Baton Rouge Dentist

Broken tooth must be pulled – do I need an oral surgeon?

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I lost a filling in one of my molars a few years ago. I lived with the missing filling for quite a while, but then the tooth broke, and it got too painful to ignore. I had a root canal treatment done, but never went back in for the dental crown placement, because I just can’t handle that much time in a dentist’s office. The temporary filling fell out about six months later, and I learned to work around the tooth, but recently it has become really painful again. I know I have to go back in, but I can hardly stand the thought of it.

I saw a dentist and he told me the tooth is infected, and that there really isn’t enough of it to save. He said that it has to be pulled, and that the condition of the tooth means they will have to cut both gum and bone. He said it would be best to have an oral surgeon do this under anesthesia, especially given my anxiety about dental work, but that is just not in my budget. He said he COULD do the procedure under a local, but that an oral surgeon would be best.

My question is, can most general dentists competently handle this type of procedure? I don’t want to spend all that extra money to go to an oral surgeon, but every time I think about getting it done my heart pounds and my hands sweat and I feel sick. Pretty intense. I think I’ll calm down some if I think my dentist is really competent to handle this.

William in Orlando

Dear William,

It sounds like you really need to a have a candid conversation with your dentist. Either he is comfortable doing the procedure, or he isn’t, and it sounds as if he will be honest with you about that. It is also encouraging that he has acknowledged that your fear needs to be considered and handled with compassion. You could also consider seeking the services of a dentist that does sedation dentistry, which they may also advertise as gentle dentistry. Very often, the use of nitrous oxide with an oral sedative is the right combination to reduce anxiety and control pain so that the appointment is much less traumatic.

This blog post courtesy of Baton Rouge dentist Dr. Perry.

Can I get all this dental work done in one sitting?

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I just went to the dentist for the first time in more than 15 years. I need a LOT of work done!

I have three cavities, and one of my teeth needs to be shortened, because it is making my bite screwy. I need six root canal treatments. I’d like to have a teeth whitening procedure, too, but I don’t know how long all of this is going to take, or whether or not I should try to plan for multiple appointments.

I am really pressed for time, but it is more than that. One of the things that has kept me away from the dentist all these years is that I just HATE to go. I get in that chair and just start sweating and feeling sick. I am afraid if I don’t go and get it all done at once that I won’t go back after the first appointment, and everything will just keep getting worse. It took me a long time to work up the courage to go back. I don’t want to mess everything up by chickening out on the necessary appointments.

Theresa in Big Rapids

Dear Theresa,

Welcome back!

It is a little tricky to answer your question. The most significant limiting factor for sitting length is usually tolerance of the patient, and you’ve said that you get very nervous and tense in “the chair”.

It sounds like you would be a good candidate for sedation dentistry. A sedation dentist will medicate you for the treatment, so you would be able to do a much longer appointment than you would without medication. A non-fearful dental patient might be able to tolerate up to a four hour appointment, but without medication it is not likely you would be able to do anything close to that.

If you do not want to go with a sedation dentist, be very candid with your dentist about your fears and he or she will be able to work with you to figure out how best to get you the treatment you need.

One thing to note: if your root canals are on your front teeth, then a general dentist could probably get them done in one appointment. If they are in your back teeth, however, you’ll need to have them done in as few appointments as possible. If that is the case, you may want to consider a endodontist (a dentist who specializes in root canals) to get your root canals done.  

This blog is produced courtesy of Baton Rouge dentist Dr. Perry.