Afraid the Dentist Will Kill Me

I have to find a dentist. Normally, I get my teeth looked after by our local hygiene school. They’re thorough and do a good job. But, if an issue pops up you have to go to a dentist. I’ve never had an issue pop up so never really worried about it. But, that all changed at my last appointment. I need to get a tooth looked after and they said it could be saved with a crown, but I need to be prepared for the fact that it will likely need to be extracted. I’m quite afraid of the dentist. I realize that you probably consider that silly. But, I keep seeing stories like this one where people die from sedation. How can I be sure the dentist won’t kill me?

Stephanie – Boston

Stephanie,

It’s not silly to be afraid of the dentist. In fact, many patients are. Sedation dentistry has done a lot to help with that. But, when you have tragedies, such as the one suffered by that little boy, it can make frightened patients more frightened.

My understanding of that case is the dentist wasn’t certified, though for certain types of sedation that’s not required. However, he also gave a significantly excessive dose of sedative drugs to the child, well above the recommendation. I was appalled when I realized how much medicine he gave that preschooler.

So, how do you prevent such a tragedy from happening to yourself?

When you’re looking for the best dentist in this type of situation, the first thing I’d ask is whether or not the dentist is DOCS certified (The Dental Organization for Conscious Sedation). You’ll also want to be certain your vital signs are monitored at all times. There should be a separate person doing this, not the dentist. He or she will be too busy with the procedure to give your vitals adequate attention.

Additionally, it would be great if the dentist and their staff are ACLS certified (Advanced Cardiac Life Support). In any medical procedure there are risks, whether there’s sedation or not. Every medical professional should be prepared for the worst-case scenarios in order to give their patients the best care possible.

Hopefully, a crown will be available to you. An extraction should always be a last resort.

This blog is brought to you by Dr. Jerome Cha.

 

Are Dentures “Really” the Worst Thing I Can Do?

I have teeth which have been a constant problem my whole life. It seems like every couple of months I’m back with a new problem even though I brush and floss as instructed. I told the dentist on this last visit that I’m just tired of it and want to just get dentures. He pretty much shouted that’s the worst thing I can do, and suggested I take better care of my teeth. I don’t know what else to do besides brushing and flossing two times a day.  Are dentures truly my worst decision?

Steve O. – Pennsylvania

Steve,

Admittedly, that wasn’t the best way for your dentist to handle the situation.  Like in every other profession, sometimes dentists lack in people skills.

You can be doing everything you’re supposed to with your dental care and still struggle with your teeth. Your dentist should know this, too. Sometimes our genetics work against us and our teeth will be a problem no matter what. There are some extra steps your dentist can take, such as fluoride treatments.

As to whether dentures are your worst possible decision, it depends. If you’re losing your teeth and cannot afford a better option, then dentures are better than nothing.  In your situation, here are the steps I’d recommend.

First, I’d try to save any teeth you can. Natural teeth are truly your best option. Even the top of the line tooth replacement, dental implants, which are like having natural teeth, have risks that you won’t have with your natural teeth.

Second, get crowns or implants on the teeth which can’t be saved. If you get to keep part of the tooth, get a porcelain crown. If the tooth is extracted, get an implant.

I realize that not everyone can afford a dental implant. In that case, I would say a removable partial denture would be okay. However, there is a downside to dentures.

When your teeth are removed, your body recognizes the roots of your teeth are gone and automatically begins reabsorbing the minerals in your jawbone. Eventually, you won’t have enough bone structure there to retain dentures. This is most common when you have a full set of dentures. You’ve likely seen patients in this situation. Their face has a sunken, aged appearance.

Implants solve this problem because it places a prosthetic root into your jawbone, so your body recognizes those minerals are still necessary.

The key here is to save what you can. Then, when you can’t, go down the list for the best replacement you can afford. I’d also talk to your dentist about getting some extra fluoride.

Another trick for fluoride is to make sure you’re drinking tap water and not bottled water. Bottled water is defluorinated. Your tap water should contain fluoride.

Also, don’t beat yourself up about your teeth. Sometimes, you can do everything right and still have problems with your teeth. You can’t change your genetics.

This blog is brought to you by Dr. Jerome Cha.