Hope Restorative & Cosmetic Dentistry

Antibiotic for a Tooth Infection

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I have a toothache. I’ll be honest and tell you that I am not fond of the dentist even in the best of circumstances. I was kind of relieved when the government shut down dental clinics. It stopped hurting for a bit, but now it’s starting to hurt worse. Which antibiotic is best for this? My doctor will write me a prescription.

Luke

Dear Luke,

man holding his jaw in need of an emergency dentist

You are definitely going to need to see a dentist. Antibiotics will not work for this. They are only a temporary stop measure for dental infections. In your situation, it sounds like the tooth has already died, so it will be even more temporary for you. The tooth feeling better is probably when the infected pulp died, but that doesn’t remove the infection itself, just the pain. Now it has spread past the tooth.

This is considered urgent dental care and therefore, your dentist will be able to treat you. This has been a consistent exception to the COVID-19 quarantine because it is medically necessary. Dental infections have to be physically removed. That is typically done in one of two ways. If the tooth can be saved, a dentist will do a root canal treatment. If the tooth can’t be saved, then an extraction becomes necessary. If that happens, you will want to replace your tooth.

Dealing with Dental Anxiety

I know you are not the most comfortable going to the dentist and hearing the procedure doesn’t have to be postponed because of the quarantine probably increased your anxiety. The good news is, there is a fantastic solution, which could change the way you view dentistry in the future.

I’d like you to see a dentist who offers dental sedation options. Most dentists offer two levels of sedation. Nitrous oxide, which is a gas administered to people with mild anxiety, and oral conscious sedation. This is administered by a pill and is strong enough where you’ll need someone to drive you to and from your appointment.

Dr. Cha offers a third level — I.V. Sedation. This is for patients with such high anxiety that they want to be out. Very few dentists offer this option and it requires special training.

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

Crowns for Teeth Whitening? NO!

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I have two porcelain veneers on my front teeth. One of them chipped and needs replacing. My dentist says it is because I grind my teeth. The adjacent teeth are yellowing so my dentist wants to do dental crowns on eight of the upper teeth, which would pretty much be all of them when I smile. One of the things I’m wondering about is if I chipped my porcelain veneer would I also damage my dental crowns?

Marie

Dear Marie,

Woman covering her mouth with her hand

I’m appalled by what I’m hearing and am truly hoping there something else to this story. Putting dental crowns on all your upper teeth is a massive overtreatment unless there is something else going on. Based on what you’ve said he’s doing it because one of your porcelain veneers needs replacing and your natural teeth need to be whitened. That’s insane! When you need to whiten teeth, you do just that. You have teeth whitening done. I can see where it would benefit him to suggest otherwise. Teeth whitening will bring him in a few hundred dollars. What he’s suggesting, which is a full-mouth reconstruction, will bring in a minimum of $30,000. I hope that is not his motive.

Another concern I have is replacing your porcelain veneers with dental crowns. Whenever a dentist suggests that, it brings up massive warning bells. This tells me your dentist doesn’t know how to do porcelain veneers. Therefore, he’s telling you to do dental crowns. No dentist in his right mind would remove healthy tooth structure if he didn’t need to. Your dentist would rather do that than admit his lack of skill and send you to another cosmetic dentist with more expertise.

Now, there is a third thing that concerns me and gets to the heart of your question — your teeth grinding. I cannot believe your dentist would know you grind your teeth and not provide a way for you to protect them. A simple nightguard would have kept your porcelain veneer from chipping. As to whether you will damage your dental crowns, yes, if you don’t have the nightguard.

Bottom Line—You Need a Different Dentist

I don’t think you are being well served by your dentist. Here’s what I want you to do. Spend this time during the COVID-19 to research some dentists in your area. Ideally, you’ll want one who is AACD accredited. If you can’t find one, look on mynewsmile.com and go over the websites of their recommended dentists in your area. Check their reviews and pick one.

Once the quarantine is over, do the following. Get your teeth whitened. If you choose Zoom Whitening, give two weeks for the color to settle, then have that single chipped porcelain veneer replaced and have a nightguard made.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

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