Emergency Dentist Archives | Dr. Currie's Dentistry Blog

Is it an emergency if a porcelain veneer falls off?

Posted on July 23, 2020 by goodtooth.

I am hoping you can help answer some questions for me about a problem with my porcelain veneer. It has been over 10 years ago now that I had 10 porcelain veneers placed on my top teeth. This was mainly to cover up my ugly tetracycline stains that I had since I was young.

I’ve always been happy with the way my smile looked after the veneers were done. But, I was disappointed when yesterday one of the porcelain veneers on one of my two front teeth split in half the long way. Then, it came right off.

I went in right away to see the dentist and they did a temporary fix by gluing the piece back in place. I don’t like the way it feels and it is really bothering me. I’m also feeling like it will break at any time. They told me they couldn’t address it for another five days. I was very frustrated when they told me this because in my opinion this is a dental emergency. The dentist explained that it typically isn’t considered an emergency since porcelain veneers are a cosmetic dentistry treatment.

Are they just not making my situation a priority? Or is this how most dentists will view a broken porcelain veneer? I am just trying to see if I have other options to get this addressed sooner.

Also, I am wondering if it would be best to get the porcelain veneer replaced or if a porcelain crown would work better? Since the veneer fell off once, I am wondering if the tooth can support a new porcelain veneer?

-Melissa in Maryland

Melissa,

Thank you for reaching out. Many general dentists will not consider a damaged porcelain veneer to be an emergency. However, if the dentist specializes in cosmetic dentistry, they will likely take a “cosmetic” emergency very seriously and make it a priority.

There is a fundamental difference between a general dentist and a true cosmetic dentist. In order to do excellent cosmetic dentistry requires extensive training beyond dental school. Less than 2% of dentists have the ability and skill to do beautiful work. The bonding techniques and skills are not taught in dental school. So, it sounds like the dentist you are seeing may not be an expert cosmetic dentist.

The dentist that placed your porcelain veneers in the first place sounds like he or she did an excellent job. That is mainly due to the fact that tetracycline stains are one of the most difficult issues to address. So, if you have loved your porcelain veneers for years, it is a good indicator that the dentist did great work. You haven’t said if this is the same dentist. But, based on the response, it may not be the case if he isn’t making it a priority.

A porcelain crown doesn’t sound like the best fit for this situation. If the porcelain veneer is done properly, there shouldn’t be any issue with it staying in place. All that to be said, you need to make sure the dentist has the skill to replace the porcelain veneer successfully. Not only does it need to blend in perfectly with the surrounding teeth, it needs to cover your stains.

In this instance, it would be wise to seek a second opinion if you aren’t positive the dentist you saw is an experienced cosmetic dentist. Whomever you choose needs to thoroughly understand the bonding techniques, chemistry and bonding agents to be successful. They also need to be passionate about creating a beautiful result. It sounds like the old bonding material needs to be completely removed so that the dentist begins with a clean surface. Or else make sure that the area is prepared properly, so the bonding adheres to the veneer.

Again, it’s worth your time and effort to find the best cosmetic dentist in your area. A seamless look will be very important since you are only replacing a single veneer.

Although you may feel this is an emergency, if you aren’t in pain and can deal with the inconvenience, it is important to take the time to find the right dentist.

This post is sponsored by York PA dentist Donald H. Currie, DMD

What do I do about my damaged tooth?

Posted on January 14, 2019 by goodtooth.

I bit down on an almond and my tooth started to bother me. Ironically, I had a cleaning the following week and I mentioned it to the dentist. He checked it out and didn’t see anything out of the ordinary. An x-ray was done and it didn’t appear that there was an concern. His advice was to take it easy on the tooth and chew on the other side of my mouth.

I did this for a couple weeks and my tooth is still bothering me. In fact, I feel like I am getting a tingly feeling in the area and my jaw hurts. He asked me about sensitivity to hot and cold when I was in and that doesn’t seem to be a problem for me. I have been taking ibuprofen every night because the pain is bothering me more then. I have this achy, throbbing that persists on and off at night.

Should I wait it out longer or do you think I need to go back to the dentist?

-Joe in Tennessee

Joe,

Thank you for your question. The symptoms you are having sound like they are worsening. The tooth may have been cracked or damaged weeks ago. It is possible that nothing showed up on the x-ray at the time. Also, there are times where a cracked tooth isn’t ever visible on an x-ray.

The main concern is the pain and throbbing you are experiencing at night. These problems are consistent with a tooth infection and a root canal may be required to save the tooth.

It is definitely time to get back into the dentist before you have an emergency situation. If an infected tooth is left untreated for too long there can be all kinds of complications. The infection can spread to other parts of your body and you may end up losing the tooth.

So don’t delay any longer! Hopefully, you will only require a root canal treatment and a crown to heal the tooth. The reason you are having pain is because the nerve inside the tooth is dying.

If the root is fractured, the tooth may end up being extracted. At that point, your options would be a dental bridge or a dental implant. Dental implants are a far more permanent solution and function just like your natural tooth.

Thank you for your question. Hopefully you can get in as soon as possible to get the tooth examined and taken care of.

This post is sponsored by Donald H. Currie, DMD, a dentist in York, PA.

I’m uninsured and need am facing a dental emergency – help!

Posted on September 15, 2018 by goodtooth.

My dad is uninsured and is dealing with a terrible toothache, which I fear will turn into a dental emergency if we don’t do anything soon. He doesn’t have dental insurance at the moment because he is unemployed. He cannot afford an expensive dental visit either. He has been putting it off for a couple weeks now and is trying to convince me it isn’t that bad. But, he needs to get it taken care of because I honestly think it may be infected. Do you have any tips on how to find an affordable dentist or some type of dentist that takes care of emergencies for uninsured?

-Pam in Kansas

Pam,

It sounds like your dad requires immediate care for his toothache. If he is in pain and you suspect infection, it would not be wise to keep putting it off. A tooth infection can spread and turn into a much more dangerous and expensive situation if it spreads.

It is understandable that he doesn’t want to see a dentist right now until he finds employment again. One thing he could try is calling around to see if there is a dentist that will work with him on payments. If you’re upfront about the situation, you may be surprised to hear that the dentist will split the fees into a couple appointments. Or if that isn’t an option, most dental offices offer financing options. One popular option is called CareCredit, which usually has zero percent, short and long-term affordable payment options.

If for some reason it isn’t as severe as you suspect, you may be able to find a dental insurance plan that he could pay as an individual. Often times, these self-pay plans don’t have waiting periods. However, some types of treatments do require waiting periods. So, be sure to look into the details of each plan, if you go that route.

If it is to the point where the pain is keeping him up at night, throbbing or he is avoiding eating, he needs to be seen immediately. If he has health insurance, he could see a primary care physician. The dental needs would not be addressed. But, the doctor would be able to tell him if he has an infection.

Without knowing exactly what is going on, it is difficult to give you specific treatment recommendations. It may be anything from a deep cavity to an infected tooth that requires a root canal treatment. If he puts it off any longer, he may end up losing the tooth. At that point, a dental implant to replace the tooth becomes an option and is much more expensive than addressing the need as it is now.

Hopefully, this information helps encourage him to get in to see an emergency dentist right away.

This post is sponsored by York PA dentist Donald H. Currie, DMD.

Should I schedule an emergency dentist appointment for a loose tooth?

Posted on March 7, 2018 by goodtooth.

I am wondering if a loose tooth is a dental emergency. I am such a klutz! When I was up on a step stool in the garage a couple nights ago, a can fell and hit me square on the mouth. I iced my face and I thought everything was fine. But, when I woke up today, one of my teeth feels pretty loose.

At first, I thought it was just in my head. But, I’m pretty convinced it’s wiggling now. I’m not having much pain. It’s just a bit sore. Do you think it will heal on it’s own? Or do I need to schedule an emergency dentist appointment to have it looked at?

-Heather in Kansas

Heather,

First off, you need to stop wiggling it and testing it. It is possible that the ligaments may have been torn or loosened. Think of it like a rubber band. Normally the ligaments that secure the teeth are kept nice an tight. But a trauma can cause them to stretch and even break. Therefore, you definitely want to call into your dentist and let them know what’s going on. They will likely want to see you as soon as possible.

Leave it alone, as much as possible. Any more strain on the ligaments and you may cause irreversible damage because they may break. If you get in right away for an emergency dentist appointment, the tooth can be stabilized. Sometimes, the dentist will actually bond them to the surrounding teeth to keep them still. Or they may use another method to form a splint to keep it secure. If this is taken care of immediately, then there is a chance that the ligaments will heal.

However, if the inside pulp of the tooth is damaged, than you may require more invasive treatment. A root canal treatment may be a possibility after the movement of the ligaments has subsided. Then, after the root canal, typically a porcelain crown is placed over the existing tooth for protection.

The first action is to get the tooth stabilized. Then, it can be assessed from there. Until you are able to get in to see the dentist, eat very soft foods and avoid touching it. If there is any inflammation or swelling around the tooth, it may impact the surrounding teeth too. Ibuprofen will help manage the swelling.

It’s difficult to assess the level of damage without seeing you in person. So, if it’s only some minor ligament issue, your tooth will be okay in a couple weeks time. However, if the damage is more extensive, you may require multiple follow up appointments so the dentist can monitor the healing and recommend additional treatment as needed.

This post is sponsored by York PA dentist Donald H. Currie, DMD

Canker sores suck! Will an emergency dentist help?

Posted on December 30, 2017 by goodtooth.

Usually my canker sores don’t bother me too badly. However, I am really struggling this time. I don’t even want to eat because it’s gotten so bad. It seems much larger than normal, about the size of a pea. Also, it has some white on top. Is that normal?

Would an emergency dentist be able to help with a canker sore?

-Gerald in Connecticut

Gerald,

It sounds like you have had canker sores before. Even though this one sounds terrible, it may not be time to visit an emergency dentist just yet.

Generally, canker sores will heal without intervention in under a two weeks. It will be a matter of managing the discomfort until it has healed.

Over-the-counter canker sore remedies

Most drug stores have a selection of products that can help provide pain relief. Check out the oral care aisle for an anesthetic. These products will help numb or lessen the pain.

You may also find canker sore care products that are designed to cover and protect it. Usually these are in a little tubes or gel pads. These types of covering products may be difficult to keep in place. But, they may be helpful in providing protection for short times, which may enable you to eat a meal without pain.

If the area becomes infected, you will want to find a product with antiseptic to disinfect the area, which most of these products will have already. Many people say that Listerine or a mixture of half hydrogen and half peroxide will also to the trick.

Canker sores can be caused by many things, so it’s difficult to figure out the culprit. A cut or bite on the soft tissue, stress, rubbing from a dental appliance, or in some cases allergies can cause them.

If canker sores are a frequent issue, it would be wise to schedule an appointment with your dentist or other healthcare professional to rule out anything more serious.

Also, if this canker sore fails to resolve itself, it would be good to schedule an appointment with your dentist. Although, it doesn’t need to be an emergency dental appointment. Just call in and explain the situation and see when you may be able to get in.

Good luck!

This post is sponsored by York PA dentist Donald H. Currie, DMD

Did the emergency dentist mess up?

Posted on October 30, 2017 by goodtooth.

I finally broke down and went to see an emergency dentist about my tooth because of the terrible pain. I kept putting it off because I hate the dentist. Sadly, I’ve been dealing with the pain on and off for a couple months now.

My brother had similar symptoms and he put if off for over a year. But, eventually he needed a root canal. So, I assumed that my tooth was doomed to the same fate.

The pain was unbearable over the weekend, so my husband made me go to the emergency dentist. But, I was shocked when he did a crown instead of a root canal. I had the same symptoms as my brother, so why didn’t he do the root canal?

-Pam in Texas

Pam,

First off, please don’t put off going to the dentist for that long. The sooner a dental issue is discovered and treated, it can often be treated more conservatively and economically. Next time, go in right away at the first symptom that something isn’t right.

Causes of Tooth Pain

Toothaches can be a symptom for many different issues. For example, discomfort could be caused from something as minor as a cavity to the more extreme cases like a cracked, broken or tooth infection, which may require a root canal.

Typically, when decay reaches the inside pulp of the tooth, a root canal is required. There is nowhere for the infection to go and sometimes an abscess forms and it must be treated. Symptoms of a root canal are throbbing, radiating pain and extreme sensitivity to heat and cold. Sometimes, the pain is so bad it will keep you up at night.

Although, everyone has different pain thresholds, so it is not reliable to diagnose a tooth solely on pain.

The emergency dentist treated the tooth based on what was seen during the appointment. The treatment rational should have been explained to you at the time. So, you could always follow up and ask more questions about the treatment plan.

You mentioned that a crown was placed. It isn’t clear if you are referring to a temporary crown or some sort of temporary solution, until you are able to get the permanent crown done at your regular dentist? Also, you didn’t mention if the pain went away.

Since there are still some questions, it is unclear whether or not the emergency dentist treated the tooth properly. It would be good to touch base with your regular dentist to discuss it further too.

This post is sponsored by York PA dentist Donald H. Currie, DMD

This emergency dentist won’t fix another dentist’s crown.

Posted on September 13, 2017 by goodtooth.

I decided to see an emergency dentist for a broken crown. It has been ailing me ever since it was placed. Several months ago, a big piece came off. This was really discouraging since I thought a porcelain crown was supposed to last for many years.

I got sick of dealing with it because it has caused me a lot of discomfort. After going back several times to have it adjusted, I decided to try a new dentist. Since it is uncomfortable, I decided to treat it like a dental emergency.

They got me in right away, which was really nice. But, the dentist refused to re-cement it back in place. Ultimately, he was recommending the crown be replaced. I’m so frustrated that I’m looking at the expense of a new porcelain crown in less than a year.

Do I have any other options?

-Mike in Iowa

Mike,

First, I’m sorry you are having so much difficulty with your porcelain crown. It is no surprise that you are frustrated. A crown should last for years and it sounds like this one was not done properly.

Every dentist will have a different opinion and sometimes varying recommendations. So, if this new dentist feels that replacing the crown is best, there is likely a reason for it. For example, you mentioned the porcelain was broken. It is possible it cannot be fixed.

You have a couple options. You could go back to the original dentist and see if they will fix it. That is the most cost effective option. Although, it sounds like he has never got it right. So, that may not be in your best interest.

So, you may be able to use the new dentist as leverage. A typical crown should last for at least five years. You may be able to tell your old dentist that you would like the crown replaced elsewhere and request a refund. You could state that it does not meet the standard of care. Refunds can be tricky and there are not guarantees. But, it is possible you may be able to get him to pay for a partial refund.

Otherwise, you may have to cut your losses and have the work redone. You don’t want to continue walking around with a broken crown. Your tooth is at risk for decay and eventually it could lead to a tooth infection.

Sorry this has happened. Hopefully, you will get the crown replaced and you won’t have to think about it for years to come.

This post is sponsored by York PA dentist Donald H. Currie, DMD

Is my tooth really dying or is the emergency dentist crazy?

Posted on August 13, 2017 by goodtooth.

My tooth was killing me over a weekend, so I decided to get into an emergency dentist. I didn’t really have a regular dentist, so I thought it would be good to get into someone who routinely deals with emergencies.

At the appointment, he told me my tooth was dying and recommended a root canal. It sounded like it was my only option, so I went ahead with the root canal. But, I expected the pain to go away. That’s why I went in to begin with – right? Well, it never really went back to normal.

When I went back into see him, he said the tooth was fine after doing x-rays. Then, he went on to tell me the pain was in my head. I’m not crazy, but I’m thinking he is crazy! No, the pain is not in my head!

After all that, he said he couldn’t help me anymore and recommended I see a neurologist. Was he just trying to get rid of me? I still am dealing with the pain and it’s getting annoying.

-Paul in Nevada

Paul,

Well, it sounds like the dentist that addressed your dental emergency may not be the most genuine. But, you may have misinterpreted what he was trying to say. He may not have meant it was in your head.

Seeing a neurologist to further examine the nerve after a root canal, isn’t unheard of. It isn’t common, but it will happen from time to time. Nerve damage can feel like you have a toothache.

There are other factors to consider. Toothaches can come from other issues, like sinus pain or infections. Tooth roots actually extend quite far into your nasal cavity, so they sometimes can feel like a toothache. But, if you don’t have other symptoms, like a head cold, then it may not be the case. If you do think it may be a possibility that your sinuses are the culprit, a general physician may be the better fit. Decongestants or antibiotics would address that possibility.

Ultimately, you aren’t crazy. But, neither is the emergency dentist. However, you shouldn’t have to deal with the pain.

Since the emergency dentist did another x-ray and found the tooth to be fine, it may be time to see another specialist. Although, it is possible that the root canal was unsuccessful or he may have missed something. Roots are tricky. And sometimes a toothache can refer pain from one tooth to another. So, although the tooth hurts, it may be another tooth entirely.

This probably doesn’t help you feel much better because you are still in pain. You may benefit from getting a second opinion at another local dentist. This way you can confirm that the tooth is indeed okay. But, it is imperative you don’t tell him your history. You want the new dentist to form an independent opinion. Then, you’ll have more direction as to see the neurologist or the primary care physician next.

Unfortunately, there is not clear answer in cases like this. Best of luck!

This post is sponsored by York PA dentist Donald H. Currie, DMD

Oh my word! The emergency dentist punctured my sinus!

Posted on June 15, 2017 by goodtooth.

I was freaking out from the pain in my mouth. So, I decided to see an emergency dentist. He told me it was a molar. And since my teeth weren’t in good shape and couldn’t be saved, he told me he’d remove booth molars.

I just wanted the pain to stop. So he gave me nitrous oxide and the rest is history. The teeth were extracted and all seemed fin. But, several days later I felt an odd sensation in my nose on the same side as the dental work was done. The emergency dentist told me to take an over-the-counter decongestant. So I did.

The next morning, I had a terrible fever. So, I called them back. They didn’t give me any other information about the cause. But, they did order me an antibiotic.

Fast forward a week and I couldn’t get this terrible taste out of my mouth. This time when I called, they asked me to come in. Finally, he told me what was up. It turns out that my sinus was perforated. Is this normal? He ended up removing bone fragments and told me to keep up on the antibiotics.

It’s now two weeks later. My face hurts, I have gunk coming out of the extraction sites and I even have junk coming out of my nose. I have had it with this emergency dentist. I’m feeling very scared. What do I need to do? Who should I see to get this taken care of?

-Drew in Nebraska

Drew,

It sounds like a lot of thing didn’t go right during dental emergency appointment. A sinus perforation isn’t normal, but can happen. But, the standard protocol is not to simply prescribe antibiotics. You should have been seen right away. Then, when the perforation was discovered, there should have been a follow up to ensure your healing was on track.

From the beginning, you should have been informed of the risk involved with extracting your molars. For example, small actions like blowing your nose or other things that cause pressure can increase your risk.

So, you are right in not wanting to return to the emergency dentist at this point. You have a nasty infection from the sounds of it. The antibiotic isn’t working. Otherwise, you would feel like things were improving.

It’s time to get in for an emergency appointment with an ENT (ear, nose, throat) specialist. They will be able to put you on the correct antibiotic, as well as pursue additional treatment if needed.

In most cases, a sinus perforation heals just fine. But, it sounds like yours has not. Just be aware that you may be required to have surgery at this point, if it doesn’t start improving. Until you can get in, be very careful and avoid extra pressure to the area. Get in right away!

This post is sponsored by York PA dentist Donald H. Currie, DMD

Is a sinus perforation issue a dental emergency?

Posted on April 24, 2017 by goodtooth.

I had all my teeth extracted and now I’m wondering if what I’m dealing with is a dental emergency? The ultimate plan is to have my teeth replaced with a mix of dental implants and dentures. Anyway, it turns out that I had a sinus perforation. I went back in and the dentist took care of it by closing it up. But, it’s been several days after that appointment and I have some clear fluid coming out of my nasal cavity. I can’t breathe out of that side either. Nothing is relieving the congestion. I’ve tried over-the-counter decongestants and nothing is working. Steam in the shower with saline rinses aren’t helping either. After all this, the last thing I want to deal with is a dental emergency. Also, I am on antibiotics since the perforation was discovered. What should I do?

-Lance in Arizona

Lance,

It’s time to see an ear, nose and throat specialist. So far, your implant dentist has taken the proper steps to resolve the sinus perforation. But it’s time to have that sinus issue examined further. Get in touch with your dentist and ask for a referral to an ear, nose and throat doctor. It could be as simple as a change in antibiotics, or as serious as a piece of bone or tooth fragment that has been displaced. Although it wouldn’t be considered a dental emergency yet, it is important to get it taken care of asap. If you are seeing liquid draining from the site, you may have developed an infection.

Sinus perforations are not that uncommon when teeth are extracted. The dentist could have done everything correctly, and sometimes it still occurs. It sounds like the dentist closed it surgically, which is the correct course of action. Yet it would be in your best interest to make an appointment with an otorhinolaryngologist. Thank you for your question.

This post is sponsored by York PA dentist Donald H. Currie, DMD