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Dental

Apr 30

Is surgery usually recommended for gum disease?

By Gum Disease, Oral Health

I have 4 crowns that I got in 2002. My gums are inflamed around all of the crowns. The inflammation became noticeable in January. My dentist has tried antibacterial liquid. She asked me to start flossing 2 times a day. The gums around my natural teeth are fine. It’s just the teeth that have crowns that are presenting the problem. My dentist is suggesting gum surgery to trim my gum tissue. She says it might not work but if there is a problem with the way the crowns fit, trimming my gums will help. I’m wondering why after 15 years there would be a problem with the way my gums fit. For some reason, after examining my teeth and gums my dentist is confident that I don’t have gum disease. That’s somewhat of a relief but I am wondering what’s going on. If she isn’t sure that gum surgery will work, why is she recommending it? Is this normal procedure? Thanks. Norm

Norm – Gum inflammation that is around teeth with crowns, but not around your natural teeth, can result from several issues.

Some possible causes are listed below, but in each case, the reaction would be immediate. It wouldn’t take 15 years to surface:

  • The area around the crowns wasn’t thoroughly cleaned and left free of cement.
  • The crowns don’t fit correctly.
  • The crowns fit too deeply below the gumline.

Other possibilities that are not necessarily immediate include:

  • Metal sensitivity to porcelain-fused-to-metal crowns.
  • Periodontal (gum disease) that can be related to your oral health or your general health.

If you have gum disease, the treatment includes regular, deep cleanings to remove plaque and bacteria from the pockets between your teeth and gums. Gum surgery is not the first resort. If your dentist doesn’t understand how to address the problem, you should be referred to a periodontist—a specialist in gum tissue.

Your dentist hasn’t referred you to a periodontist, so it’s probably best to find one on your own. You can look for online reviews or call other dentists’ office to ask which periodontists they use for their own patients. Don’t allow your dentist’s lack of understanding to delay you from getting help.

This post is sponsored by Naperville dentist Dr. Anthony LaVacca.

Feb 13
sue-dentist-cut-tongue-blog

Can I sue the dentist for cutting my tongue?

By General Dentistry, Oral Health

I’m not a person who just walks around looking to sue a dentist. I’ve never filed a lawsuit and I’m not hurting for money. I’m just considering it based on principle and rudeness and the fact that I can’t think of another way to help this from happening to another patient.

I went to an oral surgeon yesterday to get a bottom right molar pulled. The tooth was impacted and partially sideways so I was sent to this guy. I had a feeling that I wouldn’t be cared for properly. He rushed me through my consultation and made little eye contact with me. My dentist recommended him so I moved forward.

So yesterday while the dentist was pulling out my tooth, he cursed. I felt pain underneath my tongue and when I said something like, “Ouch! What’s going on?!”, the dentist said I had a soft tissue tear. Then he told me he would stich it up right away. I could tell by the look on his assistant’s face that he did something careless. She looked at me like, ‘shame on him’, but she didn’t say anything to either of us. She just patted by hand.

So when the tooth was out and everything was done I asked to look at my tongue. I could tell that he cut my tongue and it wasn’t a random tear. So as asked the dentist if he cut my tongue and his reply was, “It has 8 secure stitches and in a few weeks you won’t notice it at all.” Then he left the room. Jerk.

I’m angry that he was careless, didn’t apologize and wasn’t really truthful about what happen. I am definitely reporting this to a dental board or wherever I need to report it. I’m thinking that my report will get swept under the table and I really need to sue this dentist so that he will think twice about being rude to other patients or treating them like I was treated. What do I need to document to make sure this jerk doesn’t do this again? Thanks. Brooke

Brooke – Based on your comments, it does sound like the dentist was careless and rude. Your cut sounds like it was deep or long—eight stitches!

Even the most skilled dental surgeon can make a mistake though, and it sounds like he took immediate action to repair the damage to your tongue. It also sounds like it’s really his attitude and chairside manner that are really making you angry and feeling like suing the dentist. Additionally, the dentist’s failure to apologize and failure to tell you what really happened seemed to be adding to your frustration.

We’re not defending the oral surgeon’s attitude or response, but when lower molars are worked on, it’s easy to injure the tongue. A metal retractor can be used to hold the tongue away from the extraction site and prevent injury. Perhaps it wasn’t used and your tongue was accidently cut. The surgeon might have been embarrassed and too proud to apologize.

You can report the incident to the dental board, but it might not result in any reprimand—and not the kind you might be hoping for—unless there are multiple complaints in the dentist’s file. We’re not aware of any disciplinary action of a dentist or surgeon for rudeness.

An attempt to sue the dentist probably won’t go far. Your cut was an accident that doesn’t seem to indicate intentional negligence that wasn’t properly cared for.

What you can do is let your general dentist know about the incident, in case he or she has received repeated complaints from other patients about this surgeon. We’re sorry that you had this negative experience and hope for a better outcome if you need an oral surgeon in the future.

This post is sponsored by Naperville dentist Dr. Anthony LaVacca.

Feb 03

Will gum disease prevent me from getting dental implants?

By Dental Implants, Gum Disease, Oral Health

I have gum disease and I’m losing teeth. I want dental implants to replace them but my dentist tells me that he has to get my gum disease under control first. It was February of 2016 when he first told me I have gum disease and it seems like it hasn’t gotten any better. I’m not sure what is taking so long to get it straightened out. I don’t want to keep losing teeth while he tries to get things under control. Can I get dental implants from another dentist or do I have to wait for my dentist to figure out what he is doing? Thanks. Karmin

Karmin – Dental implants are the best option to replace teeth that are loose or missing due to periodontal (gum) disease. Before you receive implants, periodontal disease should be under control. If it’s been a year, and your dentist isn’t able to control your gum disease, it might be time to visit a periodontist—a specialist in diseases of the gum tissue.

How Periodontal Disease Can Affect Dental Implants

Dental implants are most successful in people with sufficient bone density and healthy gum tissue. Here’s why periodontal disease should be controlled first:

  • Advanced periodontal disease damages gum tissue and bone. Bone and gums should have a snug fit around tooth roots or dental implant fixtures.
  • If gum disease has caused your gums to recede, the base of your dental implants will be exposed. It will be challenging to keep the exposed area clean and free of plaque buildup.
  • Thin or receding gums around an implant fixture are unattractive. Either the fixture will show through thin gums, or be completely exposed if your gums recede.

We recommend that you have a consultation with an experienced prosthodontist. After an examination, 3-D x-rays, and a review of your medical history, he or she will let you know if you are a candidate for this treatment.

The prosthodontist will also determine if your gums are healthy enough and thick enough to support dental implants. Bone grafting and gum tissue grafting might be needed to ensure stability and success of your implants. In several months, the grafts will heal, and the implant fixtures will be surgically placed in your jawbone.

After your periodontal disease is controlled, if you receive dental implants, your oral health will likely improve. The fixtures stimulate bone grown and promote healthy gum tissue.

This post is sponsored by Naperville board-certified prosthodontist Dr. Anthony LaVacca

Jan 31

Will the bleeding around my tongue piercing stop or should I call a dentist?

By Oral Health, Tongue Piercing

I have had a tongue piercing for about 2 years. 3 weeks ago the area near the piercing started to itch. Then it became swollen. I have been rinsing my mouth with sea salt water and it calms it down again but only for a little while. This past Sunday I noticed that the area was bleeding. It isn’t a lot of blood but I can taste it and see it. I don’t have a regular dentist. My schedule is just too busy and I’m rarely at home. I’m a freelance artist and I travel a lot. Should the salt water help with the healing? Is there something over-the-counter I can buy to calm it down, or do I need to see a dentist? Thanks Cherise

Cherise – Yes, you should see a dentist. Itching for a few days is normal for a new tongue piercing while the area is healing, but not for a piercing that you’ve had for two years.

When an Established Tongue Piercing Is Bleeding

Bleeding around the piercing is a problem and it probably is a sign of an infection. Our tongues are covered with bacteria. Tongue piercing can introduce the bacteria into the bloodstream. Tongue jewelry—particularly if it is metal based—can cause an accumulation of bacteria that leaves you at risk for infection. It can also damage your teeth.

Unfortunately, if an infection occurs, it is not necessarily confined to the tongue. Infection can spread to other oral tissue and into your bloodstream. It can even lead to more serious conditions, such as hepatitis.

Although salt water rinses may give you some relief, don’t depend on them to heal your tongue—particularly if it’s infected. Make an appointment with a dentist right away. You can do an online search for an emergency dentist in your area. Be certain to explain that there is blood around the piercing. The dentist will see you promptly.

The dentist will have to remove the piercing to examine your tongue. If there is an infection, he or she will recommend that you not wear the piercing while your tongue is healing. Protect your oral and overall health by closely following the instructions for recovery.

This post is sponsored by Naperville dentist Dr. Anthony LaVacca.

Dec 28
abscessed-tooth-is-pulled-blog

Should I expect complications when my abscessed tooth is pulled?

By Oral Health, Root Canal Treatment

I had a horrible toothache for about 5 months and finally went to the dentist. Well I went to an emergency dentist because I don’t have a regular dentist. She said that I had an abscess but she couldn’t get me numb to get the tooth out. I have antibiotics and another appointment late next week. I am worried that she won’t be able to get the tooth out even if she can get me numb. Should I expect complications my abscessed tooth is pulled? Janele

Janele – An abscess is a pocket of pus caused by an infection. A tooth abscess occurs in or around a tooth root.  It may or may not be painful.

If a tooth is injured, has a cavity, or experiences trauma, an infection can occur. When the pulp, or soft tissue inside the tooth, becomes infected and inflamed, the infection can spread to the tooth root, and an abscess will form.

Properly Treating an Abscessed Tooth

Instead of extracting an infected tooth, an abscess is commonly treated with a root canal treatment. The infection is removed from the tooth, the space is filled with a special dental filler material, and the tooth is sealed. A dental crown may be required to protect the tooth.

On rare occasions, root canal treatment isn’t enough to save your tooth, and endodontic surgery is required. A specialist can locate hidden canals in your tooth that may still harbor the infection. He or she will determine which methods are best to preserve your tooth.

And that’s the goal—tooth preservation. Based on the information you provided us, we don’t understand why there are plans to extract your tooth. We recommend that you receive a second opinion from an experienced dentist who will examine, and likely x-ray your tooth, to determine the best treatment.

Extracting a tooth leads to other issues, including bone shrinkage in the area of the missing tooth, adjacent teeth start to drift into the position of the missing one, and your bite may be affected and eventually cause jaw and facial pain. When a tooth is extracted, for optimum oral health, it will need to be replaced. No form of tooth replacement is as good as a natural tooth.

You would benefit if you take the time to receive a second opinion to find out if your tooth can be preserved.

This post is sponsored by Naperville Dental Specialists.

Jun 20

How often do pediatric dentists take x-rays?

By Pediatric Dentist, X-rays

Is it normal practice to give kids x-rays with every 6 month checkup? Whenever I take my kids to the pediatric dentist the x-rays are done. Our insurance only pays for yearly x-rays, but the dentist does it twice a year. I am not really used to this. We’ve had this dentist 2 years and no previous dentist did x-rays twice a year. Of course I asked about it and I was told that it’s their normal practice. The radiation exposure on my kids makes me nervous. I have three kids under the age of 8 and I think they are too young for frequent unnecessary x-rays. I want to call ahead before the next dental cleaning to ask the office to waive the x-rays. I don’t want it to be an issue when I arrive. I am just wondering if this office is an exception to the usual yearly x-ray rate. If so maybe I need to switch to a new dentist. – Xaria W.

Xaria- The most common practice is for x-rays to be completed yearly. Some pediatric dentists increase the rate to every six months—particularly with children you are cavity prone. X-rays can assist with early detection of tooth decay. Early detection can help prevent the need for a filling, or only a small filling may be needed, as opposed to deep decay that requires a dental crown. Your dentist or dental hygienist will be able to tell you if it’s their practice for all patients, or if there is a specific reason that your children’s x-rays are being done more frequently.

Digital dental x-rays emit low levels of radiation. The level is equivalent to receiving rays from the sun after standing outside for a few minutes. Today’s x-rays have 80% less exposure to radiation than traditional film x-rays. Although the exposure level is low, patients are protected with a lead apron.

Insurance companies provide benefits for adequate preventive care, including x-rays. If more frequent care is needed, patients pay out of pocket. If your children need more frequent x-rays, but your insurance plan won’t cover the additional diagnostic studies, we recommend that you put your children’s oral health first.

If you call in advance as planned, you can find out why more frequent x-rays are being recommended. If you are skeptical about the reason given, you can opt to receive a second opinion from another pediatric dentist.

This post is sponsored by Dr. Anthony LaVacca for Innovative Pediatric Dentistry in Naperville.

Feb 29

Hole in my tooth and drugstore filler won’t stay in

By Dental Fillings, Emergency Dentistry

I have a hole in my tooth but it doesn’t hurt. It was getting sensitive to hot and cold drinks so I got some Dentek from the drugstore. It used to work fine but it started falling out recently. Maybe the hole in my tooth is getting bigger? I don’t know. Can you recommend another product other than Dentek that might hold better now? Nezaida

Nezaida – Over-the-counter dental filler is a temporary repair for a tooth. It doesn’t eliminate the need to go to a dentist to have the tooth examined, x-rayed, and restored.

Although you don’t feel pain, the tooth can still be infected. The infection can affect other teeth, your jawbone, and spread elsewhere in your body. If the pulp (living tissue) inside your tooth dies, the nerves die with it, and you won’t feel pain in the tooth. If that’s the case, a root canal treatment is needed.

Schedule an appointment with your dentist right away to have your tooth examined. If the cavity is too large for composite filling, a porcelain onlay or inlay may be used to restore the tooth. Onlays and inlays preserve tooth structure, and in addition to building up the tooth again, they look completely natural.

A badly damaged tooth may require a porcelain crown. Visit an experienced cosmetic dentist for an examination and to learn about your options. Please don’t continue to try to repair the tooth yourself. If you prolong treatment, the damage to your tooth can progress and make treatment more difficult and more costly.

This post is sponsored by Naperville dentist Dr. Anthony LaVacca.

Jan 25

My son’s gums bleed when he brushes his teeth

By Gum Disease, Oral Health, Pediatric Dentist

I finally got our 4 yr old into brushing his teeth twice a day. He actually started liking it. I was surprised. 2 weeks ago he was brushing and I was helping and his gums started bleeding. I had him rinse his mouth and everything was okay. I figured maybe he was brushing too hard, so I told him to do it softly. That seemed to work until last week. He was brushing his teeth on 2 different occasions and the gums started bleeding again. I am trying to be calm about this because he is just comfortable with brushing his teeth and I don’t want him to freak out or think that brushing teeth means bleeding gums. I know that he isn’t brushing too hard any more. Does he have gum disease at 4? Thanks. Tuscany

Tuscany – There are several possible causes of your son’s bleeding gums. For an accurate diagnosis, though, schedule an appointment with your son’s pediatric dentist.

One possible cause is dry mouth. Does your son breathe with his mouth open? Does he drink plenty of water daily? Or is he taking medication that has dry mouth as a side effect? Any of these factors can cause the gums to become tight, dry, and more likely to bleed.

Vigorous brushing is another cause of bleeding gums, but you have mentioned that your son isn’t brushing his teeth tooth hard. Continue to monitor him to ensure that he isn’t brushing aggressively. A soft-bristled toothbrush should be used.

There are certain medical conditions, including some auto-immune conditions that can cause gums to bleed easily. Bleeding gums may be related to the beginning stages of periodontal (gum disease).

Again, we encourage you to schedule an appointment with your son’s pediatric dentist for accurate diagnosis and treatment. If you have already seen a pediatric dentist about the issue, consider getting a second opinion and speaking with your medical doctor about it.

This post is sponsored by Naperville dentist Dr. Anthony LaVacca.

Dec 28

Why does my 5 yrs old’s breath smell so bad?

By Oral Health, Pediatric Dentist

My 5 yr old daughter has horrible breath. It even takes my breath away sometimes when I smell it. It’s not an oral hygiene thing. At least I don’t think it is. I floss and brush her teeth morning and night. I also make a little baking soda mouthwash for her to gargle with every day but it doesn’t help. When I take her to the dentist, even she talks about brushing out the ‘bad breath monsters’. Really I have done all that I know to do. I asked the pediatric dentist and she keeps saying that I should brush and floss my daughter’s teeth. I do that already. This is really bothering me and I know that eventually my daughter will start being teased because the smell of her breath is really horrible. I am wondering what else I can do or what can be causing the problem. thank you – Oksana

Oksana – You can start by having a conversation with your daughter’s dentist. Let the dentist know your daily routine for your daughter’s oral hygiene. Then ask the dentist for an exam to help determine what’s causing the bad breath. Also ask if the dentist has any ideas for what is causing the problem. If you don’t get a satisfactory response, you may need to choose a new dentist.

Also, ask your family doctor or pediatrician about the problem. At times, there are medical factors that can cause bad breath in children. We are by no means diagnosing your daughter’s case, but listed below are some causes of bad breath in children.

  • A medical condition – Allergies, sinus issues, tonsillitis, or other medical conditions can cause bad breath.
  • Dry mouth – Certain medications can cause dry mouth, and so can a lack of saliva production. Ensure your child drinks plenty of water to keep his or her mouth moist.
  • Oral infection – Cavities or a mouth sore can cause bad odor.
  • Food – Certain foods have odors that linger, including garlic and onions.
  • Bacteria on the tongue – It’s important to gently brush the tongue, too. A buildup of bacteria on the tongue will cause a foul odor. A tongue scraper can be carefully used.
  • Breathing through the mouth – This will quickly dry out the mouth and cause odor. If your child breathes through his or her mouth due to sinus or allergy issues, addressing the issue can make breathing with the mouth closed much easier. Give your child plenty of water to drink.

The above causes are possibilities. An examination from your child’s pediatric dentist and medical doctor will help identify the cause, as well as the best treatment.

 

This post is sponsored by Naperville dentist Dr. Anthony LaVacca.

Oct 07

For teeth’s sake! May have a little milk with my tea?

By General Dentistry, Oral Health

Each day, approximately 158 million Americans drink tea. What’s that have to do with your teeth? Tea stains your teeth—in fact, because of its higher tannin content, it’s more likely to stain your teeth than coffee. Tannin is a compound that gives tea its dark color.

Of course brushing your teeth daily can help limit surface stains in tooth enamel, and so can rinsing your mouth with water after drinking tea. But research shows that adding a little milk to your tea can help prevent stains in tooth enamel.

The study, published in the November 2014 issue of the International Journal of Dental Hygiene, shows that the casein protein in milk binds the tannins in tea and limits their staining properties. The study showed that the effectiveness of milk on teeth is greater than whitening toothpaste and comparable to some bleaching gels!

Many people like their tea “straight,” without milk or cream. But for those who can tolerate a little milk in their tea, in addition to diligent oral hygiene and regular dental cleanings, it can help keep your teeth white!

This post is sponsored by Naperville dentist Dr. Anthony LaVacca.

 

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