All posts by writeradmin

writeradmin writes blog posts on behalf of Dr. Kevin Peck

She’s PLaying with Fire with This Tooth Infection

I have an impacted wisdom tooth that is slightly infected. My ears hurt as a result. My dentist wants to take it out, which I’m fine with but I want him to take out that tooth and a tooth next to it that had a root canal treatment. He is refusing to take out the tooth with the root canal. I am likely going to wait until he changes his mind because I don’t want to go back and have the second procedure later, as I’m sure I will have to. I’d rather do them both at the same time. Is there any advice you can give me in the meantime?

Pamela

Dear Pamela,

I haven’t seen your x-rays, but I can’t imagine a dentist leaving an infected tooth in your mouth. He’d get to charge you for two extractions instead of one which could only bring him money. The only reason for him not to do that is because he has integrity. That is something to be thankful for.

My guess is nothing is wrong with the adjacent tooth so he doesn’t want to extract it unnecessarily.

Let’s say he did extract it, though. Unlike your wisdom tooth, the adjacent tooth would need to be replaced. Then, you are talking about needing to get a dental implant, something else your dentist could make money off of.

Don’t Wait on This Extraction

Unless there is something you haven’t mentioned to me, this tooth isn’t infected. If you continue to wait on the wisdom tooth extraction, you are putting yourself in danger.

Dental infections are considered dental emergencies because of their tendency to spread when left untreated. Think about how close your jaw is to your lungs, heart, and brain. You wouldn’t want an infection to end up there.

The fact that your ear is already hurting means it has started to spread. Please don’t put this off any longer.

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

Antibiotics for a Tooth Infection

I’ve had a tooth infection and went to see a dentist. He prescribed me antibiotics that I’ve been taking antibiotics for 11 days. I was fine for a while, but now it seems to have started acting up again. Do I just need to refill the prescription or do I need another visit to the dentist?

Kevin

Dear Kevin,

A man holding his jaw in pain.

I’m hoping there was some miscommunication between you and your dentist. While the antibiotic is useful until the infection can be dealt with by a dentist, it does not eliminate the infection, as you have discovered. Once the antibiotic is completed, it doesn’t take long for the infection to rear its ugly head.

With a tooth infection, a dentist has to get in there and physically remove the infected pulp. This is typically done with either a root canal treatment or by extracting the whole tooth.

It is always better to save any tooth you can, so a root canal treatment would be the better choice if it is still possible.

If the Tooth Cannot be Saved

In the case that it has been too long and the tooth cannot be saved, it is important that you replace the tooth as quickly as possible. The longer that spot is left open, the more you will be dealing with the adjacent teeth shifting or tipping into that spot. This will throw off your bite leading to jaw pain, headaches, and even TMJ problems.

Ideally, you’ll want to have a dental implant for your replacement. It is the closest thing to having a natural tooth again. This will help you preserve the underlying bone. If that is not possible, there are other options such as a dental bridge or a removable partial denture.

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

Her Dentist is Putting her in Danger

I had a root canal treatment several years ago. The area started hurting again so I went in and my dentist did an x-ray and decided I needed a re-treatment. He did it right then and gave me both Vicoden and penicillin. I was fine for a bit, but maybe that was just the Vicodin. Then the pain came back with vengeance. I called him and he said some people just take longer than others to heal and to give it another couple of weeks. I’m in so much pain I can barely breathe half the time. What do you recommend?

Stacy

Dear Stacy,

Woman grabbing her jaw in pain

I’m concerned about how your dentist is handling this infection. I can’t tell for sure if you got better and then worse or just got steadily worse to where the Vicodin was no longer working for you. Either way, it is a bad sign and he is putting you in danger.

Most root canal re-treatments are only successful 1/2 to 3/4 of the time. I realy think you need to see a root canal specialist at this point. He’s not taking this seriously. At the very least, he should have switched you to a stronger antibiotic when you were not better after a few days.

When you call a specialist, let them know what is going on so they can get you in for an emergency dental appointment. If they can’t get you in right away, they should at the very least prescribe a stronger prescription for you.

I’m sorry this is happening to you.

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

Lumineers Disaster

I went into my dentist for a smile makeover. He gave me four Lumineers. When I went there, I was very specific with him that I wanted a white smile. Yet, when my Lumineers came in and were placed, I noticed they weren’t white like we’d discussed. I tried to like them, but after a few days, I called him. I expressed that I didn’t like the color. That’s when he told me he placed a stain on them so they’d look “normal”. I was quite disappointed to hear that as it went against my expressed desires. He offered to take the stain off. That idea thrilled me. I went there with high hopes. Those hopes were dashed when I saw the results. Essentially, all he did was drill off the top layer. This made the teeth look dull and uneven, which is even worse. Do I have any way of affordably getting this fixed?

Brandon.

Dear Brandon,

A porcelain veneer being placed on a tooth

The smile makeover procedure you had reminds me a little to much of the middle-grade books, A Series of Unfortunate Events. I can tell from the way you described things that your dentist is either fairly new at cosmetic dentistry and is dipping his toes in the smile makeover waters, or he’s just completely incompetent. Because Lumineers is highly marketed to inexperienced cosmetic dentists as being easier to place than other brands of porcelain veneers, I suspect (or maybe hope) it is the former.

Let’s start with the fact that he did four Lumineers. Most people’s smiles are around eight to ten teeth wide. If you don’t want a bi-color smile, you have two choices. First, you can get that many porcelain veneers. A great option if you can afford it. However, not everyone can. In that case, your second option is to have your teeth whitened before you have your veneers made. This way the teeth will be close enough in color to make sense and blend.

The next disastrous decision is he stained them. Yes, you said you wanted a white smile, but your dentist thought, “I’m the professional and know better.” So, he put a stain on them to make them look like regular teeth. This is an attitude taught in general dental school. However, people paying for a new smile don’t want “regular” teeth. They want gorgeous teeth. This is why dentists who invest in post-doctoral training in smile makeovers learn the opposite. You aren’t creating normal smiles. Instead, you are creating your patient’s dream smile.

Amateur move number three is him bonding them on without you getting a look at them. True cosmetic dentists will use a temporary try-in paste, give you plenty of time to look at the veneers in various lightings, and decide if you are thrilled with them. If you’re not, they don’t get bonded on. The dentist will make the changes necessary to achieve the results you want. You’re paying for a stunning smile. You should get one.

His Disastrous Lumineers “Fix”

Finally, let’s get into your dentist’s “fix” for his misjudgment. What he should have done when you told him this wasn’t the color you agreed to was to start over and provide you with new Lumineers. That, however, would cost him time and money. So, he takes a short cut and drills off the stain. While this ruined your Lumineers, this is actually good news for you.

Because he damaged them, he is now obligated to fix them. I would not just get a refund or have him re-do them. He’s shown a disregard for your wishes, as well as a lack of commitment to the quality of his work. What you need to do is tell him you would like him to cover the cost of another dentist replacing them.

Before deciding on a second dentist, look at their smile gallery. Make sure there are before and after pictures of cases they’ve done personally, not just stock photos. Even then, only go forward if you absolutely love the after results they acheived.

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

Do I Need a Mercury-free Dentist to Remove One Filling?

I have a silver filling I want to get rid of. I asked my dentist and he said the panic about silver fillings is overblown and I’m safer leaving them in. I don’t want to leave it in. Do I need to switch dentists or is he right about it being unsafe to remove?

Megan

Dear Megan,

Left: silver amalgam filling Right: mercury-free composite filling

If a dentist doesn’t know how to do a sanitary amalgam removal, then yes, you’re better off leaving them in. However, you don’t have to if you truly don’t want to. Especially if they’re getting old, you’re much better off removing it before it starts to leak.

There are dentists who will know how to remove them safely. I’d look for a mercury-free dentist in your place. They’ll know how to keep you from inhaling any mercury vapors or swallowing any bits of mercury. Aside from a stopper dam, they’ll need a fan and cold water to keep the mercury from melting.

Once you remove the silver fillings, you can replace them with white composite fillings. These are actually better for your teeth than their silver predecessor anyway.

If you’re happy with your dentist, you can just go to another one for this removal and replacement. However, if you and your dentist tend to disagree in treatment philosophy, you could use this as an opportunity to find another dentist.

Look at the website of some local dentists. Make sure they’re mercury-free. It’s also good to see if they offer other services you may be interested in. For instance, if you’re looking for services such as teeth whitening, make sure you can get that as well.

Then, when you have a list of possibilities, be certain to check out their reviews. Many people leave reviews on sites such as Google or Yelp!

This will tell you if they do quality work and whether or not they have a good chairside manner and patients enjoy working with them.

Best of luck to you.
This blog is brought to you by Phoenix Affordable Dentists Drs. Kevin and Hillary Peck.

Lumineers with Dental Problems?

I wondered if it’s still possible for me to get Lumineers if I have dental problems? I’ve got some mild gum disease as well as a tooth grinding habit. Am I still able to get my smile makeover?

Dana

Dear Dana,

Lumineers Advertisement

You’ve asked some great questions. Let’s start with your gum disease. While this won’t keep you from getting a smile makeover, it does absolutely need to be treated. If it progresses, you will eventually lose your teeth. Often people don’t realize how serious periodontal disease is. I would make this treatment a priority.

I’d love to know what type of protection your dentist has provided for you with your tooth grinding. As you grind your teeth, it wears them down. This leads to decay, cracked teeth, and even wearing them down to nubs, requiring a full-mouth reconstruction.

This will be a problem with Lumineers. Grinders tend to break off and chip their veneers. There is a simple solution. A custom-fitted night guard will protect both your teeth and your veneers, giving you a gorgeous smile for many years.

Are Lumineers the Right Choice?

We’ve noticed that many patients who want to remake their smile ask for Lumineers specifically. This is because they’re highly marketed. However, they are just one brand of porcelain veneers. Many cosmetic dentists don’t feel they are the best brand. A lot of that has to do with their lab, which tends not to have the best results.

Other brands of porcelain veneers allow the dentist to choose where they have the veneers made, but the Luminners brand is owned by DenMat and they insist their lab be used.

If you want a beautiful smile makeover, my suggestion is you allow the dentist to choose the brand and not insist on Lumineers. They’ll know what brand will best give you the look you’re trying to achieve.

This blog is brought to you by Phoenix Cosmetic Dentist Drs. Kevin and Hillary Peck.

Dentist Suggesting Implants for Child?

My son had several failed root canal treatments on a tooth damaged in an accident. He’s going to lose the tooth and I was looking into replacement options. My dentist suggested dental implants were the best tooth replacement. My son’s only ten-years-old so I’m not too keen on the idea of another surgery for him after an extraction. Couldn’t I do something like a dental bridge instead?

Abigail

Dear Abigail,

A woman and her dentist smiling

I’m a little concerned here. Are you certain your dentist understood this procedure was for your ten-year-old son? While a dental implant is a fantastic replacement option for an adult, children are absolutely NOT candidates for dental implants. They can’t get them. Their jaws are still growing and developing. The implants stay fixed and will not grow and shift with their jaw the way their natural teeth will.

The standard procedure is to get a temporary tooth replacement until the child’s development is completed and then switch it out for a dental implant when his body is ready.

What’s the Right Temporary Replacement for a Child’s Tooth?

What about your suggestion of a dental bridge? You’re correct that it wouldn’t require surgery. However, it does require your dentist to grind down your son’s two healthy adjacent teeth. I’d hate for him to lose tooth structure unnecessarily. This wouldn’t be a temporary solution. A dental bridge is a permanent restoration, though it will likely have to be replaced many times over the years as he grows.

dental flipper
A Dental Flipper

Ideally, you’d want an inexpensive solution which won’t affect any of his other teeth while he finishes growing. In that case, I’d recommend a dental flipper. It’s a respectable restoration. His friends won’t know it’s fake unless he thinks it’s cool and shows them. Yes, it is removable and he could lose it. But, truthfully, you could purchase several dental flippers for the cost of one bridge. If your son does misplace one, it could be a good lesson in responsibility where he has to mow neighborhood lawns to pay back the money he owes you for the replacement.

Then, when he’s stopped growing, you can take him to a skilled implant dentist. If your dentist actually was suggesting a dental implant for a ten-year-old, it means your dentist is incompetent. Following through with his advice would have put your son at great risk. You need to find a new dentist—double quick.

This blog is brought to you by Phoenix Dentists Drs. Kevin and Hillary Peck.

Poor Man’s Smile Makeover

I wanted to get a smile makeover because my teeth are so stained. Plus, I have a tiny gap between the two front teeth. I looked at porcelain veneers, but they were way out of my budget. Is there a way to get my smile more attractive without losing my home?

Lexie

Dear Lexie,

Dollar sign hatched from an egg
There are always affordable alternatives.

I’m a firm believer in the fact that there’s always an affordable dental alternative. You’re right that porcelain veneers are a tad on the expensive side. However, that doesn’t mean you are trapped with a smile you’re not proud of. Based on what you described, you’re a good candidate for two procedures which can repair both of those problems. These can make your smile look beautiful.

I’d start by getting your teeth whitened. This is probably the most affordable procedure you can do for your smile with amazing results. It will take years off your appearance in one fell swoop.

In addition to that, there’s an easy solution for your tooth gap. Dental bonding uses a composite resin to fill in the gap. A cosmetic dentist will hand sculpt the new inner edges of your teeth in a way that they meet perfectly.

It’s important you whiten your teeth first. Once the resin is molded and dried, the color cannot be changed. That’s why you’ll want your teeth the color you’ll want permanently so your dentist can match the resin to it.

What You Want in an Affordable Dentist

I don’t want you to confuse a cheap dentist with an affordable dentist. A cheap dentist will cut corners, which rarely works out well for the patient. An affordable dentist will still do quality work but find other ways to save you money.

Generally, they’ll try to keep their fees reasonable, but often they also offer payment plans. They can do that with either an in-house payment plan or through Care Credit.

You also want a dentist who tells you all of your alternative treatment plans. Just like there was a more affordable option for your smile makeover, your dentist should give you all your options. It’s the only ethical way to handle things.

One other suggestion. You should always check reviews of every medical practitioner before you see them. It’s always wise to learn from the experiences of others.

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

Dentist “Bait and Switched” Me with Prices

I had was diagnosed with a cavity two months ago. They said it was small enough we could just watch it for now because I told them I didn’t have much money. But, a few days ago it started hurting. Because I already knew the problem I just called around to a few dentists who advertised as affordable to see what their prices were. This one dentist was significantly cheaper than the rest so I booked with him. Then, when I get there he says the decay is too extensive and he’ll have to do a crown. That is way more money than I’d planned for. I left without having the work done. Should I get a second opinion? Do you think I’m being bait and switched?

Bruce

Dear Bruce,

Dollar sign hatched from an egg
Cheap does not always equal affordable.

There are a few things going on here. First, is financial. You need an affordable dentist who’s willing to work with you on payments. But, you’re making a common mistake in equating affordable with cheap. There are good dentists who find ways to be affordable but probably aren’t the cheapest. Then, there are dentists who quote cheap prices, but end up costing you more money because either their skill or the quality of their materials are sub-par.

It’s also possible, the dentist wasn’t trying to pull one over on you. The original diagnosis was a couple of months ago. That, combined with the fact that the tooth starting hurting, tells me the decay has spread. Once decay gets to a certain point a filling isn’t enough and a crown becomes necessary. If it blows up into an infection, you’ll need a root canal treatment as well.

Get a Second Opinion from Another Affordable Dentist

It’s okay to trust your gut. If you truly feel like this guy was trying to pull one over on you then you should get a second opinion. You can bring your x-rays from your previous appointment for the second dentist to examine which will save you on additional x-rays.

Remember, cheap doesn’t mean affordable. Look for dentists who offer payment plans and phased treatment options. But, check their reviews to make sure they have a good reputation.

This blog is brought to you by Drs. Kevin and Hillary Peck.

Pediatric Dentist Missed Long Coming Cavity

My son has a bit of trouble at the pediatric dentist’s office. We’ve only been twice, but both times they were unable to get x-rays on him. The exam and cleanings seem to go fine. The x-rays scare him. Both times, they’ve sent us on our way saying everything looked fine. Then, two days after our last appointment, he came to my room crying with a toothache and massive fever. I gave him some pain reliever and called the pediatric dentist. They weren’t open, so I called my dentist who agreed to see him. Thankfully, because he turned out to have a massive tooth infection on his back molar. My dentist was able to give him an x-ray without any problem. The decay was so bad he couldn’t save the tooth, which worries me because it was a molar. He gave him some dental sedation and extracted the molar right there. He said that cavity was a long time coming. How did the pediatric dentist miss it?

Lucy

Dear Lucy,

A child holding a teddy bear at the pediatric dentists office

It’s hard to say why the pediatric dentist missed it. I’m curious as to what your dentist did differently than your pediatric dentist which helped your son feel comfortable with the x-rays. It sounds like your family dentist is good with children. If you’re not satisfied with your current pediatric dentist you may consider you and your son going to the same practice. It’s perfectly fine for general dentists to treat children if they’re good with them.

I’m glad your dentist was able to deal with the infection so quickly. That could have turned out horribly if it spread further. You’re right it’s a shame that the molar couldn’t be saved. Hopefully, your dentist placed a space maintainer there for him. Otherwise, your son’s teeth will shift and cause crowding in his teeth. That will mean expensive orthodontics. You definitely don’t want to deal with that.

Effective Pediatric Dental Care

You’re wise to take your son to the dentist regularly. Too many parents wait until there’s a dental emergency to bring their children to the dentist. That makes their first experience a negative one, which often leads to dental anxiety.

It sounds like he responded well to dental sedation for the extraction. That’s good news too. The goal in pediatric care, along with good oral health, is to feel positive about the dentist.

Hopefully, this infection hasn’t completely thrown him off and he can enjoy going again.

This blog is brought to you by Phoenix Dentists Drs. Kevin and Hillary Peck.