Infected Tooth and No Money
I’m missing one back tooth and have another that has had some decay for a while. Now I am pretty sure that it is infected. My problem is that I do not have dental insurance but I do have health insurance. Is there a way I can use my health insurance to get an antibiotic for a dental problem? My jaw is becoming quite swollen.
Abraham
Dear Abraham,
I am glad you wrote. What you don’t want to do is use antibiotics as a solution for this. Even if your medical insurance would cover a dental issue, which it will not, an antibiotic will only be a very temporary solution. Then, once the antibiotics are done, your infection will blow up even worse with no way to keep it under control.
The only way to really get rid of a tooth infection is by a dentist getting in there and physically removing the infected pulp of the tooth. Ideally, this would be done with a root canal treatment because it would save your tooth. If that is no longer possible, the other treatment option is to extract the tooth. The downside to the extraction option is that you will need to replace the tooth. Otherwise the adjacent teeth will shift or tip into the empty space. This will throw off your bite and could lead to headaches, jaw pain, and TMJ Disorder.
The best tooth replacement is a dental implant, but that is also the most expensive. There are several other options. If you do need an extraction your dentist is ethically obligated to give you all of them.
With the swelling you have in your jaw, that signals to me that your infection has spread. I would consider this a dental emergency and get in right away. I know you don’t have dental insurance, but if you call around and explain your situation, I feel like you should be able to find a dentist who would be willing to allow you to pay it out and get the treatment you need.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Can a Maryland Bridge Be Attached to Two Implant Crowns?
I have two dental implants, both on back molars. Until recently, the tooth before them was healthy. Now that one needs to be extracted. Would it be possible for me to place a Maryland bridge between the two implant crowns?
Dave
Dear Dave,
While technically you can use a Maryland bridge between the two implants, I would not recommend that option. First, to properly place a Maryland bridge your dentist would have to cut grooves into the crown, as shown above. Second, the best bond you can get is when you affix the wings to natural tooth enamel. The bond to the porcelain will not be as strong. I do not think that your bridge will hold long.
So, what do you do? Ideally, your dentist would have anticipated that you could lose the tooth between the two implants you already have. Then he would have aligned the implants in a way where you could unscrew the two adjacent dental crowns and affix a traditional bridge to the two implants. If that is not possible, then I would see if you can get an additional dental implant in the spot. If you’ve only recently lost that tooth, then there should still be enough space to fit another implant.
There are other options if that doesn’t work, such as a removable partial denture or even a dental flipper. Obviously, though, the ideal will be the implant, so start with those options. Either way you do need to replace the tooth with something. If you don’t it will throw off your bite. In addition to jaw pain, headaches and bite problems, you could end up with TMJ Disorder.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
How Long Can I Put Off a Root Canal Treatment?
If I have a tooth that needs a root canal treatment, how long can I put it off before I have to get one? I’ve been swamped with work and I can’t afford to take any time off right now.
Everett
Dear Everett,
While I cannot give you definitive timelines, I can give you some general guidelines. Please bear in mind that I have not examined you or even seen any x-rays, so this is just based on general information. Everyone’s body is different. If you want definitive advice, then it is important you see a dentist and let them examine you.
If your tooth is hurting, even a little bit, then you need to have the root canal done. This mean that you have an active infection. Another red flag is if there is a pimple on your gums. This is known as an abscessed tooth.
Depending on how severe your pain is, I would not necessarily call it a dental emergency, but you do want to get this scheduled or it will turn into one. So, don’t put off having this attended to.
Believe it or not, multiple people still die from tooth infections every year. When left untreated, a tooth infection will continue to spread outside of your mouth. If it reaches your heart or brain, what could have simply dealt with becomes life threatening.
If you do not have an active infection, then you are probably safe to wait. I’ve known people who waited years to get their root canal treatment. However, they did say that when they finally got it done, they noticed that they felt much better in general than they had in years.
I want to make sure that you are aware that by waiting, you risk external resorption. This is a condition where the infection eats away at the root of your tooth. When this happens the tooth is no longer able to be saved. Then, you are stuck with an extraction and the need to replace the tooth.
If you don’t replace the tooth, then the adjacent teeth will shift or tip into the empty space. This will throw off your bite and can lead to painful TMJ disorder.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Should I Remove All of My Wisdom Teeth or Just the Ones that Bother Me?
I have four impacted wisdom teeth. Two are infected. My dentist wants to know if I want to extract all of the impacted wisdom teeth or just the infected ones. One complication is that the bottom teeth are past a nerve. One of those is infected, the other isn’t. Here are the choices my dentist gave me and I’m feeling frozen and I cannot decide. Is one of these better than the other? He did tell me that there is a chance of nerve damage with the bottom teeth.
1. Take out all of the wisdom teeth no matter what.
2. Take out all of the wisdom teeth, but leave the roots of the bottom ones and hope the infection doesn’t spread to the roots. If it does, then he can go back in and take out the root.
3. Only take out the infected teeth, but remove the whole thing.
4. Only take out the infected teeth, but only remove the crowns of the one by the nerve.
Oh! My dentist said my age matters, but didn’t explain why. I’m 23 right now. Help.
Trudy
Dear Trudy,
Let’s start with the age issue because it will have a huge impact on your decision. The late teens to early twenties are the best time to extract your wisdom teeth. By the time you hit 30 years of age, your chances of complications double. Then, every five years, they double again. That means you are currently at a great age to extract your wisdom teeth, but that won’t last long.
Couple that with the fact that your impacted wisdom teeth are very likely to develop a problem later in life, then I strongly recommend that you have them all extracted while you are in the safest age range. You don’t want to wait until you have a dental emergency on your hands. The only question is whether or not to leave the root on those bottom teeth near the nerve.
Leaving the root is a reasonable solution. However, I do not recommend that you do not leave the whole root. I would just leave the tip and not the entire root. This reduces the chances of infection or your body having a problem with it being there.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
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I Think My Implant Dentist Scammed Me
I went to a dentist because of some jaw pain and he said I needed a full-mouth reconstruction. So, I poured a ton of money into fixing my mouth. He extracted many of my teeth and give me implants with crowns and then just crowns on the others. After just a few weeks, the crowns started falling off and I have either stubs or nothing but screws to chew with. I’m in extraordinary pain. The office keeps taking a message and then I don’t hear from the dentist, so finally, in frustration, I just drive up there. They were closing shop. Apparently, he has skipped the country. His staff said that they think he is in Egypt, but aren’t positive. I don’t know what to do.
Avery
Dear Avery,
I am so sorry that this happened to you. It sounds to me like you were dealing with a scammer. I wonder if he even had a dental license. There are horror stories about dentists who lose their license, yet still practice. Though, normally, they practice outside of the U.S.
Additionally, I’m afraid he took you for a ride twice. A full-mouth reconstruction is usually only done for the most severe TMJ Disorder, or for patients who grind their teeth down to nubs. There are several, less invasive procedures to try before doing something so drastic. Even when it is needed, your teeth aren’t extracted to do it. The dentist will just place a crown on every tooth.
If he did skip the country and is in Egypt, you may be out of luck. However, as his staff wasn’t sure, you could report him to the dental board and see if they have any idea where he is. This would certainly be something you could file a malpractice suit over if he is still in the country.
Other than that, all you can do is have this fixed. This is certainly going in the dental implant horror story file. When you do go to get this fixed. Make sure you check the dentist’s credentials, including their implant success rate which should be about 95%. Also check with review sites like Google and Yelp!, as well as the Better Business Bureau to make sure there aren’t any complaints against them.
Again, I am sorry this happened to you. Unlike the dentist who did your “treatment”, most dentists are in their chosen field because they want to help people.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Luster Premium Home Whitening
My dentist charges quite a bit for teeth whitening. I noticed that I can purchase Luster Premium Home Teeth Whitening from Amazon for a fraction of the cost. Would this work for me? Is it safe?
Jaimie
Dear Jaimie,
When I did a search for this, at first a different product showed up, which was just named Premium Home Whitening. I did some digging until I found the exact one you were asking about. With this product, I think you are dealing with a phony product. They achieve whitening by using zinc oxide, which is actually a pigment more than a whitening ingredient. This will “stain” your teeth whiter, making them look whiter briefly, but it doesn’t whiten your teeth and will not actually whiten your teeth, just paint them.
I have also noticed there is a similarly named product Premium Whitening. This currently sells for $20. While it does have a viable whitening ingredient, there are a few problems with it, all of which stem from the whitening tray they use.
It will not be custom fit to your bite. As a result, it will cause a couple of problems. First, saliva will get in which dilutes the effectiveness of your whitening gel. Second the whitening gel will leak out of the tray, which not only further dilutes the whitening gel but also puts your gums at risk of sensitivity and even a small risk of an infection from the gel.
Looking at this particular tray, I see an additional problem. Instead of having two separate trays, one for each arch of your teeth, this kit has one tray which you have to bite down on in order to keep it in your mouth. This is going to lead to jaw pain. For those with TMJ Disorder, it could be quite painful. Plus, you are not likely to be able to hold it there for very long.
Your safest and most effective option is to have teeth whitening done professionally. You could save up for it or ask your dentist about payment plans.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
A Collapsed Bite & TMJ
I have a problem with my smile that has gotten worse over the years. It is always hard to see my teeth, even when I smile. When I don’t smile it looks like inside my mouth is just a black hole. In recent months my jaw has started hurting. I do wear a nightguard because of some clenching and grinding I do. When I am wearing it, my jaw feels a bit better and you can see my smile. I spoke to my dentist about this and he said that he could provide me with porcelain veneers to improve the appearance of my smile. I just wanted to make sure this was my best option before moving forward.
Marilyn
Dear Marilyn,
It sounds to me like you are dealing with a combination of a collapsed bite along with TMJ Disorder. I am glad you are writing now instead of after you spent a fortune on a procedure which does not help. Your dentist may be well intentioned, but porcelain veneers will not solvoe your problem.
This will require advanced TMJ training so a dentist can build your bite back up properly with dental crowns. Make sure he or she does it first with provisional crowns. These are temporary and can be changed as necessary to get the crowns correct. Take that to mean they are comfortable, you like how they look, you can see your smile properly, and you have no trouble with speech as a result. Once the provisionals are correct, then your dentist can make the permanent crowns.
The dentist you choose will need advanced training in TMJ. There is not a TMJ specialty, so you’ll have to do some homework. Look at Dr. Goebel’s TMJ Credentials in order to get an idea of what you want from the dentist in that regard. Some other good training institutions, in addition to what Dr. Goebel has done are the Dawson Academy or the Las Vegas Institute for Advanced Dental Studies.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Is the Tanda Pearl Whitening System Safe and Effective?
I have bleaching trays that my dentist gave me, but they always seem to aggravate my TMJ Disorder. I was looking online for alternatives and came across this Tanda Pearl System. It says it whitens your teeth in just 5 minutes a day. I’m thinking I could handle 5 minutes, but wanted to make sure it was safe and effective before I did. Do you have any thoughts on it?
Cassie
Dear Cassie,
The system works with the same premise as your current bleaching tray system with a few exceptions. Because it is done without dental supervision the gel will be weaker. If you are considering this because your TMJ is affected, I think it will have the opposite affect from what you are hoping for.
The trays you have now are worn independently on each arch. The Tanda Pearl system has one tray that you have to bite down on in order to keep it in place. I think that will drive your jaw pain through the roof. On that basis alone, I would not recommend it for you. That does not give you a solution to your problem, however. Here are some suggestions for that.
First, were your trays custom-fitted to your bite? They should have been. You don’t want some generic trays that you get warm and then bite down on to form to your teeth. Your dentist should have taken a mold and built the trays to fit your specific bite. If that did not happen, talk to your dentist about getting new trays.
Second, you didn’t mention how long you were wearing your trays. There is no required amount of time. If you’re wearing them for an hour, but your TMJ starts bothering you halfway through, then just wear them for thirty minutes. Obviously, the longer you wear them each day, the faster your teeth whiten. However, whitening a smidge slower in order to keep yourself from unnecessary pain seems the wiser course to me.
Communicate your concerns with your dentist. You paid for professional teeth whitening. Part of what you are paying for is his (or her) expertise and oversight to make sure nothing goes awry with your treatment. Teeth whitening should be pain free.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.