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writeradmin writes blog posts on behalf of Dr. Kevin 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.

Dentist Insisting I Get a Dental Implant

I recently lost a tooth. That is stressful enough but my dentist is insisting I get a dental implant. It isn’t that I don’t want one. I just honestly can’t afford one. They are way out of my budget. He’s insisting it is the only good option. Is that true? If so, do I just have to leave a gaping hole in my smile?

Kelly

Dear Kelly,

It really galls me when dentists give ultimatums like this or make patients feel like they don’t care about their teeth just because they do not go into debt for a treatment.

I’m going to tell you right away that you will probably be better served by going with a different dentist. You want one who follows his ethical obligation to give you all the options available to you. Not everyone can do the ideal treatment.

While it is true that a dental implant is currently the best tooth replacement option, there are other choices.

The next best option would be a dental bridge. This suspends a false tooth between two dental crowns. That means the adjacent teeth will have to be crowned, but it is a permanently attached solution.

The next option is a removable partial denture. This will have a false tooth and use clips to attach it to your adjacent teeth. As the name suggests they are removable, so they won’t be as steady as a dental bridge, but will suffice.

The cheapest option is a dental flipper, but this is only meant as a temporary option while you save up for a better replacement.

I am going to suggest you do an internet search for an affordable dentist and go to them to get your replacement. Most dentists who promote themselves as affordable try to keep their fees reasonable and also offer some type of payment plan.

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

“Affordable” Dentist Disaster

I went in for a dental crown with a guy who was cheaper than the other dentists in town. I was looking to save some money but that was a big mistake. The temporary crown fell off once. I wasn’t too worried about that as it is temporary. Then, the permanent ones have fallen off over five times in as many weeks. On top of that, it is several shades whiter than my regular teeth and really sticks out…when it is staying in. I complained to my dentist and he said that he could change the color for another $400. I couldn’t afford that so felt stuck with the color. Then the crown fell out yet again and I asked him what he was going to do to keep this from constantly falling out. He said he would tell the lab the crown is defective and have them replace it. I was very clear with him that I did not want to pay any more for this crown because I’ve already paid in full and just need it to stay in. It’s not my fault it is defective. He agreed. THEN, after I get the new crown, which still doesn’t match, by the way, I get a bill for $423 saying this is what I owe after insurance from the original crown. But, I already paid that and feel like they are being deceptive to get me to pay for the new crown. What do I do?

Jenny

Dear Jenny,

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

Wow. I am sorry to hear everything you have gone through with this unethical dentist. The first thing I want you to do is NOT pay any further money. If you already paid the new fee, see if your bank will reverse the charges.

When a dentist provides a dental crown, there is a basic understanding that it will match your other teeth and stay in. That is dentistry 101. It seems like your dentist is more of a scam artist. What he’s telling you is “I will provide a dental crown. However, if you want it to match your teeth it will be $400 more. Plus, if you want it to stay in, that will be another $423. He sounds more like a used car shyster than a medical practitioner.

Next, do not return to the office. I want you to go to another dentist in your local area and recruit them to help you get a refund. If you are not dealing with a front tooth, you will not need an expert cosmetic dentist, just an honest one. There are more honest dentists than unethical ones, though it probably doesn’t seem that way now.

If your dentist refuses the refund, tell him you will be reporting him to the dental board. Believe me, they will be on your side.

Please don’t forget to leave a review about what this dentist did to warn any other potential victims.

I know you were looking to save money, but there is a big difference between a cheap dentist and an affordable one. Never go with the dentist who is substantially lower than the rest of the dentists in that area. It’s usually a red flag. However, look for an affordable dentist whose prices are reasonable and who is willing to work with you on payments.

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

Can a Dental Crown Cause a Yeast Infection?

I had to get a dental crown on a back tooth. When the temporary crown first went in, my teeth felt sensitive. Then, since the permanent crown came in, I have had extra saliva, sores in my mouth, a bitter taste, and bad breath. Is it possible the crown caused a yeast infection in my mouth?

Pamela

Dear Pamela,

You’ve listed a lot of symptoms here and all of them have various causes. The sensitivity after temporary crowns is normal and usually ends shortly after the permanent ones.

As for a yeast infection, is it possible you’ve been rinsing a lot with peroxide in an effort to help with your situation? While it can be a good periodic disinfectant, using it more than just occasionally will lead to a yeast infection.

Sometimes after a stressful dental appointment, a person can develop burning mouth syndrome, but one of the main symptoms of that is dry mouth and you said extra saliva, so I am going to rule that out.

Sores in your mouth are usually from either stress or a virus. The other two symptoms, bad breath and a bitter taste, usually have to do with oral hygiene. Sometimes, after getting a dental crown where someone’s mouth is sensitive, they ease up on the brushing and flossing, but that actually exacerbates the problem. Dig in there without being delicate and it will help.

Of course, there is the possibility you are having trouble getting everything from around the crown. In those cases, something like a WaterPik will help.

Try those things and if it doesn’t help after a couple of weeks, see your dentist again and have him or her look at things.

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

Pain from Composite Filling

I recently had my first composite filling done. I sort of had to pressure my dentist into it because he usually places the old silver amalgam fillings. He finally relented and agreed. Since then, my tooth hurts when I chew. Oddly, it doesn’t hurt under normal circumstances. I can even clench my teeth and nothing. But, if I am chewing there is a sharp pain which lasts a second. Did my dentist do something wrong?

Aaron

Dear Aaron,

While composite fillings are far superior to their amalgam dental filling compatriots, the procedure for bonding them is completely different. If your dentist does not normally place them, he will not be aware of the different techniques needed.

I wonder if you had a small filling placed. The pain you described is an unusual phenomenon we see mostly with small composite fillings. Fortunately, there is a way to prevent the problem, or in your case, fix the problem.

If a dentist uses either a self-etching primer or a glass ionomer base, we are seeing this issue practically eliminated. I would talk to your dentist about the problem and ask him to re-do the fillings using a glass ionomer base.

I am surprised your dentist is still almost exclusively placing amalgam fillings. Most dentists have moved on to the composite technology which is healthier for your teeth and contains no mercury. It may be time for you to find a dentist who is more interested in keeping up with the technology and advancements in his or her field.

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

Premium Home Teeth Whitening

I keep receiving a Groupon order for Premium Home Teeth Whitening. Is this something worth investing in? I’ve always wanted to whiten my teeth but never really talked to my dentist about it.

Amy

Dear Amy,

teeth whitening trays
teeth bleaching trays

After looking this over, I can tell you that the whitening ingredient they use is legitimate. It will whiten your teeth. That is the good news. The only real bad news is it will not be as effective as you’d hope, even though they do have a good percentage of their active ingredient.

The reason for that is the whitening trays. Pictured above are the type of teeth whitening trays you would get with your dentist. These are custom fit to your bite. This serves to protect the whitening gel, as well as your gums.

The trays that come with this kit are not fit to your bite. It’s a DIY. This means that your saliva will leak into the trays, thereby weakening the gel. It also means some of the gel will leak out. This not only means less whitening potential for your teeth, but it can put your gums at risk. There have even been cases where patients ended up needing a root canal treatment from using an over-the-counter whitening kit.

My suggestion is you simply talk to your dentist about your desire to whiten your teeth. The cost of Premium Teeth Whitening is not that much less than what your dentist would charge you. Ask him or her if they would be willing to come down on their price a little or allow you to pay out the current cost. Most dentists are happy to find ways to help their patients afford dental work. I think you’ll end up much happier with your results that way.

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

Will Medical Insurance pay for Dental Implants

I have serious dental issues on my front teeth, including two missing teeth and a 20 year old bridge. I’m having trouble with other teeth as well. I’d like to take out all my upper teeth and replace them with dental implants. I have tried to use upper dentures on those missing teeth but the dental plate was too much. I couldn’t keep wearing it. If I don’t do something, I won’t even be able to eat. Do you think medical insurance will cover it as not having them will affect my health?

Becky

Dear Becky,

You brought up a good point about dental plates that I think others need to be aware of when making decisions about their tooth replacement options. Dental plates can be a nightmare for people with a strong gag reflex or a sensitive palatte. With dental implants, you do not have to worry about anything extraneous like that.

In the case of medical insurance, almost all of them have a dental exclusion clause. That leaves you looking to dental insurance to pay for this. While it is unlikely they will pay for all of it, they will have a percentage they will cover.

If money is really tight, I would look for a qualified implant dentist who also advertises as an affordable dentist. Just do an internet search using that term.

While in most cases you pay out dental implants in two stages, once after the surgery and once after the crowns or supported dentures are placed, affordable dentists may allow you to break up those payments even further.

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

Tanda Pearl Ionic Teeth Whitening

I have teeth whitening trays my dentist made for me. He told me to wear them an hour a day, but that is hurting my jaw. I saw an advertisement for the Tanda Pearl system. They report that you only need to wear their tray for 5 minutes. It only has a few reviews. I wondered if you’ve heard of it and if you know whether it works or not.

Laurie

Dear Laurie,

Teeth Whitening Trays

I am glad you wrote. Looking at the product, it is just like any other run-of-the-mill whitening product, with the exception of their tray and light. As for the light, I don’t see anything in it that makes it work the way they are promoting. If it did, they could market it to dental offices and make a fortune. The fact that they are not, tells me that they do not want any professional scrutiny with it.

As for the trays, that is a bigger deal. Unlike your professional bleaching trays, these do not have individual trays. Instead, it is a single tray that you will bite onto and hold into your mouth for the five minutes. I actually think this will be worse for the jaw pain you are experiencing.

Not only will it be worse, but it will be less effective as well. The trays your dentist made for you should have been custom fit to your bite. We’ll get back to that in a moment. The trays that come with this kit are DIY. That means some of the whitening gel will be getting out and some of your saliva will be getting in. Both of these things dilute the effectiveness of your gel.

I’m going to suggest two things in your case. First, you don’t have to wear them for an hour. If they are bothering you, lower the wear time to half an hour. The second thing I would like you to do is to talk to your dentist about the pain you are experiencing. He or she can make sure they are actually fit to your bite correctly and make adjustments if they are not. Your teeth whitening will be much more effective with the gel and trays your dentist provides.

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

Advice About Dental Allergies

I’ve been having problems in my mouth as well as with some skin conditions. I went to an allergist and it turns out I have multiple allergies to dental materials, including the elements in my dental fillings. Here is the thing. I need to get different fillings, but I also need to replace a tooth. Is there a safe way to do this given what we now know about my allergies?

Layla

Dear Layla,

Safe Amalgam Removal

Let’s start with the fillings you need to remove and replace. In order to do this safely, especially with your allergies, you will need a dentist who knows and has the equipment for a sanitary amalgam removal. This will be important so you do not inhale or swallow any mercury or mercury vapors, not to mention any other materials you may be allergic to that are in those amalgam fillings. I would also wear clothing over as much of your skin as possible.

There are two types of dentists that will be the most willing to work with you and understand how to do amalgam removal properly. The first is a mercury-free dentist. The second is a biological or holistic dentist. I would do an internet search for those.

Dental Implants and Dental Allergies

Dental implants are a little easier. While there are metal free implants available made of zirconia, the traditional dental implants made from titanium are very bio-compatible. It is rare for someone to have a titanium allergy.

The benefit to the traditional implants is their proven longevity and the amount of long-term data we have on them. Titanium has been used for decades in prosthetics, not just in implants, but in hips and other joints. The only downside to the zirconia is we don’t have that data as they are fairly new.

I hope this helps.

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