Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

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.

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.



Can I Charge My Assailant for My Dental Appointment?

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I was at a frat party and was assaulted by a guy from another frat. He knocked out one of my teeth. I’m ended up going to an emergency dentist but he couldn’t save my tooth and now I have to have an implant too. Can I charge the guy who caused the problem for these?

Adam

Dear Adam,

Woman with boxing glove hitting man in face

Who Pays for Emergency Dental Appointments When You’ve Been Hit?

First, I’m sorry you were in a fight. That must have put a real damper on the party. A dentist, even an emergency dentist, can only charge the person who received the services unless they’re a minor. I’m assuming because you were at a frat party you’ve reached the age of majority.

This doesn’t mean you can’t get your cost recouped. You have a couple of options there. First, you can see if he’s a young man of integrity. If he is, he’ll be willing to help cover your costs. I’d just talk to him about it. Maybe in the sober light of day, he’ll see things more reasonably.

If he doesn’t take responsibility, you can always take him to court. Normally, in a situation like that, it would be small claims court. However, if you need a dental implant that will go over the limit for small claims court and you would take it to the next level.

When to See an Emergency Dentist

You were smart to go to an emergency dentist when your tooth was knocked out. To have the best chance of saving a tooth, you need to be receiving treatment within 30 minutes of losing the tooth. Also, be careful not to touch the roots of the tooth. Only handle it by the crown. It sounds like you tried to do that. Maybe the damage was just too extensive to do anything.

So you know for future reference, there are other reasons to go in for an emergency dental appointment as well.

  • A Toothache

Usually, a toothache is a sign something is wrong. It can often mean an infection. If you see a pimple on your gums it means the infection has progressed enough where it will require a root canal treatment. Other times it can just mean you’ve got a cavity that is close to the pulp and causing pain. You’ll want to get in as soon as possible to ensure the least invasive treatment possible.

  • A Graying Tooth

If you have a tooth that is turning gray, it means the tooth is either dead or dying. It will become a harbor for bacteria. The sooner you go in and get a root canal treatment and dental crown, the better.

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

Can I Go to an ER If I Can’t Afford a Dentist?

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My insurance covers ER visits but not dental visits. I think I have an infected tooth and wondered if I could just go to the ER to cover it?

Andrew M.

Dear Andrew,

Unfortunately, a hospital ER will not treat dental conditions. They’re not trained for it. The most they’ll do is give you some pain relief and possibly an antibiotic. Though, with dental situations, an antibiotic isn’t enough. A dentist has to get in there and remove the infected tissue from the pulp of the tooth.

This isn’t something you’ll want to put off. The longer you wait, the more the infection will spread. Your jaw is very close to both your heart and brain. If the infection gets to there it will be life threatening.

In your place, I’d look for an emergency dentist. They’ll see patients in your situation fairly quickly, even if you’ve never been a patient there. If you tried to schedule a regular appointment, as a new patient, with a dentist it would likely take several weeks. That’s entirely too long for the infection to spread.

Because of your financial situation, it would help if the dentist also advertises as an affordable dentist. Not only are their fees generally a bit lower, but almost all of them have payment plans.

This 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.

Why is There a Pimple on My Gum?

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I’ve had a toothache for some time and kept meaning to get to the dentist, but we’re new in town and I haven’t found a regular dentist yet. Now there seems to be a pimple on my gum. Do you know what that is?

Marie B. – New York

Marie,

It would appear that you have developed an abscess on your gum from an infected tooth.  I hate being the bearer of bad news because I know that moves can be stressful and now you’re needing to add dealing with this on top of everything else.

I realize you do not have a dentist at the moment, but you need to get this treated right away. There are emergency dentists that will see non-established patients in times like this. They’ll get you out of pain, diagnose the problem, and schedule a follow-up.

If you don’t like the dentist, you can schedule with a different dentist. Just make sure you at least get seen by someone quickly. It will only get worse and this will spread.

This blog is brought to you 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.

 

How Long Can You Delay a Root Canal?

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I have a tooth that needs a root canal but I don’t feel any pain in the tooth. How long can my root canal be delayed before I get the procedure?
– Jonathan from Oklahoma

Jonathan,

It’s hard to estimate how long you can go without a root canal without seeing your tooth. If your tooth is causing you pain, you need to do the procedure right away. If your tooth hurts a little or hurt recently and the pain went away, you still need to have the root canal as soon as you can schedule it. Pain, past or present indicates an active infection that’s growing and when it comes to your teeth, the sooner you deal with it, the better.
If you notice a pimple in your gums or drainage in your mouth, the same applies. Active infections must be handled promptly. While it’s not an emergency, you want to schedule the procedure soon.

If your tooth hurt a long while ago, or never hurt at all, it may or may not be a problem to delay your procedure. Sometimes a tooth infection slowly eats away at the tooth root and will keep growing until the tooth is destroyed. If you are told the infection is latent and your tooth is fully intact with no active decay, you may be able to wait. Be sure you get expert advice.

This blog sponsored by Dr. Noah of Region Dental