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writeradmin writes blog posts on behalf of Dr. Kevin Peck

Ugly Teeth With Lumineers

We had Lumineers placed on my daughter’s teeth to improve her smile. We were told by our dentist that this would be the least invasive. We were also told that we would get to see and approve the results before anything permanent was done. However, that did not turn out to be the case. When they came in, I could tell right away they were going to look too big for her mouth. They did use a temporary try-in paste. We were told she’d get to walk around with them and decide what she thinks, but that didn’t happen. When I expressed concern about them looking too bulky and box-like, they told me that they would look normal once they were bonded in. That did not turn out to be the case. I said that and they told me to give it a week and we’d probably love it. When she went to school, the kids teased her mercilessly. Most called her horse teeth. The “nice” kids told her they looked okay but not natural. Now she’s in tears and doesn’t want to go back. This is the beginning of our school year and I don’t want her falling behind. Now they are saying they can shave them down, but I’ve lost confidence in them, what do I do?

Lisa

woman covering her mouth with her hand.

Dear Lisa,

I am very sorry for what your daughter was put through with this. Classmates can be quite cruel. It sounds like you went to a general dentist who doesn’t have much experience with porcelain veneers and bought into the marketing the Lumineers are easy to place because the teeth do not need any preparation.

The problem with that is very few smiles will look natural without some preparation no matter how thin the brand of porcelain veneers is. This is why your daughter ended up with what her schoolmates called “Horse Teeth”.

I do think you are entitled to a refund and can then have this done by a more experienced cosmetic dentist. I would insist on seeing before and after images of work they have done themselves before agreeing to let them work on your daughter’s case.

Don’t let this dentist do any more work on her Lumineers. Instead, tell them that you would like a refund and would like to work this out without going through a lawyer, but you are willing to do so if the need arises. They misrepresented several things and tricked you into bonding them on without liking them.

I hope you can resolve this quickly for your daughter’s sake.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pain After Root Canal Treatment

I need some advice about my root canal treatment. I had one done in three sessions that was the most discomfort I have ever been in. Then, I remained in pain for quite some time. I went back to my dentist and he decided to refer me to a root canal specialist, which I am wondering if he should have done in the first place. The endodontist thought maybe I was in pain because a canal was missed and I opted for a retreatment. During the procedure, he did not find a missed canal but said that he gave the end of the root more of a seal than was there before. He did tell me it would hurt for a few days. The swelling is down, but I am on day five and still in quite a bit of pain. Is there something wrong or do I need to wait this out?

Drew

Dear Drew,

Man in pain holding his cheek

I am sorry you are in pain. The good news is there are some things to be optimistic about here. First, it looks like the original problem of the infected tooth was resolved during the root canal treatment. In some complicated cases, it is better to go to a root canal specialist, but for most normal root canal treatments, your general dentist is just fine.

It should be noted that the failure, in this case, was not because he missed a canal but could have done a better seal at the tip of the root, which your second treatment resolved.

You said the swelling has gone down. This is another positive sign. The question about healing after a root canal treatment is not as much “how long should you be in pain”? Rather, the question is, “Are you improving?”

In your case, it appears you are. Some patients are in pain for longer than others. I would ask your dentist or endodontist to give you something for the pain but make sure you taper off of it each day.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.
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Can’t Afford My Sinus Perforation

I had a molar extraction about six months ago. During the procedure, my dentist perforated my sinus. After a few weeks a piece of bone came out. I thought it had healed over after that. However, recently I blew my nose and so much air came through that it literally blew my partial denture out a bit. I don’t have the money to get this fixed at the moment and my dentist has retired. What do you recommend?

Laura

Dear Laura,

I am glad that you wrote. While a sinus perforation can happen to any dentist because of mouth structure– there are some maxillary molars that have a very thin membrane separating them from sinus cavities. That being said, your dentist should have addressed the issue. While it sounds like he let you know that it was perforated, it does not sound like he actually closed the perforation.

At this point it should have healed. Because it did not, I would suggest you see an oral surgeon. I know you said you are not able to afford a dentist right now, but I think your dentist should take responsibility for this. If the dentist had partners, talk to one of them about what is going on. They should cover the cost of this.

If his practice was sold, there should be provisions in the contract dealing with post-operative complications, etc.

I feel confident that you can get this covered without expense to yourself (except for your time, of course).

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Tooth Infection and Fevers

I called our pediatric dentist’s office to schedule an emergency appointment because my daughter has a fever and has been saying her tooth hurts. They said that a tooth infection will not be the cause of her fever and they don’t think she’ll need an emergency appointment. I tried to ask some more questions but they didn’t seem to want to answer them. Am I confused? I thought any infection could cause a fever.

Yoon

Dear Yoon,

happy girl in a dental chair

I hope there is just some miscommunication here. Yes, you are correct, any infection can cause a fever. That includes tooth infections. While most do not, it would be foolish to write it off. Any time a tooth hurts it is a good idea to check it out.

The bigger issue I have here is the way they blew off the questions you had. A good pediatric dentist is willing to talk to parents and make sure they are comfortable and understand the need or lack of need for a treatment.

If they’re blowing you off and acting too rushed, they may have too many patients to adequately serve your daughter well. If this continues, I recommend looking into another pediatric dentist who has more time for their patients.

I don’t know the age of your daughter, but cutting teeth can also cause a fever and tooth discomfort. If you’re concerned, I suggest you call them again and tell them you really want her seen. If they don’t agree, there are general dentists who work with children that also do emergency dental appointments. They can probably schedule her in more quickly.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Getting Discounted Dental Care

Is there a way to go to a dental school to get your dental work done cheaper than you would with a graduated dentist? I’m sort of broke at the moment and I’m pretty sure I have at least one cavity.

Benton

Dear Benton,

Dollar Sign hatching from an egg

Yes, there are dental schools that will do your dental work. It will cost about half of what you would pay with your dentist. Not all states have dental schools. For instance, there is not a dental school in Arkansas. So you would have to make sure there is one in your area.

If so, it will be students who do the work and then that work is checked by an instructor. You will not get shoddy work, but it will not be top of the line work either. Another factor is the time it would take you.

If you were going to a regular dental practice and needed three dental fillings, you could have those procedures done in one appointment, which could be done in about 45 minutes.

At a dental school, each of those three fillings would have to be done at separate appointments and each appointment would take about an hour and a half. So, you are looking at 4 and a half hours of work, plus travel time back and forth for each of those three appointments. If you’re paid by the hour, you might end up losing money.

Another option is to look for a private dentist who doesn’t mind advertising themselves as an affordable dentist. This usually means they work to keep their prices down. Often, these dentists will offer payment plan options as well. This way you can save time and likely get better quality work done.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Delayed Pain with a Root Canal Treatment

My dentist told me that pain from a root canal treatment will peak in 48-72 hours so don’t worry if there is still pain after the procedure. However, I recently read a blog post on a dental website that said pain after a root canal treatment meant the treatment has failed. Which is it?

Laura

Dear Laura,

I’m wondering if the wording of the blog led to the confusion here. There will usually be some pain after a root canal treatment. Plus, as the Novocain wears off the pain will gradually increase. This is normal and, as your dentist mentioned, should peak somewhere between 48-72 hours, though some are pain-free sooner.

When you need to be concerned is if the root canal had completely stopped hurting and then several days later (or even longer) begins to hurt a second time. That would be a sign of a failed root canal treatment. In that case, you would need to see the dentist again in order to have it redone and hopefully save the tooth.

What If You Can’t Save the Tooth?

Sometimes, despite the dentist’s best efforts, a tooth is unsavable. When that happens there is nothing that can be done except to extract and replace it.

Hopefully, this will not become an issue. But, if it does, then the best tooth replacement option will be to get a dental implant. These are the closest to having a healthy, natural tooth again.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Affordable Dentistry During Inflation

The rising costs of everything have been eating away at the worth of my husband’s paycheck. He already works so hard so I can raise our four young children and I’m worried that we won’t be able to afford the dentist this entire year. Our dentist’s prices went up again this year. I don’t blame him. He’s dealing with inflation just like the rest of the country. But, I haven’t been able to afford their last appointment and I’m worried about the children’s teeth. Are there ways to find affordable dentistry in this climate?

Gina

Dear Gina,

Dollar sign hatching from an egg
There is a difference between affordable and cheep dentistry

I understand what you are going through. Everyone seems to be feeling this pinch, which is causing a vicious cycle of rising costs. I have some things that may help, even if it doesn’t solve all of your problems.

What You Can Do At Home

While most parents know and do the obvious things, such as brushing and flossing their children’s teeth daily, there are a couple of things that seem to surprise people. In case your pediatric dentist hasn’t told you about them, here they are:

First, limit snacks. Believe it or not, one of the best defenses against decay is actually saliva, which contains bacteria fighting minerals. However, the more your children snack, the less chance their saliva has to do its job. I know growing children are always hungry, but if you can limit them to one snack a day it will go a LONG way to fighting cavity causing bacteria. Plus, you will have the additional benefit of them actually being hungry enough to eat the food you lovingly prepare for them at their meals.

Second, know many juices contain citrus acid. This can eat away at their enamel. While some of those juices, like orange juice, can be healthy, you don’t want it to counteract what you’re trying to do for their teeth. One mistake people make is thinking brushing immediately after drinking something acidic will protect their teeth from the damage. Unfortunately, it has the opposite effect. Instead, it grinds the acid into their teeth. If you’re going to give them a juice right before bedtime when they are going to brush, have them swish some water around their mouth first, to neutralize the acid.

Finding An Affordable Dentist

Don’t confuse cheap with affordable. If a dentist is significantly lower than all other dentists in their area, it is a red flag. They could be using poor quality fixtures to keep their profits up, or they are terrible dentists who have to keep their prices super low to draw in new patients.

Sometimes an area a dental office is in can keep prices higher. Rent for office space is different depending on the real estate location. Sometimes you can save some money from going to a dentist that is just outside of an expensive area. You can get high quality care with slightly lower prices because the dentist’s overhead is lower.

Do an internet search using the term “affordable dentist” and the area you are looking. Often dentists who strive to keep their prices down will have a web page devoted to how they strive to make things easier for families. Just be certain to check their reviews to make sure the quality of care is what you want for your children.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

My Bite Doesn’t Line Up After My Implant Bridge

I had a bridge made with two dental implants that replaced four teeth. The weird thing is when I bite down one side of my mouth, my bite reaches my teeth (on the left), but the other side of my bite isn’t touching. I hope that makes sense. It feels weird to me and I wonder if it is supposed to be like that. I went to two doctors to have this done. First an oral surgeon. When he was done with the implants, he referred me to a dentist for the implant crowns. I’m not sure which doctor I would even go to if something is wrong.

Jan

Dear Jan,

dental implant illustration

It would be hard to tell you exactly what is wrong without examining you, but I do have some advice. First, this isn’t normal. Your bite should line up on both side at the same time. This is important to fix or it will lead to TMJ Disorder.

One thing that concerns me the most is that you said the surgeon decided on the placement of the dental implants and you didn’t see the restorative dentist until after that was done.

It is standard practice and an established principle of implant dentistry for the restorative dentist to be the one to determine the placement of the implants, NOT the surgeon. He violated the standard of care here.

I am going to recommend you see an expert implant dentist. Have them look at your implants and if they tell you they were placed incorrectly, you will need to have them redone. The good news with that is your oral surgeon will be liable for this repair.

However, do not just ask for a refund. As a result of removing the implants you will need some bone grafting done too, so instead he needs to pay the cost of redoing the case, including the grafting.

One tip when getting this opinion. Do not tell them who the surgeon or the dentist was. The dental world is a small one and they probably know one another. Instead, just tell him you want an unbiased opinion on what is wrong with your dental implants.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Child Restraints in Dental Care

I just read an article online about a dentist who was strapping down children during their dental appointments. Is this a common practice? It seems pretty barbaric to me, especially in this day and age. I don’t have children myself. I’m just curious.

Len

Dear Len,

I wish I new the article you were talking about. There are a couple of kinds of legitimate restraints that are used in pediatric dental care, but without seeing the article I can’t tell you if that was one of them. What I can tell you is what is commonly used and why.

Mouth props used in dental care

The first type of restraint is pictured above. These are mouth props and are designed to prevent patients, including children from closing their mouth or biting down during a procedure. This is for their protection as much as the dentists.

I have a colleague who, while attending dental school was observing a classmate perform a filling on a child. He did not use a mouth restraint and, at some point, the child bit down which caused the drill to go into her jaw. He told me he never forgot that and has always used a mouth restraint ever since.

Papoose board

Another type of restraint is called a papoose board. These are not as commonly used. In fact, most dentists that I know only use them in the most serious of circumstances.

A good pediatric dentist knows how to put most children at ease. Every once in a while, however, you get a child whose fear causes them to get out of control. In some cases, using just a little nitrous oxide helps. But, if you have a child with a dental emergency and they are completely uncooperative a papoose board can save them.

Almost every dentist I know that has had to use one, said the moment the child was wrapped in the board, it helped them feel more secure and they calmed down enough to get the work done they desperately needed.

I hope this helps clear some things up. It’s great that you care about kids.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

My Dentist Doesn’t Seem to Care

I had a fractured tooth and the dentist put a crown on it without telling me it may need a root canal treatment. I probably would have just had it pulled if I knew that ahead of time. The crown never felt right and I told the dentist that it was painful whenever I had to chew on that side, but he blew me off and said it is normal to have some irritation after a crown. I waited and then the next month, I ended up needing a dental crown on the next tooth. I asked them to fix the first tooth before crowning the second one, but they weren’t interested in that. All he did was numb the first tooth a little and crown the second tooth then tell me to come back in a couple of weeks. Now I find out the first tooth has a periapical abscess. At this point, I think they should refund me on the crown and I just pay for the extraction at this point. Is there a way to get this money back?

Margie

Dear Margie,

In the long run, this is not going to be the best dentist for you. Though, I am sure you have already figured that out. He is sloppy in his work and doesn’t have good follow through. In fact, he seemed more interested in collecting a fee from a second procedure than fixing the first one.

While it is true that there can be some sensitivity after having a crown placed. That sensitivity has more to do with temperature changes. Pain when you are chewing is completely different. That is a sign something is wrong. When a crown is done well, you don’t even notice it is there.

What Treatment Should You Get For This

I don’t think you should get this tooth extracted. Because of the periapical abscess, it will be extremely difficult to get the surrounding area numb and this will end up being a traumatic experience.

If you, instead, had a root canal treatment done, you would be in a better position. Not only will you save your tooth but a dentist could drill down in there and you wouldn’t feel a thing. The tissue inside the tooth is dead.

I don’t trust your current dentist, so I recommend you see an endodontist (root canal specialist) to have this done.

Can You Get a Refund?

That’s a bit tricky. It wasn’t great care, but it doesn’t necessarily qualify as malpractice. Your best bet is asking for a refund. If he refuses, which he probably will, you can tell him you are going to leave a bad review explaining that he doesn’t care about his patients and does poor quality work. That may convince him that it is in his best interest to make this right with you.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.