Tag Archives: root canal treatment

Adult tooth knocked loose

Is there anything which can be done about an adult tooth which is loose? I had an accident and dropped a hammer on my mouth. I thought everything was fine except for a fat lip, but this morning I can swear the front tooth feels loose. I thought I was imagining it at first, but now I’m pretty sure. It’s wiggling. Is this a lost cause or can it be saved?

Lizzie

Dear Lizzie,

Woman holding her jaw in pain from TMJ

Before I go over anything else, I’m going to encourage you to stop wiggling the tooth no matter how tempting it is to check. There are ligaments on your tooth which help keep them secure. Often when there is some trauma to the tooth those ligaments get stretched. However, if you keep wiggling it, the ligaments could snap, putting your teeth at greater risk.

Now that I’ve warned you about the wiggling, I can have some sympathy. Ouch! I can’t imaging how much it hurt to drop a hammer on your mouth.

It’s possible the tooth can be saved, but this is considered a dental emergency and you need to see your dentist right away. If you don’t have one, do an internet search for an emergency dentist. They are simply general dentists who are willing to see non-established patients quickly in situations such as yours.

Saving Loose Adult Teeth

The dentist will examine and do x-rays of the tooth. The x-rays are to establish whether there’s been any internal damage to the tooth. If there has, you’ll need a root canal treatment and possibly a dental crown.

If there hasn’t, and it’s just a matter of the ligaments being stretched, your dentist will stabilize the tooth with some type of splint to keep it secure while the ligaments heal.

Don’t put this off. Get it looked at quickly so you don’t risk loosing the tooth.

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

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.

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.

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.

Help! My Tooth Crumbled Into My Food

I just received a temporary filling and am getting a root canal treatment in just a few days. I was eating some sticky rice at an Asian restaurant when I felt something weird going on with my tooth. Then I felt grains of what I think is my tooth structure in the my food. I think my tooth is crumbling. Can this wait until my root canal appointment or do I need to be seen in an emergency visit?

Marsha V. – Nashville

Marsha,

That depends on whether it’s the actual tooth structure crumbling or just the temporary crown coming apart. They’re designed to come out fairly easily so that is a real possibility. Sticky foods can also help that along.

Here’s what I’d like you to do, if you haven’t already. Look at the tooth. Does it look like it’s the tooth structure itself that’s coming apart, or is there a divot where the filling was placed?

If it’s the tooth itself, I’d call the dentist and ask if he wants you to come in for an emergency dental visit. If it’s the temporary filling, you’ll be fine.

There is dental filling material you can purchase at a local pharmacy. It’s also designed to be temporary and will not be a good subsititute for a permanent filling. You’re the exact type of case this store bought filling is used for. It will help keep things in place until you go in for your root canal treatment.

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

Treating a single dark tooth

My daughter had an accident that ended up with her needing a root canal on one of her upper front teeth. It has since turned a darker color and I would like to somehow get this repaired for her. She’s always had a pretty smile and this is making her very self conscious. Do you have a recommendation for fixing this one tooth or do we need to do a complete smile makeover?

Dena L.- San Francisco, CA

Dena,

Yes, there is a way to fix this single tooth, but it will require an expert cosmetic dentist. Because she is happy with her smile with the exception of the darkened tooth, I don’t recommend changing her other teeth. Instead, she could have a porcelain veneer or a porcelain crown placed.

I would not recommend her current dentist for this procedure, because he didn’t know how to prevent her tooth from going dark after a root canal procedure. Instead, I would either look for someone who is accredited with the American Academy of Cosmetic Dentistry (AACD), or who is recommended by the mynewsmile.com website for your area. You’ll be safe with anyone of them.

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