Tag Archives: Salem 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.

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.

Is There a Dentures Support Group?

Please help me. I feel so foolish. It’s bad enough losing your teeth. But, being poor and losing your teeth is the absolute worst. I couldn’t afford to get dental implants, and yes, I know they’re better. I’m just stuck with dentures. I absolutely hate them. I don’t know if there’s a group or something which talks about how they deal with dentures, but I really need one.

Carolyn

Dear Carolyn,

An image of a snap-on denture
Snap-on Dentures will keep them secure

I’m not aware of a denture support group, but it sounds like a good idea. You might even be able to start one at your local dentist’s practice. I say that with confidence because you’re not alone in your feelings. Many people struggle with dentures.

Common Struggles with Dentures

One of the biggest complaints is it’s much more difficult to eat food. Many times that can be improved with a better fit of your dentures. However, there are limitations. Even the best fitting dentures still reduce your chewing capacity by 50%. Cutting your chewing capacity in half is a huge drop in quality of life.

Another problem is they slip and slide. Removable dentures are, by their very title, removable. Because there’s nothing anchoring them there, they will move. This will happen more and more as your jawbone shrinks, which is a devastating side effect of dentures known as facial collapse. Eventually, you won’t be able to keep them in at all.

I realize I’m not telling you anything you didn’t already know and you want solutions, so let’s move on.

A Snap-on Dentures Solution

Without having the money for dental implants, most patients feel hopeless, like they’re trapped. However, there is a sort of “part way” procedure that will help a little.

Generally, when you’re talking about implant supported dentures, you’ll need about six for each arch. However, with snap-on dentures, you can get as few as two. This can make a world of difference.

Benefits of Snap-on Dentures

The most obvious benefit is they cannot fall out. The implants anchor the dentures to your mouth securing them so you’ll never have to worry about embarrassing public slips.

They’ll help you retain your jawbone where the implants were placed.

They give you a stop gap while you work toward more implants. Obviously, the more implants you have the better, but starting with two gives you hope, a bit of relief, and a place to start.

Our life circumstances change all the time, and there may come a time you can afford to get more implants. This also allows you to save up a bit at a time and you can add two implants in stages as you’re able, until you have the security and chewing capacity you want.

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

Denture Disaster

I can’t afford a full set of dental implants, which is what I really wanted. I know they’re better, I just have no way of getting them. I wasn’t thrilled about getting dentures but just thought I could make the most out of it. But, I just can’t deal with the movement. The stupid things haven’t fallen out, but they slide enough to make me nervous. This whole thing has been a disaster. It’s so discouraging. Is there anything I can do which will keep them in?

Mona B.

Dear Mona,

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

You’re in a tough spot. While some people can get along with dentures, no one really loves them. Even the best fitting dentures cause you to lose 50% of your chewing capacity. Unfortunately, that will only get worse. Your body begins reabsorbing the minerals in your jawbone to use elsewhere throughout your body. So, the longer you wear dentures, the more jawbone you lose. Eventually, there’s not enough jawbone left for you to retain your denture any longer. This is known as facial collapse. The only way to repair it is if you get bone built back up through bone grafting.

Solution to Slippery Dentures

Snap-on dentures are a good intermediate step for you. It will allow you to anchor the dentures to your jaw with as few as two implants. Obviously, the more implants you have the better, but this is an affordable way to get dental implants to preserve at least some jawbone. This also gives you time to save up to get more implants as you’re able to.

Don’t get too discouraged. You’re at least doing the research to find out about solutions. Many people go years without hearing the warnings about dentures or learning of any solutions.

Just be sure to not let any old dentist do the work. It is an advanced procedure. You don’t want to risk it being done improperly. Make sure they have significant post-graduate training in restorative dentistry.

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

What Would Getting Dentures Entail?

I’m losing my teeth and making some decisions about what to do next. What would it entail to get dentures? Do they put you out and then take out all your teeth at once? Do you get the dentures right away?

Carla

Dear Carla,

Dentures

I’m sorry you’re facing this decision. I know how heartbreaking it can be. I’ll answer your question about dentures, but before you make a decision I want to be certain you know your options other than full dentures.

Options to Full Removable Dentures

Dental Implants

illustration of a dental implantIf you’re removing all your teeth, ideally you’d get dental implants. As you can see from the illustration at the left, it implants a prosthetic root into your jawbone. This is why dental implants are so useful. They’re much more stable than other options. You can eat and brush/floss as you normally would with your normal, healthy teeth.

However, their biggest benefit is the prevention of facial collapse. When your teeth are removed, your body immediately begins to reabsorb the minerals in your jawbone to distribute elsewhere throughout your body where they’re more needed. It’s efficient, but the result will be you won’t have enough jawbone left to retain a denture. Dental implants prevent that.

Implant Retained Dentures

dental implants anchoring denturesVery few people can afford to get an implant placed on every tooth. However, implant supported dentures are another option which is more do-able financially. With these, your dentist will place an implant in even distribution throughout your bite. When that’s completed, he can anchor your dentures to them. You get the benefit of preserving a good deal of bone along with having your dentures secure in your mouth.

Obviously, the more implants you can afford to place the better, but this can be done with as few as two implants, which are called snap-on dentures.

How Are Removable Dentures Placed?

First, the teeth are extracted. Some people prefer to have dental sedation for this part of the procedure. This way they can sleep through the procedure if they’d like. Others prefer just to use a local anesthetic. It’s completely up to the patient. Once that is completed, the next step depends on the type of dentures you decide on.

Immediate Dentures

These can be placed as soon as your teeth are removed. The benefit is you can walk out with a full set of “teeth”. They tend to end up being a bit more expensive because they require more follow-up visits and adjustments.

Conventional Dentures

These are placed about eight weeks after extraction. The benefit is they tend to fit better, requiring less adjustment. The obvious drawback is the wait to have a smile.

Discuss these options with your dentist. I’m sure the two of you can come up with what works best for your lifestyle and budget.

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

Can’t Eat Since Getting Dental Implants

I need help and I’m not sure how to get it. Over a year ago I went to the dentist for the first time in a long time. She said my teeth couldn’t be saved and recommended removing all of them and replacing them with dental implants. I couldn’t afford that initial procedure she recommended, but we finally settled on implant supported dentures. Even then, I had to get a loan through this program they use. Ever since the implants were placed I’ve been in massive pain. In fact, I’m in more pain now than I was when this started. I’d hoped when they added the denture after my healing period I’d feel better. That’s what the dentist’s office told me too. Unfortunately, that hasn’t been the case. In fact, it hurts so much I can’t even wear the dentures. I’ve lost over 60 pounds because I’ve essentially been on a liquid diet for this whole time. I can’t live like this anymore. The dentist says everything’s fine and I’ll adjust, but I’m not seeing any improvement. What do I do?

Belinda K.

Dear Belinda,

Salem Dental Implants

I’m sorry you’ve been in so much pain and am a little concerned that you’re losing so much weight and your dentist doesn’t seem to care. While some postoperative pain is normal, what you’re experiencing seems to be anything but normal. Your dentist should be willing to make this right on her own, but it seems like she may need a little nudge.

If it were just the dentures hurting I’d think they’re just in need of adjustment. But, this pain has been consistent from the beginning. I haven’t examined you, but I am wondering if the dental implants were improperly placed. What I’d like you to do is get a second opinion from a highly skilled implant dentist. Look at some of the training and experience Dr. Burba has to get an idea of what kind of dentist you’ll want to visit to have this looked at. Don’t tell them who your dentist is, just explain your symptoms and go from there.

If it turns out your dentist did something that caused the problem you should be able to get a full refund. You’ll still be in the position of needing to replace all your teeth. Implant-supported dentures are a good option. Unfortunately, once you’ve had implants placed, if you lose them, you’ll need to have bone grafting done in order to have more. This procedure is fairly easy and can be completed in a day.

I almost wish you’d had a second opinion before going through all this. There may have been a chance to save at least some of your teeth. Of course, there’s no turning back the clock now. Hopefully, your experience will help someone else.

I’m also hopeful you can get this resolved quickly just by getting a second opinion. I’m sorry you’ve had such a negative experience.

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.

Diet or Dentist For TMJ?

I feel a little foolish asking this question but I’m wondering if TMJ can be a diet related problem? I have horrible jaw and head pain, especially in the mornings. My closest friend truly believes that if I switch to a whole foods diet it will be taken care of. Even as I type it, it seems like a stupid idea. However, I’ll have to admit my friend is a lot healthier than I am. So maybe there is something to what she has to say.  Do I need a dentist or a diet change?

Lucia M.

Dear Lucia,

There is one aspect of TMJ which can be diet related, but one only. Chewing. TMJ is a disorder of the temporomandibular joint.  Changing your diet won’t repair the joint. However, if you’re eating things such as raw carrots and apples it could be adding stress to the joint. It might be a good idea to lay off the hard and chewy foods while your dentist gets to the cause of your problem.

Your symptoms sort of sound like the cause could be teeth grinding. You wouldn’t necessarily even know you’re doing it if it’s happening while you’re asleep.

If that’s the cause, a simple mouthguard could be just the solution for you. Your dentist can custom design one to fit comfortably in your mouth while you sleep. If you start to grind your teeth, the mouthguard will absorb the pressure, protecting your teeth and your joint.

This will also protect your teeth from damage. The grinding can cause your teeth to become loose or cracked, causing you to need a dental crown.

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