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

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.

Pediatric Dentist Left Bruises on Son- Normal or Not?

January 20, 2021 by Athena Smiles

My six-year-old had to see the pediatric dentist to have two teeth removed yesterday. He was incredibly sore after and overnight. We tried icing it and giving him ibuprofen, but it didn’t really help. By this morning, it looked like he’d been in a boxing ring. I phoned the dentist to find out what happened and they told me there was nothing out of the ordinary about the treatment—just that sometimes this happens. I want to believe them. We have a good relationship with the doctor and all my kids have seen him, so we’ve been patients for probably a decade by now. But, I’ve never seen or heard of anything like this and it’s quite alarming. My son doesn’t remember anything about the treatment. They sedated him during the visit. So, I really don’t have anything but the word of the dental office to go on. Is this normal? Or should I have my son seen somewhere?

Thank you,

Ann

Dear Ann,

As scary as it may look right now, your son is probably experiencing a side-effect of receiving anesthetic and will be just fine in time. However, you should get him checked out by the pediatric dentist or a physician just to be sure.

Hematomas May Occur by Receiving Anesthetic

As Jacqueline J. Freudenthal, RDH, MHE, associate professor and chair of the Department of Dental Hygiene at Idaho State University explains, “A hematoma develops when a blood vessel (artery or vein) is inadvertently injured by the needle. If the injury is minor or the tissue is dense, a hematoma is unlikely to be noticeable extraorally.” She notes that the care team can help diminish the impact by stopping treatment and applying pressure and ice right away and continuing with ice off and on for the next six hours. So, you did the right thing by applying ice at home. However, she also notes that, “ If an artery or vessel is injured in a vascular area, such as the pterygopalatine or infratemporal fossa, a more dramatic response of swelling and bruising may occur.”

Most hematomas heal on their own with no further care needed. However, more serious cases do require additional treatment and follow-up care with the dentist or a physician. This has been observed and studied in children.

Sometimes Bumps Happen During Extractions

It’s also possible your son is more susceptible to bruising or was bumped during the extractions. This doesn’t happen much with baby teeth because they have shorter roots and tend to come out easier than adult teeth, but it’s possible trauma occurred during the extraction too.

Take Him to the Pediatric Dentist or His Pediatrician

It sounds like your instincts are spot-on here. Your son is in pain and has obvious signs of injury. Whether they happened during the course of normal treatment or not, he should be seen right away. Chances are, he’ll be sore for a bit and the marks will dissipate over the next couple weeks. However, if he is experiencing one of the rarer complications, medical intervention could be necessary. Give the pediatric dentist a call back and let them know you’d feel better if the doctor took another look at your son. If they can’t get him seen right away or you have concerns about what may have happened in the treatment room, have him visit his pediatrician or another doctor instead.

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

Can My Auburn Dentist Dismiss Me if I Get Implants in Mexico?

January 10, 2021 by Athena Smiles

I have a good relationship with my dentist here in Auburn, but I need to get implants done and they’re way out of my price range. I initially tried saving up to have them done here but something always came up and I never got anywhere close to having my portion after nearly two years of trying. I have a sister who lives in Texas near the border and she’s gone a couple times and says most there are accredited by the American Dental Association and that it’s the same as having it done here because of it.

I tried to approach the subject gently with my dentist the last time I was in and he told me that he wouldn’t continue to treat me if I went. He said that it’s not safe and, if he continues to treat me and there’s an issue, he could be held liable for the Mexican dentist’s shoddy work. I’m heartbroken. I understand what he’s saying and respect his concerns. At the same time, I would have loved for him to do the work. I really would have. I just can’t afford to have him do it. And, I would never in a million years go after him if something didn’t go right in Mexico. In a way, I feel betrayed. He’s making me choose between having a full set of teeth and staying with him as a patient. Can he even do that?

Thanks,

Sharon

Dear Sharon,

So sorry to hear you’re dealing with all this. The short answer is, “maybe.” The full answer is complicated. Let’s take a look.

Exercise Caution if You Seek Treatment Outside the United States

There is nothing that’s “the same” as visiting a dentist in Mexico versus one in the United States other than both are dentists and both will provide similar types of treatment. When you talk about the licensing, the continuing education requirements, and the recourse if something goes wrong, it’s night and day. That’s not to say there aren’t good dentists in Mexico, but they simply do not have the same requirements as they do here. And, if you do wind up with a dental emergency, you’re a day’s drive away from your provider and have little recourse if he or she doesn’t do right by you.

Dentists Can Dismiss Anyone from Their Practices

A dentist doesn’t really have an obligation to keep you as a patient in the long run. You can be dismissed from a practice for virtually any reason. The only general caveat to this is that there are generally guidelines about the dismissal process that involve providing care for a period of time while you become established with a new dentist.

It May Be “Unethical” for Him to Dismiss You for This

Dismissing a patient for seeking treatment in Mexico is a bit different, though. The ADA addresses it in terms of a patient’s freedom of choice.

“The ethical dentist will treat the patient who has received dental treatment outside the United States in the same manner as he/she would treat a patient who has transferred their care from any other practice, irrespective of the fact that the treatment performed outside of the United States might or might not be substandard and, in some instances, a possible detriment to the patient’s health. A dentist should consult applicable state law to determine the definition of “patient of record.” Failure to treat such a patient may raise ethical concerns under ADA Code Section 2.F, Patient Abandonment.”

So, what we can ascertain is that your dentist could find himself in hot water with the local dental board if he dismisses you, even though his concerns about you receiving poor quality treatment are valid. In the same narrative, the ADA reminds dentists to keep good records, so it’s easier to identify the root cause of any issues if multiple providers are involved.

The Final Decision is Yours Alone

At the end of the day, you’d have to report the dentist to the board and they’d ultimately decide whether he behaved unethically or not. They may indeed agree he’s out of line in this case. But, whatever the board might decide, you feel betrayed by your dentist and seem to have lost faith in him. For that reason alone, it sounds like your needs are better served by a dentist who will honor your wishes. As an aside to this, it might be worth checking out other local dentists to see if someone here can still help you. True, you won’t get the same prices as you would in Mexico, but you can be assured the dentist treating you will be held to a higher standard of care. You may be able to find an affordable dentist who offers payment plans or similar as well. Best of luck to you.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, Alabama dentist who provides affordable and comprehensive care.

My Dentist is Pressuring Me to Do Work- What Do I Do?

December 20, 2020 by Athena Smiles

I don’t want to name names, but I see a local dentist in Auburn and have done so for quite some time. I’ve always been good about keeping up with my cleanings and never have outstanding work. Actually, most of the time, he’ll do my fillings the same day they’re diagnosed and I’m good for another six months.

Then, last February, he told me I needed to have a crown done on one of my molars. I have a big silver filling on that tooth and it’s starting to go. He said he thought there was decay there and the crown was the only fix.

Well, then COVID happened, and you know what that means. The office was closed for some time, and then on top of everything else, I lost my job and my dental insurance. Thankfully, I got a new job in October (with new insurance!), but I’m still recovering financially and I haven’t been in a position to schedule the crown work. I’m a couple months off my cleaning schedule too.

They called me when they opened back up and I got my reminders about my cleaning. Then they started calling and I explained to them what I was dealing with and thought they’d give me some breathing room. However, a couple weeks ago, I started getting letters too. The latest talked about how important it was to complete my treatment and basically said I’d be foolish to let my insurance benefits go to waste by not using them before the year is up.

I already felt terrible, but now I feel even worse. I don’t know if I can even go back for my cleaning. Should I bother trying to talk to them again or should I just move on?

Sincerely,

COVID Stinks

Dear C.S.,

Yikes! Sounds like you’ve had quite the year. Glad to hear things are looking up for you now. Let’s break apart what’s happening and what your options are.

Most of Your Contacts Were Probably Automated

These days, dental offices rely heavily on automation. Your recall reminders and even notes to use your benefits before the year rolls over were probably computer-generated or, at the very least, kicked off with a couple of clicks. That may sound impersonal, but on the bright side, there wasn’t anybody looking over your chart and passing judgment. They use these tools to make sure nobody falls through the cracks and to make sure the team can focus on the patients in the office receiving care rather than licking hundreds of envelopes.

You Can Still Tell Them You Feel Pressured

The reality is, most dental offices don’t staff writers or marketing teams. The person who penned your note was probably the same person who greets you warmly with a smile when you walk through the door and asks you about your kids and hobbies. They’re probably not an expert in what words to use or how many times they should try reaching out to someone. They’re just someone who cares about whether you’re having your needs met. All the same, if you took the notices the way you did, chances are others did too. It’s totally ok to tell them that, so they can refine their process and language.

Don’t Let Finances Stand in the Way of Vital Treatment

That said, there is a whole lot of people in situations like you are now. If the office hasn’t discussed financial arrangements with you, you may want to find someone who makes providing affordable dental treatment a priority. That’s not to say you should accept cheap dental care, but rather, seek someone out who will give you options and either accepts payment plans or Care Credit. That way, you can move forward without that crown looming over you.

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

My Dentist Forced Me into Unnecessary Implant Surgery

November 20, 2020 by Athena Smiles

I’m at a total loss for what to say here. I had a tooth extracted a while back and my dentist has been after me to have an implant placed for as long as I’ve been seeing him. I finally saved up enough to do the procedure and was assured everything would be fine. However, when I came out of surgery, he told me that my bone may be inadequate to support the implant.

He gave me some explanation about how it had been too long since I’d lost the tooth and the bone had thinned out… more or less shifting the blame on me for not starting the work sooner.

As a “courtesy to me” he went ahead and placed the implant, but he says it will probably fail because I waited too long. He wants to remove it and do a bridge. But, he says the final decision is mine.

I’m not sure what to do here. I’m already out a couple thousand dollars on this implant. I’m tempted to go ahead with it since I’ve already invested so much. At the same time, I don’t want to seem like I’m questioning his judgment. Maybe I should be doing the bridge. What’s the best course of action here?

Sincerely,

Greg

Dear Greg,

You should be questioning his judgment. If that’s what he told you, you absolutely should be questioning everything coming out of his mouth.

The Lack of Bone is Not Your Fault

What he said about how bone diminishes the longer a tooth is missing—that much is true. It’s referred to as resorption. When the bone isn’t needed to hold a tooth in, the body breaks it down and reroutes it to places that need the nutrients being held in the bone. The thing is, assessing the bone level before surgery is his job. If he couldn’t tell whether there was adequate bone from an x-ray, he should have been ordering additional scans. For him to put it on you like it’s your fault that he did a procedure without visibility—that’s simply wrong. He didn’t do his job.

He Shouldn’t Have Placed the Implant

When he realized the procedure couldn’t be completed properly, he should have stopped and gone over the options with you. It sounds like you might have been sedated, so he just went ahead with it anyway. That was not the appropriate course of action.

You Have Options Beyond a Bridge

If there isn’t adequate bone to hold this dental implant, sadly, it will have to go. However, that doesn’t mean you’re not a candidate for an implant. It usually just means that you’ll need additional procedures, such as bone grafting, to build the area up enough to be able to support the implant.

Visit a Different Dentist

Have a consultation with a new local dentist to see what your options are. It may go without saying, but if the new dentist feels the implant you have is not going to be stable as well, it would be unreasonable for the dentist to keep the fee for it. Best of luck to you.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, Alabama dentist dedicated to quality care.

A Crown Done by My Local Dentist Falls Off Once Per Month!

October 12, 2020 by Athena Smiles

I saw a local dentist about three months ago because one of my molars broke. It was one of those watch-and-see deals. My former dentist said the amalgam filling I had there was old and would probably cause problems for me at some point, so I wasn’t overly surprised when it went. However, I had fallen out of routine with him and I was honestly a little embarrassed, so I booked the exam for that tooth with someone new.

In any case, it’s been a mess since the very beginning. The temporary crown they fitted me with came off just about every day until they gave up on it and told me to leave it off and “baby it” until my permanent one was ready. When I got this one, it was wrong from the beginning too. It NEVER felt right. I told them that and they said I just needed time to get used to it. It also didn’t match my other teeth. It’s a very bright white. I pointed that out as well and the dentist told me he could have the lab remake it but that it would be at cost. Well, since it’s a back tooth nobody but me is going to see, I decided to let that part be.

But, about three weeks after it was “permanently” cemented, it came off. I wasn’t even doing anything. It literally fell off while I was sitting at my desk at work. I went back and they put it on. AGAIN, it didn’t feel right and AGAIN, they told me I’d get used to it. Well, just yesterday it came off again. The dentist put it back on but he also told me that if it comes off again, the lab will have to make a whole new crown and he wants something like $600 to cover the cost. Needless to say, the crown STILL does not feel right and I think I’m on borrowed time.

This doesn’t make any sense to me. I feel like he’s in the wrong here and should fix it at his expense, but at the same time, I don’t feel good going back to him. What are my options?

Thanks,

Eric

Dear Eric,

Yikes! That’s terrible. He is in the wrong and you deserve better.

The Color Should Have Matched

If the coloring was that far off, it’s pure laziness. It shouldn’t have been that far off to begin with, but even if it was a slight variance, he should have offered to send it back right away. A responsible dentist would have made ensured it was a good match and would have covered the expense if his office was at fault or expected his lab to cover it if they were at fault.

They Should Have Worked with You on the Temporary

It can be difficult to keep temporary crowns on some people, especially if they have a hard bite or do things they shouldn’t with it, like chewing gum. All the same, they shouldn’t have given up on it. Unless there’s more to the story, it’s worrisome that they did. Actually, if they’d paid attention to this, they might have caught the underlying issue with your permanent crown.

There’s No Excuse for Your Permanent Crown to Fall Off

While there are “reasons” crowns fall off, none of them are good excuses, especially at this stage. It sounds more like the tooth wasn’t prepared correctly. Basically, the dentist needs to make the tooth peg-shaped—more cylindrical, like a can of soda—in order to get the best retention. Any angle—where the tooth becomes more of a cone shape—is referred to as “taper.”

If the taper angles upward, like an inverted pyramid where the top of the tooth is wider and the base is narrower, a crown literally cannot go on the tooth.

If the taper angles downward, where the biting surface of the tooth is narrower than the base, the degree of that taper influences how likely it is to fall off.

Chances are, your dentist failed to prepare the tooth properly. That’s why neither the temporary nor the permanent crown will stay in place.

Go to Another Dentist

The dentist who did this crown for you has had ample time to catch his error and correct it and he hasn’t. Moreover, he’s trying to charge you for it. Either return to your regular dentist or visit another dentist to confirm this, but chances are, you’re going to need the tooth re-prepped and a new crown made. If this is correct, the first dentist should refund you or pay the new dentist to do the work properly. Best of luck to you.

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

Can Dentists Prescribe Antibiotics?

September 29, 2020 by Athena Smiles

I have a raging toothache and called around to several dentists in Auburn to see what their policies on prescriptions are. To be clear, this thing doesn’t just hurt. Half my face swelled up. I told them all this—that I’m in agony with some kind of tooth infection but that I can’t afford to treat the tooth until I get paid in two weeks. Maybe four, depending on how much this is going to cost me.

Not a single one would give me a straight answer. They all said that I’d have to book an appointment and that the doctor would let me know my options after an exam. I get that they want to take precautions, but this is beyond ridiculous. At this point, I’m deciding whether I should just go to my primary care physician to get medications and revisit dental treatment after payday. I would love a straight answer though. Should I bother booking?

Thanks,

Joey

Dear Joey,

Sorry to hear your situation wasn’t treated with the care and consideration it deserves. Let’s break down your answer.

Yes, Dentists Prescribe Antibiotics

Dentists are doctors. They can prescribe all sorts of medications, including antibiotics and pain medications. Particularly given the symptoms you described, antibiotics would be a necessity in this situation and it’s hard to imagine a dentist not prescribing them unless something else is going on.

Pain medication is a different story entirely though. Given the current regulations and high potential for abuse, many will not prescribe narcotics. In fact, you may have raised red flags with these offices if you called around without specifying what kind of medication you were hoping to receive. They probably thought that’s what you were looking for, not antibiotics for a swollen face.

You Need to See a Dentist ASAP

This qualifies as a dental emergency. Anytime you have an infection like this, it’s imperative to start treatment right away. As odd as it sounds, people still die in this day and age from untreated dental infections. Rather than calling around and asking about meds, find out which dentist can see you today. You’ll probably leave with your antibiotic prescription and a complete estimate on doing the repair work when you’re ready.

Explore Affordable Dentists if Budget is a Concern

It sounds like cost has been a major concern for you, possibly preventing you from treating this tooth to begin with. Don’t let cost be a barrier—it leads to issues like what you’re experiencing today. Instead, find someone who can work with you a bit. Each office will approach affordable dentistry differently. While you do NOT want someone who does cheap dental work, you can find offices that have reasonable fees, will break up your treatment and help you prioritize appointments, and even some that offer payment plans or accept Care Credit (a medical credit card). This is something to keep in the back of your mind while you’re getting that tooth squared away—you’ll want to come back for a full exam soon and start addressing other issues as you can before they get a chance to turn into an emergency. Best of luck to you.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist offering comprehensive care and same-day appointments for dental emergencies.

Can My Dentist Force Me to Use a Dental Dam?

August 10, 2020 by Athena Smiles

I’ve been seeing the same dentist in Auburn for many years and he’s been pretty good with me. I have some dental anxiety… I wouldn’t call it a bad case but I do white-knuckle it a bit while I’m there. He’s been understanding about it in the past and worked with me to get things done. Anyway, I went in for a cleaning at the start of March and he discovered a cavity. Not a huge deal—he’s done a few fillings for me in the past and I thought this would be no different. However, the office shut down due to COVID and my appointment was rescheduled several times. This past week was the first time I could get in… suffice it to say, it was a different experience. The only real issue, though, was when he attempted to place a piece of plastic or rubber over my mouth. No warning. Nothing. He just put it on without talking to me about it and I panicked. I couldn’t breathe with it on, started hyperventilating, and then tore the thing off myself.

Well, bad turned to worse because, instead of calming me down, the dentist jumped out of his chair and stormed out of the room. His assistant was even stunned by it. I could tell. She didn’t say anything at first… just sort of stood there in shock and patted my arm and told me to take a minute to myself.

When I finally calmed down… no thanks to them… the dentist came back in and told me that I had to wear it as part of their new COVID precautions. I told him there was no way I could wear it. It sent my anxiety through the roof. He then told me I could wear it or leave. He would not do my filling if I didn’t. I left.

Can a dentist really force me to wear one of these things? I’m worried because, if they’re all this way, I don’t think I can get my filling done anywhere.

Best,

Jerome

Dear Jerome,

Sorry to hear you’ve been through all this. It sounds like a horrible and frightening experience, especially considering you had anxiety beforehand. Let’s break down what this device is and what your options going forward are.

The Rubber Sheet is a Common Tool Called a Dental Dam

Although your provider may not have used them in the past, dental dams are quite common. Dentists routinely use them to keep a tooth isolated to ensure a tooth isn’t contaminated while it’s being repaired and to prevent debris from falling into a patient’s mouth.

Many Dentists Are Using Dental Dams to Reduce Airborne Saliva During COVID

It probably goes without saying, but when dental handpieces are whirring around in your mouth and there’s saliva present, they can and do whip that saliva into the air sending microdroplets in every possible direction. There are things the dental team can do to keep saliva away from the handpiece, but none are as effective as creating a barrier between the saliva and the area the dentist is working. That’s exactly what the dental dam does. And, although it’s not a formal requirement from any governing agency at this time, many dentists have started using them as an extra precaution. They and their teams obviously need to minimize their risk, lest they get sick and spread coronavirus too. If your dentist feels the dental dam is necessary, and you don’t allow him to use it, he can decline to treat you. You are, in essence, preventing him from doing his job safely and well.

Find Another Dentist

At the end of the day, this dentist didn’t do right by you because he didn’t honor your dental anxiety. He made it worse and behaved poorly. If he had explained his methodology first or even paused to talk to you while you were struggling, this would have had a much different ending. He didn’t, and for that reason, it probably time to move on.

That leaves you with two options. First, you can find a new dentist who does not require you to wear a dental dam. Just call around and see which offices in your area do not require them. As a second option, you can search for a “gentle dentist” or sedation dentist—someone who understands dental anxiety and will take extra precautions to keep you comfortable. That may simply mean having a calmer demeanor or it could involve using something like nitrous or medications to keep you relaxed while still using the dam. In any case, it’s a good idea to find someone you’re comfortable soon, so you can get that cavity fixed before it grows too much. Best of luck to you.

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

Dry Socket with Wisdom Tooth Removal

August 8, 2019 by writeradmin

I need to have a lower wisdom tooth extracted because of an impaction. I’ve spoken to someone else who’s had this done and they said they ended up with dry socket which was absolutely miserable. Is there anything I can do which can help to prevent this?

Katie

Dear Katie,

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Dry Socket Can Be Prevented.

Dry socket is what happens when the blood clot dissolves or disappears leaving the nerves and bone exposed. It’s quite painful.

Some dentists tell their patients that dry socket will happen if they suck the blood clot out unintentionally and suggest the don’t drink through a straw until after the healing process is over.

There really isn’t much evidence for this. Though, obviously, you don’t want to do anything which will intentionally remove the blood clot.

Your Dentist is the Best Defense in Preventing Dry Socket

There are two things your dentist can do to prevent dry socket.

The first is to recognize that the greater the force used in extracting the tooth, the greater the chance of dry socket. To counter this, if a dentist encounters a tooth extraction which is requiring a greater than moderate elevator force it is better to section the tooth. Sometimes bone has to be removed in order to do this, but it can be done.

The second thing which helps is for your dentist to place a square of Gelfoam soaked in a suspension of clindamycin antibiotic into the socket after the extraction and suturing the tissue over it. An experiment was done which showed this. They tried it on patients with two wisdom tooth extractions. On one side they put the Gelfoam; on the other they didn’t. Only the teeth without the antibiotic developed dry socket.

You can let your dentist see this post prior to your wisdom tooth extraction, if you are concerned.

This blog is brought to you by Auburn Family Dentist Dr. Raymond Bolt.