Tag Archives: sedation dentistry

Replacing all Crowns because of One?

I had crowns placed on all my front teeth about 17 years ago. Since then, my dentist passed away. I’ve been happy with his replacement, up until now. One of my porcelain crowns started to feel loose. I looked at it closely and there’s a dark spot on the top edge. I went to see the dentist. He said there’s decay at the edge and the crown needs to be replaced. But, (and here’s the catch) he says I have to replace all of them if I want them to match. That’s a LOT of money. Is that really necessary or can I wait until they need replacing individually?

Mara Lynn

Dear Mara Lynn,

Side by Side images of dental crowns done by two different cosmetic dentists on the same smile. One is ugly. One is beautiful

Believe it or not, the images above are of the same smile. In both pictures the patient had dental crowns placed. The only difference was the quality of the cosmetic dentist she used. I’m guessing your current dentist is more like the one on the left. He’s not a cosmetic-oriented practice, therefore his skill is limited.

It sounds like the margins on your porcelain crown opened, leaving a little ledge ideal for the development of decay. At the very least, the one with the decay needs to be replaced.

When your current dentist says your crowns won’t match if he doesn’t re-do all of them at the same time, he not lying to you. He’s admitting the limitations of his skill. In this case, you have two choices.

Choosing a Cosmetic Dentist to Re-do Your Smile

  • Just replace the crowns as needed to save money.

You’ll definitely need a new cosmetic dentist in order to do it this way. A good cosmetic dentist CAN just match one crown to the rest of your teeth. They won’t need to do the entire arch. The first thing I’d do, though, is check all the crowns for suspicious marks and open margins. You’ll want to replace any of those at this go-round before they turn into decay. After that, it’s fine to just change them as you need to.

  • Replace them all at once to save time

Even though this is what your dentist suggested, he did it for the wrong reasons— to cover his lack of cosmetic skill. Because of that, I’m not sure you’d be happy with his results. I believe you’d be better served with another dentist in this case as well.

The top cosmetic dentists in the country are those who’ve reached the accreditation level of the American Academy of Cosmetic Dentistry (AACD). AACD accredited dentists create beautiful smiles. In fact, most of them even have a beautiful smile guarantee.

On a side note, you’ll be much more comfortable using sedation dentistry to have that much work done in one sitting. You can simply go to sleep (if you want to) and when you wake up all the work is done.

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

Affordable Tooth Replacements for Patient with Traumatic Brain Injury

My cousin had a traumatic brain injury. I’ve taken over his care while he’s not able to care for himself. I was surprised to discover he hadn’t had dental care in quite some time. I took him in worried what the prognosis would be. Most of his teeth can’t be saved. I don’t have a lot of money, but I don’t want to leave him without teeth. Is there an affordable way to replace teeth?

Benson P. – Seattle

Benson,

It’s great that you’re stepping up to care for your cousin. And, you’re right, he doesn’t need to be left without teeth. It will cause more problems. The ideal tooth replacement is dental implants, but they’re quite pricey. Depending on the severity of his brain injury and his prognosis for quality of life, that may not be your best option anyway. The most affordable replacement option for him will be dentures. Though, they’re not anchored.  If his brain injury is severe you may want to consider anchoring them, even with just mini implants.

However, make sure you work with a dentist who has experience with traumatic brain injuries and patience.  Sometimes their personality changes and not always in the easiest ways to deal with. You want your cousin’s experience to be as pleasant as possible.

With the extractions, he’ll need sedation dentistry. I know you’re trying to save money. Many dentists offer payment plans. I don’t know if you’ve applied for disability for your cousin, but there are resources for you. You’re not on your own, but it wouldn’t hurt to talk with someone who knows the best and fastest way to access those resources.

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

Left Without Help By An Emergency Dentist

It took a lot for me to go to the dentist even though it was an emergency. I knew I had a cavity on one tooth, but had been putting off getting it dealt with because dentists terrify me. The pain became so great I had to do something. I was especially worried because the pain seemed to have migrated onto the next tooth as well and I was worried it was spreading. I told them this and said I wanted to get all of it dealt with at one appointment because I don’t think I’d have the courage to go back again. They agreed. The dentist banged at the tooth that was bothering me. He took x-rays. He said there was a cavity that need to be filled. I reminded him about the other tooth. He acted surprised and looked at it again. Then said, “Oh yeah, there’s a problem there too.” Then he told me to schedule an appointment for follow up treatment and walked out the door. I was stunned. They had agreed to help me that day. I told the receptionist that as I checked out, but she said it’s the end of the day and there’s nothing more they can do. I practically had a panic attack getting there and not I’m left with nothing accomplished except what I knew before I got there. I’m still in a tremendous amount of pain and now out several hundred dollars. Is there any way to safely deal with this myself?  Please help me.

Natalie N. – Maryland

Natalie,

I’m am so sorry that this was your experience, especially after it took so much courage for you to go in. At the very least, the emergency dentist should have gotten you out of pain.  I want you to understand that not all dentists are this callous. I suspect he was rushing. You mentioned it was the end of the day. I’m a little disconcerted that he missed the original cavity. That hints that he was rushing.

Unfortunately, there is no home remedy that we’re aware of for dealing with cavities. They still have to be dug out and filled.

I’d like you to see another dentist in your area. Before you panic, I want to suggest something else. I want you to go to a sedation dentist or a cater to cowards dentist. They’re used to working with patients that have dental anxiety. They’ll also give you a pain-free experience.

To make sure you don’t repeat the experience you had, it will be helpful to also check their reviews. That way you’re more likely to  get a dentist with a positive chairside manner.

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

Fill my own cavity

I think I have a cavity and was wondering if I could just fill it with that store filling material I’ve seen? I don’t like dentists and I rather take care of this myself.

Bruce S.- Staten Island

Bruce,

I can understand the desire to do what you can, but a cavity is not a self treat kind of situation.  Store bought filling is designed to only be used for a couple of days. It will not actually treat your cavity.

If you are in a lot of pain, I suggest you call an emergency dentist. They’ll be able to get you in right away and get you out of pain.  I realize you do not like to go to a dentist. I suspect it is because you’ve had a bad experience in the past.

I think you should ask if the dentist does sedation dentistry. That will help not only put you at ease, but will keep you from experiencing pain.

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

Worried about getting dentures

I have to get complete dentures in a month, and I’m a little worried about it. Will they take out all my teeth at once? Do they put you under for it?

Name withheld

Yes, they will more than likely take out all of your teeth at once. However, there are many ways to make this procedure painless for you. You may want to look for a sedation dentist. Each of them have different procedures they use. Some use oral sedation, and some use IV sedation.

We’ve had patients even just use a local anesthesia, because they prefer to be alert for the entire procedure. However, if you’re very nervous, your metabolism will burn off a local pretty quickly. In that case oral or IV sedation may be a better idea.

You may be interested in reading about Dental Implants, which can prevent you from having more problems down the road.

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