Emergency Dentist Archives | Dental Care at Flint's Crossing

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.

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.

Home Remedy for Toothache

April 23, 2020 by writeradmin

My dentist is closed due to the shutdown. I had a small cavity when this all started, but I think it’s gotten worse because I have a massive toothache. Do you know of a home remedy? I’m sure it will take longer than the dentist but I’ve got to do something. I’m in a lot of pain.

Drew

Dear Drew,

I am very sorry you are in so much pain. Generally, tooth pain is a sign you have a dental infection. This is especially likely because you already had some decay there. Dental infections are a tad different from other types. The only way to treat the infection is to remove the infected pulp. That is typically done by a root canal treatment, if the tooth can be saved, or a tooth extraction if it cannot. I don’t think either of those are something you want to do on your own at home.

The good news is these are considered dental emergencies. Even under the COVID-19 quarantine, urgent care is permitted. Your dentist will be able to treat you. So yay for not having to treat your own tooth.

You don’t want to put this off. Aside from the pain you are in, leaving an infected tooth is dangerous. Believe it or not, people still die from tooth infections. The reason for that is our jaws are very close to our hearts, lungs, and brain. Once the infection reaches any of those areas, it becomes life-threatening very quickly.

If Your Tooth Can’t Be Saved

You will want to replace a missing tooth. If you don’t, aside from looking strange, the adjacent teeth will drift into the empty space, causing severe bite problems. The top of the line tooth replacement is a dental implant. This is the closest to having a healthy, natural tooth again. Hopefully, this won’t be necessary.

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

She Needs to Get a Second Opinion

March 13, 2020 by writeradmin

I am not having great confidence in this new dentist I saw. I was having tooth pain. I’m new to the area and had to see a discount clinic. I’ve heard they see people quicker. I think I know why. First, it was more like a cattle station than a medical clinic. Second, I’m not sure how much I trust them. Here’s the deal. When he examined my tooth, he did an x-ray and determined a tooth which already had a filling had an infection. He told me only about 10% of the tooth was healthy. Once he got in there, he’d probably need to extract the tooth and then we’d work out a dental implant procedure. Something doesn’t sit right with me about this. I scheduled the follow-up appointment, but I think I need to get a second opinion first. Am I overreacting?

Elaine

Dear Elaine,

Dental Infections are Serious

The first thing I want you to do is call the dentist you saw and ask him to prescribe an antibiotic for you. Dental infections are serious and you don’t want it to spread while you get your second opinion. And, yes, I definitely think you need a second opinion.

If the tooth were as far gone as he indicated, you would have been in pain for a while. You didn’t seem to indicate that. Secondly, a tooth in the condition he described would not require an x-ray to see the decay and infection. In fact, the filling would have fallen out by now. Something hinky is going on here.

Don’t put off the second opinion, though. I mentioned earlier that dental infections are serious. While the antibiotic will hold it at bay temporarily, it won’t get rid of it. That is typically done with a root canal treatment.

A Word about Getting a Second Opinion

You want to make sure, when getting a second opinion that it is a blind opinion. Don’t tell them who the dentist was or what their diagnosis was. Let them examine you and give their unbiased opinion first. After that, feel free to tell them what the current doc said.

If what your first dentist said was true, which I doubt, his suggestion about replacing the tooth with a dental implant was solid. It is the best tooth replacement option out there. Though, I suspect you are not going to have to worry about that.

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

Will this Tooth Infection Spread to my Brain?

November 22, 2019 by writeradmin

I went to the dentist because I suspected I had a tooth infection. It turned out I was right. What worries me is the dentist doesn’t seem that worried about it. He scheduled me to come back in several weeks. While he did prescribe an antibiotic, he told me not to start taking it until the week before the procedure. I’ve been told that a tooth infection can spread to your brain. Should I be worried about that in this case? It seems like a long time to wait.

Percy

Dear Percy,

You are correct that a tooth infection could grow and spread to the brain. It can also spread down the lower jaw and interfere with breathing or reach your heart. However, that doesn’t necessarily mean your dentist is putting your life in danger.

There are some tooth infections which are so small, they don’t pose a threat to you at the moment. If it were to start spreading, you’d feel increased pain and the area would swell. At that point, it would be considered a dental emergency. The smart thing to do then would be to call your dentist tell him what is going on. You would start taking the antibiotic right away at that point.

Bear in mind, an antibiotic isn’t enough when it comes to a dental infection. The dentist has to physically remove the infected pulp. This is done with a root canal treatment. Then, your dentist will protect the tooth with a dental crown.

A dental crown can be made to match any tooth color. If you’re happy with the current color of your teeth, do nothing. If, however, you’d rather have a whiter smile, the time to whiten your teeth would be before getting your porcelain crown. Once the crown is made, the color is permanent and will not whiten after it is bonded.

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

Root Canal Failure

October 7, 2019 by writeradmin

I had a root canal several years ago and about three weeks ago it started hurting again. I went back to the dentist and he agreed to do a re-treatment. When it was done, he prescribed me penicillin and gave me Vicodin for pain. The pain was bad at first then got a little better. But, now it is worse then at the beginning. I’ve been in pain ever since then. I called him back and he said to give it two more weeks and if it isn’t feeling better by then to call him back. I don’t think I can take two more weeks of this. My Vicodin prescription has been out and I’ve been on constant ibuprofen since then. I need help. Am I imagining things or is something really wrong?

Madeline

Dear Madeline,

Pain is usually a sign of a dental emergency

I’m concerned about some things I’m hearing. You should be aware that once an initial root canal treatment fails, the following treatment will only be successful 50-75% of the time. However, this sounds like you need to see an endodontist quickly. This is a root canal specialist.

Your dentist should have at the very least changed your antibiotic. Once it was obvious the first antibiotic wasn’t working, the next step would have been to switch you to a more potent antibiotic like clindamycin.

I’m concerned that the pain started to get better and then got worse. This is a bad sign. In fact, I’d consider it a dental emergency. If your dentist doesn’t get you in with an endodontist right away call one yourself and let them know what is going on.

At the very least, they’ll get you a new prescription until they can get you in. Hopefully, they leave room in their schedule for emergency appointments and can get you in right away.

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

Can a Broken-Off Tooth Get Infected?

August 23, 2019 by writeradmin

I had a molar break off partially several years ago. I wasn’t too worried about it because it didn’t hurt and was in the back and not visible. Last year the rest of it just fell off. Again, not worried. The root was still there, so the only thing missing was the top. Recently, it has started hurting like mad, but not consistently. Sometimes I’m fine, but other times the pain shoots through my jaw. Can a broken-off tooth get infected?

Paul

Dear Paul,

Not only can a broken off tooth become infected, yours is already infected. This is a dental emergency and you need to be seen. It will continue to spread until you deal with it. When you think about how close your jaw is to your heart and brain, you do not want the infection getting too far. Believe it or not, people still die from tooth infections.

At this point, the remainder of your tooth will have to be extracted. When you go to the dentist, even if it is just an emergency dental visit, make sure the dentist looks over your other teeth so you don’t end up in the same situation. Prevention is always the most affordable dental care.

The Progression to Needing a Tooth Extraction

At first, your molar just had a simple cavity. This requires an inexpensive filling. If it is left untreated, the decay will grow until you need a dental crown. The cost for that is between five to tens times that of a filling, depending on the dentist.

If the decay reaches the pulp, you are then looking at a root canal treatment and a crown. Your cost has now gone ten to twenty times higher. The next step is tooth extraction, where you are now.

Unfortunately, when you’re missing a tooth it will need to be replaced. If you don’t, the adjacent teeth will drift over or tip which can lead to expensive and painful TMJ problems. Two of the most common tooth replacements are a dental bridge or dental implant. Now you’re at twenty to forty times what a filling would have been.

This is why I want you to have the dentist look over your other teeth. It will save you a load of hassle and money.

This blog is brought to you by Auburn, AL Saturday Dentist, Dr. Raymond Bolt.

Tooth Infection with No Money

June 12, 2019 by writeradmin

I don’t know what to do. I am sure I have a tooth infection. My cheek is so swollen and there is a pimple on my gum. My problem is I have no dental insurance and no money. I was laid off six months ago, my savings has run out, and I have no job prospects. I do have some leftover antibiotics in my house, from a time they decided to switch me to a different antibiotic. Would that work?

Livvie

Dear Livvie,

I’m very sorry for what you are going through. I am going to discourage you from using these antibiotics. Once a tooth infection has reached a certain point (and yours has) because of the anatomical structure of teeth, the antibiotic won’t even get to your tooth. Instead, the infection will continue to spread.

This is super dangerous for you because of how close your jaw is to your brain. This infection can cause a brain infection, a heart infection, or even spread to your throat and swell up so much that you can breathe or swallow.

This is a dental emergency. It does need to be dealt with. Ideally, you’d be able to get a root canal treatment and a dental crown to be able to save your tooth. If that is not possible, you’ll end up with a tooth extraction, which also requires you to find a tooth replacement.

Now that I’ve completely depressed you, I also want to give you a solution. First, you should know that most dentists went into their field because they care about people. Many will be willing to help you and let you pay it out. Some of them have in-office payment plans. However, most work through Care Credit. This is a medical credit card which has low and no-interest plans.

If You Lose Your Tooth

If the worst case scenario happens and the tooth can’t be saved there are good options these days. The ideal tooth replacement is to get a dental implant. In your current circumstances, that is impractical for you. Instead, you could look at a dental bridge.

Sometimes even that isn’t affordable. In that case, I suggest you get a removable partial denture and save up for the better replacements in the future when you have found your new job.

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

Are Wonky Implants a Dental Emergency?

March 18, 2019 by writeradmin

I had two dental implants placed about three months ago. Everything seemed fine until recently. I had some weird pains and tingles in it the last few days and today the area surrounding the two implants seems spongy. I don’t know if that’s the right way to describe it, but the gum was moveable. My implant dentist is on vacation. Can this wait or do I need an emergency dentist?

Candace

Dear Candace,

It’s good that you are attentive to what’s going on with your dental implants. That alone could help save them. This need to be looked at before your dentist returns. You could have an infection brewing.

Infection is the leading cause of dental implant failure. So you’ll want this looked at as soon as possible. Your implant dentist should have a protocol in place when he’s not available. Usually, they will have a colleague who will stand in for them if a patient needs urgent care.

If by chance your dentist does not have that in place, you’ll need to see an emergency dentist.

Ideally, you’d want one versed in the dental implant procedure, but if you can’t find one, they could at least prescribe you a broad spectrum antibiotic which should hold off any infection while you’re waiting on your dentist’s return.

If Your Dental Implants Fail

Though with an experienced implant dentist there is a very high success rate (around 98%), sometimes, even when everything is done right, the dental implants will fail.

When that happens, there is still hope. You can get bone grafting done to build back up the area and then try again.

Cosmetic Opportunities with Implants

As you are adding teeth to your smile, one thing you can do is use it as an opportunity to update your smile a bit. Teeth whitening is an inexpensive cosmetic procedure and dramatically transforms your smile’s appearance.

The reason I bring it up is the color your implant crowns are made with is permanent. If you decide later you want to whiten your teeth, the porcelain crowns will have to be re-made.

It saves you money to do your whitening now, so you can have the crowns made a color you will be proud to keep for years to come.

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