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Sedation Dentistry posts

Antibiotics Are Not Helping My Throbbing Toothache

Posted on by AllSmiles.

Last Wednesday, I saw a dentist who takes emergency patients. I don’t have a dentist of my own. My top left second molar is throbbing, and the gum around it is very swollen. It hurts just to touch it. I can’t get a toothbrush anywhere near it. The emergency dentist gave me an antibiotic, but I don’t have any relief from it at all. My tooth hurts, and my ear and face on the left side ache too. Today I started feeling a little nauseous, which is beginning to scare me and increase my anxiety. Should this antibiotic have kicked in at all, or do I still need to get help? I don’t like the idea of returning to the same dentist because he didn’t check out my tooth thoroughly. He just rushed me out of the office with a prescription like he had an emergency of his own. Thanks for your help. Franz P. from Nashville, TN

Franz – If you have no improvement with your tooth and are not pleased with the treatment you received last week, quickly but carefully find another dentist.

What Should You Do When a Toothache Doesn’t Improve?

When a throbbing toothache does improve, it is infected. It will not improve until a dentist removes the infection with root canal treatment. Although a dentist gives you antibiotics, the medication does not remove an infection from your tooth.

  • During root canal therapy, a dentist will do the following
  • Apply a topic anesthetic to numb your gums
  • Inject a local anesthetic
  • Make a small opening in your tooth
  • Clean out the infection
  • Disinfect the tooth
  • Replace the tooth pulp with a dental filler material
  • Seal the tooth
  • Protect it with a temporary crown
  • Order a lab-made crown
A young woman lying in a hammock that is tied to palm trees alongside the ocean; for information on how relaxing sedation dentistry should be.

Sedation will help you relax during root canal treatment

Look for a dentist experienced with root canal treatment and explain your anxiety. The dentist will examine and x-ray your tooth, confirm the diagnosis, and explain your options for sedation to help you relax. Dentists experienced in root canal treatment are gentle and make treatment painless. Don’t delay. The infection will worsen and get more painful with time.

Dr. David Finley, a Monroe, Louisiana dentist and Fellow of the Academy of General Dentistry, sponsors this post. Read about Dr. Finley’s commitment to providing patients with some of the best dental care in Monroe.

 

Is Wisdom Teeth Removal Worth the Risk for Me?

Posted on by AllSmiles.

Pensive African American woman portraying concern over sedation and wisdom teeth removal.I still have all my wisdom teeth. I am 42 years old, and after my last dental x-ray, my dentist said that two teeth are partially impacted. One tooth has a cavity and is impacted by the bone and gums. My dentist referred me to an oral surgeon for an evaluation. The surgeon said that my tooth roots are long, so nerve damage is a risk. Also, my dentist says that one impacted tooth is angled beside a root canal tooth. I am anxious about dental appointments anyway, and I have never had any surgery. Is it worth the risk? Thank you. Alexis from Savannah, GA

Alexis,

Thank you for your question.

Anxiety About Wisdom Teeth Removal

Although wisdom teeth removal is a common procedure, your anxiety is not unusual. Tooth roots lengthen as we age, thicken in dense bone, and sometimes get entangled in nerves. Removing the teeth becomes increasingly complex and risky the longer you wait. Still, you can have successful wisdom tooth removal. It is a common surgery, and oral surgeons and dentists trained in oral surgery remove impacted wisdom teeth regularly.

Wisdom Teeth Removal Risks

Oral surgeons and dentists with oral surgery training must explain the risks of wisdom teeth removal, including teeth that are entangled in nerves or affecting other teeth. Usually, a skilled oral surgeon can navigate nerves and avoid long-term damage. Remember, a dentist with oral surgery training and experience and oral surgeons complete thousands of wisdom teeth extractions.

An impacted tooth with a cavity will eventually spread the infection to your gums, bone, and adjacent teeth. So, removing it is wise. An angled wisdom tooth beside a root canal tooth requires extra care. When practical, an oral surgeon will cut a tooth into sections for easier removal and to decrease the risk of damaging adjacent teeth. After examining a 3-D CT scan of your teeth, the oral surgeon may recommend removing all your wisdom teeth to prevent future problems and another surgery.

Sedation for Wisdom Teeth Removal

An oral surgeon or dentist may use a local anesthetic and a sedative for wisdom teeth removal. The local anesthetic will numb your gums and teeth. Oral or IV sedation can relax you and block pain. Speak with an oral surgeon or a dentist trained in oral surgery about sedation options during wisdom teeth removal. Also, ask questions about your concerns to increase your comfort in wisdom teeth surgery.

 

Monroe, Louisiana dentist Dr. David Finley sponsors this post. Dr. Finley is a Fellow of the Academy of General Dentistry.

Are Painful Deep Cleanings My Only Option?

Posted on by AllSmiles.

I am considering interrupting my dentist’s treatment plan, but I am unsure how to do it or where to begin afterward. My teeth are sensitive after three deep cleanings that do not seem to help. My tooth pockets seem deeper than over. They only make the pain worse. Although I did not have dental anxiety before deep cleanings, my teeth are so sensitive not that I cannot bear the cleaning without sedation. I am unsure what to look for in a new dentist. Can I expect a similar treatment plan with another dentist? Where do I begin? – Thank you. Quinten from MD

 

Quentin,

Thank you for contacting our office

You have an advanced case of gum disease that requires immediate attention before it ruins your teeth. Dr. Henderson or Dr. Finley would need to examine your teeth and gums to determine why you are in so much pain.

How to Increase Comfort of Deep Cleanings

You can increase the comfort of deep cleanings if your dental team applies a local anesthetic before deep cleaning to minimize your discomfort. Your gums are already infected and inflamed, and your teeth are sensitive. And if your anxiety level requires it, you can ask for sedation.

Deep cleaning can provoke infection and pain. If that is what you are experiencing, you may need antibiotics to control the disease until completing a course of treatment. A dentist or periodontist (gum specialist) will need to examine your teeth and gums and develop a treatment plan.

Man sittng up in a hammock on the oceanside portraying relaxation with sedation dentistry

Sedation can help you relax for deep cleanings

We recommend that you schedule an appointment with another dentist. You can request a second opinion, but you will eventually need an exam and x-rays. Depending on the dentist you choose and their depth of training in gum disease, they may be able to complete your treatment. Otherwise, the dentist will refer you to a specialist for further care.

Depending on how comfortable you are with finding another general dentist, you may choose to self-refer to a specialist. And if you need to coordinate care with a general dentist, the specialist can recommend one.

 

Monroe, Louisiana dentist Dr. David Finley sponsors this post. Dr. Finley is a Fellow of the Academy of General Dentistry.

Why Are My Teeth Showing at the Top of My Veneers?

Posted on by AllSmiles.

My veneers are three years old. When I got them, I loved them. Actually, I have really loved them for the past 2 1/ 2 years or so. Probably last July or August, when I was brushing and flossing my teeth, I noticed that I could see the tooth above the veneer on two teeth, my center front tooth and the one behind it. I guess it looks as if the veneer has slid down from my gums, so the teeth are showing beneath. This sliding, or whatever it’s called, makes the two veneers longer than my other teeth at the bottom. Now it’s happening on my front right tooth. It is not noticeable yet, though. I moved from NY to Georgia last February.

I have a cosmetic dentist who told me that veneers need to be gently removed and bonded again, but I am not sure that this is the answer. What is the right treatment for veneers that start sliding down, and why is this happening? Will the dentist need to remove all my veneers and re-bond them? Last summer, I began caregiving for my mom, and my anxiety level is higher than ever. I am not sure if I can get through removing veneers and putting them back on. Thanks. Fisher

Fisher,

Dr. Finley or Dr. Henderson would need to examine your teeth and veneers to determine the issue’s exact cause. But we will explain some possible reasons.

What Causes Natural Teeth to Show Above Porcelain Veneers?

Man sittng up in a hammock on the oceanside portraying relaxation with sedation dentistry

Sedation can help you relax while getting your porcelain veneers re-bonded

If your natural teeth are showing above your veneers, two possible causes are gum recession or the bonding process.

  • Gum recession – It may be that you are experiencing the natural process of gum recession. As we age, our gums recede. Sometimes, gum disease can cause gum recession. If this is the issue, an expert cosmetic dentist can use composite material to fill in the space at the gumline. Or, the dentist may contour your gums, remove the veneers, and re-bond them.
  • Bonding technique – If a dentist does not bond veneers securely, they may begin to separate from your teeth. The cosmetic dentist may need to remove and clean the veneers and bond them again. Bonding porcelain veneers requires technique and skill. Sometimes, aggressive tooth preparation can cause veneers to loosen.

Find an experienced cosmetic dentist for an examination and discuss your options. Speak with them about your anxiety, and they will explain sedation options to keep you comfortable during your appointment. You may want to consult with more than one cosmetic dentist to ensure you get the best resolution.

 

Dr. David Finley, an accredited Fellow of cosmetic dentistry in Monroe, Louisiana, sponsors this post.

What If I Don’t Want IV Sedation at the Dentist?

Posted on by AllSmiles.

I am super nervous at dental appointments. I know I need help to bring me down a few notches. Still, I am a little afraid to be unconscious at the dentist. Something just doesn’t sound right about that. My sister told me that IV sedation is not general anesthesia, but I could fall asleep. Why do I need an IV for sedation anyway? I saw a dentist two days ago who says he uses nitrous oxide and IV sedation. He recommended IV because my anxiety level is moderate to high. But what if I don’t want an IV? The thought of an IV is making me more nervous than the dental appointment. Thanks. Tyra from VA

Tyra,

Your sister is correct. General anesthesia makes patients unconscious, but IV sedation does not. When you receive IV sedation, a commonly-prescribed sedative is administered through your veins. Many patients fall asleep during treatment. Others are simply deeply relaxed.

Is Dental Sedation Through an IV Your Only Option?

IV sedation is one type of relaxation that dentists offer, but it is not your only choice. Although IV sedation works faster, many dentists provide oral medication to help you relax.

Woman's face with eyes closed at the dentist, perhaps after receiving sedation.

IV sedation is not the only option for dental anxiety


Someone would need to drive you to and from the dental office. You would take an anti-anxiety medication, such as Valium or Halcion, about an hour before your appointment. But during the dental procedure, your vital signs are monitored. So, the dental team will give you proper attention.

You can consider having a consultation with a dentist who offers oral sedation. It will allow you to ask questions, learn more about the procedure, and discuss your concerns with the dentist. The more information you have, the more comfortable and confident you will be during your dental procedure.

David Finley, DDS of Monroe, LA, sponsors this post. Dr. Finley is a Fellow of the Academy of General Dentistry.

Please let me know what to do about a broken tooth. No dental insurance.

Posted on by AllSmiles.

Young woman holding the side of her face - perhaps with a broken tooth and no insuranceI have a tooth that was rotten and smelly. I thought it was completely dead, but it broke last Saturday while I was eating, and now it is starting to hurt. Since that time, the pain only increased. I am taking Advil for it, but other than that, is there anything that I need to do? Since the pandemic, I have not been to a dentist, but before that, I never had a dental appointment without needing laughing gas. I know that is an expense that I cannot handle right now. My daughter is sick, so I had to reduce my schedule to part-time work, so I cannot see a dentist. What kind of antibiotic can I ask my doctor for until I can afford a dentist? Thank you kindly. Olga from GA

Olga,

Thank you for your question.

Although you don’t have dental insurance, you need to see a dentist promptly. If the broken tooth is hurting, it is probably infected. If a dentist does not treat the infection, it will spread, and you can start having problems with nearby teeth.

Will Antibiotics Get Rid of Your Tooth Infection?

Even if you take antibiotics, they will not get rid of the infection. They will temporarily control the infection until you stop taking the medication. Eventually, you can develop antibiotic resistance, and the condition will get worse. And you will not be able to take pain medication indefinitely without it harming your health.

No Dental Insurance and a Broken Tooth

Many dentists have patients that don’t have dental insurance. Some dentists have discount plans or offer financing or payment plans to make treatment affordable for you. Find a few dentists in your area who will work with your budget. If you have no funds, look for a dental clinic or dental school that might offer free care. And explain your dental anxiety and that you need some sedation to complete the procedure.

David Finley, DDS of Monroe, LA, sponsors this post. Dr. Finley is a Fellow of the Academy of General Dentistry.

Are some cavities too deep for white fillings?

Posted on by AllSmiles.

Photo of a young woman who has received sedation dentistry and is relaxing in the chair during treatment.

Find a dentist you can trust to do quality work while you’re sedated

My dentist relocated to Florida, and a new dentist bought the practice. I have cracked silver fillings in three upper molar teeth. After the dentist recommended replacing them, I asked for white fillings. The dentist said that white fillings would not work because the cavities were too deep. I did not think white fillings were only for small cavities because my previous dentist mentioned replacing all my silver fillings with white ones. Are some cavities too deep for white fillings? The thought of the dentist drilling through my teeth for silver fillings makes me nervous. – Lydia

Lydia,

Thank you for choosing our office for your question.

Are Some Cavities Too Deep for White Filling?

A dentist can use white (composite) fillings for deep cavities. The deeper the cavity, the more it makes sense to use composite. Amalgam (silver) fillings increase tooth sensitivity to heat and cold. Deep fillings conduct more temperature changes to teeth.

Also, deep fillings are usually wide and make cavity walls thinner. Composite fillings strengthen cavity walls, but amalgam will weaken the walls and increase the risk of tooth fracture.

Check with your dental insurance company to verify if your plan provides any coverage for white fillings. Some insurance plans only contribute toward amalgam filling because they cost less.

Look for a Cosmetic Dentist

Placing composite fillings requires more skill and time. Look for a dentist with cosmetic dentistry training who understands the techniques needed to keep your teeth dry throughout the process and ensure good bonding between the tooth enamel and composite. When a dentist places composite fillings well, they are healthy for your teeth and will last for years without cracking.

A skilled dentist can use local anesthesia to prevent you from feeling pain during the procedure. But if your anxiety level is high, speak with the cosmetic dentist about helping you relax with sedation.

 

David Finley, DDS of Monroe, LA, sponsors this post. Dr. Finley is a Fellow of the Academy of General Dentistry.

What Type of Sedation Will I Get for Impacted Wisdom Teeth Extraction?

Posted on by AllSmiles.

Brunetee man with beard holding the right side of his face - for information on sedation and impacted wisdom teeth from Monroe, LA dentist David FinleyWhat kind of sedation would I get for wisdom teeth extraction? Three of my wisdom teeth are impacted, and I put off getting them removed. They are hurting more than ever, and I know I will have to do something soon. I’m afraid of any surgery, and I hate dental visits. When I saw my dentist almost two years ago, she told me that wisdom teeth need extracting. She said I would have sedation, but I also hate the thought of being out of it and not in control or not knowing what people are doing to me. Will a dentist ask me what type of sedation I want (I am not even sure about that), or do they just give every patient the same thing? I am worried about having too much sedation, but not enough sedation is scary, too. I’m sorry for rambling. Thank you. Colby from GA

 

Colby,

Thank you for your question. We understand that many patients have dental anxiety, so you do not need to apologize for your concern.

What Type of Sedation Is Used for Impacted Wisdom Teeth Extraction?

Most impacted wisdom teeth extractions only require a moderate level of sedation with conscious or IV sedation. The American Society of Oral and Maxillofacial Surgeons confirms that moderate sedation is preferred for impacted wisdom teeth extraction.

How Age Affects Wisdom Teeth Extraction

Our jawbone is somewhat pliable when we are young, and tooth roots do not have as much solidified connective tissue anchoring them in the jawbone. So, wisdom tooth extraction is easier for a dentist or surgeon. As we age and the jawbone becomes more rigid, extractions can take longer. But a skilled dentist or oral surgeon can perform the extraction easier than a dentist with limited experience.

Reasons Other Than Pain to Extract Wisdom Teeth

Although impacted wisdom teeth can be painful, other reasons to extract them include:

  • Teeth that will not erupt properly trigger a gum infection
  • Infection can spread to nearby teeth
  • Impacted teeth can move other teeth and create misalignment issues

Schedule a Consultation

We recommend scheduling a consultation with your dentist or oral surgeon to discuss your concerns about wisdom teeth extraction and sedation. Understanding the process and getting clear explanations can help some of your anxiety. And sedation will help you remain calm throughout the procedure.

David Finley, DDS of Monroe, LA, sponsors this post. Dr. Finley is a Fellow of the Academy of General Dentistry.

Can I remove a loose root canal post before replacing the filling?

Posted on by AllSmiles.

In 2017 I had a root can on my top left, second molar. I have severe dental phobia and probably could have prevented the root canal if I had gone to the dentist sooner. The dentist sedated me for the root canal. It went fine, but I have not been to a dentist since. Last week, the cap fell off the root canal tooth. I can see a metal rod in the tooth, and it is loose. Can I remove the rod, or will it fall out by itself? I bought some DenTek tooth filling material from the drug store. I would hate to go back to a dentist and get sedated if I do not need to. Thank you – Jason from NV

Jason,
Thank you for your question.

What to Do When a Root Canal Filling Falls Out

Root canal filling seals saliva out of your tooth and prevents reinfection and root canal failure. If you leave the tooth untreated, fluid and saliva will leak into it and loosen the root canal filler material. When root canal filling falls out, a dentist must replace it. You would need repeat root canal treatment to save it.

A temporary root canal filling material from a dentist can protect your tooth. But don’t use DenTek. Your tooth may already be irritated, and you can make it worse. A dentist will recommend a dental crown, which you can get later.

What About Removing a Root Canal Post?

Putting a metal post and filler material lasts for several years but eventually loosens, as you have experienced. If a post is showing in the tooth, please do not remove it. Removing it can damage the filler material and increase the risk of needing repeat root canal treatment.

See a Dentist Instead of Self-Treating

A young woman lying in a hammock that is tied to palm trees alongside the ocean; for information on how relaxing sedation dentistry should be.

Explain your anxiety level to the dentist, and he can offer the appropriate level of sedation

Schedule an appointment with a dentist right away and explain your anxiety during dental appointments. The dentist will use a level of sedation to match your anxiety. We hope the dentist can save your tooth with the existing root canal treatment. But delaying getting the hole sealed—or trying to take care of it yourself—will make your tooth worse. And it can become painful.

David Finley, DDS of Monroe, LA, sponsors this post.

Why did my new Maryland bridge break twice?

Posted on by AllSmiles.

My dentist placed a Maryland bridge in March, and since that time, he replaced it twice. Is it unusual for this to occur? I cannot keep it in my mouth without falling apart. And the problem is that I am inn the middle of a treatment plan. If I leave this dentist, the work will be incomplete. I’ve already spent almost $9,00 at this practice. And I had to pay out-of-pocket costs for sedation that my insurance would not cover. My anxiety about switching dentists and prolonging the work is overwhelming. Why might a Maryland bridge repeatedly break? – Thank you. Kennedee

Kennedee,

If your dentist cannot keep your Maryland bridge in place, it is time to switch dentist. You have spent enough money at the practice.

What Is a Maryland Bridge?

A Maryland bridge is an oral appliance. Two etched metal wings suspend a false tooth in the middle. After a dentist etches the backs of teeth adjacent to the missing one, they place dental composite between the wings and the back of your teeth.

Why Does a Maryland Bridge Fall Off?

A Maryland bridge can fall off prematurely due to poor design or faulty bonding technique—or both. Your dentist can return the bridge to the laboratory to etch it again, replace the wings, or both.

Get a Second Opinion

Woman's face with eyes closed at the dentist, perhaps after receiving sedation.

Sedation dentistry will help you relax

We recommend that you schedule a second opinion with an accredited cosmetic dentist to examine your teeth and Maryland bridge. You can switch dentists in the middle of treatment. Your dentist is ethically and legally obligated to release your dental records. And speak with your dentist about a refund for your Maryland bridge because it does not work.

After an examination, your new dentist will recommend treatment options for replacing your missing tooth, which may or may not include a Maryland bridge.  Your cosmetic dentist will understand your anxiety and explain your sedation options.

David Finley, DDS of Monroe, LA, sponsors this post.

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