Should I get charged for root canal failure?

Posted on April 21, 2012 by writeradmin

I had a root canal on my #30 tooth. Now the dentist says I need an apicoectomy because the root canal failed. Can I require the endodontist to charge me a reduced fee for the next procedure because it didn’t work? I’m on such a limited income that I’m really going to have trouble paying my bills with this extra fee.

Jennifer R.- Maumelle, AR

Jennifer,

I sympathize with your situation. Living on a tight budget is never easy. Unfortunately, standard procedure is to charge the extra fee even with a root canal failure. Here’s why.

Generally, the reason for root canal failure is out of the control of the endodontist. There could be difficult curves inside the tooth, unexpected mini-canals branching off from the main canal, calcifications that can’t be penetrated, or other factors.

Even the leading endodontists in the world have had occasional failures that require apicoectomy. In some cases, the tooth can’t be saved at all and has to be extracted.

This blog is sponsored by York PA Dentist Dr. Donald Currie.

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Do white fillings last as long as silver?

Posted on April 21, 2012 by writeradmin

I had some old silver fillings replaced about five years ago by my old dentist. I’ve since moved to another state and my new dentist says they are cracking need to be replaced. He said he only places silver fillings because the white ones don’t last as long. Is that accurate? Because to be honest with you I really want to keep using white fillings because I hate the mercury in the silver ones. But, I don’t want to have to keep replacing them.

Janet S. from Maryland

Janet,

When white fillings (composite fillings) are placed correctly you will not have a problem with cracking. In fact, they bond to your teeth making them stronger than their silver (amalgam) filling counterparts.

More than likely the reason your new dentist is not comfortable with them is he is an old school dentist who hasn’t been trained on the new bonding methods. I would never push a dentist to do a procedure he is not comfortable with. Instead, I would look for a dentist who is experienced in placing composite fillings. In order to find a dentist like that I would call around and ask which type of fillings the dentist prefers to place on back teeth. You want someone who is comfortable with the procedure, so it can be done correctly.

If you go to an inexperienced dentist for this procedure, you’ll end up with lots of problems with your fillings.

This blog is brought to you by York PA Cosmetic Dentist Dr. Donald Currie.

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Discolored root canal tooth

Posted on March 20, 2012 by writeradmin

I have a front tooth that had a root canal a little over a year ago. Now my tooth has turned this ugly, dull yellow. What are my options? The tooth is otherwise healthy, so I don’t want to damage it any further.

Betsy G.-Orlando, FL

Betsy,

You have several options for a discolored tooth:

1. Teeth Whitening: If it is only done on the crown of your tooth, you won’t have to worry about weakening the tooth any further. Make sure you use a dentist who knows how to do this.

2. Porcelain Crown: Because you said your tooth is otherwise healthy, I wouldn’t recommend this option to you. Why ground down a healthy tooth?

3. Porcelain Veneers: This has very minimal shaving on your tooth and is more conservative than a crown. One work of caution– Matching a single front tooth takes an expert cosmetic dentist. Make sure you go to one with great credentials. One way to find an expert cosmetic dentist is to look on the mynewsmile.com website. They recommend only the best cosmetic dentists in each state. Dr. Currie is a recommended dentist with them and he had to submit all his qualifications as well as samples of his work, so he knows they don’t do these recommendations lightly.

For future reference with root canal treatment. If your dentist gets all root canal filling materials and cements from the inside of the crown of the tooth, the tooth won’t discolor for maybe ten years. Not all dentists know this so go armed with the information and protect yourself from this incident again.

This blog is sponsored by York Cosmetic Dentist Dr. Donald Currie.

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I keep breaking off teeth

Posted on March 20, 2012 by writeradmin

I keep breaking off teeth when I’m chewing. My dentist says it is because my teeth are out of line and he wants to do a full-mouth reconstruction. That would be 28 crowns for me! Do you think this is necessary for breaking off teeth.

Deborah- Kansas City

Deborah,

That would depend on why you are breaking your teeth. I might first check for “gorilla bite”. Your dentist can recognize this condition in a profile view. The bottom edge of your lower jaw will be practically parallel to the upper. This causes the muscles on the sides of the jaw, the masseters, to have a much stronger mechanical advantage and can generate much stronger biting forces. People with gorilla bite tend to have squarish faces, and you can see the large masseter muscles that make up their cheeks. Patients like this have a strong tendency to break off teeth, and great care needs to be exercised when restorations are created for them.

I would also be careful whom you pick to do a full mouth restoration. It is a very complicated procedure. Be sure the dentist you pick has extensive training in occlusion (TMJ Treatment). You might look for someone who has training from LVI.

If it is a case of gorilla bite, I would suggest a night guard. You are probably grinding your teeth at night, unaware, which weakens them. Combine that with a gorilla bite and you can see why teeth can break off. I would try this simple procedure before doing such an invasive procedure as full mouth reconstruction.

This blog is brought to you by York Cosmetic Dentist Dr. Donald Currie.

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No front teeth

Posted on January 10, 2012 by writeradmin

I am having to have my front teeth and a few back teeth pulled because of extensive decay. I have avoided dental care for some time and now I am paying the price. I’ve looked into dental implants, but the cost is pretty high. I was thinking about dentures, but wondered if they would look natural, or if I would look like someone with fake teeth.

Andrew- Washington

Andrew,

How natural your dentures look will depend on what cosmetic dentist you choose. That actually goes for almost any cosmetic procedure. The results depend on how artistic and “picky” the dentist is. With an excellent cosmetic dentist you can get dentures that are absolutely stunning and cannot be told apart from attractive natural teeth.

You are right that Dental Implants are more expensive. For some people they are just plain out of reach. They have some real benefits though, and if you can afford them, they are the treatment I’d recommend. First, dentures move around. No matter how tightly your dentist tries to get them to fit, there will be moments when food gets under them. There will even be days when the slip out of your mouth at embarrassing times. Implants avoid all of that because they are implanted directly into your jawbone. This also is the reason they prevent facial collapse.

If they are too far out of your budget, you might consider mini implants. They can at least stabilize your dentures.

This blog is brought to you by York Cosmetic Dentist, Dr. Donald Currie.

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My dentures make me gag

Posted on December 31, 2011 by writeradmin

I’m hoping you can give me some advice. I have a strong gag reflex. I got dentures about 8 months ago, but my gag reflex is so stong that I haven’t even put them in for the last six months. At first I just kept hoping I would get used to them, but when that didn’t work, I gave up. I hate having most of my teeth gone on the bottom, but I don’t know what to do.

Lisa. M-Pheonix

Lisa,

One of the best options for replacing missing teeth, without all the drawbacks of dentures is to get dental implants.  Not only will you have no gagging, such as you’ve had with your dentures, but there is no moving around or risk of it falling out during embarrassing times. It is like having your own natural teeth back.

Another advantage is you don’t have to worry about facial collapse. If you keep your dentures, even wearing them, in about 20 years your jawbone will have been almost completely reabsorbed into your body. Not only can that make you a denture cripple, but your face will looked scrunched up and you’ll have trouble eating. Implants prevents all these problems.

I hope this helps.  This blog is brought to you by York PA Cosmetic dentist Dr. Donald Currie.

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Can I replace one veneer?

Posted on November 11, 2011 by writeradmin

I have a wonderful set of porcelain veneers that are beautiful. One of them on the front has some exposed dentin and my tooth is occasionally sensitive. My dentist wants to replace that veneer, but I have two worries. 1. Will the veneers match? 2. Can it damage the natural tooth underneath to take the veneer off early?

Janice- San Francisco

Janice,

The answer to your first question depends on the quality of your cosmetic dentist. If you have an excellent cosmetic dentist, with a high artistic standard, then he will have no problem matching the color of your other veneers. The fact that you are thrilled with your veneers, combined with the fact that your dentist wants to replace the veneer with the exposed dentin makes me think you are safe. Another way to check is to look at the mynewsmile.com website. That site screens cosmetic dentists and lets you know how qualified they are. If your dentist is recommended there, you are certainly safe.

Your second question is even easier. Exposed dentin has tubules that go straight to the pulp, which is why your tooth is sensitive. You actually run more risk to the tooth by leaving this source of irritation than by re-doing the veneer.  The open tubules are a risk for bacteria getting into the pulp, which will lead to a lot of problems. You are safe having the veneer removed.

This blog is brought to you by York, PA cosmetic dentist Dr. Donald Currie.

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If Novocain doesn’t work, what are my options?

Posted on October 31, 2011 by kkzeluff

I hope you can help me with some good information. I really need reliable advice, and just can’t seem to find a dentist that I can really talk to about this.

I have always had a real problem with Novocain. Specifically, it doesn’t work for me. Not at ALL. I’ve been to no less than five different dentists in my life, and have not found one single one that believes me when I tell them this. I swear, I am not just being wimpy. Every single time I have to have Novocain, it doesn’t work to make my mouth numb. I can ALWAYS feel whatever the dentist is doing.

I’ve been avoiding going to the dentist for a couple of years now, and I have a pretty good idea that I need some significant work done. I have a dental bridge that is loose, and am pretty sure I have at least two cavities. I would like to have those white fillings, but my last dentist didn’t do them.

I really need a forward thinking, sympathetic dentist. How can I find one?

Thanks,

Toby in Orlando

Dear Toby,

Though it it not a well understood phenomenon, some patients have to be sedated before numbing drugs work for them. Increased anxiety decreases the effectiveness of drugs like Novocain, so sedatives are necessary to reduce the anxiety so the numbing drugs work.

You need to seek the services of a sedation dentist, to find someone who is sympathetic to the complex issues of pain and anxiety. You may also want to search for a “mercury free dentist“, to find a dentist who is trained and skilled in placing the white fillings you refer to.

Post courtesy of Dr. Currie, York PA cosmetic dentist.

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If I am taking Fosamax, what are my options to replace a front tooth?

Posted on October 25, 2011 by kkzeluff

I had to have one of my front teeth extracted. I’ve been wearing a flipper, but that has to go, and soon.

The dental surgeon who did the extraction said I might not be able to get a dental implant to replace the tooth, because I have been taking the medication Fosamax for years. If I had my choice, I’d like to go with a dental implant, but what are my other options?

I’ve seen some information about dental bridges that looks interesting. One kind that looked good was an Encore bridge, and another kind was a Maryland bridge. When I mentioned a dental bridge, though, my dentist said he is reluctant to file down one of my front teeth to place it.

I guess I feel like he is not really offering many options. Can you help?

Darius in Jacksonville

Dear Darius,

A dental implant might actually be an option for you. There is a slightly elevated risk of serious problems involving the bone at the site of the implant associated with Fosamax usage. Percentage-wise, the risk is small, but the consequences can be quite serious, so talk this option over carefully with your oral surgeon and your primary care physician. Perhaps it would be possible to discontinue Fosamax use on a temporary basis while you get the procedure completed.

If you decide that a dental implant is not worth the risk, a dental bridge would be a viable option. It is a little concerning that your dentist does not seem confident about this procedure when it involves the front tooth. You may want to seek the services of an experienced cosmetic dentist for this procedure, so you can be more confident of a positive outcome.

This post produced courtesy of York PA cosmetic dentist Dr. Currie.

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Could an infection in my tooth actually be dangerous?

Posted on September 30, 2011 by kkzeluff

Last Friday I was eating some peanuts and one of my back molars just broke in half. It is the tooth that is right before where my wisdom tooth used to be before I had them taken out. I don’t have any dental insurance right now, so I didn’t go in right away to get it looked at, but I have been in a lot of pain, and it isn’t getting any better. It is not just located where the tooth was. The pain feels like it is all over my face—in my sinuses, my nose, and now even in my temple and down my neck.

I don’t have any money for a dentist right now. I got some antibiotics and have been taking them, but as I mentioned things seem to be getting worse. Is there any kind of home remedy I can try? I started Goggling for information, but that is kind of freaking me out. One article said an infection in a tooth can actually be dangerous, and can spread to the brain. Is that true?

Thanks for your help,

Zane in Big Rapids, MI

Dear Zane,

You have reason to worry. An infection in your tooth can be very dangerous indeed, and from what you describe the infection is spreading. This is very serious and you need to get it taken care of right away.

And you should discontinue use of the antibiotics until you see a dental professional. The reason the infection is spreading is that oral antibiotics transmitted by the blood stream cannot address the source of the infection, which is inside your tooth where there is no blood supply. All you are doing by taking an antibiotic without addressing the source of the infection is make the bacteria that remain stronger and more resistant to treatment.

Call your local hospital and see if they have an emergency service that is free or reduced cost. From your signature, it appears that you live in a college town. If you are a student, go to the university’s health service and explain the situation. They should have some way to get you treated in a way you can afford.

You will almost certainly need a root canal treatment, and the broken tooth should really be covered with a porcelain crown. If the tooth is too far gone to be salvaged, it may have to be extracted. Ideally, you would replace that missing tooth with a dental implant, but that is quite expensive and will likely have to wait. You may want to consider a dental bridge.

This blog has been posted as a courtesy of the dental office of York PA cosmetic dentist Dr. Currie.

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