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Allergic to Her Partial Denture

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I’ve been sick for a couple of years. It stated not long after I got my partial denture. Then I started getting sores in my mouth and on my tongue. My dentist couldn’t figure out what was going on. Eventually, I just had my doctor run every test possible. It turns out I’m allergic to a lot of metals. Could the metal in the partial denture be what is making me sick?

Andrea

Dear Andrea,

Woman in pain in need of dental care

Metal sensitivities are serious

I’m continually perplexed and frustrated by dentists who don’t understand the seriousness of metal allergies. There should be a standard question on the medical history form about metal sensitivities. Some patients can even have trouble breathing. If you’ve got a metal allergy, then yes, that partial denture is making you sick.

We are a mercury-free practice, but have had patients come in with a mouth full of mercury fillings which they suspect are making them sick.

We are careful to do a sanitary amalgam removal process. When they come in for their next appointment we ask if they’ve felt a difference. Almost always they have had an ailment that disappeared after they get rid of the silver fillings. One particular patient had her arthritis disappear. Most just felt like they felt better overall.

There are metal-free options for you to get as a tooth replacement. You don’t have to have a removable denture either. Often you can have a zirconia bridge to replace the tooth. This is completely metal free. The only downside is you will be required to crown your adjacent teeth.

If those teeth are healthy, you might be better off with a dental implant. These are made from titanium. It’s very rare for someone to have an allergy to this particular metal. Titanium is very biocompatible and has been used for decades in both hip replacements as well as implants.

However, because you’ve already been diagnosed with some metal allergies, you might want to get checked just in case. If you are allergic, there are zirconia implants as well.

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

Baby’s Front Teeth Haven’t Erupted

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I’m a little worried because my daughter’s two front teeth haven’t come in yet. She’s almost ten months old. The weird thing is the teeth that would be next to them have come in, so she looks like a baby vampire. Is this okay or is something wrong?

Nervous Mama

Dear Nervous Mama,

Chart of children's teeth with their names

Take a deep breath. There’s no need to grab some garlic yet. While there is a general schedule, teeth don’t always follow that schedule. It is not unheard of for the lateral incisors to erupt before their central incisors do.

Here’s a loose schedule of when teeth come in:

Lower Central Incisors – 6 to 10 months

Upper Central incisors – 8 to 12 months

Lower Lateral Incisors – 10 to 16 months

Upper Lateral Incisors – 9 to 13 months

Lower Cuspid (Canine) – 17 to 23 months

Upper Cuspid (Canine) – 16 to 22 months

Lower First Molar – 14 to 18 months

Upper First Molar – 13 to 19 months

Lower Second Molar – 23 to 31 months

Upper Second Molar – 25 to 33 months

When Should I Child First See a Pediatric Dentist?

It’s recommended you first take your child to the pediatric dentist or a general dentist who treats children when their teeth first start erupting. This is usually a simple appointment where the child is just introduced to the dentist and staff and shown what the different tools are. Its intention is to allow the child to get familiar with the dentist in a non-threatening environment. In your sweet babe’s case, they will likely do an x-ray as well just to see if the central incisors are actually there.

Sometimes, a person will have congenitally missing teeth. This is okay too and there are many solutions. Either way, your child will not go toothless throughout their life. Even if they are missing both baby and adult teeth there are fantastic tooth replacement options these days.

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

Tooth Infection with No Money

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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,

Woman in pain in need of dental care

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.

How Often are Pediatric Dental X-Rays Necessary?

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I’m very faithful at taking my children to the pediatric dentist. The problem I’m running into is I have three children and our pediatric dentist insists on doing x-rays at every appointment. First, I worry about that amount of radiation. Second, our dental insurance only covers it once a year. Is it really necessary to do it both times? I can’t always afford the cost. Can I request to just do it once a year?

Laurie

Dear Laurie,

four children smiling

We’ll cover the insurance issue first. Dental insurance companies do not look out for the best interest of the patient. They are more interested in paying for what is adequate rather than what is best. So, while getting x-rays once a year is the standard in some offices, it really depends on the child. Even pediatric dentists who generally prefer doing x-rays once a year will have some patients where they require them twice.

Why Require Extra X-Rays at the Pediatric Dentist

There are two general reasons why a pediatric dentist would require x-rays at every appointment. The first is if the family or child has a genetic predisposition to decay. In that case, it is much safer to do x-rays more often than to risk decay sneaking up. It is better for the child, the tooth, and your budget to catch it early and do a small filling than to have it grow unseen and then require a dental crown.

Another reason would be if you have some decay the dentist is just watching. They are trying to make sure it doesn’t start growing toward the pulp requiring a pulpotomy.

Radiation and Dental X-Rays

One thing which should make you feel a bit better is dentists use digital x-rays. These carry far less radiation than traditional film x-rays. It exposes your children to no more radiation than if they stood outside in the sun for a few moments.

Dealing with the Cost of Multiple X-Rays

If your children aren’t in one of the two categories mentioned above, which justifies requiring x-rays at each appointment, then you can request to have them only once a year. If they say no even after you explain your financial situation, it may be time to switch to a more affordable dentist who understands budget constraints.

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

Pain with Composite Filling

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I think I’ve asked my dentist to do something he wasn’t ready for. I needed a filling and really wanted a white filling. He reluctantly agreed. I will admit I pressured him. Here’s what is going on. When I clench my teeth, everything is fine. But, when I bite something crunchy I get this zing of pain. My dentist has no idea what’s going on. Have you heard of this?

Acelyn

Dear Acelyn,

Amalgam and Mercury-free white fillings

This seems to be an issue with dentists inexperienced with composite fillings. For some reason, it is more common with small fillings where the filling is bonded to the dentin.

There is a solution for it, though it will mean the filling will have to be re-done. Hopefully, you have a dentist who is open to learning. Though, it does worry me that your dentist isn’t caught up on updated advancements in dental fillings.

With these fillings, it is helpful to have a glass isomer base under the filling to protect the dentist. This will keep you from feeling that zing with certain foods.

Some dentists are okay learning from patients and others are offended. If you find yours falls in the offended category, I’ll suggest you see a dentist who is well-versed in composite bonding. Do a quick internet search for a mercury-free dentist. They place white fillings exclusively and will know exactly what to do.

You May Want a New Dentist

One thing which is important with any medical profession is continuing education. You want your dentist to be up to date on the latest research as well as the new treatment options.

There have been significant developments in crown and dental implant options in recent years as well, making use of zirconia instead of metal based options. This is great for people with metal sensitivities. Again, though, if your dentist doesn’t keep up, he’ll never know.

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

Are Wonky Implants a Dental Emergency?

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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,

Woman in pain in need of dental care

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.


Conveyor Belt Dental Care

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I’ve been shopping around for affordable dental care. Each place that’s advertised as affordable seem to treat patients like cattle, running us in and out. At one point I wondered if I was on my way to the slaughter house. Is there a way to get an affordable dentist and feel like a person?

Cathy

Dear Cathy,

Dollar sign hatched out of an egg
Affordable dentistry can be personal

You’re wise to continue seeking treatment. Too many people avoid the dentist altogether because of financial issues. Even with the hardships you’ve undergone finding the right affordable dentist, you will end up saving money in the long run.

As you have experienced, many dentists who advertise as affordable try to make up profits with the sheer volume of patients they get through. Truthfully, that’s not a pleasant experience for either of you. You miss out on personalized care and attention. The dentist misses out on the beauty of getting to know their patients.

Affordable Versus Cheap Dentistry

While the conveyor belt method can be annoying, the cut corners method is downright dangerous. This is where dentists cut corners to make up their profits. They may buy discounted materials which can lead to infection or failure.

Other times, dentists are significantly cheaper because they’re just plain bad at their job and can’t retain patients. They keep their prices super low to draw in new patients.

Think of it this way. One dentist makes a dental crown for $500 but it lasts 5 years. Another makes a crown for $800 but it last 15 years. The more “affordable” crown actually ends up costing you significantly more money.

Finding an Affordable Dentist

Start by looking for dentists in your area with good reputations. Check their services offered, then check their reviews. Are patients satisfied with the service they’ve received?

Once you’ve found a suitable list of dentists, call their office. Ask if they offer payment plans, Care Credit, or cash discounts. These are just some of the ways dentists can help patients.

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

Silver Crowns in Children

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I have a classroom full of children with silver on their back teeth. Most of them look like crowns and some could be fillings. Why would so many children need crowns? And why do they all seem to be silver?

Andrea

Dear Andrea,

children smiling
Healthy Smiles Make Happy Children

It’s obvious you’re a caring teacher and want to understand more about your student’s health. When it comes to why your children have so many restorations, there can be a variety of factors:

  • Genetics plays a huge part. Some patients do everything right and still have decay. They just lost the genetic lottery when it came to teeth.
  • Another factor is socioeconomic. If they didn’t have dental insurance for their children they may only take them when there’s a problem.
  • Lack of sealings: If parents don’t regularly take their children to the dentist, they may not be aware of dental sealings which protect children from getting decay on their molars.

Silver Crowns for Pediatric Patients

There are usually two very good reasons to give children silver crowns instead of a traditional porcelian-fused-to-metal crowns or an all-porcelain crowns.

They are pre-fabricated in set sizes. This means the pediatric dentist can place them in just one appointment. This makes the appointment much easier for the patients.

Often, children need some form of dental sedation to get through more complicated appointments. This way they only need one appointment.

That makes it easier on the parents, both for interruptions to their lives with scheduling and cutting down on costs for a second appointment.

Probably the best way you can help your students is to have a pediatric dentist come visit your class and teach the children about the proper way to brush and floss. Then, keep up with things like free clinic days and dental sealing days and let the parents know about them.

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

My Kids are Afraid of My CPAP

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I have sleep apnea. While it it is helpful I don’t enjoy it very much. Plus, my kids are absolutely terrified of it. They won’t come near the room and they scream when I turn it on.

While I know they’ll adjust, I’m neither my wife nor I are crazy about it either. Is there an alternative or should I just start saving up for therapy for the kids now? They’re going to grow up thinking I am Darth Vader.

Mark A.

Dear Mark,

Woman covering her ears trying to block out her husband snoring

Sleep Apnea can cause a great deal of problems. Most people get a CPAP machine for the treatment because it’s been the standard treatment for years.

However, they’re bulky and loud, as your family has noticed. Fortunately there are alternatives for something which makes you sound like Darth Vader.

If You Hate Your CPAP

While there is a great alternative, I don’t want you to stop using your CPAP in the meantime.

Sleep Apnea means you are not breathing in intervals throughout the night. The stress this puts on your heart can lead to stroke and other life-threatening problems.

I’d like to suggest you see your dentist and ask him about an anterior positioning splint. This is a simple orthotic device which re-positions your jaw in such as way that the back of your throat is no longer obstructed.

It’s silent and about the size of a mouth guard. You’ll find it much more comfortable.

Even better, they’re super easy to transport if you have a business trip or family vacation.

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

Why Do Some Dentists Still Do Mercury Fillings?

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My sister-in-law said her children’s pediatric dentist still does silver fillings. I was stunned. I wouldn’t think ANY dentists were still using those because of their mercury content, especially a pediatric dentist. I tried to tell her to switch, but she said her children love their dentist. Why are there still some dentists using the old materials?

Kelsey

Dear Kelsey,

Amalgam and Mercury-free white fillings

I’d say there are usually three reasons dentists give for still doing these:

1. The leading reason dentists are still doing silver/amalgam fillings is the American Dental Association (ADA) still says the mercury released in the silver fillings is within safe health limits. This gives them no outside impetus to change, especially if their patients aren’t concerned.

2. It’s always served them well. They’ve been doing this for years and never had any problems. Some dentists just like doing things the way they’ve always done them. Here’s the problem with that. As medical practitioners, we’re supposed to constantly be learning and improving our care. What if doctor’s in the past had that mindset? “Well, my patients have always done fine with leeches….”

3. This one is regarding pediatric dentists. It is harder to do white fillings on children than adults. This is because the composite material has to stay completely dry or the bond will not hold. Children can be wiggly and sometimes have trouble controlling where they put their tongues. Now, is that a valid excuse? Not in my opinion.

Especially, when you work with children, you have to be creative. If you have a child who absolutely cannot stay still, there are still ways to make sure they get the best treatment possible. Most children do very well with sedation dentistry.

In fact, they don’t even need a strong form of sedation like Oral Conscious Sedation. They often fall asleep just using the mild form of sedation— nitrous oxide.

Of course, it is up to your sister-in-law who treats her children. However, if she starts to think about the mercury content and comes to you for advice, tell her there are great dentists who work with children which are also mercury-free dentists. That’s what she should be looking for.

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