Baton Rouge Dentist

I am taking amoxicillin and my tooth infection is worse

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Young brunette woman holding the side of her face with a toothache emergency despite amoxicillinMy dentist could not have my second molar tooth, so she removed it. I have been taking amoxicillin since the extraction, but the swelling and pain are worse. And the pain reliever barely takes an edge off. The left side of my face is hard and thick. I am afraid that my dentist did something wrong. My sister suggested calling another dentist for an emergency appointment if my tooth is not better instead of seeing my dentist again. Should I go back to my dentist or see a different one? – Thank you. Monica T. from LA

Monica,

Thank you for your question.

When infection does not improve, it does not necessarily mean that your dentist was negligent. Amoxicillin is a good choice for tooth infections, but sometimes it does not work.

Reasons Your Antibiotic Might Not Work for Your Tooth Infection

Antibiotic resistance can develop if you have a history of taking antibiotics or if a bacterial strain has developed resistance. According to the Center for Disease Control (CDC), each year about 2.8 million people experience antibiotic resistance.

  • History of taking antibiotics – Some people have medical conditions that lead their doctor to prescribe antibiotics. But taking them for an extended period might increase your risk of getting a severe infection that does not respond to certain antibiotics. Also, taking antibiotics to treat viral infections for a cold or flu can increase your resistance to antibiotics.
  • Bacterial strain resistance – Bacterial strains mutate and adapt to changing environments, including environments with antibiotics. If the bacterial infection in your tooth is amoxicillin resistant, the condition will increase and thrive.

Jaw infections can become severe, so report the problem to your dentist and get a new prescription. If your dentist is not available for some reason, schedule an emergency appointment with a dentist you can trust.

 

Ryan Perry, DD, a Baton Rouge family dentist, sponsors this post.

Is it too late to save my broken tooth?

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Three days ago, my tooth broke off at the gumline. I didn’t go to a dentist right away for reasons that I don’t want to talk about online. Will you please tell me if it is too late to fix the tooth? Also, what is the least expensive and easiest fix? Thanks for your help. Tim C. from GA

 

Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry.Tim – Thank you for your question. Unfortunately, a cheap, easy fix for a tooth broken at the gumline will not last. The priority is a lasting solution. And you may want it to look natural; neither is cheap or easy.

When Your Tooth Breaks at the Gumline

When your tooth breaks at the gumline, possible solutions include root canal treatment and a crown or a dental implant.

Root Canal and Crown for a Tooth Broken at the Gumline

Sometimes root canal treatment and a crown can restore a tooth broken at the gumline. But the treatment works if the tooth is not subject to a lot of stress. For example, if you have a strong bite (the force of biting or chewing) or deep overbite, it would be challenging for the crown to stay on.

Root canal treatment – A dentist must complete the root canal on what remains of your tooth. A flexible fiberglass post in the tooth root can help stabilize the tooth. In some cases, a dentist will place two side-by-side fiberglass posts to withstand stress on the tooth and keep the tooth intact. The dentist would build up the tooth with composite and bond a dental crown to it.

Dental Implant for a Tooth Broken at the Gumline

A dental implant is a long-term solution for a tooth subject to a lot of stress from a deep overbite or a strong bite. Although an implant can cost twice as much as root canal treatment, posts, and a crown, it will last. An implant dentist or oral surgeon anchors a dental implant in your jawbone, and it takes three to four months to heal. But when it heals, it is a solid foundation for a natural-looking crown.

Although you might choose a root canal and crown, you will need a dental implant anyway if it doesn’t work.

It helps to see a dentist right away after tooth trauma, but it is still possible to save your tooth. We suggest that you schedule an appointment with a skilled dentist to examine your tooth. The dentist will explain your treatment options and what you can expect from them.

 

Ryan Perry, DD, a Baton Rouge family dentist, sponsors this post.

How long can I wait to get a root canal if I don’t feel pain?

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I’m trying to figure out when I need a root canal if I don’t feel any pain. I am job searching, and if the tooth can wait, I would prefer to postpone it. My left first molar tooth is discolored, and my dentist says that the tooth is infected. She wants to complete a root canal and cover the tooth with a crown. If the tooth does not hurt, is this really urgent? – Thank you. Marcus from OK

 

Marcus,

Thank you for your inquiry. Your dentist is right; a dark infected tooth requires treatment.

Why Is Your Tooth Turning Dark?

Diagram of abscessed tooth in need of emergency dental care and root canal treatment
A dead tooth need urgent dental care to stop the infection

Your tooth can turn dark from infection. When the tooth pulp (the living tissue inside) dies, it turns dark, and the discoloration shows through your tooth. Tooth pulp contains tissue and nerves, so you will not feel pain if the tooth is dead.

Can You Delay Root Canal Treatment?

Although you do not feel pain, your tooth infection is lingering. A dark tooth means that you have probably had the infection for some time. It can spread into your bone or your bloodstream. Although you may not feel pain, other symptoms of a long-term tooth infection include:

  • A foul taste or smell in your mouth
  • Difficulty breathing or swallowing
  • Swelling in your face or cheek
  • Tenderness or swelling under your jaw or in your neck (lymph nodes)
  • Fever
  • Gum disease
  • Dehydration
  • Stomach pain
  • Fatigue

A dead tooth is an urgent matter because the infection can poison other parts of your body.

What Can You Expect with Root Canal Treatment?

Root canal treatment is painless, but your tooth will be weak. And your dentist must protect it.

  • Painless – A skilled dentist uses a local anesthetic for painless root canal treatment. But if your tooth is dead, you will not feel any nerve pain.
  • Foul smell – A tooth that has been dead for years has a bad smell. You will probably notice it and be happy that your dentist removed the infection.
  • Protecting the tooth afterward – If you have a strict budget, you do not have to get a dental crown right away. Instead, ask your dentist to complete the root canal and protect your tooth until you can afford a crown.

After the dentist completes the treatment, you will probably feel better. You might have mild symptoms that you ignored or did not associate with your tooth.

Best wishes.

Ryan Perry, DDS of Baton Rouge, sponsors this post. For more information read our post, Does a Root Canal Tooth Always Need a Crown?

My dentist doesn’t know what to do for my cracked tooth

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One of my right lower molars has a filling in it. The tooth cracked last Friday, but my dentist’s office is closed on Friday. I found an appointment with another dentist to look at it and see if anything needed to be done to save it. The dentist said it didn’t look like I would lose it, so I followed up with my dentist on Monday. My dentist then referred me to an endodontist who suggested that I get the filling replaced with a crown. My dentist wanted the endodontist to remove the filling to see the depth of the crack. When I returned to my dentist, he tried to mend the crack. Now the tooth is very sensitive. My dentist does not want to put a crown over the tooth. I suggested that he refer me to another endodontist. My dentist seems a little clueless, but maybe because he is young and in a big practice. Anyway, should I go with a crown or see another specialist? – Thank you. Clay from MS

 

Clay,

Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry.Dr. Perry would need to examine and x-ray your tooth for an accurate diagnosis. Cracks in teeth can be tricky, but we will provide some insight. You were wise to see a dentist right away to ensure your tooth was stable enough to see your regular dentist.

Types of Cracks in Teeth

Cracks in teeth have varying degrees of severity. But cracks differ from fractures. When tooth pieces move independently, the tooth is fractured.

Types of tooth cracks

  • Superficial crack in the enamel
  • Deep crack beneath the enamel
  • Crack into the tooth pulp
  • And tooth cracks can vary in location and can be vertical or horizontal.

Restoring a Cracked Tooth

There are different ways to protect your tooth depending on the extent of the crack. But if your tooth is sensitive, it may be infected. Your dentist or an endodontist will need to determine if root canal treatment is required.

  • Porcelain onlay – An onlay is a custom-made restoration that covers a portion of a tooth. If you have a horizontal crack on just one cusp, or peak, of your tooth, an onlay can cover it. But an onlay is not strong enough to stabilize a vertical crack.
  • Gold onlay – Gold is durable, and a gold onlay can cover the entire chewing surface of a tooth to protect it.
  • Dental crown – It will cover and protect the entire tooth.

 

Consider Getting a Second Opinion

Your dentist and the endodontist disagree on which treatment is best for your tooth. Consider getting a second opinion from another dentist. You can also ask your dentist for a referral to another endodontist for a second opinion.

Ryan Perry, DDS of Baton Rouge, sponsors this post.

Does a root canal tooth always need a crown?

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I had an emergency dental appointment for a toothache on my top right first molar. The dentist scheduled a root canal for me. But he also looked at my left incisor and noticed that the tooth was a little dark. I told him that I had a root canal on that tooth in 1986. The only reason I remember the year is because it was a month before I got married. The dentist recommended doing a dental crown on that tooth to prevent it from breaking. I do not feel any tooth pain. Is a dental crown necessary? – Karson from GA

 

Karson,

Thank you for submitting your question to our office.

Whenever you have a lingering toothache, it is wise to see a dentist promptly. But do not agree to let the dentist complete cosmetic work without verifying if he or she has advanced cosmetic dentistry training.

Although root canal treatment can make a tooth weak and at risk for breaking, not every dentist automatically places a crown over the tooth. But the condition and location of a tooth can determine if it is wise to get a crown.

Stress on Molar Teeth

The stress on molar pushes the four cusps—or peaks in the biting surface—apart. Premolars have two cusps. And stress can cause them to split also.

Stress on Front Teeth

Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry.Front teeth are subject to horizontal stress. Canine teeth have long roots to absorb some of the lateral pressure on back teeth. When you chew and grind food with your back teeth, the canine tooth forces the back teeth apart to relieve stress.

Protecting a Root Canal Tooth

  • Back tooth – A dentist can protect a back root canal tooth from fracture by covering it with a dental crown or an onlay. An onlay covers a tooth’s chewing surface and at least one cusp, or tooth point.
  • Front tooth – Although root canal treatment weakens a front tooth, preparing it for a dental crown will further weaken it. A dentist prepares a tooth for a crown by removing about one millimeter of tooth structure on every side of the crown. A tooth can be left with 50% or less of its initial fracture resistance.

When little healthy tooth structure is left, a dentist may use a crown to protect a front tooth. Otherwise, a crown will only weaken the tooth.

Some advanced cosmetic dentists use this technique:

  • Clean out the crown of the tooth, removing root canal filler material and cement
  • Insert a flexible fiberglass post deep into the tooth
  • Cement the post
  • Fill the tooth with durable composite
  • Bond a custom porcelain veneer to the front of the tooth

 

We recommend scheduling a consultation with a cosmetic dentist to examine your tooth and explain your options.

 

Ryan Perry, DDS of Baton Rouge, sponsors this post.

Horrible toothache and headache, but my dentist sees no problem

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In January, my dentist did a root canal on an upper right molar tooth. The tooth felt better afterward but has not been symptom free. Two weeks ago, I felt a flare-up of pain that felt like it affected the tooth next to the root canal tooth, and I have a headache, too. I returned to my dentist on Monday, and she took x-rays. She says that both teeth look fine. She suggested that I see a neurologist. I do not think my dentist is investigating enough. Why a neurologist?  Thank you. Bryson from Arkansas

Bryson,

Although Dr. Perry would need to examine your tooth and x-ray to give you an accurate diagnosis, we can offer insight that might help you decide what to do next.

Pain from a tooth that looks healthy

Man in his 40s with a headache and toothache holding the side of his face
Headache and toothache pain are not always easy to diagnose

It is not uncommon to feel pain in a tooth that looks healthy in a visual examination and on an x-ray. Some causes of tooth pain include:

  • Referred pain – Infection from a tooth can refer to an opposite upper or lower tooth. Or it can feel like the pain is coming from an adjacent tooth. But pain does not refer from one side of the mouth to the other.
  • Neuralgia – Chronic nerve pain can transfer in your face, jaw, teeth, or gums. Although the condition is usually not the cause of a toothache and headache, a nerve problem can feel like a toothache. That is why your dentist recommended that you see a neurologist.
  • Infection – A sinus infection can cause headaches and pain that feels like a toothache. The maxillary sinus is near the roots of upper teeth and can press on the roots, causing a toothache sensation. Sinus pain can also transfer to a lower tooth.
  • Other health issues – Some conditions that can feel like a toothache and cause headaches include jaw pain, clenching or grinding your teeth, or gum disease. According to the American Migraine Foundation, TMJ (temporomandibular joint) disorders can contribute to chronic headaches.

If you feel that your dentist is not a good listener or rushed for a diagnosis, we suggest getting a second opinion. You can get a second opinion from another dentist or a root canal specialist (endodontist).

Are your tooth pain and headache a dental emergency?

Sudden or lingering toothache – If you have a sudden or lingering toothache and headache but no recent dental work, see a dentist right away. Toothaches are most often a symptom of infection.

Toothache after dental work – If you had root canal treatment or other dental work that seems to be your pain source, contact the dentist who completed the treatment. If the pain persists beyond the healing period or gets worse, consider it an emergency.

Dr. Ryan Perry, a Baton Rouge family dentist, sponsors this post.

 

My son fell and broke his front tooth. Can a dentist save it?

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My son fell on his face last night and broke one front tooth and cracked the other. He is ten years old. I’m in an odd situation because I quit our family dentist and had not found a new dentist since the pandemic, so I called a few friends and we saw a dentist this morning. The dentist took a quick look at the tooth, said it looks okay and added that he can’t fix the tooth until March, but he also said that the tooth root needs time to desensitize. What does that mean? Should I wait or find another dentist who will see him right away? – Kristen

Kristen,

There is no reason to wait. The dentist you saw would need to explain why he recommends allowing time for your son’s tooth to desensitize. Before treatment, a dentist will desensitize the tooth for a painless procedure. Sometimes a tooth has internal damage that you cannot see. But it seems that the dentist’s exam was too quick to evaluate your son’s tooth. It’s best to get the tooth thoroughly examined and treated.

Repairing a Child’s Broken Tooth with Dental Bonding

A skilled cosmetic dentist can often repair a child’s tooth with dental bonding. Hopefully, you saved the piece of the tooth that broke off. A cosmetic dentist can bond the piece back in place. But if you don’t have the broken piece, we recommend direct dental bonding to fill in the tooth. A cosmetic can seamlessly restore the tooth so you won’t be able to tell where the bonding and tooth meet. The dentist will do the following:

  • Clean the tooth
  • Etch the tooth
  • Apply dental bonding and shape it
  • Harden the bonding with a curing light
  • Further shape and polish the tooth

When your son is older and the tooth pulp shrinks, he may need a dental crown. But for now, find a dentist who will see your son right away and has cosmetic dentistry training and experience.

Before-an-after dental bonding photos for a broken tooth
A cosmetic dentist uses dental bonding for emergency chips and breaks

 

Dr. Ryan Perry, a Baton Rouge dentist, sponsors this post.

Both my front teeth broke. Can a dentist save them?

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I broke both front teeth today. The roots are still intact. I’m checking into an emergency appointment for a dentist to examine them. I know I can get a partial or a bridge, but are root canals and crowns an option, too? Thanks – Kyle

Kyle,

Although Dr. Perry would need to examine and x-ray your teeth for an accurate diagnosis, it may be possible to save broken front teeth with root canals and crowns.

Saving Broken Front Teeth with Root Canal Treatment

Depending on the extent of damage to your broken front teeth, root canal treatment may save them. But not all dentists are willing—or know how—to save teeth with severe breaks. And with the availability of dental implants, most dentists will recommend extractions and implants. A dentist who is interested in preserving your natural teeth might take the following steps if it’s an option:

  • Complete root canal treatment to remove the tooth pulp and prevent infection
  • Put two flexible posts in each root canal tooth to add strength and resistance to rotational forces
  • Attach a crown to the posts

Risks with Posts and Crowns

One risk with post-supported crowns is that rigid metal posts can crack tooth roots. Force on a post can transfer deep into tooth roots and crack them. Many dentists who perform this procedure prefer flexible posts for front teeth, like carbon fiber or fiberglass. Flexible posts are more likely to absorb the stress without breaking your tooth roots.

A flexible post in a rooth canal tootth to build it up in preparation for a dental crown
Sometimes a flexible post can help save a front tooth

We recommend that you look for a dentist with advanced experience and training. Saving your teeth with posts and crowns might not be an option, though. And if a dentist is not experienced with the technique, insisting that they use it anyway can cause more harm than good.

Remember your options:

Please do your research to find two experienced dentists who will see you when their office opens. Get their opinions on treatment options and the results you can expect and schedule treatment promptly. Don’t let the problem linger because it can get worse.

 

Ryan Perry, DDS of Baton Rouge, LA, sponsors this post.

Need wisdom teeth removed but I don’t have dental insurance

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In January, a corner of my bottom right wisdom tooth broke. It eventually fell off, and gradually, little bits of the tooth are falling off. About two months ago, the wisdom tooth started to hurt, and I knew it was trouble. The pain was so bad that I made an emergency appointment with a nearby dentist. She gave me an injection to numb the pain and said that I need an x-ray and probably need a referral to an oral surgeon to remove all my wisdom teeth. I’m nervous about my wisdom teeth now, but I cannot afford oral surgery. Not much is left of the tooth, and it looks like the pulp is dissolving. I don’t have dental insurance. I will start a new job in January, and I hope to make it until then. But the job doesn’t offer dental insurance. Will the broken wisdom tooth eventually fall out? Konnor from Albany, GA

 

Konnor,

A decayed and broken wisdom tooth will continue to decay and fall out. But you’re at risk of a tooth infection that can spread to your jawbone and create a pus-filled abscess. The dentist you saw for the emergency appointment was right. It’s best for an oral surgeon or a dentist skilled in extractions to remove the tooth.

We are not sure what you mean about the tooth pulp dissolving. But if the pulp was exposed and infected, it’s dead. And if the pulp is dead, the tissue and nerves inside it are dead too, and you should not feel any sensitivity or pain in your tooth.

No Insurance and a Broken Wisdom Tooth?

Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry.
Don’t ignore tooth pain or swelling. Schedule an emergency dental appointment.

If you don’t have dental insurance and your wisdom tooth is badly broken, your next step depends on whether you feel any pain or sensitivity. Keep in mind that these suggestions apply to wisdom teeth only. They do not apply to other teeth, including first or second molars.

  • Pain, sensitivity, or swelling – When you feel pain or sensitivity in a tooth or see swelling, it is a dental emergency that you need to take care of right away. A lingering infection will get worse, spread into your jawbone, affect other teeth, and eventually get into your bloodstream. Even if you don’t have dental insurance, you can find a dentist or oral surgeon who offers payment plans. Your oral health isn’t worth the delay.
  • No pain, sensitivity, or swelling – Eventually, your tooth will decay on its own and fall out. But if you can see a dentist for extraction before it falls out, please do so. If you begin to feel pain or have swelling, see a dentist right away. Don’t mask the problem with over-the-counter pain relievers. And please don’t let anxiety keep you from getting the tooth removed. Most dentists offer some form of sedation to help you relax.

Another option

The ideal solution is for you to get the tooth removed. If you live in an area where there is a dental clinic or a dental school, they might be willing to remove your tooth at a reduced rate or no cost at all. You can call a few local family dentists’ offices to ask if they know about a clinic in your area.

 

Best wishes.

Ryan Perry, DDS, a family dentist in Baton Rouge, LA, sponsors this post.

 

What to do about a repeatedly rude dentist

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After the anesthetic wore off from a root canal, the pain was horrible. Swelling and terrible pain lasted three days. My dentist prescribed Flagyl. I saw my dentist a week later, and he told me to keep staying the medication because the root looks fine.

My pain didn’t stop, so I had an emergency appointment with another dentist. They recommended that I see a neurologist. The neurologist says I have trigeminal neuralgia and should let my dentist know. I called my dental office, and they said that the dentist wanted to talk to me in person. He spoke rudely and told me that he had nothing to do with my nerve pain.

When I scheduled my dental crown appointment, the nurse said I need clearance to see the dentist, and without it, I won’t get a crown from their office. I’m waiting to hear from my dentist, but I wonder why I’m being treated so rudely. I didn’t accuse my dentist of anything. Should I trust him to place the crown? Thank you. Heather

 

Heather,

What you describe is odd and rude behavior from your dentist. We suggest that you switch to another dentist and ask for a refund for incomplete work. Although emergency dental visits are appropriate in many cases, you need a doctor who will take time to identify the source of your pain.

Doctors usually prescribe Flagyl for the lower GI tract and vaginal infections. It is an alternative antibiotic when other types won’t work for oral infection. Flagyl has a limited spectrum and is usually combined with amoxicillin or another.

Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry.
Sometimes, an emergency dental appointment isn’t enough

Trigeminal neuralgia causes extreme facial pain when an area of the face is touched or stimulated. Strangely, a neurologist diagnosed your case based on your dental incident alone. But why would your dentist become rude and defensive? We can’t answer that, but your dentist’s office doesn’t seem like a trustworthy place to get a new crown.

You can report the “non-visit” to your dental insurance company. You can ask for a refund. If your dentist doesn’t cooperate, you can report the incident to the state dental board.

 

Ryan Perry DDS, a Baton Rouge family dentist, sponsors this post.