Category Archives: Emergency Dentist

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.

Dental Double Cross

I’ve kind of had it. I had a dental crown placed on a back tooth. It didn’t feel right from the beginning. The dentist adjusted it, then it fell out. He put it back. It felt worse. He adjusted it again, but nothing got better. He told me I’m just not used to crowns and I’d become accustomed to it. I was frustrated, but what could I do? Now, a piece of it broke off at dinner. I’d had it with the dentist that placed it. Instead, I went to see an emergency dentist. All I needed him to do is reattach the broken piece, but he’s insisting the entire crown needs to be re-done. Now, I have to pay for an entirely new crown. Can’t he just fix it? I’m willing to live with the pain at this point. I just need a dentist who’s not going to do a double cross.

Karen

Dear Karen,

A Dental Crown being Placed

I don’t blame you for your frustration. It doesn’t sound like your dentist has done his job. Nor does it sound like he’s shown any interest in the fact you’re in pain. I have to say, in most cases the “You’ll get used to it line…” is code for I don’t know what I’m doing or how to make it right.

As for the emergency dentist, I don’t think he was trying to cheat you. It’s very likely that the crown broke in a way where a true repair is impossible.

What Caused Your Emergency Dental Visit

There are a couple of things which can cause pain on biting with a crown. The first is a lingering infection. I don’t know if your crown was due to large decay or a root canal treatment. If it was a root canal for an infection, it’s possible there is still an infection there causing pain. There are canals in the tooth which can be quite adept at hiding. It’s possible your dentist missed one.

The second thing which can cause pain is when a crown is seated too high. I tend to lean toward this because of the fact that it broke when you bit down. Generally, our biting force, which is quite substantial, is spread out as our teeth meet together. However, if a crown is seated too high it absorbs all the force. This could lead to it breaking.

Crowns on molars are a little trickier because you have to factor in the occlusion with the other teeth. It’s very likely your dentist could do a fine crown on other teeth, but a molar is a bit beyond his skill set. The fact that his bonding didn’t hold makes me question his skill set already. But, occlusion requires the kind of extra training you would see with dentists who take an interest in treating TMJ Disorder.

Your Options

Option One: You could ask your original dentist to make you a new crown (free of charge). His didn’t meet even the minimum standard of longevity. I don’t know that you’ll get any better results the second time with him, but you’re certainly able to try.

Option Two: You could ask for a refund and allow the emergency dentist to make a new crown for you. The refund would keep you from having to pay for two crowns and you may have better luck with this dentist.

Option Three: As it didn’t sound like you were thrilled with either dentist, you could take the refund and find a completely different dentist altogether.

I hate that you’re having to go through all of this trouble for a crown.

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

Is a Gray Tooth a Dental Emergency?

I have a tooth that’s turning gray. I’ve tried whitening it but it didn’t help. I wondering if something serious is wrong. Is this like a dental emergency? What if I don’t have a regular dentist?

Carrie

Dear Carrie,

Woman giving thumbs up in a dental chair

A gray tooth is usually a sign that the tooth is dead or dying. Is there a chance that you’ve had some recent trauma to your mouth? That would explain the tooth. You do need to see a dentist soon. You’re going to need a root canal treatment and porcelain crown.

If you don’t have a regular dentist, that’s okay. There are emergency dentists. That’s not a specialty. It just means that they’re regular dentists that are willing to see non-established patients in the case of an emergency. This would be what you need. They’ll take x-rays and get a good look at the damage and go from there.

How Not to Need an Emergency Dentist

Trauma can’t always be avoided unless you’re someone who likes to hang out in front of a ball machine. That’s not recommended.

But, certain things, like tooth infections, can almost always be avoided. The key is regular check-ups. There are usually two reasons people avoid going to the dentist regularly. The first is financial. They don’t have dental insurance so they feel they can’t afford it. Most dentists are willing to let you pay out your treatment. You just need to talk to your dentist ahead of time.

The second is fear of the dentist. Most dental anxieties start in childhood. Some dentists enjoy helping patients with anxiety. Dr. Burba realized that with patients, their fear stemmed from the shot. That’s why he invested time learning how to give pain-free shots. In fact, most of his patients don’t even realize he’s administered the shot at all.

Planning Ahead with Dental Crowns

Like your gray tooth. porcelain crowns will not whiten, even with professional teeth whitening. That’s why it’s important to get them the color you’d like them to be when they’re placed. Your dentist can create them to any whiteness you desire. But, you’ll want your natural teeth to match, so make sure you whiten your teeth before the final color of your crown is decided.

This blog is brought to you by AACD accredited dentist Dr. Randall Burba.

Is a Cracked Porcelain Crown a Dental Emergency?

I had several porcelain crowns placed on my front teeth. They’ve served me well for over fifteen years. One has always had a minor defect you couldn’t see just by looking. My dentist told me about it and offered to do a different crown, but she did say that even our natural teeth have minor defects and it shouldn’t be a problem. I appreciated her honesty and her willingness to make an entire new one. I didn’t feel that was necessary and their longevity has born that out. Today, however, I noticed I can both see and feel the defect. I’m sure it needs to be replaced at this point, I’m just wondering if it is a dental emergency or I can wait. The original dentist has since retired and her replacement and I are just getting to know one another so I don’t yet have the same confidence in her.

Lindsey

Dear Lindsey,

A Dental Crown being Placed

It sounds like you and your old dentist had a wonderful doctor-patient relationship. It’s certainly hard to lose a trusted caregiver. Hopefully, her replacement will end up being equally honest and skilled. While this change in your dental crown isn’t necessarily a dental emergency, I don’t want you to get too comfortable and let this slide. You do need to be seen.

The fact that you can now see and feel the defect tells me it’s cracked. It will at some point completely break. Those type of things inevitably happen at the worst possible moments, like when you’re on vacation or out to dinner. It’s much better for you to get this dealt with well before it can become an emergency issue. Plus, it will give you peace of mind knowing it’s no longer at risk of breaking.

Who Should Replace Your Dental Crown?

You’re not familiar with your new dentist yet, so before you allow her to replace your porcelain crown, you will need to research her cosmetic skill. At the very least check out her smile gallery. It’s a collection of before and after pictures of cosmetic work she’s done. You can click here to look at Dr. Burba’s work to get an idea of the type of quality you want. These are front teeth so you want them to be beautiful when you smile.

Some dentists would try to persuade you to replace all the crowns so as to make them easier to match. That’s usually a sign they’re not top-notch cosmetic dentists. The crowns are aging, so if you want to go ahead and replace all of them, that’s fine. But, you mentioned they’re still in good shape. In that case, you really only have to replace the broken one.

Replacing a single crown to your remaining teeth takes an expert cosmetic dentist. I’d suggest you look for a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are experts in their field both in technical skill and artistry. They’ll match your crown perfectly.

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

Dentist Perforated My Sinus!

I need help. I’m in complete agony. I don’t like dentists to begin with, so it took a lot of pain for me to go in to see one to begin with. I don’t have a regular dentist so I contacted an emergency dentist. He said my pain is being caused by two molars that are beyond repair. He offered to extract them and I agreed. The next day, my nose felt weird and kept making strange popping sounds. I called the office because I’d never had this procedure before and didn’t know what was normal. They suggested I take a decongestant. Mind you, they never mentioned the possibility that anything else could be wrong. I started taking the decongestant, but by morning I developed a fever. I called them back and they called in an antibiotic for me. Still no mention of a problem during my procedure. A week later, I’m in so much pain I just show up at their office and tell them someone has to check me right then. They bring me back. That’s the FIRST time they mentioned that my sinus had been perforated during the procedure. He removed some pieces of bone and said I should be good to go. It’s now another week later and I’m getting worse. Do I need to go to a hospital?

Missy

Dear Missy,

Woman holding her jaw in pain

Holy Molars! That is one heck of a horror story. I’m very sorry you’re facing this. Your emergency dentist really blew it on a lot of levels. Our sinus cavities are quite close to some tooth roots, so perforated sinuses do happen. But, there is a protocol he’s supposed to follow to help aid healing. Part of that is informing you so that you know not to place unnecessary pressure on it during healing and to not blow your nose.

Secondly, it sounds like he has you on the wrong antibiotic. You should be much better by now. Here’s what I want you to do. While most perforated sinuses heal on their own quite nicely, yours has progressed way too far. I think you need an emergency ENT (Ear, Nose, and Throat) appointment. Let your medical doctor know what is going on so he can recommend one for you TODAY.

They’ll not only get you on the correct antibiotic but will give you a treatment plan for healing. Be aware, if it’s progressed as much as I think you may need surgery to correct this.

Dental Emergencies and Dental Anxiety

Fear eyes looking out from behind a chair
Dental Anxiety Leads to Dental Emergencies

In our practice, we’ve noticed that many dental emergencies we end up seeing, developed because the patient has dental anxiety and avoids the dentist. It sounds like you’re in this category. Plus, with the experience you’ve just had, I wouldn’t be surprised if you never wanted to step into a dental office again.

I don’t want you relegated to going from one dental emergency to another, always having painful visits to the dentist. Because of that, I want to let you know that there are dentists who cater to fearful patients. They’re gentle and compassionate. They won’t lecture you about not coming in. Instead, they’ll help you get your oral health on track.

You’ll find even your body feels better once your dental issues are in hand. There’s a way to do it both stress-free and pain-free too. I want you to look for a dentist who uses sedation dentistry. This will allow you to sleep through your appointments. It has changed the lives of many fearful patients who were eventually even able to come without sedation.

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

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.

Which One of Us Did the Emergency Dentist Give the Wrong Treatment?

Something doesn’t seem quite kosher in a recent experience my husband and I had with an emergency dentist. We both had similar symptoms on different days, but received vastly different treatment. I had a toothache that would flare up every now and again. It was tolerable and I was busy so I just went on with things, while keeping a gauge on it. Eventually, I had some time and went to an emergency dentist. I was surprised to hear I needed a root canal treatment and crown. I went ahead and got them because he was the dentist and I was in pain. A few weeks later, my husband mentions his tooth hurts. I warned him to go in right away so he wouldn’t end up needing a root canal treatment, but like me, he’s stubborn. He waited for several weeks until it blew up and the pain was more than he was willing to put up with. But, when he saw the same emergency dentist, he just got a filling. The way I see it, either I was cheated and given a treatment I didn’t really need or he wasn’t properly cared for. Which do you think I should be worried about?

Aleiya M.

Dear Aleiya,

A man in pain needs to see a Salem Emergency Dentist

What to Expect From Your Emergency Dentist

There are a couple of issues going on here. The first is that this emergency dentist didn’t explain why you needed those procedures to either you or your husband. It’s unfair for a dentist to allow you to get a procedure without first explaining why it’s necessary and takes the time to answer any questions you may have.

I haven’t examined either of you but can give you a general idea of why some patients need a root canal treatment and some don’t, even with the same symptoms. A root canal treatment can be done for a number of reasons. Some of those include having an infected tooth, a cracked tooth, or even a cavity where the decay has reached the pulp of your tooth or gotten too close to the nerves in your tooth. The crown can be necessary if the tooth has died or if a cavity is so large it would weaken the tooth too much to do a simple filling.

It’s possible you had a cavity which was so large it reached the pulp requiring a root canal treatment and a crown. Your husband’s decay may have spread much slower causing him to only need a simple filling. Again, I’m sorry your dentist didn’t explain to either of you why you needed the procedures.

How to Prevent Dental Emergencies

Another item that occurs to me is both of you needed to go to an emergency dentist. That often indicates you’re either new to the area and haven’t found a permanent dentist yet, or you have enough dental anxiety that you avoid getting regular dental care and only go in on an as-needed basis.

If you’re among the latter, let me assure you that there are dentists who cater to anxious patients. Working to put you at ease and give you a stress-free, pain-free dental appointment. I know getting regular care can be nerve-racking, but often just one or two appointments a year can not only prevent your cavities from spreading so far that the more intrusive procedures such as root canal treatment are not needed, but they can even prevent cavities altogether.

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

Canker Sore or Cancer?

My husband complained that his mouth was hurting too much to eat. I thought he was just avoiding vegetables, but he didn’t eat dessert either. I took a peek and he has a horrible spot in his mouth that looks like his skin is getting eaten away. He’s sure it’s just a canker sore and thinks it will go away. I’m worried it’s oral cancer. Is there a way to know? Would we see an emergency dentist to find out?

Tea L.

Dear Tea,

Your husband’s dentist likely does an oral cancer screening at his check-ups. If he hasn’t seen any warning signs, then it is likely just a canker sore. These will generally clear up in about two weeks. There’s no reason for an emergency dentist yet.

There are over-the-counter remedies you can try which could help with some of the pain. While they make pads to cover them, quite a few patients have found that saliva makes it difficult to keep them in place. I’ve found relief (though only temporarily) with some numbing cream.

If you’ve found it hasn’t healed after a couple of weeks, then you can schedule an appointment with your dentist to have a peek at it. Not healing quickly doesn’t necessarily mean it’s cancer. It could just as easily be a virus or simply a canker sore taking a wee bit longer to heal, so I don’t want you stressing over it.

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

Can I Wait Before Getting a Filling?

My dentist told me today that I need two fililings. I spent most of what I had available for the dentist today.  Can I wait before getting them filled or will that cause problems? I just don’t know where I’ll find the money.

Percy M.

Dear Percy,

Mosts dentists understand that medical and dental care can be expensive. Generally, they’re willing to work with you to pay out the services. So, if the only thing holding you back is money, I bet just a simple phone call explaining your situation will help. Most offices have payment plans and will help you.

As far as how long you can wait, it really depends. Some cavities are in their early stages and you can wait a month or possibly even longer before it breaks through the enamel. Others are deeper and close to breaking through the dentin already.

You don’t want it getting to the dentin. That can blow up quickly and become a dental emergency situation. That can end up costing you a lot more money than getting the cavities covered.

For some people, there’s more to them avoiding dental care than finances (though I’m definitely not minimizing the impact of finances).  Many patients also struggle with dental anxiety.  If that is an additional concern of yours, you may want to look into a dentist who works with fearful patients. Depending on the level of your anxiety, you may be interested in sedation. But, it’s not always necessary with the right dentist.

What you don’t want to do is put it off so long where the only solution is to extract the tooth. Then you’re stuck researching tooth replacement options.

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

Is This White Sore in My Mouth Cancer?

I’ve got this painful white sore in my mouth. It’s making it hard to eat. Do I have cancer? Should I see a dentist?

Missy P. – Kentucky

Missy,

I couldn’t tell you if it was oral cancer without examining it.  Before you panic, though, it could just as likely be a canker sore. Your dentist should be doing regular examinations for oral cancer. If you don’t have a dentist, you can see an emergency dentist if it turns out not to be a canker sore.

True canker sores usually clear up between 10-14 days. It will just be a matter of managing the pain until then. There are oral antiseptics you can purchase over the counter.  They won’t take care of all the pain, but they can take the edge off of it.

If it doesn’t clear up in that amount of time, it’s time to get it checked out.  As I said before, if you don’t have a regular dentist an emergency dentist will see you. I have seen that most people who avoid the dentist do so out of fear.  There are dentists who are compassionate with fearful patients, who have methods of giving you a pain-free dental appointment.

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