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Dentist or Oral Surgeon for Extractions?

Posted on September 13, 2019 by writeradmin.

I have a terrible fear of the dentist and pretty much only go when I need a tooth pulled. I’m 50 years old and missing a large number of teeth at this point and feel like I need to get dentures. Do I go to a dentist or an oral surgeon for that?

Ben

Dear Ben,

I’m sorry for the struggles you’ve encountered. Many times, when someone is dealing with dental anxiety it is a result of trauma in the past with a dentist, often in childhood. This causes many patients to only go in for treatment when they have a dental emergency, such as you’ve done.

I would go to the dentist who is going to do the dentures for the extractions. If you go to two practitioners, one for the extractions and one for the dentures, there will need to be perfect communication. Denture preparation is something most dentists know how to do.

Because of your dental anxiety, I’m going to suggest you use a dentist who has sleep dentistry available. This will allow you to get your dental work done without any anxiety. In fact, if you want, you can nap through the entire procedure.

A Danger with Dentures

Before you settle on dentures, I want you aware of what you’re getting into. Even the best fitting dentures will reduce chewing capacity by 50%. The dentures for your top arch are held in by suction and the bottom ones just sit on the ridge of your jawbone. This is where the biggest problem arises.

When your teeth are removed, your body recognizes you no longer have any teeth roots. In an effort to be efficient, it resorbs the minerals in your jawbone to use elsewhere in your body. This causes your jawbone to slowly shrink. Eventually, you won’t have enough jawbone left to support your denture. This is known as facial collapse. Because of your young age, this is especially important for you.

The Solution to Facial Collapse

The best way to prevent facial collapse is to have dental implants placed in your jaw. These will mimic the roots of your teeth and let your body know you still need the bone to retain teeth. With about four to six implants you can anchor dentures to them. These are known as implant overdentures and will completely eliminate the problems caused by dentures.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Oral Surgeon or Dentist for Extraction

Posted on June 29, 2019 by writeradmin.

I had a filling fall out. I ignored it because I’m not the best at keeping up with my needed dental care. I have some dental anxiety that tends to help me justify putting things off. Well, the tooth became painful again and I went to see a dentist who did a root canal treatment. I didn’t follow up with the crown and the dentist never contacted me. At the time I considered that good luck. Now I’m not so sure. The tooth was reinfected. I went to see another dentist who said the tooth is too far gone and needs to be extracted. He told me it’s a complicated extraction so I could go to an oral surgeon who’d use anesthesia or him with a local. Would it be unsafe to use a regular dentist? Anesthesia is pretty pricey but I don’t want to do anything unsafe.

Carl

Dear Carl,

Sedation dentistry is sometimes called sleep dentistry…for a reason.

It’s not unsafe to do an extraction with a general dentist unless the dentist is in over his head. That may be what your dentist is hinting at by even suggesting you go elsewhere. The first thing I’d do is ask him his comfort level with this procedure. If he’s comfortable then you should be fine. If he’s not you have two other choices.

Go to an Oral Surgeon

An oral surgeon will be experienced in any number of complicated extractions and you can do it under anesthesia. However, as you mentioned earlier, this is a more expensive proposition for you. I have a middle ground, which I think will also help with the dental anxiety you face as well.

Go to a Dentist who Offers Sedation Options

There are dental sedation options with a general dentist which cost less than what you’d have to pay with anesthesia. You will still be completely relaxed. In fact, it is sometimes dubbed sleep dentistry because most patients are so relaxed they sleep through the entire appointment.

You’ll find this allows you to get a lot more work done in each sitting as well. This means you can get caught up on all your neglected dental work as well.

Once your tooth is removed, it will be time for you to look at tooth replacement options. I’m going to suggest you get a dental implant as it is the best replacement option. However, if the adjacent teeth need extensive work, such as porcelain crowns, it will be more cost effective for you to get a dental bridge instead. This will crown the adjacent teeth while filling in the missing tooth.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Can I Get All My Work Done at Once?

Posted on April 13, 2019 by writeradmin.

I need a lot of dental work done. I need three root canal treatments with dental crowns and four other cavities to fill. I’d like to get it done all in one appointment to avoid multiple trips to the dentist. Sort of take a personal day at work and be done with it. Is that possible.

Elliot

Dear Elliot,

You are a brave person. Most people try to avoid dental work and you’re ready to jump right in there all at once. Every dentist has different policies when it comes to how much work they are willing to do at once.

You will find that the dentists who are willing to do the most in one sitting are sedation detnists.

For the level of work you are looking at you’ll want a dentist who does oral conscious sedation. This will make you very sleepy. Most patients sleep through the appointment, which is in part why you can have so much done in one appointment.

However, the sedation is so strong you’ll need someone to drive you to and from your appointment. You’ll also need them to stay with you while you recoorperate throughout the day. You’ll want them there until you are lucid and able to easily get around.

Cosmetic Considerations

You’re having a lot of work done, including dental crowns. You didn’t say where the crowns were. In case they will be visible when you smile, I want you to be aware about coloring.

The color of the crowns created for your teeth undergoing the root canal treatment is permanent. If you are pleased with the current color of your teeth than there is nothing further to think about.

However, if you’ve ever toyed with the idea of whitening them, the time to do it is before your have your dental crowns made. This saves you the money of having to re-do them after you whiten them later.

I know you like doing things quickly, so ask your dentist about in-office teeth whitening. This whitens your teeth completely in just one appointment.

Best of luck to you.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Getting a Lot of Work Done at Once with a Dentist

Posted on January 23, 2019 by writeradmin.

My mouth is in bad shape. I need to get a lot of work done. I need about 4 root canal treatments, two crowns, and a filling. However, I’d also like to improve the appearance of my teeth by whitening them. How much of this can be done in one appointment?

Ben

Dear Ben,

Sedation dentistry is sometimes called sleep dentistry…for a reason.

Each dentist has a different threshold for how much they’ll do in one appointment. However, you will find that sedation dentists are more likely to agree to longer appointments. That is because it is easier for the patient to have extensive work done while under sedation.

If you use a strong sedation, such as oral conscious sedation, it allows you to sleep through the appointment. You’ll be completely relaxed while the dentist goes about the business of doing your procedures.

The one thing you will want to split up is the teeth whitening. So, this is the tricky bit. It’s a matter of convenience over cost. While natural teeth whiten, dental work does not. That boils down to whatever color your dental crowns are when they’re made is permanent.

That means you can whiten your teeth before getting your crowns so they can be made to match the new color. Or, you can get the work done, then whiten your teeth. However, that means you’ll have to replace the crowns if you want them to match. Of course, that’s only necessary with crowns which are visible when you smile.

My suggestion, in that case, is to have your root canals and any fillings done. Then, whiten your teeth. After the tooth bleaching is completed, your dental crowns can be made to match the new color.

Your Best Bet is In-Office Whitening

Because you are in a hurry to get all this work done, I’m going to recommend you use an in-office teeth whitening, such as Zoom Whitening.

With Zoom Whitening, your teeth will get as white as possible in just one appointment. You will want to wait about a week afterward to allow the color to settle a bit, but that is still faster than take home whitening which can take several weeks to get to the level of brightness you want.

Best of luck to you.
This blog is brought to you by Lexington Dentist Dr. John Weaver.

Dentist Wants to Sedate My Son

Posted on October 31, 2018 by writeradmin.

I don’t think of my son as bad, but he is wiggly. I think that’s pretty normal in a six-year-old boy. However, the dentist noticed a cavity and he wants to fill it before it gets too big. Something about it being a molar. Then he wants to seal the tooth. He says he’ll need to be sedated. Is that really necessary? Is it safe in children?

Avery

Dear Avery,

I know the idea of our children being sedated can be frightening. However, dental sedation is perfectly safe. While every procedure has risks, dental sedation is conscious sedation. He’ll be able to communicate the whole time, though most children just fall asleep.

There are two levels of sedation usually used on children. The first level is nitrous oxide. It’s simple a gas mixture that relaxes him. This is actually my recommendation for your son if he’s cooperative but wiggly. He’ll probably fall asleep, but when the procedure is over, they just change the gas mixture and he wakes up and is back to his normal wiggly self, able to function as he normally would.

The second level is oral conscious sedation. This is designed for people (adults and children) who have either severe dental anxiety or have a more invasive procedure. It is safe, but I tend to do the lesser level of sedation if it’s adequate.

Benefits of Dental Sedation

Your son will be completely relaxed throughout the procedure
No negative experiences at the dentist which cause him to fear the dentist
The dentist can get more work done at each appointment

Questions to ask a Sedation Dentist

Will you have someone in the room with him at all times (besides yourself)?
Will his vital signs be monitored the whole procedure if using oral conscious sedation?
Do you have emergency protocols in place?

This blog is brought to you by Lexington Kentucky Dentist Dr. John Weaver.

Dentists for Special Needs Adults

Posted on August 17, 2018 by writeradmin.

My parents recently passed away in a car accident. That puts me in the care of my brother. He’s 25, with special needs. After moving him to our house and going through my parent’s notes about his care, I realized he hadn’t been to the dentist in many years. Much of that is likely because he has issues with other people touching him. Sometimes he’s fine and sometimes he’s a nightmare. I love my brother. I don’t want to upset him, but I feel strongly he’ll need his teeth tended to. Based on how long it’s been he probably needs a lot of work. Do you know if there are dentists who are better in these type of situations than others?

Catherine Anne

Dear Catherine Anne,

First, let me give a shout out to you for the amazing way you’re stepping up even in the midst of your grief. I’m terribly sorry for the loss of your parents. You seem to be a woman with great strength of character and your brother is lucky to have you.

Though more and more dentists are gaining experience in treating special needs patients, especially with the rise of autism, most of those are children. When it comes to adults in your brother’s situation, we usually recommend you see a sedation dentist.

Advantages of Seeing a Sedation Dentist

There will be a couple of very specific advantages for your brother:

He will be completely relaxed

This is important. Because he’s an adult, his size when he panics makes it hard to keep him safe. Not only that, but anxiety causes a person’s metabolism to burn faster. This will mean anesthetics won’t be as effective. It’s why many patients with dental anxiety have trouble getting numb when they see a dentist. A simple measure, like dental sedation, will relax him enough for his medicine to actually work as it should.

Most people are so relaxed they’re able to sleep through the whole appointment. It’s like your brother getting his oral healthcare dealt with while he naps.

He can have more work done at each appointment

Because he’s so relaxed and likely sleeping, the dentist can accomplish more for him at each appointment. You mentioned his teeth have been neglected, so this will really help get him back in shape. You’re likely to find he’s got several things going on.

If there’s decay brewing, you want to catch it before it becomes an abscessed tooth. The last thing you want to put your brother through is an emergency dental appointment. Preventative care will be especially important for him.

This blog is brought to you by Lexington KY Dentist Dr. Weaver.