Are All Dentists Judgmental?

I’ll admit I don’t get to the dentist as often as is recommended. It’s not that I don’t want to, it’s just I can’t afford it. Not only do I not have dental insurance, so everything must be paid for out of pocket, but I lose income by going. I’m paid by the hour and dentists only seem to be open during normal working hours. I have to miss work to go. Essentially, I’m charged twice if you think about it. Even though I don’t go very often, I do try to go every two years. I rarely have a problem with my teeth, but I get a lecture every single time. I’ve switched dentists every couple of years for that very reason, but no matter who I go to, there’s still that lecture. Why are they so judgmental? Why can’t they seem to understand it’s a sacrifice for many people to get to the dentist?

Avery L.

Dear Avery,

I can understand your frustration. Here you are trying your best, making sacrifices to even get to the dentist and when you do, they treat you like someone who doesn’t take care of things. First, I want you to know that not all dentists will lecture you. In fact, some dentists will just be grateful you came and tell you so. Both sets, judgemental and non-judgmental, likely have the same mindset behind their response. They care and want you to get the proper care for your teeth. They go about it different ways, some more productive than others, but they mean well.

It sounds to me like you want dental care, but you need an affordable dentist. There are dentists who work to keep their fees down. They may even work with your schedule, so you don’t lose income. Explain your work situation. It may not be that they hold regular Saturday or evening hours, but would be willing to meet with you twice a year at less than peak times so you don’t lose income to get your teeth cleaned. They wouldn’t want you to advertise they’re doing that, but would be willing to help.

Another option is to consider using a program such as Care Credit. It’s a medical “credit card” of sorts. It allows you to go ahead with treatment and then slowly pay out the bill for the services you receive. Depending on what type of credit you have, you may even be able to get zero interest payments.

Something patients don’t generally consider is how much going to the dentist regularly saves them money, health, and time. If you get your teeth cleaned regularly you’re less likely to develop a cavity. If you do happen to develop one anyway, they’re often caught so early that a simple, small filling will be enough. When things are left to progress without early intervention you end up with a more invasive (and costly) procedure, such as a root canal treatment, or worse, an extraction and the need to get a tooth replacement.

This blog is brought to you by Dr. Kevin Peck.

Please Tell My Boyfriend He Needs An Emergency Dentist

My boyfriend is in so much pain he can’t eat. He still has his wisdom teeth at 24. The gums are swollen. He insists it happens periodically and goes away. It looks like one of his gums has a flap in it. That could be the problem but I think a dentist needs to look at it. I don’t know how to convince him to go.

Liz B. – Montana

Liz,

You may not be able to convince him, but you’re right, he needs to be seen. “Normal” pain for wisdom teeth would be aching in the arches. That happens because the other teeth are being pushed. However, even if it was normal pain, if it’s recurring it’s a good idea to remove the wisdom teeth. If he was under the care of a general dentist they’d have told him that.

Your boyfriend’s pain is not normal. In fact, it’s dangerous. This could blow up into an infection quickly. It likely already is one, given that he’s in so much pain he can’t eat. This infection needs to be dealt with. If he doesn’t already have a dentist he needs to be seen by an emergency dentist. People still die from tooth infections. They can blow up quickly and then it’s too late. Just this past February, there was a news story about a 26-year-old father of two, in California, who died because the infection from his tooth spread to his lungs. People often underestimate how essential proper dental care is.

That gum flap you described could be a big part of the problem. It may be opening just enough for food to get trapped in there. If so, bacteria will thrive and spread, causing an infection. It’s likely they’ll recommend their removal.

This blog is brought to you by Dr. Kevin Peck.

Bummed My Son’s White Filling Keeps Falling Out

I don’t know what to do. I’ve been going to a pediatric dentist for my son. I wanted a white filling for him. The dentist understood that and gave him one. Or, at least he tried. He’s given him three and all of them have fallen out. I don’t know what to do. I don’t think it’s the pediatric dentist. He’s a respected dentist. He knows what he’s doing. Can you help me know what’s going on? I don’t want to give him a mercury filled filling.

Christina – New Jersey

Christina,

I understand your feelings about mercury-free fillings. Many patients are opting for them. Some patients even insist on them. With children it’s tricky. The process is completely different than with ye old silver amalgam fillings. Composite fillings work almost like a glue. The surface is etched and then the composite is bonded to it. As you can imagine, even a tiny bit of moisture missed in during this bonding process will destroy the bond, which is why a lot of dentists prefer to use amalgam when they’re working on back teeth or helping wiggly children. However, that doesn’t mean it’s impossible.

Without an examination it’s impossible to tell what the actual culprit is. But, moisture is the likely bad guy. With adults, you can usually work around this and take steps to keep the tooth dry during the procedure. Doctors generally use a mixture of cotton rolls, air, and dental dams to isolate the area they’re working on. Kids, especially little ones, have the tendency to fight this kind of stuff. They’ll move around in the chair, push their tongue into the preparation, and they aren’t typically fond of dental dams. So, when you get to the point where a parent really wants the white filling and the child can’t cooperate enough to keep it dry, sedation during the procedure becomes the next solution.

Dental sedation is not like surgical sedation. He will be conscious, but completely relaxed and very sleepy. It will help him stay still and cooperative during the procedure and is perfectly safe.

If you want to, you can get a second opinion from another pediatric dentist to determine if moisture is the actual issue. Then make a decision from there.

This blog is brought to you by Dr. Kevin Peck.