When Is a Gum Problem a Dental Emergency?

My husband has an ache in his mouth. He swears he just nicked it with his fork, but to me, it looks like a pimple. That seems a strange way for a cut to manifest. I think it’s something serious and he thinks I’m over-reacting. Have you seen this before?

Amanda

Dear Amanda,

Illustration of an abscessed tooth

Your husband is going to hate to hear this, but you’re correct. This isn’t from a cut. A pimple on the gums sounds like his tooth is abscessed. This means he had a cavity that went deep enough to affect the pulp of his tooth, turning into an infection.

I’ve got an illustration of this above, When the infection no longer has anywhere to go, it tends to spill out into your gums and form a pimple.

Unlike your typical bacterial infection, with a dental infection, an antibiotic isn’t enough. A dentist has to get in there and physically remove the infected pulp. This is known as a root canal treatment. Often, a crown has to be placed as well because the tooth will become brittle and need to be protected.

An Abscessed Tooth is a Dental Emergency

An active dental infection is considered a dental emergency. These infections can spread quickly. Believe it or not, in 2018 we still have people dying from tooth infections because they put off seeing the dentist.

The reason for that is how quickly they can turn life-threatening. Think about how close his jaw is to both heart and brain. When an infection reaches those areas, things spiral downward rather quickly. Last year, a father of three young children passed away because he was planning on going to the dentist and was delayed. It spread suddenly and they couldn’t save him.

I’m saying this so your husband knows to take it seriously. If he happens to be one of many patients who have some dental anxiety and tend to avoid regular dental care, let him know there are dentists who cater to fearful patients giving them a pain-free appointment.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Dentist Blamed my Bite for Broken Teeth

I kept breaking teeth when I ate. My dentist said it was because of my bite and suggested I crown every tooth so he could fix it. That was 50K+ so I expected decent results. Instead, I have several broken crowns. Now, my dentist is blaming my habits for breaking my teeth. He said I’m grinding my teeth at night and need to wear a night guard and something else during the day. I’m having trouble buying this for two reasons. First, because he originally said the cause was something else but when his repair didn’t work he’s now suddenly coming up with a bad habit that’s my fault. And this is the first time I’ve heard of this so-called habit. Second, because I break my teeth when I eat and not when I sleep. Do you have a recommendation?

Kyle

Dear Kyle,

Chart of TMJ and Neuromuscular Dentistry

I understand why you’re concerned. It doesn’t sound like your dentist really knows what he’s doing with this. After spending over $50,000 dollars, you have a right to be frustrated. I have two suggestions for you. First, I want you to get a second opinion. However, I don’t want you to get it from any dentist. Instead, I want you to find a TMJ Dentist.

While there isn’t a TMJ Specialty, there are dentists who’ve invested more time in studying the causes and treatments. You want a dentist who’s invested the time doing that post-doctoral. For instance, Dr. Burba studied at both the Dawson Academy and Spear Institute. Both are well known for their TMJ and neuromuscular training. Another great school for that is the Las Vegas Institute (LVI).

The reason I want you to see a TMJ dentist is due to the crowns you’ve had placed. What your dentist did is known as a full-mouth reconstruction. It takes expert level knowledge in occlusion to do this correctly or you could end up with serious problems with your bite. I don’t have the confidence your dentist has done this training.

TMJ and Night Guards

The second thing I’m going to recommend is you follow through with his suggestion of a mouth guard. While he didn’t run any tests or talk about evidence of teeth grinding before this problem, a night guard is not a bad idea. Though, I doubt you’ll need one during the day. The reason I say that is because people who grind their teeth at night don’t realize they’re doing it.

Teeth grinding causes a bunch of problems. Not only can it lead to TMJ Disorder, but it can also cause you to crack or break your teeth. I realize when your teeth break is during meals, however, that doesn’t mean they’re not being weakened by the habit.

One other thing. If you do grind your teeth and there was evidence of that, but your dentist didn’t mention it until now, that is severe negligence on his part. If that’s the case, I think you need a new dentist.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.

Invisalign Issues

Invisalign has one of the highest patient satisfaction rates in dental care. It’s such an improvement on the old way of dealing with orthodontics. However, that doesn’t mean there aren’t things you need to be aware of and prepared to deal with if one of them become an issue for you. It’s always better to be informed.

Clear Invisalgin Aligner

Solutions to Invisalign Issues

Invisalign Issue 1: Pain

While the clear aligners you get are much more comfortable than their metal cousins found with traditional braces, you are still moving teeth. There’s bound to be some uncomfortableness as your teeth are shifting into their new position.

With Invisalign, this discomfort hits its peak about 24 hours into putting on the next pair of aligners. Rarely, does it last more than a day or two. After the initial shifting is over, the next two weeks go by like a breeze.

That doesn’t mean you want to brush the pain aside. I would recommend taking an over-the-counter pain reliever on schedule starting an hour before you start your new aligners. Being proactive lowers the amount of discomfort you’ll have to deal with.

Invisalign Issue 2: Excess Saliva

This is another issue that passes very quickly. Our bodies are amazing. When your mouth senses there’s something there which isn’t a normal part of your anatomy, it tries to digest it. One of the ways it does that is by producing excess saliva.

Fortunately, this goes away quite soon. Practice speaking with them when you’re alone (preferably without spitting) and that should speed up the demise of this issue.

Invisalign Issue 3: Death Breath

man with bad breath

Think about it. You eat food. Bits of bacteria get between your teeth and in your gums. If you don’t remove them pretty quickly with brushing and flossing, you’re going to have problems. If you also pin them down and let them stew in some clear plastic aligners, you’re going to have death breath.

It’s is very important you brush and floss after each meal before you place back in your aligners. This will keep your breath sweet smelling. It will also prevent you from developing decay and needing to get fillings on your soon to be straight teeth.

Invisalign Issue 4: Kiss Killer

There are two specific things people bring up when it comes to kissing and Invisalign. One is the breath issue. That one is easily solved by following our instructions above. The second one, however, is a bit different. Some people have complained that it feels bulky when they’re kissing.

If this becomes an issue for you, there are two potential solutions. The first is to take them out. You get two hours a day where you don’t have to wear your aligners. It’s up to you how you use those two hours. A second option is practice, practice, practice. Kiss enough where it’s easy to work around.

This blog is brought to you by Salem Cosmetic Dentist Dr. Randall Burba.

Dentist wants to CROWN a Chipped Tooth!

I fell on some ice and chipped my tooth. I wanted to repair it but my dentist said the best repair would be a crown. I know he’s not big on cosmetic dentistry, but I was hoping for something that wouldn’t grind the whole tooth. Aren’t there some cosmetic options?

May

Dear May,

before and after a chipped tooth is repaired

I’m sure your dentist is a decent general dentist and is giving you the best service he can provide for you. Unfortunately, he not the best dentist for you in this particular situation. Yes, there are cosmetic solutions to this which are much simpler. The ideal one is much more affordable than a crown too.

However, I don’t recommend you force his hand on this. If he isn’t familiar and experienced in cosmetic dentistry you will not like the results you get. Many people use one dentist for their general dental work and one for their cosmetic work.

Fixing a Chipped Tooth

The standard repair for a chipped tooth is to have dental bonding done on it. This uses a composite resin that the dentist will sculpt onto the tooth freehand. It does require an artistic cosmetic dentist. As you don’t have one, I’m going to tell you how to find the best cosmetic dentist in your area.

I mean if you’re going to do a cosmetic procedure, you may as well go to the person who can not only do it well, they do an awesome job. My suggestion is you get an AACD accredited dentist. These dentists have gone through stringent oral and written exams as well as demonstrated their artistic ability on a large number of cases.

Any of them could not only fix your chipped tooth, but they could also give you a stunning smile makeover with porcelain veneers.

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