Emergency Dentist Archives - Dental Care at Flint's Crossing

Can I Transfer My Treatment to a Local Dentist?

Posted on September 30, 2022 by Athena Smiles.

I’m wondering if it’s possible to have an Auburn, AL dentist take over my treatment. I’m 38 and didn’t go to a dentist at all until I was 25. To be blunt, that visit was pretty traumatic because I had a lot going on and I guess they weren’t used to seeing people like me. I only ended up having a tooth pulled that day because I was in pain but never went back after that. Then, about two years ago, I got decent insurance and signed up with another practice.

Obviously, I still have a lot going on, but they were really good about creating a plan for me that involved doing at least some treatment each month and then paying $200 each month. Some months, I’d receive less treatment and some months, I’d receive more, but with the plan, I’d get everything done within my budget in a little over four years. It sounds like a long time, but going this route really made it more manageable. They described it as being like paying for a car, only at the end of it, I’d have the smile I wanted.

All that’s been great. I’m about two years in now and I’ve really been happy with the practice. The problem is that I just moved to Auburn and that practice is about a two-hour drive each way for me. I pretty much need to take a whole day off work each time I visit the dentist and that’s not realistic for me right now.

I mentioned this to the practice and asked if they could give me a copy of my records. They not only refused to give me my records but said that I couldn’t transfer my treatment because some of the work, like crowns, are only partially done and the dentist who started them is the only one who can finish them.

I think there’s a possibility I’m upside down with them in terms of payment, but it’s impossible for me to know where I am without a detailed statement and my records, so I know what’s been done. I don’t want to be difficult since they’ve been so good to me, but I feel like they’re holding me hostage. Are they allowed to do this or can I force them to transfer my treatment?

Thanks,

Carmen

Dear Carmen,

First, it’s commendable that you kept at it and found an office that would help you restore your smile. You should feel good about that. You’ve come such a long way! Let’s dig into your question a bit.

Your Old Office is Required by Law to Provide You with Your Records

Regardless of their logic and previous behaviors, your old office is not doing right by you and may even be breaking the law.

You may have heard of HIPAA, otherwise known as the Health Insurance Portability and Accountability Act of 1996. Most people think of it in terms of privacy or security, but there’s a provision in it that guarantees you the right to access your records. There are stipulations about what that includes, fees they can charge, and other details, but the gist is they have 30 days to provide you with your records after you’ve requested them. They cannot legally hold your records hostage.

You Can Begin Treatment with Another Dentist at Any Point

You don’t need their permission to find a new dentist in Auburn. True, things get a bit more complicated when a procedure was not finished. For example, if the dentist had a crown made for you, but it wasn’t seated yet, it’s better to go back to him and have him put the crown on. But, the reality is that sometimes people genuinely can’t return to the dentist who started the work. They may move, become ill, or any number of things. Another dentist can step in to finish, though you’ll likely be financially liable for any work that is already complete.

Identifying Where You Stand Financially May be Difficult

Dentists break up treatment like this dentist did all the time. Usually, it’s done in a way that you’re pre-paying for treatment or the practice is allowing you to carry a very small balance with them that gets cleared when you make the next payment. Hopefully, this is what they’ve been doing and you’re close to even right now or perhaps even have a credit. However, if they started with the more expensive treatment, you may have a balance to pay off when leaving. What you’re going to need to do here is go over your records with a fine-toothed comb, looking at each procedure code and identify what was started and completed. Then, confirm with your insurance company what they were allowed to charge for each procedure and what should have been written off. From there, you should be able to identify what your total personal balance owed was compared to what you paid.

Because you don’t have a dental background, it’s advantageous to have your new dentist confirm what work was completed and work with your insurance company to determine what you should owe for that.

The bottom line is that you can transfer to a new dentist and the old one must give you your records, but working out what’s still owed, or if you’re due money back, will be the bigger challenge if they’re making this difficult. Best of luck to you and keep up the good work!

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

Can My Newborn Have a Tooth?

Posted on August 15, 2022 by Athena Smiles.

My little guy is eight days old. He’s my third and I’m worried that something isn’t “right.” Nursing has been difficult, so I took a look in his mouth and noticed he has a weird bump on his gums. It protrudes and kind of looks like a tooth but doesn’t feel firm like one.

Is it possible he already has a tooth? And if so, is it better to contract his pediatrician or should we have a pediatric dentist evaluate it?

Thanks,

Kendra

Dear Kendra,

These are great questions. You should have him checked out by his pediatrician right away, but here’s a quick breakdown of what’s likely happening and what to expect.

Yes, Babies Can Have Teeth

When a baby is born with a tooth, it’s referred to as a natal tooth. When a tooth emerges in the first month of a baby’s life, it’s called a neonatal tooth. They’re not common. Studies place the prevalence anywhere from about one in 21 to one in 30,000, though most seem to point to about one in 3,000 babies experiencing one of these conditions.

Natal and Neonatal Teeth Can Be Problematic

Sometimes a tooth that emerges early like this is a normal and healthy primary tooth that the child will carry until the natural exfoliation phase when the adult tooth comes in. More often than not, though, these teeth don’t develop quite right. They may have defects, lack roots to hold them in place, or not even be fully formed.

Based on your description, it sounds like your son’s tooth is loose, which means it’s a choking hazard and could explain the difficulties you’ve had with breastfeeding.

It’s important to note that any parent who observes similar symptoms in their baby, be it a tooth-like protrusion or discoloration of the gums, should have it checked out. Even if it’s not symptomatic or causing feeding issues, it could still become a problem. For example, it may have malformed roots and start out firm, but then loosen as the baby’s mouth grows because it’s not anchored well enough. They can be fragile or break too. You don’t want to wait until these issues emerge, so always consult a doctor as soon as you notice it.

Talk with the Pediatrician First

Because your son isn’t getting the nourishment he needs, it’s important to connect with your pediatrician first. You’re already established with the practice, so hopefully they’ll get you a same-day appointment.

You May Need a Pediatric Dentist Too

Natal and neonatal teeth are usually extracted by a pediatric dentist. Babies generally respond quite well to this, in part because these aren’t like adult teeth with large roots, and in part because the teeth can be uncomfortable, which often results in difficulty eating and sleeping.

If your family is already established with a pediatric dentist, they might be able to handle this right away for you too. It’s not wrong to start with a pediatric dentist. However, since this may not be a natal or neonatal tooth and requires diagnosis, plus you’ll have to address immediate nutrition, starting with the pediatrician makes more sense.

Best to you and your new bundle of joy!

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

My Child’s Crown Keeps Falling Off – Can We Pull the Tooth?

Posted on July 14, 2022 by Athena Smiles.

My eight-year-old had a bad cavity on one of his back teeth a few months ago. The pediatric dentist said the best solution was a metal crown. I was worried about metal because of how it looks but the dentist said that’s what they do for kids and that my son would lose the tooth in a couple of years anyway.

About two months after it was put on, the crown came off. I took my son in and the dentist put it back on. We got maybe three months out of it before it came off this time but my son doesn’t know what happened to it. I haven’t taken my son back in to have it fixed yet. I don’t want to have to pay for a whole new crown again.

Is this normal? I have a couple crowns and nothing like this happened once. Can we just have the tooth pulled since he’s going to lose it soon anyway?

Thanks,

Kira

Dear Kira,

These are good questions! You’re going to need to get him back to the pediatric dentist as soon as possible, but let’s break this down so you know what’s happening.

Stainless Steel Crowns Are the Gold Standard for Children

When people have cavities, there are two main fixes: fillings and crowns. Fillings work in most situations but if the decay is extensive or spreads across multiple surfaces, it’s usually best to give the tooth coverage on all visible surfaces. It fortifies it a bit more and protects it from further damage.

Stainless steel crowns have been the go-to solution for kids for generations. While you could potentially get a tooth-colored crown, it’s usually overkill and adds to the expense, which is totally unnecessary when the tooth will be lost soon anyway.

Studies have shown that stainless steel crowns outperform multi-surface fillings for kids. They last longer. So, if your child is going to have a large restoration, it’s the stainless steel crown you want.

Removing a Tooth Too Early Can Impact Development

The alternative to repairing the tooth is removing it. The problem with this approach is that your son might ordinarily have that tooth until age 12 or so, so he’s actually got about four more years with that tooth based on your description.

Adult teeth are somewhat guided by baby teeth as they emerge. The baby tooth holds the space for the tooth that will come in. If there’s no tooth there, especially for years, the teeth around the empty space will likely shift and the adult tooth will likely come in awkwardly.

So, it’s better to keep that baby tooth as long as possible. When a baby tooth is lost prematurely, dentists will usually place a space maintainer. There are a few types of these, but the most common looks like a metal rectangle and is fixed to the adjacent teeth, so it holds the space open. This helps kids avoid problems down the road. And, while they don’t hurt, they can feel tight, it takes kids a while to get used to them, and they become something else for kids to clean around… the latter is more concerning for kids who are already struggling with oral hygiene and decay issues.

With all this in mind, the crown really is the best solution out of everything available.

The Crown is Falling Off for a Reason

Your crowns are different than your son’s crowns and they’re affixed differently. While it’s possible the dentist isn’t doing a great job with this crown, it’s far more likely your kiddo is eating things he shouldn’t. Gum and sticky candies are common culprits. He’ll need to avoid these things as long as he has the crown.

Schedule an Appointment with Your Pediatric Dentist ASAP

As long as that tooth is unprotected and without the restorative crown, it’s at significant risk for breakage. It might be sensitive or start to hurt too. Plus, if you wait too long and it breaks, then extracting the tooth may be your only option. You want to avoid that, so get him into the dentist as soon as possible.

There’s a good chance your dentist won’t charge you for this replacement but confirm when you make the call. Even if he does, this is still likely the best and most cost-effective solution at this point.

If your son continues to lose crowns, you probably will be responsible for replacement, particularly if the dentist believes the child is doing something to cause the crown to fall out. Keep a close eye on your son after this one and make sure he understands why taking care of that crown is important. If it falls off another time despite avoiding sticky things, you may want to consider getting a second opinion on the tooth from another dentist.

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

Why Do Kids Grind Their Teeth in Their Sleep?

Posted on May 16, 2022 by Athena Smiles.

I recently noticed that my youngest child seems to be grinding his teeth at night. He’s five, if that matters. At first, I thought it was a one-off thing or a fluke. He fell asleep in the car on the way home from a family function that ran late, and I caught his jaw moving when I looked back in the rearview mirror. I always pop in and check on him before I go to sleep, so the next few nights I paused to watch for a few minutes and realized he’s doing it all the time. He doesn’t remember doing it and doesn’t seem to be any worse off for it. The pediatric dentist hasn’t said anything while we’ve been in.

So, I’m wondering why do kids grind their teeth in their sleep and is this something he’s going to grow out of? I know it’s a problem for adults—his dad’s a grinder too—but I’ve never heard of children doing it.

Thank you,

Morgan

Dear Morgan,

This is a great question! Teeth grinding, formally known as “bruxism,” in children is more common than you might think. Studies show that up to 50% of kids do it, but that doesn’t necessarily make it a harmless habit. Let’s dig into the details a bit.

Why Do Kids Grind Their Teeth in Their Sleep?

Kids grind their teeth for many of the same reasons adults do.

Familial Links: Studies show teeth grinding tends to run in families, though researchers aren’t sure if it’s a genetic link or an environmental factor that causes it. Boys are more likely to grind their teeth than girls as well.
Stress and Anxiety: Yes! Kids get stressed out too. They worry about tests, things happening with the family, chores, and all sorts of other things.
Mental Health Issues: Grinding is linked to a multitude of sleep disorders as well as issues like ADHD.
Dental Issues: Kids with misaligned teeth, those who wear fixed orthodontic appliances, and those who breathe through their mouth tend to grind their teeth more.
Secondhand Smoke: Even moderate exposure to secondhand smoke increases the risk of grinding for kiddos.

What Happens When Kids Grind Their Teeth in Their Sleep?

Although you didn’t ask about potential complications, it’s important to recognize that sleep grinding isn’t a harmless habit. Kids with bruxism are at risk for a number of complications.

Fractured teeth
Receding gums
Teeth and jaw problems like temporomandibular joint disorder, sometimes referred to as TMJ or TMD (TMJ is actually shorthand for the jaw joint’s name rather than the disorder)
Mental health issues like anxiety and depression
Sleep problems
Eating disorders

Do Kids Grow Out of Teeth Grinding?

Generally speaking, kids do not grow out of bruxism. Remember, there’s an underlying cause, so although a contributing factor may end, and the child may seemingly stop grinding at night, they’ll probably resume if the trigger returns.

You mentioned that the dentist didn’t say anything at your last visit. It may be that it’s so early for your son that there are no outward symptoms yet. You should proactively bring it up so he or she can look specifically for signs of trouble and keep a close eye on your son as he continues to grow.

Treatment for Sleep Bruxism in Kids

Treatment for kids is much like that of adults and may vary depending on the trigger or underlying cause.

Dental Care: If misaligned teeth or other oral health concerns are contributing, the dentist will need to address them. Equally, if a child is displaying signs of grinding, such as broken teeth, the dentist will need to repair them.
Nightguards: Although nightguards don’t prevent grinding, they can protect teeth from damage and often reduce jaw strain.
Stress Relief: Talk to your kiddo to find out if he’s feeling anxious or stressed about anything. Sometimes just talking it out with you will be enough. If not, consider bringing in a mental health professional to help your kiddo learn ways to manage stress.
Bedtime Routines: If bedtime routines are inconsistent or chaotic, stress elevates and sleep issues may develop. Try to incorporate a winddown period before bed and set the stage for sleep by ensuring the room is quiet and dark. Limiting screens, especially close to bedtime, and making sure your child is eating well may help too.

As always, if you have concerns or your child develops symptoms that suggest they’re experiencing pain or discomfort, be sure to get him into the dentist for an evaluation right away.

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

Will Toothpolish Ruin My Teeth?

Posted on March 15, 2022 by Athena Smiles.

I’m 15 and have good teeth. We go to the dentist and I’ve only ever had one cavity. There’s this thing called Toothpolish trending on TikTok and I want to try it. It’s like nailpolish but for your teeth. It comes in lots of different colors and I really want to try the white so I can get brighter teeth.

Because you can only get it online and I don’t have a credit card, I asked my mom to order it for me and told her I’d give her money from my allowance. She said no because she thinks it’ll ruin my teeth – that I’ll start getting cavities or that it will somehow cause permanent damage.

Everything I’m seeing says it’s safe and everyone I see using it says it’s fine. What can I tell my mom to get her to let me get it?

Thank you,

Storm

Dear Storm,

It sounds like you’re referencing CHRŌM. Your mom’s probably being overly cautious here, but you may want to hold off on placing an order. Let’s dig into it a bit.

What’s “Toothpolish?”

To get others up to speed who may not be on TikTok, CHRŌM is a temporary paint-on colorant similar to nail polish that’s become popular with specific demographics, especially teens and those in their 20s. This is largely because the company has been doing a whole lot of influencer marketing. They seem to be paying people with large social media followings to demonstrate how their product is used.

Is Toothpolish Safe?

The big question you’re asking is whether toothpolish is safe. There are no long-term studies that show it, which is usually a red flag when it comes to healthcare/ cosmetic products. Very much a buyer beware type situation.

The company notes that it’s not suitable for people with certain pre-existing conditions. For example, if you wear braces, have Invisalign, have cavities, or have sensitive gums, it’s a no-go. If you have sensitive teeth, it may cause some issues during application and while drying because of the alcohol content. That should also be a red flag. If you’re constantly applying it and causing pain/ irritating your tooth, you can permanently damage the nerve, which would ultimately require a root canal and usually a crown to repair and can sometimes result in the loss of the tooth. It would be unlikely for this to happen, and even harder to trace it back to the toothpolish, but it’s something to be aware of.

With all that said, it’s probably safe for most people based on the ingredients listed, but it’s also not something you should try without talking to your dentist first.

Covering Up Issues is Not a Good Idea

The big concern dentists are reporting with it is that people may use it to cover up what they think are “cosmetic issues,” when, really, they’re covering up issues like cavities that will get worse over time if left untreated. If you’re unsatisfied with the look of your teeth, tell your dentist what’s bothering you. You’ll learn what all your options are so you can make an informed decision.

Toothpolish as a Whitening Solution Would be Expensive!

Bear in mind, toothpolish is temporary and you remove it by scratching it off or brushing. You’ll need to plan to reapply it anytime you eat something that could scrape, brush, or rub it off.

When you’re using colored varieties to accessorize or to achieve a certain look occasionally, that’s not necessarily a problem. It’s like having to reapply a colorstay lipstick throughout the day. When you’re trying to use it to make your teeth look whiter on an ongoing basis, that’s going to add up.

The company says you’ll get 10 applications per bottle if you’re applying it to all your visible teeth, and each bottle is around $20. Let’s say, conservatively, you’re only applying it twice per day—at the start of the day and after you eat lunch, since you’re probably going to chip some off or scratch it up while you eat. It’s only going to last you a week. You’d spend $80 per month just having it for school. Assuming you’re in school 10 months of the year, that’s $800 per year.

A professional whitening solution provided by your dentist would come out less expensive in the long run, would give you lasting results, and would be way way way less hassle. And, yes, you could potentially whiten your teeth at your age, but it’s something you need to discuss with your mom and dentist.

Now, if you’re just talking occasional use, like maybe you want a pop of white when you’re filming your own TikTok clips or having school pictures taken, it’s probably going to be suitable for something like that as long as your dentist and mom approve.

Bottom Line: Your Mom is NOT Wrong – Sorry!

Your mom is right. You’re young and it’s important to protect your teeth. If you take good care of them now, you’ll likely still have them when you’re 80. So, it’s just not a good idea to be trying products that could potentially cause an issue, especially when finding out if you have any of the contraindications is so easy.

You sound like a mature child—you’re able to save up and pay for your own products at this point. And, you also say your mom takes you to the dentist. Instead of jumping in with this, why bring it up with your dentist and/or hygienist next time you go in for your checkup and cleaning?

That’s not to say you should go against your mother’s wishes—you shouldn’t. But, handle this with the same maturity you‘d handle the money with. Let your mom know that you’re respecting her wishes and not using it, but that you’d like to run it past the dental team when you go in to get their feedback on the safety. That way, you’ll settle the dispute and, even if you don’t get the green light, you’ll leave knowing why and what your options are.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist providing general dentistry, pediatric, and emergency care services.

Will a Root Canal Make My Son’s Front Tooth Whiter?

Posted on February 28, 2022 by Athena Smiles.

My son almost knocked one of his front teeth out while horseplaying in the pool a few summers ago. Back then, he was seeing a pediatric dentist who suggested we take a “wait and see” approach. She thought it would heal up on its own and it seemed to have, but it’s turning a grayish color now. He graduated to seeing the family dentist who says the next step is getting a root canal because the tooth is dying, and that it’s up to us whether we want to do it right away or wait until the tooth starts hurting. I’ve never heard of a root canal whitening a tooth. Has the process changed over the years?

Thanks,

Tyra

Dear Tyra,

Did the dentist say the tooth was dying or that it was already dead? That’s an important distinction. True, it can take months or years for a tooth to turn gray after trauma. The coloring is a common symptom of the blood flow being cut off or nerve being severed. But, most people do have other symptoms and, for the dentist to indicate the tooth is presently dying with no symptoms beyond a color shift, it’s a bit unusual. You wouldn’t want a root canal if the tooth is vital and not infected and there are other things that can cause gray discolorations. Let’s go over this a bit.

Many Things Can Cause Teeth to Go Gray

While trauma is perhaps the likely culprit here, it’s important to remember there are lots of potential causes of gray teeth. Although some of the following won’t apply to your son, a detailed list is provided below for others following along too.

Decay: Cavities can cut off blood flow just like trauma can.
Dentinogenesis Imperfecta: Although rare, this hereditary disorder weakens teeth and can turn them a bluish-gray color.
Tetracycline: When children under 8 receive this antibiotic or expectant mothers take it, it can turn developing teeth gray.
Restorations: Metal tooth restorations, such as amalgam fillings and crowns, can discolor teeth too.
Aging: Sometimes teeth take on a blue-gray hue as a person ages.
Root Canal Medications and Materials: Certain medications used to disinfect during root canal treatment can turn the tooth a brownish-gray color. Sometimes the inert filling used to fill empty chambers after a root canal, or cement used, can cause discolorations as well.

Get Clarification from Your Dentist or a Second Opinion

Color alone does not signify the tooth is dead or dying. Find out what he’s seeing beyond the coloration and what condition he thinks the tooth is presently in. It may be a good idea to get a second opinion before starting treatment too.

A Root Canal Will NOT Whiten a Tooth

A root canal is the next step if the tooth’s nerve is dead or the tooth is infected, but that’s only because a dead tooth will eventually develop an infection. Think of it like a stagnant pool of water. Bacteria gets in there and thrives until you have a raging infection. It’s no fun at all! You don’t want to let it get to that point, so if your son has other signs the nerve is no longer vital, it’s best to move forward with the root canal as soon as possible.

With that said, a root canal won’t do anything about the color of the tooth. For that, you’ll want to explore cosmetic options, such as internal bleaching (performed by a dentist) or a veneer. Best of luck to you and yours.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist providing pediatric dental services and emergency dental care.

Did My Dentist Place Crowns I’m Allergic To?

Posted on January 31, 2022 by Athena Smiles.

A couple of years ago, my dentist did some crowns for me across my four front teeth. I’d chipped them in my early 20s and, although the fillings that had been placed served me well for many years, they were starting to fail and cause some issues.

Anyway, I mentioned that I had a metal allergy at the time of placement and the doctor assured me it wouldn’t be a problem with these. I probably should have asked more questions but I didn’t. I just took him at his word.

Lately, I’ve noticed that the spot right between my two front teeth is quick to bleed. It often bleeds when I’m eating and, I’m embarrassed to say, one of my coworkers pointed it out to me the other day when I hadn’t done anything at all that could have triggered it.

I’m told that most crowns are metal. Is it possible these are or that metal was somehow used and that’s what’s triggering the bleeding? If so, will I need to have them replaced or is there another fix?

Thank you,

Fatima

Dear Fatima,

It’s probably not a metal issue, but let’s break down why that can be ruled out and go over some potential causes.

The Bleeding Between Your Crowns is Likely Not Related to Metal

Generally speaking, dentists try to avoid using metal on anterior crowns. Front teeth don’t usually need the additional strength afforded by metal and it’s harder to get the aesthetics right with a metal layer underneath.

Moreover, if this was a metal allergy you were dealing with, it would likely be impacting all the surfaces of all the crowns done at that time, versus just between the middle two, and it probably wouldn’t have taken so long to manifest.

Something Else is Causing Gum Irritation

Odds are, something else is causing irritation there. If you’re not getting in there and flossing, that should be a priority.

It could also be that there are issues with the margins of those crowns or perhaps a small amount of cement was left. In these cases, food can easily be trapped or plaque can build up; the latter of which you may not be able to remove on your own.

Focus on Homecare and See the Dentist for an Exam

If you’ve been keeping up with your dental cleanings, it’s ok to work on this a bit at home. Work on flossing. You can use floss picks or similar if you’re not a fan of floss or it’s hard to use there. You can also use salt water rinses to try to speed up the healing, but avoid alcohol-based mouthwashes that can dry out your gums and make the problem worse.

If you start to notice signs of infection or it begins to hurt, go get it checked out right away. Otherwise, you can work on your homecare for a couple of weeks to see if that improves things and then have it checked out at your next cleaning. And, of course, if it doesn’t start to improve with extra TLC, have it checked out sooner. Best of luck to you.

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

Dentist Grilled Me About Pain Meds: Is That Normal?

Posted on November 30, 2021 by Athena Smiles.

I see a local dentist here in Auburn fairly regularly but fell out of schedule because of COVID. Prior to that, I had no issues and got my cleanings as needed. I recently visited family in Florida and, of course, came down with a terrible toothache. I couldn’t see anything wrong with the tooth, but it absolutely killed me to eat just about anything and it was somewhat tender just from breathing. In any case, I had to visit a dentist there to get it checked out. He said he couldn’t see anything wrong with it on the x-ray but that, based on my symptoms, it was probably a cracked tooth.

The first problem was that he said only a crown would fix it. Well, that apparently meant I’d have to return to his office to finish it in two weeks… not realistic since I was only supposed to be there for a week. I asked him about possibly just getting some pain medication and having it fixed by my dentist when I got back home. That’s when it went from bad to worse.

The next thing I know, he’s looking me up in some database and telling me that I already have a strong pain prescription and he can’t give me anything else. Yes, I had another pain prescription. I received it a month ago when I went in for a medical procedure. I was fine and recovered and that medication was here at home, not something I took with me. I’m not some addict and I was in serious pain. Is it normal for doctors to behave like this over prescriptions now? I didn’t have any issue when I came home. My doc patched me up right away and didn’t bat an eye when I asked for something for the pain, but I’m not sure if it was because he knows me or what.

Thanks,

Gerry

Dear Gerry,

That sounds like a nightmare! Sorry to hear you went through all that. It sounds like the practice you visited could have handled it better, but let’s go over what happened and why.

All Prescribers (Including Dentists) in Many States Are Subject to New Prescribing Laws

Around three-quarters of the country now has very strict laws about how prescriptions are handled. Some states even extend the new laws to any prescription, while others simply have stringent requirements when it comes to controlled substances or opioids. This is necessary and vital. You spoke about not being an “addict,” but the unfortunate truth is that the country’s opioid crisis is largely driven by prescription medications. Without more oversight on how potentially habit-forming medications are handled, it’s historically been very easy for the average person to unintentionally get hooked on pain medicine… in much the same way you could have. One prescription from a doctor after surgery, another from an emergency dental visit, another after dental treatment, another down the line from a physician, and so forth.

Compounding the problem, 21-29% of people who are prescribed opioids for chronic pain misuse them, according to the NIH Between 8-12% will develop an opioid use disorder. It has exploded into a widespread epidemic with 50,000 opioid-involved overdoses per year.

To address this, most states now require prescribers to send prescriptions for controlled substances electronically. Some also have mandates that doctors check a database and assess a patient’s risk before prescribing.

Florida Has Stringent Prescribing Laws

Florida is one of the many states with advanced laws for prescribing controlled substances. Doctors need to submit prescriptions electronically and check a database to assess risk of addiction. This isn’t because the doctor thinks you’re an addict, but rather because it’s his job to ensure you’re not placed at risk. Prescribers can get in legal trouble for not following these new mandates.

Alabama Does Not Have Stringent Laws

Alabama is presently one of the very few holdout states that isn’t implementing similar laws just yet. This may be why your regular office didn’t respond in a similar manner. You could also be right in that, because you’re an established patient, they didn’t worry that you might be shopping for medications. Or, maybe it was because you were getting treatment right away. In all likelihood, all these factors probably played a role. Hope this helps clear things up a bit. Glad you’re feeling better now!

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

Do Any Affordable Dentists Do Root Canals Too?

Posted on 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 Left Bruises on Son- Normal or Not?

Posted on 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.