuss getting a dental implant with him.

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

Will My Face Really Collapse if I Get Dentures?

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I’ve had massive problems with my teeth. So much that they’re all coming out. I’m new in my career and don’t have a lot of money. Because of that, I want to get dentures. My dentist wants me to get dental implants and said because I’m in my 30s getting dentures would cause my face to collapse. Is that true or is he trying to scare me into the more expensive procedure?

Marcus

Dear Marcus,

dentures and dental implant side by side

I don’t know how your dentist explained this to you. I’m sorry you have had so much trouble with your teeth. What your dentist is calling facial collapse, is a term used to describe the shrinking of your jawbone.

This happens after your teeth are removed. Your body recognizes there are no longer teeth roots there. As a result, in an effort to be efficient, it takes the minerals from your jawbone and redistributes them elsewhere to areas it perceives they’ll be more useful. As your dentist mentioned, this has unfortunate repercussions.

How Dental Implants Prevent Facial Collapse

As you can see from the image on the top right, dental implants place a prosthetic root in your jawbone to replace the root you lost when your tooth was extracted. This signals to your body that there are still teeth there and your jawbone remains intact.

So, here’s is what I’m going to recommend to you. First, try to save all the teeth you can. Natural teeth are always worth fighting for. You can get dental implants for the ones which can’t be saved.

If you are unable to save any teeth, it would be too much money for you to do a one-to-one ratio of teeth to implants. Instead, you’d get something called implant overdentures. This places four to six dental implants and then you can anchor a denture to them.

This gives you the protection of dental implants without needing one for each tooth.

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

Emergency Dentist for Gum Injury

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We don’t yet have a dentist in this area. We’ve been busy relocating and haven’t had the time. My husband recently complained about an injury to his gums that is swollen. He can’t remember when he did it or what happened, but it looks to me like it resembles a giant swollen pimple. Of course, I know we don’t get pimples on our gums so it must be inflamed from an injury. Will this go away on its own or does he need an emergency dental appointment?

Karen

Dear Karen,

Tulsa emergency dentist

Relocation is stressful, so I completely understand you not getting to finding a new dentist. However, what you described on your husban’s gums doesn’t sound like a gum injury. Instead, I think he has an abscessed tooth. This manifests in what looks like a pimple on the gums.

This is considered a dental emergency, so he will need to see a dentist right away. It means his tooth is infected. These infections can blow up quickly and become life-threatening.

I know you don’t have a dentist right now, but there are dentists who will treat non-established patients in cases of emergencies like yours. You can do an internet search using the term “emergency dentist“.

It’s Important He Doesn’t Put This Off

The tendency for men is to “tough it out” and hope it goes away. This won’t go away. Eventually, the tooth may stop hurting, but that is because the pulp of the tooth will die, That won’t stop the infection from spreading though.

It’s always better to take care of these things sooner rather than later. Better a root canal treatment and dental crown than to need a tooth extraction and replacement.

If the Tooth Can’t be Saved

There’s always a chance, depending on how long this has gone that the tooth can’t be saved. In that case, you’ll need to look at tooth replacement options.

Two of the best are to get a dental implant or a dental bridge. A dental implant is the better treatment, but it is more costly than the bridge.

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



Dental Implants or Implant Overdentures

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I’m a little confused. I can’t figure out the difference between dental implants and implant overdentures. Some people seem to use them interchangeably but I think they’re different. Can you help me? I need to replace a few teeth and don’t know which one to get.

Sandy M.

Dear Sandy,

Dental Implant Diagram

A dental implant is the fixture that is implanted into your jawbone to take the place of your tooth root. When the healing period is over, then it is topped with a porcelain crown to stand in for the visible part of your tooth.

Uses of Dental Implants

Dental implants can be used to replace a single tooth or multiple teeth. They’re also used to completely replace all your teeth. That’s where implant overdentures can come in handy.

Because these are the top of the line procedure for replacing your teeth and the procedure itself is very advanced and requires a great deal of post-doctoral training, it is the priciest of your options.

If you wanted to replace each and every tooth with a single dental implant, you’d end up costing yourself a fortune. Implant overdentures gives you the advantages of dental implants without having to place one at every tooth.

You can usually place four to six dental implants per arch and then anchor a set of dentures to them.

Advantages of Implant Overdentures

When your teeth are removed, your body begins to reabsorb the minerals in your jawbone to use elsewhere in your body. This has the unfortunate result of causing your jawbone to shrink.

After a number of years, there isn’t enough jawbone left to retain dentures. This is known as facial collapse. The implants protect you from this because your body interprets the implants as teeth roots and leaves your jawbone intact and secure.

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

Dentist Says Dental Implants are a Necessity

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I’d planned on getting dentures once my teeth are extracted. However, my dentist says he only does partial and no longer does complete dentures. Instead he’ll only offer me dental implants. Of course, they’re way, way more expensive. That doesn’t make any sense to me. I noticed on your site you offer both. Is my dentist just making a money grab?

Megan

Dear Megan,

dentures and dental implant side by side
A good dentist explains the pros and cons of your options.

It sounds like your dentist will only offer what he considers the ideal treatment. Dr. Noah’s treatment philosophy is not everyone can afford the ideal. Instead, he’ll tell them all the pros and cons of their decision and then leave it up to them.

It’s a shame your dentist just told you the ideal without explaining why. I’ll try to explain the difference here.

The Danger with Dentures: Facial Collapse

Before and After Facial Collapse

When your teeth are removed, it doesn’t just take the crowns of your teeth, but the roots underneath the gums as well. Your body recognizes this and (being the efficient living machine it is) decides to take the minerals in your jawbone which were used to help support your tooth roots and use them elsewhere in your body where it perceives they will be more useful.

The sad result of this is your jawbone begins to shrink. This is known as facial collapse. It means after 10 or more years, you will appear many years older than you really are. Even worse, you will no longer have enough jawbone left to support your dentures.

Dental Implants Prevents Facial Collapse

If you look at the image at the top of the page, I have a side by side of dentures on the left and a single dental implant on the right. Notice especially the dental implant. There is a root form that is implanted into your jawbone. Then, after a healing period, a porcelain crown will be placed on top.

It’s the prosthetic root which signals to your body, “Hey! There are still teeth here. We need our jawbone.”   This protects your jawbone from being resorbed.

Implant Overdentures Can Save You Money

implant overdentures
Implant Overdentures

While dental implants are more costly, implant overdentures can work using just four to six dental implants and then attaching the dentures to them. This has several benefits.

  • It much less expensive.
  • It will preserve your jawbone.
  • Your dentures will be secure, unlike regular dentures.

Again, I’m sorry your dentist didn’t explain this to you. I hope it helps in your decision making process.

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

Why is My Face Shrinking?

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I’ve heard you can get smaller as you age, but lately, it seems like the lower half of my face is shrinking as well. I don’t know what’s going on. My dentures barely fit anymore. I’m afraid to go out in public because there’s no room for them and they slip out. Is this typical?

Avery

Dear Avery,

An illustration of the damage done by facial collapse using two pictures of a woman, one before and one after

Wearing Dentures for Too Long Causes Facial Collapse

What you’re suffering from is known as facial collapse. This occurs when you’ve been wearing dentures for a number of years. When you remove your teeth, your body realizes that you no longer have teeth roots in your jaw. Because our bodies are incredibly efficient (I mean what other pieces of equipment holds up for 80 years living mostly off burgers and fries?), it resorbs the minerals in your jawbone to use elsewhere, perceiving they’re no longer needed.

This is why your jaw is slowly shrinking. It’s also why your dentures no longer fit properly. Eventually, you will be unable to keep them in your mouth at all, leaving you a dental cripple stuck on a liquid diet. I’m concerned your dentist neither warned you about this nor recognized what was happening to you.

A Solution for Facial Collapse

There are two solutions for you. Both will include getting bone grafting done. This is where a surgeon builds back up the bone you’ve lost. After that, you can choose to have your dentures remade to fit the new structure. Just bear in mind, you’ll face the same issue of disintegration that your original dentures caused.

Another option is for you to replace your teeth with dental implants. This uses prosthetic tooth roots, usually made out of titanium, to help your body to know the bone is still necessary to hold in the new roots of your teeth. They have other benefits as well.

Advantages of Dental Implants

  • They are permanently secure. Once they’re placed, it’s like having healthy, natural teeth back. There’s no slipping. No sliding.
  • Your chewing capacity will increase dramatically.
  • They protect you from developing facial collapse.

The key is to communicate with your dentist and let him look and advise.

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

A Tale of Two Emergency Dentists

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I’m a bit confused. My husband and I both developed toothaches at about the same time. We were in the process of moving and didn’t have time to deal with it. Once we got to our new place, the first thing I did was try to schedule emergency dental appointments because we were both ready to get out of pain. The first practice I called said they could see me but didn’t realize I wanted my husband seen too. It was a Friday morning, which is their half day. they said they could see one of us today and the other Monday. I scheduled my appointment and then called another practice who agreed to see my husband that day. I figured the upside was we’d get to check out two different dental offices to see what we thought before picking our new practice. When I went, they gave me a root canal treatment, but my husband only had to have a filling. Why the two different treatments for two toothaches? Was mine just overly aggressive or did my husband not get the care he needed?

Karen

Dear Karen,

All toothaches are different. They can be caused by a decay, infection, cracked teeth, etc. Plus, while all toothaches are different so is each person’s ability to deal with pain. Maybe you have a higher pain tolerance than your husband so your toothache had been there longer and turned into an infection, while his was just decaying and needed filling.

I can’t answer your question about overtreatment or negligence without examining you and seeing the x-rays. I’d just be taking a stab in the dark. However, the one thing that concerns me is neither of you seems to have been told why your dentists did the treatment they did.

Dental emergency or not, a dentist is supposed to explain the diagnosis along with your options and their recommendation. It’s up to the patient to say yes or no. So, you shouldn’t have been given a root canal treatment without knowing why.

Finding Your Permanent Dentist

When you start looking for your permanent dentist, be sure to check their reviews so you get some idea of what patient’s who’ve been there have experienced. Also, because the emergency dentist did x-rays (or at least should have), you can have your recent x-rays transferred so you don’t have to have those done again right away.

Though you had to have the root canal, I’m glad you got to the dentist before you ended up losing the tooth. The last thing you’d want to pay for right after a move is a tooth replacement.

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

Affordable Options for Dental Implants

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I need to get almost all my teeth replaced. Are dentures a decent affordable option for dental implants?

Casey

Dear Casey,

Wearing Dentures for Too Long Causes Facial Collapse

Are dentures affordable? Yes. Are dentures an option for dental implants? Yes. Are dentures a decent option to dental implants? Absolutely not. Look at the image above. This woman has lost most of her jawbone, a condition commonly known as facial collapse. It’s caused by wearing dentures for too long, meaning about ten years or so, depending on your bodies reaction. Here’s why.

The moment your teeth are removed, your body begins reabsorbing the minerals in your jawbone to use elsewhere throughout your body. This causes your jawbone to get smaller and smaller. The longer this goes on, the less jawbone you have. Eventually, you won’t even be able to wear your dentures because there will be no ridge for them to adequately rest on.

Dental implants protect you from facial collapse. It does that by having prosthetic implants in your jawbone. That tells your body the minerals are needed and leaves them in place.

Working with Dentists to Get Affordable Care

You don’t have to compromise on your procedure to afford the care you need. First, you should know that in most cases the dental implant procedure is paid for in stages because the procedure itself is done in stages. That may help you with the cost.

If you’re having trouble finding a dentist who’ll allow you to do that, I suggest you do a search for “affordable dentist” online. They will be much more willing to work with patients financially. Those who don’t have in-house payment options will work with Care Credit.

Care Credit is a medical credit card. But, it has better features. You get to pick your terms. Depending on your credit, you can even get zero percent interest on repayment. Plus, if you end up having additional funds, there is no penalty for early repayment.

I hope this helps you.

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

Are Dental Implants Really Superior?

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I’ve got three teeth that need replacing thanks to a baseball bat that hit me instead of a pinata. The neighbor kid has a swing like you would not believe. Seriously, the Yankees should already be on the phone with his parents. I wanted to get a removable partial denture because it seemed the most in line with our budget. But, my dentist keeps pushing me toward dental implants. He says it’s because the teeth are at the front of my bottom jaw. I looked into it and, yeah, they’re stronger, but I get the feeling he’s saying to get them because he’ll make LOADS more money.

LeeAnne

Dear LeeAnne,

Dental Implant Diagram

If you call the Yankees and it pans out, maybe you’ll get a recruiter fee. Before we get into your treatment options, I wanted to ask whether your dentist had given you a reason in the past to doubt his integrity and think he’s just trying to get you to do the most expensive treatment? It’s important you’re able to trust your dentist. If you have a reason not to feel he can be trusted, you’d be better served to find a different dentist. You want a dentist you can trust.

Now, onto your question. I think your dentist is concerned about the effects of facial collapse on your lower jaw. If you’re missing three teeth in that same area, your jaw will begin to shrink. Dental implants protect you from that. The implanted prosthetic root tells your body teeth are still there and your jawbone is still needed. So, yes, they’re stronger. But, they also protect your jawbone from slowly disappearing.

What Your Dentist Should Provide

Ethically, your dentist should tell you all of your options whether he thinks they’re good options or not. However, he should also recommend which options he thinks are better, along with why. He’ll know the pros and cons of each option and should take the time to share them with you.

The second thing he should provide is answers. You should be able to ask as many questions as you need and he patiently provides answers. It sounds like you were totally unsure about his recommendation. I don’t know if you asked questions and he refused to answer or if you weren’t comfortable asking.

Know when you’re talking about your health and finances, you have every right to ask questions. I know some dentists tend to get offended when you ask questions as if because they’re the dentist they should not be questioned. But that is unfair to patients.

Options for Missing Teeth

  • Removable Partial Denture

These have the obvious downside of not being permanent. Plus, we already discussed facial collapse. As far as quality of life goes, some patients complain of food getting under their denture. Their big benefit is their price.

  • Dental Bridge

These are permanent, but you still have to deal with the facial collapse. Additionally, the more teeth you need to replace on the same bridge unit, the less stable. If one part of the bridge breaks, the whole unit has to be replaced. Where your bridge would have to be placed is especially tricky.

  • Dental Implants

These are permanent, strong, and will protect you from facial collapse. Their biggest drawback is their cost and the fact it requires surgery.

Those options are up to you, though. A dentist can strongly recommend one solution over another, but it is up to you which one you pick.

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