Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Do I Need to See an Emergency Dentist for Implant Pain?

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I’m about halfway through the healing phase of my dental implants. I’ve been so excited about this and hadn’t had any problems until recently. Yesterday, it felt tingly and spongy. Today, I woke up with the area swollen and painful. I haven’t eaten.  Can I wait until I can get in to see the implant dentist or do I need to see an emergency dentist?

Sylvia P. – South Dakota

Sylvia,

This requires you get seen immediately. I’d let your implant dentist know what it going on. If he or she can’t see you right away, then go to an emergency dentist.

It sounds like you’ve developed an infection at your implant site. You don’t want it to settle in or you’ll lose your implant. If they have to remove the implant, you’ll have to get bone grafting done in order to re-start the procedure.

Even without the worry about the implant, you don’t want a tooth infection to spread. It’s close to your heart and brain. People still die from tooth infections.

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Affordable Porcelain Veneers? Is that Possible?

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I’m looking for a dentist who will give me affordable porcelain veneers. Is that even possible?

Marie Ellen C. – State Island, NY

Marie Ellen,

Generally, I’m all for finding a skilled affordable dentist. Cosmetic dentistry, and especially porcelain veneers, are not something you want to just find the most affordable dentist. It’s generally one of those procedures that costs a lot of money. That’s because of the amount of post-graduate education and training that go into being able to do it well.

That doesn’t mean you won’t find someone with reasonable prices. I just don’t want you to be lured by price and end up with a smile you’re not proud of.

When evaluating whether or not to use a dentist for a cosmetic procedure, be certain to ask to see before and after images of their work. Make sure it’s their work and not stock photos they’re trying to pass off as their work.  A simple direct question should clear up any doubt.

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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.

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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.

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Are Retainers Even Necessary?

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I wore braces for three years.  I got them off six months ago.  I know I am supposed to wear my retainer but I just hate it.  Are they really going to move back if I don’t wear it?

Thanks, Angie

Dear Angie,

I know you probably hate it, but your teeth absolutely will move if you don’t wear it.  They may not move completely back to where they were when you first got your braces on but they WILL move.

More than likely, if you had severe crowding, your lower front teeth will start to overlap.  Teeth that were the most difficult to move, like turned teeth, will begin to turn again ever so slightly.  Before you know it you will not be able to wear your retainer because it will no longer fit.  Then you will be too embarrassed to go back to the orthodontist because you think he may say, “I told you so!”  Meanwhile, your teeth will continue to move.

In order to stop the movement, you will need to spend a couple of hundred dollars for a new retainer.  Don’t forget, you will also need to get new impressions and you know how much people love those!  So, wear the retainer….even if you only wear it at night.  It is a small price to pay to keep that beautiful smile.

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Can an Epileptic Get Braces?

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I’ve wanted braces for as long as I can remember. However, because I have epilepsy, my mom was always terrified and seizure would tear up my mouth. I’m an adult now and am considering it again. I was thinking about Invisalign because they’re softer. What do you think?

Anna G. – Alabama

Anna,

I don’t know if you’ve ever seen the meme about how things look to moms. There’s a toddler being gently tossed by the dad. But, what the mom sees is him skyrocketing. Your mom saw the potential for injury and that shut the option down in her mind. It’s because she loves you.

However, you can get orthodontics, even with epilepsy. Obviously, because of the risks, some precautions need to be taken. There is the risk of some soft tissue damage during a seizure, but it’s generally minor.

I’d certainly tell the dentist what medications you’re on. I’d also ask for smaller brackets than the traditional ones.  That is possible. Many epilepsy medication cause swollen and bleeding gums.  Braces can also aggravate that, so diligent oral hygiene will be a must.

You asked about Invisalign. Yes, they are softer, so you wouldn’t have to worry about tissue damage. However, I’d be concerned about the possibility of the aligners dislodging and blocking your airway.  Visit with your orthodontist. There is a way to get your teeth the way you’ve always dreamed.

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Help! I Messed Up My Crown

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I was on vacation when my crown broke off. I didn’t want to cut my vacation short so I superglued my crown. I don’t think I glued it correctly. Will my dentist be able to fix it?

Shelby T. – Georgia

Shelby,

I’m sure that worried you to be away from familiar surroundings when your crown came off. SuperGlue may have seemed like a good idea at the time, but as you know now, it is easy to glue something, but not always easy to get it in the exact correct position.

First, don’t panic. Your dentist will be able to get the superglue off. That doesn’t mean your crown can be saved, but hopefully the dentist will be able to get it off in one piece.

If this ever happens again, you don’t have to glue it. There are emergency dentists in every city, who will see you even if you’re not an established patient.

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Who’s Getting Ripped Off, Me or Other Patients?

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I went to a dentist because he was touted as being affordable. I don’t really have anything to complain about. The care was good and I’ll be back. I just noticed that on top of having much more reasonable prices than many of his peers, he also had very expensive furnishings, a flat screen television, and other goodies in rooms for patients. It got me to thinking either my dentist is cutting corners on treatments or other dentists are seriously overcharging. Is it common for dentists to overcharge?

Brooks S. – New York

Brooks,

Well, that’s a difficult question to answer. Every dentist works on a different budget. Then even if two dentists had the same budget they all allocate it differently.

It could be that your affordable dentist allocates more of his funds to patient care and less to marketing, feeling his quality care will help him with patient retention.  Obviously, you were happy with the care you received there.

While it is possible that other dentists overcharge, it’s a big assumption to make. To be honest, if you’re happy with the care from your dentist who charges less, why worry about what the other dentists do?

Enjoy your affordable care and spend your time thinking about how you can use all that money you’re saving.

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

I’ve Ruined My Invisalign Aligners

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Can you help me? I’m so embarrassed. I left my aligners in the car when I went on a date. I was worried my date would notice. Now that I think about it, that was pretty stupid. No one has ever noticed I wear them. It’s just that I hadn’t been on a date in a long time and I was pretty nervous. Long story short. The heat warped my aligners. Can I use a hairdryer to try to get them back in the right shape?

Karen B. – Michigan

Karen,

I hope your date went well.  Dating can be nerve-wracking sometimes, so don’t feel too bad. Besides, you are not the first patient to do something similar. Unfortunately, the hair dryer isn’t a good plan. They’re carefully designed by computer. The chances of you getting them back to the exact correct position to continue your treatment are astronomical.

Generally, you switch Invisalign aligners every two weeks. If you’re early in those two weeks, I’d just tell your dentist what happened and then have him make you a replacement pair. If you’re later in that two week period then I’d speak to him or her about moving you onto the next pair.

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Can I Whiten My Dental Crown?

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My dental crown is showing it’s age, like my regular teeth. If I whiten my teeth, can I also whiten my crown?  Will I need a cosmetic dentist or a general one?

Natalie – Wisconsin

Natalie,

Despite how it sounds, there isn’t a cosmetic dentistry specialty, so every cosmetic dentist is just a general dentist who also does cosmetic procedures. Teeth whitening is an easy procedure, so any dentist can do it. However, while it will whiten your teeth, it will not whiten your dental crown.

Here is where someone who has more training in cosmetic procedures will come in handy. My suggestion is for you to whiten your teeth first. then, get a porcelain crown done to match your new bright, white teeth.

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