Baton Rouge Dentist

New Dental Implant Bridge and My Bite Is Off

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After getting a new implant bridge in November, my teeth on the left side do not line up. My bite  The bridge has two implants and replaces four bottom teeth. I think this is weird, but my dentist says it’s better each time he tries to adjust it. Maybe it looks better, but it doesn’t feel better. Is this a common issue? If so, who do I need to see to resolve it? I no longer value my dentist’s opinion. I’m frustrated and think that I deserve a refund. I don’t know how I could afford to finish the work again. Thanks for your help. Justin from Dayton, OH

Justin,

We are sorry to read about your disappointing experience with your implant bridge.

Model of a dental implant bridge for three lower molar teeth
Dental implant bridge

When you bite down, your upper and lower teeth should meet simultaneously. Although the issue can occur, it is related to the quality of dental implants and the skill of the implant dentist. If the problem continues, it could lead to TMJ disorder.

What May Cause Misalignment in a Dental Implant Bridge?

Misalignment can occur in a dental implant bridge from miscommunication, implant placement, or dental bridge construction.

  • Miscommunication. Sometimes, miscommunication can occur between an oral surgeon who places the implants and a dentist who restores them with crowns or a bridge.
  • Dental implant placement. If the surgeon places the implants in a location, the dentist did not anticipate, your crowns or bridge will not fit correctly, and it can misalign your bite. Or a dentist can misplace implants. Symptoms can include teeth, jaw, neck, ear pain, and other jaw joint issues.
  • Dental bridge construction. Mistakes while taking impressions of your mouth or errors with dental bridge construction can affect how the oral appliance fits.

We recommend getting a second opinion from a skilled implant dentist. You will need an examination and a 3D X-ray to determine whether the surgeon placed the implants incorrectly or whether there is an issue with the position or quality of the implant bridge.

Getting a second opinion promptly can prevent you from experiencing symptoms that will worsen with time. Also, you paid for a functional implant bridge, but your teeth are misaligned and interfering with the bridge function. You can ask for a refund after getting a second opinion and evidence of your current dentist’s faulty work. If your dentist took shortcuts for your bridgework, it might cost more than your refund amount for a dentist to complete the necessary steps. Ask your new dentist about payment options to make your treatment more affordable.

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

Can I Get Teeth Fillings Without a Numbing Shot?

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Can I ask a dentist not to give me a shot before filling three medium-sized fillings? I hate needles and prefer not to get local anesthesia for fillings. I have a high tolerance for pain anyway. How can I convince her not to give me a shot before filling the cavities? Is this something my dental insurance company or primary care doctor can talk to my dentist about? I want the cavities filled. I just do not want the injection. Thanks for your help. Enrique

Enrique,

Thank you for contacting Dr. Perry’s office.

Can You Get Teeth Fillings Without a Numbing Injection?

Although you can get fillings without a numbing injection, your dentist will explain the difference between treatment with local anesthesia and treatment without it. Medium-sized cavities may take some work to remove the decay, and they may become uncomfortable for you. Your dentist is knowledgeable about your case and will let you know what to expect either way.

Before and after composite fillings, for information on numbing shots for dental fillings
Talk to your dentist about your concerns regarding numbing injections for dental work

If you are anxious about receiving injections, ask your dentist what she does to deliver pain-free injections. Be open to her opinion and weigh your pros and cons before making a final decision. Your dentist can apply a topical anesthetic to your gums to numb them and prevent you from feeling the injection.

Many dental offices offer distractions like music or an overhead TV to help you focus on something other than the dental procedure and its sights and sounds.

Also, dental sedation can help you relax and lower your sensitivity to pain or discomfort during a dental appointment. Depending on your anxiety level, your dentist may recommend nitrous oxide or oral conscious sedation before beginning your dental procedure. Contact your dental insurance company to ask about plan benefits for sedation. Your dentist may also offer payment plans to make care more affordable.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Please read about how he strives to provide his patients with the best care possible.

How Long Can I Delay Treatment for a Tooth Infection?

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Man holding face in pain and needng an affordable dentist for root canal treatmentI need some advice. I am out-of-town on business. My tooth has been hurting on and off for three weeks. This week, the pain became constant, and my cheek is a bit swollen. I will be on this assignment for two more weeks. And yes, I know that I should have taken care of this before I left home. Is this something that can wait, or do I need to find a dentist here who will take me on an emergency? Thanks for your answer. – Jason from Chicago

Jason,

Based on your description, it’s likely that you have an infection in your tooth that has spread and created an abscess.

It’s best to find an emergency dentist to treat the infection. You have two more weeks on your out-of-town assignment, during which an untreated infection will continue to spread and cause more problems.

Treating a Tooth Abscess

The dentist will give you an antibiotic to treat the abscess. Root canal treatment will clear the infection from the pulp of the tooth. That may be all that is necessary if the tooth is otherwise in good condition. If the tooth is cracked or damaged, a dentist may need to remove it.

Although many people get anxious about root canal treatment, the procedure is painless.

  • A dentist will numb your gums before injecting a local anesthetic.
  • After making an opening in the crown of your tooth, the dentist will clean out the infection deep into the roots.
  • After treatment, the dentist will cover your tooth with a temporary crown.

If You Need an Extraction

If an extraction is necessary, find an experienced cosmetic dentist to replace the tooth with a dental bridge or a dental implant when you return home. The restoration will look completely natural. In either case, you can ask each dentist about their payment options, including payment plans or financing.

 

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

Are partial dentures my only option?

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Senior woman holding jher mouth portraying concern over parital denturesAfter a battle with advanced gum disease, seven of my upper teeth are missing. I still have my two front teeth, but gum loss created a gap between them. I want dental implants, but my dentist says my bone won’t support them, so I can get partial dentures, which are more affordable. I know that if I try to close the gap, I will need braces and more partial dentures after my teeth are straight. It’s just the expense of all this that scares me. Are partial dentures my only option? I’m not sure what to do. Thank you. Vickie from Columbia, SC

Vickie,

Thank you for your question, Vickie.

We understand your concerns about your smile and your oral health. Although your dentist is offering the most affordable option, we recommend that you look for a dentist who is just as—or more—concerned about your appearance as you are.

Dr. Perry would need to examine your mouth, teeth, and x-rays for an accurate diagnosis and treatment options. Still, two options that will give you a better smile than a partial denture are an implant-supported bridge or individual implants.

Before offering a solution, a dentist will need to gather more information, including:

  • A comprehensive examination
  • A CT scan to measure your bone volume
  • The size of your front teeth
  • The size of the gap between them

We recommend getting an opinion from a skilled cosmetic dentist concerned about your appearance but will work with you to make dental implants or whatever treatment you choose affordable. After diagnosis, the dentist can explain if you can complete treatment in phases. Financing and payment plans will help you pay for care over time without accumulating a lot of debt.

 

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

Should My Root Canal Tooth Still Hurt?

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Last week, I had a repeat root canal on a lower molar. My dentist thought she might have missed a canal, so she referred me to an endodontist. The endodontist repeated treatment but did not find a missing canal or an untreated canal. He said that my dentist did a great job. The endodontist told me that I would have some discomfort, but the tooth still hurts. This tooth has been problematic for most of 2021, and I hate to think that the root canal was not the solution after all. How long will it continue to hurt? Also, the endodontist reminded me to follow up with my dentist for a crown, but I cannot afford a crown right now. Is it necessary? Thank you. Dom from GA

 

Dom,

You can assess the success of root canal treatment by the way your tooth feels over time. If pain or swelling is not increasing, your tooth should begin feeling relief in a few days.

How Long Is Root Canal Recovery?

After root canal treatment, as local anesthesia wears off, you will feel soreness and tenderness in your tooth and jaw for a few days. The American Association of Endodontists confirms that you should contact your dentists or specialist if severe pain or pressure lasts for more than a few days.

What Can You Do While Your Root Can Tooth Heals?

While your root canal tooth heals, you can increase your comfort in these ways:

  • Take over-the-counter pain reliever or medication as your dentist or endodontist prescribed
  • Avoid chewing on or biting down with the root canal tooth
  • Avoid sticky, chewy, crunchy, sugary, and acidic food
  • Gently brush your teeth and floss around them
  • Keep your follow-up appointment

Contact your dentist or endodontist if your discomfort continues or increases or if you feel that your bite (the way your upper and lower teeth meet) is off.

Do You Need a Crown After Root Canal Treatment?

Diagram of a root canal tooth (left) and the healed tooth with a crown (right)
A dentist can work with you to make a root canal and crown affordable

A crown on a molar tooth will protect it after root canal treatment. Molars grind food, and the crown can absorb the stress on a tooth that is already weak. If you cannot afford a crown, speak with your dentist about payment plans or financing.

 

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

My dentist seems afraid to extract my tooth

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Man holding face in pain and needng an affordable dentist for root canal treatmentIn 2019, my upper first molar tooth broke two after the filling came out. The pain increased, so I went to a dentist who did a root canal on the tooth. I still had some pain in the tooth on and off, but I was afraid to see a dentist, and since the dentist did not follow up with me, I left the matter alone. So that’s how I got to the temporary filling falling out. Two weeks ago, I went to a new dentist that my coworker recommended. My coworker likes the dentist’s patient care, and she has lower fees than most dentists in our area. The dentist said that repeating a root canal is too invasive and prefers to remove the tooth. She told me that the extraction might include removing some bone. She seemed a bit hesitant or afraid about extracting my tooth. The other option she gave me is to see an oral surgeon who can extract the tooth under anesthesia. Which option should I choose? Thank you. Dylan from SC

 

Dylan,

Thank you for your question. Dr. Perry would need to examine your tooth and x-rays for an accurate diagnosis. But your new dentist may be uncomfortable with the complexity of the extraction. Or, your dentist may think that the experience could be traumatic for you.

You have had bad dental experiences in the past. Even after the root canal issue, your anxiety kept you away from the dentist. So perhaps an extraction under anesthesia is a good idea for you. Millions of people have dental anxiety that prevents them from getting proper care. If your dentist attempts the extraction and it is unusually uncomfortable for you, the experience will add to your stress.

What to Ask If Your Dentist Is Hesitant About Tooth Extraction

If your dentist is hesitant about tooth extraction, you can talk with them to help you decide your course of treatment. We recommend that you speak to your new dentist about her comfort level with your tooth extractions. You can apply these questions to almost any procedure your dentist is hesitant about:

  • How many extractions like this have you performed?
  • What form of sedation will you use for the procedure?
  • Do you think removing the tooth might be traumatic for me due to the condition of my tooth roots?
  • Do you expect complications?

Although it sounds like your dentist is honest about what you can expect with the extraction, it might help to ask a few more questions. And you mentioned that your dentist makes your treatment affordable. Although you may have found a knowledgeable dentist, please do not let low fees alone determine who will extract your teeth. Ensure your dentist has training and experience to make your experience pleasant. You can also schedule a consultation with the oral surgeon and get their opinion.

 

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

 

My new crown is now sensitive to heat and cold

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Man holding face in pain and needng an affordable dentist for root canal treatmentAlthough I had not seen a dentist in more than five years, I knew I needed help when my bottom left second molar cracked. I asked co-workers about a dentist they like because none of us have dental insurance from the job. And we all need affordable care, so I looked at Google reviews for recommendations and chose a dentist. I probably should have asked my co-worker if he ever had major work done with this dentist and not just a dental cleaning. Anyway, the dentist prepared my tooth for a crown. While I wore the temporary crown, it hurt when I chewed, and it was sensitive to cold. Maybe it was too tight or something because it made my gums sore. I got the permanent crown in earlier this month, and the symptoms got worse. The dentist took another x-ray and did a cold and pressure test, and tapped on my tooth. The cold sensitivity went away quickly, but I felt no pain with the pressure test. And he tested my bite, which of course hurt because it hurts when chew. The dentist said the pressure sensitivity is expected for up to three months. So he wants me to wait. Now my tooth is sensitive to hot food. Is my tooth nerve dying.? I hate to see another dentist, but I am not a fan of pain either. What is going wrong? Thank you. Myles from GA

 

Myles,

Thank you for contacting our office and clearly describing your symptoms. We recommend that you call and endodontist today.

Issues that Can Result from a Cracked Tooth

When a tooth cracks, the tooth pulp (living tissue and nerves) can be damaged. And if the pulp is irritated and infected, it will die.

When a New Crown is Sensitive to Cold and Painful

When a new crown is sensitive to cold and pain, and the symptoms linger, it is usually a sign of an infection. Although it is common to feel some sensitivity for a few days, it should not last if the dentist adjusted your bite correctly. As the crown gets sensitive to heat, you might have irreversible pulpitis, and an endodontist will look for damage to your tooth ligaments.

Your tooth sensitivity began after crown preparation. Possible causes include:

  • Incompletely sealing the temporary crown
  • Tooth irritation during preparation
  • A combination of the above

A dentist can minimize sensitivity by:

  • Coating the tooth with a desensitizing product, but may your dentist did that
  • Cementing the temporary crown with strong material to help the tooth settle down
  • Remove the crown for root canal treatment if symptoms do not improve
  • Not cementing the final crown on an already irritated tooth

Finding a New Dentist

After root canal treatment, you will need a quality dental crown. Look for a dentist with advanced cosmetic dentistry training who offers financing or payment plans—ways to make your care affordable. Most dentists have payment options for patients who do not have dental insurance.

Do not delay getting treatment because an endodontist may be able to save your tooth.

 

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

Dental insurance dropped my dentist

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My dentist of 12 years is no longer in-network with my insurance. Over the years, I had perfect results with crowns from the dentist. But during open enrollment in November, I learned that the dentist is not in my dental plan. I was waiting for this year to use my flexible spending money toward another crown, but I am nervous about the choices I have for available dentists. If I go out of network and back to my former dentist, I am afraid that I cannot afford it. How can I find a dentist with reasonable fees and quality work within a small network of dentists? – Thank you. Reuben from GA

 

Reuben,

Over the years, we have heard and seen many stories of dental care casualties that resulted from dental plan changes that exclude your trusted dentist. Patients often feel forced to switch to a new dentist that accepts their insurance, and sometimes trouble follows.

Why Insurance Companies Exclude Dentists from Their Plans

Insurance companies often exclude dentists from their plans because the company is trying to save money. An insurance company may contact all dentists in an area with a list of their discount fee plans. But dentists who focus on quality care know that they cannot maintain their high standards at the insurance company’s rates.

Other dentists will accept the insurance company’s rates but take shortcuts or skip steps to accommodate patients with that insurance plan. The result is lower-quality care and dental treatment that will not last as long. And it is not easy to find a dentist who offers high-quality crowns and knows how to ensure your new crown is in harmony with your bite.

How to Get Quality Dental Care with Your Current Insurance

Many insurance companies allow you to see the dentist of your choice if you are willing to pay more. You can submit your dental claims to the insurance company, and they might provide minimal benefits. Speak with your former dentist to find out how they can make treatment affordable for you. Some ways include:

  • Financing – Some dentists offer no-interest financing through companies like CareCredit®.
  • Phased treatment – Many dentists are willing to complete dental work in phases to help you pay for services as your dentist provides them.
  • Payment plans – Some dentists have in-office payment plans that allow you to pay for dental services in installments.

What If You Must Switch Dentists?

Diagram of the stages of affordable dental crowns
Talk to your dentist about making crowns affordable before switching to a new dentist

If you must switch dentists due to insurance limitations, you can find a new one with these steps:

  • Ask for recommendations – Talk to friends, family members, or co-workers about their dentist. Ask how long they have been with the dentist and if the dentist completed any major dental work for them.
  • Search online reviews – You can find patient reviews on Google, Yelp, and Facebook.
  • Schedule consultations – Schedule at least two consultations with dentists. Look online for information about the dentist’s post-graduate training and experience. Ask each dentist how many patient cases like yours they have completed. And ask how often the dentist completes the procedure.
  • Examine the dentist’s smile gallery – Some dentists have online smile galleries. But during a consultation, you can ask to see before-and-after photos of the dentist’s work. Ask to see pictures of patient cases like yours.

During the next open enrollment, you can look for available insurance plans that include your dentist.

Best wishes.

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

Looking for a dentist to bring out the best in a Snap-On Smile

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After my online research about getting an affordable smile makeover, I know that I cannot afford cosmetic dentistry. So, I looked at other options and learned about a Snap-on Smile. It’s clear that this isn’t the best option, but anything will look better than my teeth.

Many dentists online criticize the Snap-on Smile, but when you don’t have money for porcelain veneers, there are no good alternatives. The shape of my teeth is irregular, and they look mismatched. Based on everything I read, I hope to find a dentist who can adjust the Snap-On Smile to make it look better and not so bulky.

Is it possible to find a dentist with reasonable fees to flatten the Snap-On Smile teeth, especially near the gumline and deepen the grooves between the teeth so it looks more natural? And does any dentist have the tools to do this, or should I look for a Snap-On Smile dentist? I was hoping for a dentist with an artistic eye who won’t make the appliance look worse. I know that my regular dentist is not willing to do this. I already asked, and she refuses. Thanks for your help. Elysia from TN

Elysia,

Our priority is to protect patients’ oral health, so we must be upfront about your expectations from a Snap-On Smile. It will not give you the smile makeover you’re hoping for. The appliance is not designed to do that.

Reasons a Snap-On Smile Won’t Give You a Smile Makeover

As you read during your research, many dentists criticize the Snap-On Smile. And it’s because they or their peers have used it with disappointing results. Any honest dentist will tell you that a Snap-On Smile will give you an acceptable smile—not an attractive smile. Although the smile might look natural from a distance, when you’re close enough to talk to anyone, it will be easy to tell that your smile is not real.

  • Tooth color – The teeth have a uniform flat whiteness with no variation in color like natural teeth.
  • Tooth shape – The shape of the teeth in a Snap-On Smile does not look real. Think of artificial flowers that look artificial. You understand their purpose to provide decoration, but you know they are fake. It’s the same with this oral appliance.
  • Limitations of the appliance – Although you feel confident about helping a dentist get the smile just the way you want, the appliance’s limitations will not allow it. And an artistic dentist will not want to be involved in helping you create a cosmetic dentistry nightmare.

A Snap-On Smile is designed to be a quick way to make a lousy smile look half-way decent. It won’t last if you wear it every day.

Dental Bonding – An Affordable Alternative to Porcelain Veneers

Before-and-after dental bonding photos
A dentist with cosmetic dentistry training can use dental bonding to reshape teeth and fill small gaps

Your comments suggest that you found no solution between porcelain veneers and a Snap-On Smile. Were you able to find information on cosmetic dental bonding? An artistic dentist can apply dental bonding to your teeth to conceal chips, reshape your teeth, and fill small gaps.

Cosmetic dentists know how to blend composite to match your natural tooth color, translucence, and gloss. Although bonding doesn’t last as long as porcelain veneers, it is a fraction of the cost.

We recommend looking for a cosmetic dentist, scheduling a consultation, and discussing your treatment options. You can also ask about the dentist’s financial options for making treatment affordable.

 

Ryan Perry, DDS, of Baton Rouge sponsors this post

Dentist Placed the Wrong Crowns Without Your Consent? How to Resolve It

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In February, I switched dentists because I moved 70 miles from my former dentist. I chose my new dentist because her office is close to work and her fees are more affordable than most. My teeth were severely decayed, so the dentist recommended porcelain crowns for my upper six front teeth.

My dentist told me that I would receive all-porcelain crowns, so when the crowns were placed, I assumed that I was receiving them. But when I looked at my teeth in the mirror, I knew something was wrong. My dentist explained that halfway through the procedure, she saw that there wasn’t enough space for all-porcelain crowns, and their contact with the bottom teeth would wear down the edges of the bottom teeth. She ordered porcelain-fused-to-metal crowns from the lab. She never told me about the switch. She placed them, and only after asking me to look in the mirror, she mentioned the change.

My eyes were full of tears. I’m disappointed because I know I’ll have a black line around my gums that shows when I smile. Although the crowns don’t look bad, they aren’t what I expected and agreed to.

My dentist told me that the crowns look good so I shouldn’t complain. She also said that if I get a second opinion, the next dentist will tell me that same thing. She said that my case is closed. I’m beginning to regret looking for a dentist based on location and fees. I’ve been robbed of my money and my smile. What are my options? – Thanks, Kelsie from Mobile, AL

 

Kelsie,

How do you know when your tooth needs a porcelain crown? Generally speaking, when a tooth is damaged to the degree that it is in danger of breaking, a crown is required to protect what remains of the of the tooth's structure. You may wonder why Dr. Perry would not just remove a tooth damaged to that degree–it is because the loss of a tooth also means the loss of bone mass in the jaw at the site of that missing tooth.
You can find an affordable dentist with advanced training in tooth restoration and crown placement

Porcelain-fused-to-metal crowns are not your only option. Many skilled cosmetic dentists place all-porcelain—or all-ceramic—crowns on upper front teeth. The difference is that cosmetic dentists are artists with advanced training who understand which materials to use to minimize wear on opposing teeth. An advanced cosmetic dentist will ensure your porcelain crowns fit well and keep your bite aligned.

You can pursue legal action against your dentist, and you might have a good case based on her actions:

  • Gave you porcelain-fused-to-metal crowns without your consent
  • Didn’t give you the opportunity to refuse the crowns.
  • Isn’t agreeable to correcting the issue and ensuring our satisfaction.

Another option is to get a trained cosmetic dentist to re-do your crowns at the expense of your current dentist You can report the case to the state dental board and ask an attorney to send a letter to your dentist about the violations of your rights. Your current dentist will likely be willing to compromise.

How Can You Avoid Receiving the Wrong Restorations in the Future?

  • Ask your dentist what type of restorations you will receive.
  • Keep track of when your dentist says he or she will place an order with the lab to craft your crowns. Ask again about the type of crowns you’ll receive.
  • Before your crowns are bonded to your teeth, as your dentist if your crowns have a metal foundation, or if they are all ceramic.

Although a skilled cosmetic dentist’s fees might not be as low as your current dentist, there are ways to make treatment affordable without sacrificing quality. Talk to your new dentist about payment options.

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