Auburn AL Dentist Archives - Dental Care at Flint's Crossing

Can My Dentist Dismiss Me for Refusing to Vaccinate?

August 15, 2021 by Athena Smiles

I’ve been seeing the same family dentist for nearly 20 years. I genuinely respect and trust him, but I recently received an email from his practice that has me quite upset. The notice indicated that, going forward, he was requiring all staff and patients to have the COVID vaccine. The letter indicated that, if I chose not to comply, he would continue treating me on an emergency basis for the next month and then I needed to find a new provider. The letter made no allowances for age or medical reasons, let alone philosophical ones.

The problem is, my primary care physician has told me that I should not vaccinate due to a pre-existing health condition. And, the real kicker is, I’ve already had COVID. I am, for all intents and purposes, immune.

I phoned the office thinking they’d make an exception. Nope. They promised to send my records to my new dentist when I found one and wished me well. After 20 years. I’m heartbroken and, honestly, a little dumbfounded. Can they really do this?

Thanks,

No Vax in Alabama

Dear No Vax,

So sorry to hear this! These are definitely challenging times and everyone is trying to navigate a new normal. Unfortunately, the news here is not positive for you.

Vaccinations are a Great Ethical Debate

The American Dental Association (ADA) recently released a detailed report called “Ethics of Vaccination.” Throughout the 16-page document, experts weigh in on various aspects of the debate. On one hand, it notes that refusing to treat an unvaccinated patient could indeed violate ethical standards.

“The dentist has a legal and ethical obligation to treat patients who may have a disability, which may include those unable to be vaccinated,” the report reads. It goes so far as to say the dentist may need to communicate with a patient’s physician if the patient cannot vaccinate due to disability and suggests a variety of ways practices can help reduce risk.

With that said, if your vaccination status hinges on a disability or because you belong to a protected class, it could potentially be considered unethical to dismiss you. The ADA nudged doctors in the direction of lawyers if they’re making decisions such as this.

The California Dental Association published similar remarks, saying “Dental practitioners are obligated to protect their patients’ health, but that obligation extends to those who may be exposed to a communicable disease — and unvaccinated patients are the most at risk.”

But, Yes, Your Dentist Can Dismiss You for Not Being Vaccinated

In the end, though, the ADA gave tips for dentists on how to address this concern with patients if they decided not to see unvaccinated patients. There is no official ruling on this, and so dentists have to do what they feel is right.

Request to Speak Directly with Your Dentist

Your dentist may have reasons he didn’t list for his new policy. For example, if he’s unable to be vaccinated and is afraid of catching and spreading COVID, his response would be understandable.

Equally, he may not know your situation and he may be able to make an exception for you given the circumstances. Give the practice a call back and ask to speak directly to the doctor when he has time. You may still not get the answer you want, but perhaps you’ll get some closure. Best of luck to you.

This blog is sponsored by Auburn, AL dentist Dr. Raymond Bolt.

Daughter Tried TikTok Trend- Can a Dentist Fix Her Teeth???

July 30, 2021 by Athena Smiles

I’m ashamed to say we haven’t been to our local dentist in about two years. COVID hit and I lost my job, and my insurance, and we’re just now getting back into the swing of things. Well, my 12-year-old just took it upon herself to try some things she saw on TikTok thinking she’d be able to whiten and reshape her teeth at home and save us money. I’m horrified but she’s not in pain or anything and I’m trying to assess the damage and whether or not this requires an urgent dental visit or whether it can wait until the new year when my insurance kicks in.

Basically, she started by rinsing with regular peroxide trying to whiten her teeth at home. I don’t think this is inherently dangerous, but worth noting. The big thing she did is take a file to her canines. She thought they were too pointy and wanted to flatten them out. I’m worried this caused permanent damage that will cost her those teeth. Again, though, she’s not in pain and they look ok. They’re just visibly flatter. Are these things that require an urgent visit or can they wait? And, when we go, what is the likely outcome?

Thanks,

Chris

Dear Chris,

Yikes! It’s good you’re asking questions and your daughter will need to get checked out. But, let’s break this apart, so it’s easier to understand what’s happening and what your options are.

Lots of Kids Are Falling Victim to TikTok Trends

First, don’t beat yourself up too much. A lot of kids are following things they’ve seen on TikTok. One of the other trends is to file teeth down into points in to look like a vampire or to file them into peg shapes in the hopes they’ll be able to get veneers. These things absolutely destroy teeth and can be expensive to correct.

Peroxide Can Damage Enamel and Irritate Tissues

While there are peroxide-based whitening solutions, they’re different from the peroxide you probably have in your cabinet at home. Studies suggest that it’s actually better for your enamel to use stronger peroxide for a shorter amount of time than it is to use weaker peroxide for longer periods. Peroxide can irritate the tissues in your mouth too. So, if your daughter’s still using this tactic, make sure she stops and holds off on any peroxide-based solutions until after she’s under the care of a dentist and has his or her green light to move forward with any at-home whitening treatments.

Long-term consequences could be things like tooth sensitivity and increased risk for decay going forward. However, it’s unlikely she caused any permanent damage with this. She’ll need an exam to confirm.

Filing Teeth Can Potentially Result in the Loss of the Tooth

The filing of teeth is more worrisome on two fronts. First, the mere act of filing can traumatize the tooth and “kill” it. It’s not always apparent right away, so symptoms might not manifest for days or weeks after. The only fix here is a root canal. Similarly, removing tooth structure can expose the nerve or leave it with less protection which can make it more sensitive. A root canal would be the likely repair here as well. If the tooth needs to be strengthened or rebuilt, it will probably need a crown. A filling might suffice in some cases though.

Visit the Dentist for an Exam and X-Rays

It’s impossible to say what issues your daughter may have without a dentist performing an exam and evaluating her x-rays. In the grand scheme of things, a quick check is relatively inexpensive. Your dentist will be able to advise you whether treatment can likely wait until after your insurance begins or if delaying may result in more issues.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, Alabama dentist.

How Can I Make Pediatric Dental Visits Easier for Autistic Child?

June 30, 2021 by Athena Smiles

My six-year-old daughter was just diagnosed with Autism Spectrum Disorder (ASD). She was five the last time we tried going to the pediatric dentist and it went very poorly to say the least. She was screaming and crying. At the time, we didn’t know what was going on and the dentist treated it as a behavioral problem. He insinuated it was our fault—that we weren’t good parents—and told us not to come back until we could “control our child.”

I look back on that and it just breaks my heart. I knew the dentist was way off base and that something more was going on but I couldn’t place it at the time. Now, trying to get back into things, we not only have to find a pediatric dentist who can work with kids on the spectrum, but also try to make up for a horrific first dental visit. I’m really not sure where to start. Any help would be greatly appreciated.

Thank you,

Kandace

Dear Kandace,

Big hugs to you and your little one, mama! It sounds like you’ve had quite the journey. As you probably know by now, ASD is a broad term and kids on the spectrum can have different symptoms or respond in unique ways to the same stimuli, so what works for one kiddo may not be what works for your kiddo. Because of that, the following will be general tips. You’ll need to consider your daughter’s specific needs and work with her care team to come up with the best solutions.

Find a General or Pediatric Dentist Who Already Works with Kids on the Spectrum

You don’t necessarily need to stick with a pediatric dentist, but you do need to find someone who already works with those diagnosed with ASD—more specifically, kids who are similar to your daughter. Make note of specific behaviors your daughter exhibits—is she sensitive to sounds? Lights? Touch? Changes in routine? How does she behave when she experiences these situations?

Find out how the dentist will handle each situation and make sure the team is prepared prior to bringing your daughter in. You can also request a consultation with just you prior to your daughter’s first appointment, a visual “no touch” appointment, or a tour beforehand. While not all dentists offer these options, they can be incredibly helpful for kids with ASD.

Prepare Your Daughter for the Visit

When you’ve selected a dentist, get a complete walkthrough of what the visit will entail from the moment you walk through the doors. Because many kids on the spectrum struggle with new places and situations, you’ll want to familiarize her with the process and expected behaviors as much as possible beforehand. Some families find it helpful to create a storyboard or book together, while other families like to create a checklist of activities.

Bring your daughter’s favorite tools with her. If lights bother her, bring a pair of sunglasses along. If noise creates issues, bring along some music and headphones or noise-reduction headphones. Touch may always be a sensitive spot, but you may be able to prepare her for the visit better by acting out events ahead of time. For example, you can roleplay and count each other’s teeth using a toothbrush or mouth mirror from the dental aisle or practice what sitting still in the dental chair will be like.

Be Open to the Idea of Sedation

At the end of the day, your daughter will need to have her teeth professionally checked and cared for. If visits end in chaos or are creating undue stress for her, sedation may be the only route to proper care and can help her maintain a more positive attitude about dental visits in the long run. It’s not right for every child, but if visits are still difficult despite everyone giving it their best, it’s something worth talking to your dentist about. Best of luck to you and yours.

This blog is sponsored by Dr. Raymond Bolt, a family dentist and provider of pediatric dental services in Auburn, AL.

Did Jason Derulo Really Send Will Smith to the Dentist?!?

June 15, 2021 by Athena Smiles

I just saw this crazy video of Will Smith getting his teeth knocked out by Jason Derulo. Will posted it online and Derulo responded with “I know a good dentist … text me back.” Is that for real?!? I’ve seen pics of Will since and his teeth look ok. How would a dentist even fix that?

-T

Dear T,

Ah, the infamous Smith and Derulo golf video. It went viral a while back, but for those who missed it, it’s posted below.

View this post on Instagram

A post shared by Will Smith (@willsmith)

Derulo has become somewhat known for his social media antics. You can see Smith allegedly taking Derulo’s ear off with a drone in this one.

View this post on Instagram

A post shared by Will Smith (@willsmith)

This isn’t even Derulo’s first video about lost teeth.

View this post on Instagram

A post shared by Jason Derulo (@jasonderulo)

And, it’s not the first time the pair has posted something obviously fake.

View this post on Instagram

A post shared by Will Smith (@willsmith)

These Are Likely Fakes

While some point to their apparent lack of pain in the videos as evidence as a fake, that’s not necessarily a smoking gun. Certain types of dental work, such as previous root canals, could leave those teeth without sensation. That means they might not feel pain if they were broken later. But, given the fact that both stars have a history of producing edited videos for social media and seemed quite lighthearted about the whole affair after, it’s far more likely this was just some great video editing and acting.

Word of Caution: Don’t Try That at Home

It hopefully goes without saying, but if those events were real, they’d be incredibly dangerous. Even duplicating them as stunts could be dangerous. Don’t try to copy them for any reason.

How Would a Dentist Repair Similar Damage?

Each case is different. A dentist would need to perform an exam and have x-rays to make a proper diagnosis. However, if this case had been real, several treatments might have been effective.

Dental Implants

The ideal repair would probably be dental implants. They’re often selected when a tooth is entirely missing or the remaining portion of the tooth cannot be saved. They tend to be the best missing tooth replacement because they mimic natural teeth in form and function. The implant, itself, serves as a root, and a false tooth sits on top.

Veneers or Crowns

With partially broken teeth, veneers or crowns could be options depending on how the tooth broke and how much broke off. Veneers would be more ideal for slight chips, as they’re designed to cover just the front of the tooth and hug the sides a bit. Crowns, on the other hand, offer full coverage around the tooth and allow the dentist to build it back up if a portion is missing.

Bridges or Partials

Bridges and partial dentures are missing tooth replacements that can serve as affordable alternatives to implants. Bridges include crowns on either side of the missing tooth, with a false tooth in the middle. A partial denture works more like a retainer with false teeth attached. Of the solutions outlined here, partials are the only removable option.

This blog is sponsored by Auburn, AL dentist Dr. Raymond Bolt.

Do Any Affordable Dentists Do Root Canals Too?

May 30, 2021 by Athena Smiles

I’m not saying anything bad about dentists who do root canals, but their rates are crazy. I don’t have dental insurance and have been cash pay for years. Last weekend, my face swelled and my regular dentist said that I either needed a root canal or to have the tooth pulled. If I had the tooth pulled, he could do it, but if I wanted to save the tooth and get a root canal, I’d need to see a specialist. I’m only 45, so I want to save the tooth. The problem is, the specialist wants around $1,500 to do it and the extraction is around $400. Well, if I don’t have $1,500, I don’t have much of a choice. Plus, he says it might need even more treatment after the root canal which will probably cost another $1,000. That’s one expensive tooth!

My dentist put me on antibiotics but cautioned me that my infection would likely return as soon as they ran out. So, I have little time to work with to get this sorted, but not much. Before I give up on the tooth, is there not a cheaper way to get my dental work done?

Sincerely,

Rajesh

Dear Rajesh,

This is a great question! Let’s break it down.

Find Out Why Your Dentist Wouldn’t Do the Root Canal

Some general dentists just don’t like performing endodontic treatment (root canals). Especially when you get into molars with three roots, it’s an intensive and time-consuming process. If your dentist passed on doing the work because he fits into this category, you may be able to call around and find a different general dentist who will do it. If he normally performs endodontic treatment but your case is unique—perhaps your roots curve or you have other considerations—and he referred you to an endodontist because he thinks it’s best for your situation, you’ll probably want to see an endodontist regardless.

Request Quotes from Nearby Dentists

Ask your dentist for a copy of your x-ray and the exact codes from your treatment plan. You can use the codes to call around and get pricing from other dentists in your area. It probably goes without saying that you likely do not want to go with the cheapest dentist. You want someone who has a good reputation taking care of this tooth. It is an investment, but it’s a worthwhile one. As you said, you’re only 45. You could literally have another 45+ years ahead of you without that tooth. And, without it, your other teeth will start shifting and you will likely have more trouble eating. If you can find a way to save it, you should.

You Can Find Ways to Make Treatment More Affordable

When you find a dentist who will do the root canal and you feel comfortable with him, then start digging into ways to make the treatment more affordable. A few tips:

Ask for a cash pay discount
See if the office will let you make payments
Find out if the practice accepts programs like Care Credit (a medical credit card)
Inquire about discount plans

Best of luck to you and your tooth!

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL affordable dentist.

Pediatric Dentist is Billing for Things That Weren’t Done

May 15, 2021 by Athena Smiles

I think our pediatric dentist is billing for things that weren’t done. My son started going to this new office about two months ago after our insurance changed. On the first visit, the dentist caught a couple of cavities she said needed to be filled. My son is usually great about brushing. He’s eight, was getting regular checkups at a different office before this one, and never had an issue. I was a little surprised that she found two but I didn’t question it all that much. After all, she’s the doctor.

Anyway, he went in and had those two fillings done and, just the other day, I got a notice from the insurance company. It seemed like the standard post-visit thing that breaks down pricing and what we were responsible for paying, but instead of saying he had a filling, it listed code D2930 and said something about a stainless-steel crown. At first, I thought I was mistaken, but I looked at the work and my son doesn’t have any metal showing in his mouth. So, then I called the office and they gave me a story about how sometimes the insurance company changes the code to allow for al alternative payment.

Does this sound right? If not how should I address it?

Thanks,

Trea

Dear Trea,

You’re correct. Something’s not right here. Either the person who helped you at the pediatric dental office was very confused or there’s something else going on in that office.

Dental Insurance Companies Are Known to Downgrade

Oftentimes, dental insurance companies will pay for the least expensive treatment that will solve the issue. For example, if the dental office had billed for tooth-colored fillings, it wouldn’t be unusual for the insurance company to only pay the price of amalgam (silver) fillings. Dentists rarely use amalgam nowadays because composite fillings allow for more of the natural tooth to be retained and don’t generally have the same kind of leakage and breakage we see with older silver fillings. But, insurance companies see them as an acceptable level of care, and so sometimes they’ll only cover the cost of those rather than white fillings.

When an insurance company downgrades, they make it quite clear that’s what they’re doing. They’ll list the procedure that was billed and note that they’re paying a downgraded fee.

Dental Insurance Companies Don’t Upgrade

What you don’t often see is the inverse—dental insurance companies offering to pay more than the rate the dentist is charging.

There isn’t Much of a Price Difference Between Resin Fillings and Stainless-Steel Crowns

The price for a composite (tooth-colored) filling depends on a few factors, such as whether it’s a front tooth or back tooth and how many surfaces are involved. Generally speaking, a two-surface posterior (back tooth) filling is going to be less than the price of a stainless-steel crown. At three surfaces, the fillings become more expensive. With that in mind, it seems like an odd scheme if an office is intentionally trying to gouge the insurance company. Especially because anyone can look inside your son’s mouth and easily identify if a metal crown is present.

Talk to Your Insurance Company About the Pediatric Dentist

Given how you describe the situation, it doesn’t sound like they’re intentionally up to no good, but they may not be billing accurately. Give your insurance company a call and let them know what your concerns are. They’ll be able to read the documentation sent and any codes submitted to determine what treatment the office is saying was performed. Since it sounds like they have a contract with your dentist, they’re likely to launch an investigation of their own if they have concerns about the validity of the claims being submitted. You may want to ask them to follow up with you to let you know the results. They don’t always do that without a formal request. Best of luck to you and yours.

This blog is sponsored by Dr. Raymond Bolt, a provider of pediatric dentistry services in Auburn, AL.

Pediatric Dentist Sent My Child a Bill—What Do I Do with It?

April 30, 2021 by Athena Smiles

This is going to sound weird, but our new pediatric dentist sent my five-year-old son a bill. We’d been back and forth with them quite a bit—there were issues with them getting the insurance verified and them not getting paperwork to me in time. The day of the appointment, they called me and told me and told me that they had just stopped taking our insurance and that the visit would be billed with out-of-network charges. Quite frustrating because I’d booked the appointment a month in advance and had gotten their info from the insurance company.

Anyway, I decided just to go through with the appointment because my son was already prepped for it and the remaining balance would be small. So, we went ahead with the appointment and it didn’t go well. My son was squirmy and the pediatric dentist didn’t get to do the full exam. The “cleaning” was about 30 seconds of them brushing his teeth with a toothbrush. Not exactly what I’d call top-notch clinical work. We got through it, though, and I paid my portion at the end, and we left.

Here we are almost three months later and a letter comes in the mail for my son. It’s not just a bill—it’s a notice that they’re going to send him to collections if he doesn’t pay the remaining portion, which is now pretty much the full amount because apparently there’s no out-of-network coverage.

I’m somewhat tempted to blow it off and let them try. It’s not going to go anywhere and I’m more than a little upset that we wound up with the bill anyway. The whole thing could have been easily prevented if they’d just been on the ball. Can I safely disregard the notice?

Best,

Talia

Dear Talia,

You’re probably not going to like this answer, but you should just pay the bill. No doubt, you signed an agreement saying you’d accept full responsibility for payment even if insurance didn’t pay. Ultimately, it’s your bill to pay since you entered into an agreement with the practice. Sending the bill to your son could give you some wiggle room if it ever came down to it, but that’s really something you’d need to take up with a layer.

Yes, they biffed this one pretty big. It sounds like there were a lot of things they could have done better. It’s hard to say how you could have gotten around it other than to be more familiar with your insurance plan and confirm on your own what the charges will be and what insurance plans to pay beforehand. Granted, that’s not something most people do, and most offices will take care of it for you with a high degree of accuracy too. But, ultimately, any charges accrued are your responsibility.

This blog is sponsored by Dr. Raymond Bolt, a provider of pediatric dental services in Auburn, AL.

Can My Dentist Charge for PPE

April 10, 2021 by Athena Smiles

I just visited my local dentist for the first time since the pandemic started. I know everyone said it was safe to go, but I really wasn’t going anywhere and didn’t feel comfortable returning until after I was vaccinated. In any case, I feel think they’ve done something they shouldn’t’ve. They didn’t say anything to me in advance, but when I checked out, I noticed there were additional charges on my statement that I’m not used to seeing. I asked what they were for and the woman at the desk said PPE but that they felt the insurance would cover it and I shouldn’t worry about it.

First, doesn’t the dental clinic always use PPE? Why am I suddenly being charged for something that’s always been a part of treatment? I feel like They’re just trying to pad their bills to make up for people like me who didn’t go in during the pandemic. Secondly, shouldn’t they have warned me that there would be an extra charge? If my insurance doesn’t cover it, I would then have to pay. It seems in poor form to add things in without properly warning someone. It’s $20, so not a significant amount, but it bothers me how they handled it. Are they even allowed to do that?

Thanks,

Amir

Dear Amir,

That sounds frustrating! This is a tough question that the dental community was largely divided over during the pandemic. Let’s take a look.

PPE Costs Skyrocketed During the Pandemic

The pandemic rocked the world as we know it in so many ways. One of the first ways it impacted dentistry was through the supply chain. The gloves, for example, are usually made from latex and nitrile and a single company in Malaysia had a 26% share of the market when the pandemic began. In fact, most of the word’s gloves come from a few select countries, including Malaysia, Thailand, and China.

That’s a twofold problem—the countries producing the most gloves were hit with the virus first. Companies ramped up big time, but not as much as they might have been able to do if workers weren’t falling ill. And, demand spiked at the same time. Rates climbed with it.

So, a practice that could previously buy a box of 100 gloves for around $3 was suddenly paying a minimum of $12 per box and, in many cases, $30 or even $50 if they needed them quickly. Similar shortages were seen with masks too. Plus, offices were expected to layer on additional PPE and take additional infection control processes.

There Was No Consensus on Who Should Pay the Additional Costs

You’re right that the pandemic was very hard on some offices because many people held off on their appointments. And, on top of it, dentists were being saddled with all kinds of new expenses. Many closed their doors for good.

Some insurance companies took a proactive approach and just started compensating dentists for the additional PPE costs. Others simply agreed to pay a fee if it was billed. The amount, usually between $10-$20 depending on the practice, was also passed on to the patients in some cases or written off by the practice if it wasn’t paid. Not all practices charged an additional fee, but certainly, enough did that it was quite common. Some are still charging it today.

They Should Have Told You About the Fee

It’s possible there was a notice slipped into your paperwork or mention made on your reminders but the practice may have simply wordlessly added it in like any other charge, perhaps thinking it was so minor it wouldn’t be noticed or, as you mentioned, expecting insurance to pay. In any case, it sounds like you’re frustrated with the lack of communication and that’s perfectly understandable. Their charge was normal given the circumstances and was within their rights to add, but if you’re put off by how they handled it, voice your thoughts to the dentist so they can handle it differently in the future.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist.

What Now? My Dentist Said Charcoal Toothpaste was OK…

March 15, 2021 by Athena Smiles

I had a lengthy chat with my dentist a couple years back regarding charcoal toothpaste. I tend to prefer natural medicine and was hoping charcoal would be a good alternative to the professional teeth whitening he offered. He was pretty blunt that I shouldn’t expect the same kind of results but said that there was no harm in using charcoal toothpaste. Now, I’m following the news and it seems like he and half the population was wrong. I’m worried I may have done permanent damage to my teeth. Is there a way to find out?

Thanks,

Rebecca

Dear Rebecca,

The latest class-action lawsuit is against Procter & Gamble, makers of Crest Toothpaste. However, there have been several others in the past and there are likely to be more down the road. The argument is that charcoal is so abrasive that it takes off layers of your enamel. And, while there’s certainly a case for it being harsh, studies have largely been inconclusive.

Studies on Charcoal Toothpaste are Inconclusive

When the American Dental Association (ADA) pulled every study they could find on charcoal toothpaste, the results were all over the place.

“Two studies offered nonspecific caries reductions, 3 studies reported deleterious outcomes (increased caries, enamel abrasion, nonquantified negative impact), and 1 study indicated only that brushing with raw charcoal had no adverse effects on oral hygiene,” the report said.

So, although the scales tipped in favor of it not being safe, it wasn’t by a wide margin. With that in mind, the ADA concluded “this literature review showed insufficient clinical and laboratory data to substantiate the safety and efficacy claims of charcoal and charcoal-based dentifrices.”

The organization said dentists should “advise their patients to be cautious” when using charcoal toothpaste. If nothing else, though, claims that charcoal toothpaste is somehow good for you could also not be substantiated. In absence of evidence, most dentists would generally suggest not using something. Lack of an ADA seal is usually a solid indicator that a product is deviating from the trusted norms.

Even Still, Charcoal Toothpaste is Highly Abrasive

Many people like yourself turned to charcoal toothpaste in the quest for whiter teeth. It’s actually the abrasiveness of the material that gives it the ability to “whiten” by scrubbing off stains. The real question is whether it was so abrasive that it damaged enamel. Some studies did come to this conclusion by measuring the roughness of a tooth before using charcoal toothpaste and again after a month of use. With that in mind, it could theoretically damage your teeth in as little as a month.

However, each person responds differently to abrasive products to some degree. Habits and genetics, among other things, can determine the quality and strength of your enamel and, thus, your susceptibility to damage. That may be why the studies couldn’t prove anything. If they weren’t isolating for those factors, they would have different findings.

It Wouldn’t Hurt to See a Dentist

If you had damage from using charcoal toothpaste or anything else, you’d probably have telltale symptoms, like yellower teeth from thinning enamel, picking up stains fast due to rough enamel, or sensitivity. If you aren’t experiencing any of these issues, chances are your teeth have come through it ok. However, for your own peace of mind, you may want to get a thorough exam. It’s best to see a dentist who does a lot of cosmetic dentistry for this, as he’ll be more finely attuned to picking up minor changes Best of luck to you.

This blog is sponsored by Auburn AL dentist, Dr. Raymond Bolt.

Anything My Dentist or I Can Do About Numbness After Extractions?

February 10, 2021 by Athena Smiles

I was originally on the fence about whether I needed to see an oral surgeon of it my general dentist here in Auburn should do my wisdom teeth extractions. My dentist assured me I’d do fine and said that my extractions wouldn’t be complicated—that the only reason to see the oral surgeon would be if I wanted full anesthesia. Long story short, I went ahead and had him do it last week but I’m still feeling numb on my lower right side.

When I called and told them this, they more or less dismissed me, saying this “just happens sometimes,” I signed a form saying I understood it beforehand, and to come back in two weeks to have it checked again. I’m more than a little frustrated because I’m having trouble eating and chewing because of it really bothers me that they seemed more concerned covering their backsides about the form I supposedly signed. I may have, but that’s not the point.

Is there something they or I should be doing to get me back to normal faster?

Thanks,

Ruben

Dear Ruben,

It sounds like you have nerve damage in your lower right jaw. This will, in all likelihood, heal on its own, but let’s dig into what happened and what your options are.

The Inferior Alveolar Nerve Runs Along the Lower Part of Your Jaw

“Innervation of the dentition” by Lesion / CC BY-SA 3.0

The image here shows approximately where your jawbone nerves sit, with “B” being the aveolar nerve. Everyone is a little different, so sometimes the nerve can run much closer to the teeth or it might be distanced more. Your dentist should have taken an x-ray before the extractions before deciding how to proceed. The nerve can even been seen on traditional panoramic x-rays as a dark line. Although it’s not the same as a 3-D image, it’s generally enough for the doctor to be able to evaluate the potential for issues during the extractions.

Nerve Damage During a Wisdom Tooth Extraction Falls into Three Categories

There are multiple ways nerve can be damaged during a tooth extraction. Healing is largely dependent on the type of injury.

Bruising

Also referred to as “stretching,” bruising is generally the mildest form of nerve damage that can occur during an extraction. This might be the case if mild pressure was applied to the nerve during the extraction or if swelling put pressure on it. In these cases, the nerve will generally heal in about a month on its own unless the stretching is severe. If a patient is experiencing pain, a doctor might offer some kind of palliative treatment or medication to help with that, but there’s nothing that can be done to restore sensation.

Crushing

It takes more pressure to cause a crushing-type injury. That might happen if downward pressure is applied to the tooth during the extraction or if the tooth breaks and the dentist has to go in and remove fragments, pressing on the nerve in the process. In these cases, the nerve fibers will regrow and heal, but it can take a year or so before sensation is restored.

Severing

The same things that cause crushing injuries can also sever the nerve, as can outright trauma directly to the nerve. However, the nerve will not regrow in these cases and the injury is permanent. On the whole, though, research shows latrogenic paraesthesia (abnormal sensation following medical treatment), is only permanent 25% of the time. And, even then, there are potential treatments such as nerve grafts that may help. Prognosis is best when surgery happens within three months of injury, but people have success much further out too. Many people simply adapt to the situation as well.

Sit Tight and Do Some Soul Searching

Chances are, you’re dealing with bruising. In which case, there may have been nothing the dentist could do to prevent it. The latter two are questionable—dentists are taught techniques to avoid damaging the nerve and many never see a single case of permanent damage their entire careers, but that doesn’t necessarily mean there weren’t extenuating circumstances either.

The main point is that you feel they dismissed your concerns. Their offering you an appointment in two weeks might be them trying to set you at ease though. It’s unlikely anything will be different in two weeks. Again, no change is likely to happen for three more weeks. So, give this some time and see what happens at your next visit and when you hit the month-mark. If you feel they’re still being dismissive, you may want to start looking around for a new Auburn dentist. And, if the numbness is still happening a month from now or you simply want more assurance, you may want to visit an oral surgeon for evaluation. Best of luck to you.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist specializing in comprehensive family care.