Will an Emergency Dentist Charge the Cause of the Accident?

I was at a stag party. We were at a pub when one of the group got a little too drunk. He started trouble which ended up causing a fight. The result of which was my front tooth lost a piece and is now loose. I’m assuming I need an emergency dentist, but I’m broke. Will the dentist charge the fee to the moron who started all this?

Casey C.

Dear Casey,

A chipped tooth in need of an emergency dentist
Tooth trauma requires an emergency dental visit

I’m very sorry this happened to you. It’s hard when you’re trying to be responsible and the people around you cause problems. You’re right that this needs an emergency dentist. Your loose tooth needs to be splinted to stabilize it. There are several ways a dentist can do this. What method he or she uses will depend on what other issues your tooth is facing.

He’ll also want to examine it for trauma to the nerves or pulp. Internal damage could mean a root canal treatment and possible crown.

Once the tooth is secure, if there’s no other damage you can fix the broken piece with dental bonding. You don’t have to have the piece that broke. A skilled cosmetic dentist can sculpt a composite resin onto your tooth which will look just like your natural tooth structure and blend in perfectly.

Who Pays for Emergency Dental Care?

Unless the person responsible comes and agrees to pay for treatment, the dentist can’t bill him. He can only bill the person receiving the services or their legal guardian without prior approval. However, you can ask for a detailed bill of the damage and send the bill to the offender. If he has integrity he may just pay. If he doesn’t, you may have to take him to small claims court.

Just be aware, many dentists are willing to work with patients financially, especially those in emergency situations. Just talk to the dentist ahead of time. If he’s not willing to work with you, try Care Credit, though most dentists offer that in-office. It’s a medical credit card that has low and even no-interest payments.

This blog is brought to you by Dr. Randall Burba.

How Do I Know if I Have TMJ or TMD?

I’m at a loss. I’ve been doing some research and have narrowed it down to two conditions, but I can’t tell the difference between them so don’t know who to see.
Here are my symptoms:

  • Jawpain
  • Headaches
  • Clicking in jaw
  • Teeth have shifted

Do I have TMJ or TMD? Who do I see for it?

Marilyn

Dear Marilyn,

A Chart showing how joints muscles and teeth all work together in TMJ

I understand why you’re confused. These two acronyms are used interchangeably. TMD stands for Temporomandibular Disorder. TMJ stands for Temporomandibular Joint. When the joint is out of alignment, which can happen for several reasons as seen in the chart above, it causes TMD.

Your symptoms are pointing to this disorder, whether you call it TMJ or TMD. You’ll want to see a dentist, but not just any dentist. First, not all dentists treat it because it is so complex. Secondly, some do treat it who shouldn’t. You really want a dentist who’s invested significant training in diagnosing and treating this disorder. As an example, look at Dr. Burba’s TMJ Dentist credentials. This is the type of dentist you want to find in your area.

What to Look for in TMJ Treatment

Because TMJ is so complex, it is imperative your dentist finds the underlying cause of your TMJ in order to begin proper treatment. You also want to start with the least invasive treatment possible. For instance, if it turns out your problem has stemmed from nighttime grinding, the first thing to do is protect your teeth from any further damage.

From there, you can take up repairing the damage. Maybe your teeth are ground down to nubs and you need dental crowns. Or possibly, your teeth have been pushed out of place and you need Invisalign to realign your bite. Maybe you need a combination. The key is a dentist who knows what to look for.

This blog is brought to you by Dr. Randall Burba.

Options to Dentures or Dental Implants?

I’m having every tooth extracted. It’s a long story I won’t go into as to how this happened. I’m looking for options now. My dentist wants me to get a dental implant on every tooth. Even if I owned a house (which I don’t). I’d have to sell it to pay the cost of something like that. He said if I didn’t do that I’d have to get dentures. I don’t want that either. Isn’t there a middle ground?

Darren L.

Dear Darren,

An image of a snap-on denture
Snap-on Denture

Absolutely there’s a middle ground. There’s also varying degrees of ground. I’m personally appalled that your dentist gave you only those two options. That’s like telling a potential homebuyer they either purchase the multi-million dollar mansion or they’ll have to like in a decrepit shack with no power. Ethically, he’s supposed to inform you of all your options.

First of all, you can get dental implants without having an implant placed at every tooth. In fact, only the richest of clients could afford something like that. When all your teeth are missing, patients normally get implant supported dentures. It utilizes a dental implant, but they’re anchored to your jaw with implants. Obviously, the more dental implants you have placed, the more secure they’ll be. However, you can get them with as few as two.

These are generally called snap-on dentures. They help keep the denture from slipping out. It also preserves your bone where the two implants are placed. That’s very important. In fact, the more implants you have placed, the more you’ll prevent the facial collapse that comes with jawbone shrinkage, one of the biggest problems with dentures.

How Dental Implants Prevent Facial Collapse

When you remove your teeth, your body begins reabsorbing the minerals in your jawbone to use elsewhere throughout your body. It’s remarkably efficient, but devastating to the use of dentures. Eventually, your jawbone shrinks to the point where there’s no way to keep the dentures in.

Every implant placed, including those from snap-on dentures, retain the minerals in each place there are implants. That’s because your body recognizes the implant as a tooth root and knows you need the jawbone intact in that area.

This is one of the reasons I’m frustrated with your dentist. Just telling you about dentures without giving you the dangers and how to prevent them is irresponsible.

This blog is brought to you by Dr. Randall Burba.

My Porcelain Veneer is Crooked

I’m not sure if you can help me but I’ll try anyway. I had bonding done on a front tooth that was chipped. That chip wasn’t that big. It kind of worn out after quite a few years. My new dentist said it can’t be replaced and I’ll need to have a dental crown placed. I wasn’t keen on that. Like I said, it’s just a small chip. Instead, we compromised on a porcelain veneer, but when he put it on it was crooked. Now he says because it’s bonded there’s nothing I can do about it. Is he right? I can’t go around with a crooked front tooth.

Denise H.

Dear Denise,

A single porcelain veneer being held up by a dental instrument

I’m concerned about the quality or honesty of the dentist you’re going to. First, there was no reason why he couldn’t have re-bonded your tooth. I have no idea why he told you that unless there’s something else going on that you haven’t mentioned. This is one reason I am questioning his honesty.

I’m thrilled you decided not to get a dental crown for the tooth. That would have been a massive overtreatment, costing you healthy tooth structure. I understand why you compromised on a porcelain veneer, which is a little better. However, it’s obvious your dentist didn’t have the skill or it would not have been improperly bonded. At the very least, without replacing it, he should have offered you a refund. it’s unbelievable to me he’s expecting you to go about with a crooked veneer.

In fact, it’s unethical. This doesn’t meet the minimum standards of treatment. At some point, because of how it’s placed, it will break off.

Who Should Do Your Porcelain Veneer?

You’re in a bind now. Here’s what I’d recommend. Go to a good cosmetic dentist and have them give a second opinion. I’m pretty sure they would tell your dentist it’s unsatisfactory. A dentist will sometimes listen to a peer where they wouldn’t listen to a patient. They’ll give you a refund so as to not look bad.

Then, you can go to another dentist to have it replaced. Finding an expert cosmetic dentist is a matter of knowing what resources to find. First, look for a dentist accredited with the American Academy of Cosmetic Dentistry (AACD).

If you live in an area where there isn’t one within a reasonable drive, your next step is to look on the mynewsmile.com website. They recommend highly qualified and artistic cosmetic dentists by area. You’ll be safe getting a dentist who can give you a great veneer. In fact, they’ll give you a gorgeous smile.

This blog is brought to you by Dr. Randall Burba.