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writeradmin writes blog posts on behalf of Dr. Kevin Peck
Dental implants

Can I Get Dental Implants After Years in Dentures?

I have been in dentures for a little over seven years while I saved up for dental implants. It took me a little longer than I expected. Is it too late at this point for me to get dental implants?

Stacy

Dear Stacy,

implant supported dentures

Technically, it is never too late to get dental implants, but you will need one other procedure to make it work— bone grafting. The moment all of your teeth were removed, it signaled to your brain that there was no longer any teeth roots to support. As a result, your body begins to resorb the minerals in your jawbone in order to use them elsewhere in your body where they will be more useful. Honestly, it is a remarkably efficient system.

The unfortunate side effect is that your jawbone begins to shrink. Eventually, there won’t be enough of your jawbone left for you to even retain your dentures in your mouth, making you a dental cripple. This is known as facial collapse and in addition to make it impossible for you to chew, will also make you look decades older.

The solution to this is bone grafting. This will build up the bone you lost. It is also the procedure that will enable you to get the dental implants you want. Once you have the implants placed, that signals to your body that you DO have teeth, so it leaves your newly built up jawbone alone. Then, after a period of healing, you can have new dentures anchored to them. You will once again be able to eat anything you want, even things you loved before having trouble with your teeth.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.
Click here to learn about affordable dentistry.

Teeth Whitening

Using Lemons for Teeth Whitening?

I was thinking about whitening my teeth. I know not to use household bleach. A friend of mine tried that and it ended up a disaster. I recently read an article about people who use lemons to whiten their teeth. Lest I go the way of my friend with the bleach, is this a safe option?

Tara

Dear Tara,

teeth whitening trays
teeth bleaching trays

For those reading who may not realize why you don’t use bleach to whiten your teeth, it is because bleach is a base, like lye, which is very corrosive. It can eat away at organic material. In fact, many dentists use it to do just that in cleaning out dead organic material in a root canal treatment.

As for the lemons, I don’t recommend that either. Lemons contain citric acid. What the citric acid will do is etch your teeth. While this can scrub off some surface stains, it also damages them. That damage makes them pick up stains much more easily, which will make them darker than when you first started.

There are over-the-counter whitening kits that work, like Crest Whitestrips, however they are much weaker. It will take a large number of kits to see any real difference. In the long run, that doesn’t save you much money. The safest and most cost effective way for you to whiten your teeth is using professional teeth whitening through your dentist.

You can get results much faster under the watchful eye of a dentist to ensure that nothing else goes wrong while you are getting the white smile you want. There have been cases of people needing a root canal treatment because of an over-the-counter treatment. That is the last thing you need when you are just trying to get a white smile.

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

Teeth Whitening

Can You Bleach Your Teeth with Household Bleach?

I’m thinking about getting my teeth bleached. Before I do, I just thought I’d check about a question I have. Is there a reason that I couldn’t just use household bleach? It seems like I should be able to swish it around in my mouth every day and get some whitening, right?

Ellie

Dear Ellie,

Teeth whitening trays
Teeth Whitening Trays

I like that you’re trying to think outside of the box. That being said, this won’t be a good option for you. Household bleach, such as Clorox, is a base, like Lye. These are very corrosive. Not only can they burn through living tissue, but if they combine or come in contact with certain other chemicals it can poison you by releasing chlorine gas. There are also warnings about you mixing bleach with other household cleaners for the same reason.

Something you may find interesting is that the corrosiveness of bleach makes it ideal for dentists to use it in root canal treatments. They’ll use the bleach to dissolve all the dead, organic material inside the tooth. You wouldn’t want to use it inside your mouth and let it damage your soft tissue.

When a dentist does teeth whitening, they do not use bleach. Instead, they use a special peroxide gel developed specifically to safely, but powerfully, whiten teeth. If you want to whiten your teeth, then I would recommend doing it with a dentist.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.
Click here to learn about how we keep our treatments affordable.

Root Canal Treatment

A “Watch” Tooth Needed to be Extracted

I’m confused about the care I’m getting from my dentist. He had a tooth under “watch” saying that it looked like a problem was developing. By my next appointment, just about 5 months later, he tells me the tooth is too far along for a root canal treatment to be useful and I need to extract the tooth and get a dental implant placed. Is this a normal progression?

Joyce

Dear Joyce,

Illustration of an abscessed tooth

I am concerned about what I am hearing. It would be highly unusual for a tooth to go from watch status to needing to be extracted between appointments, especially as diligent as you seem to be about keeping them.

While decay could have progressed to the point of needing a root canal treatment, I have serious doubts that it would be unsavable. Your tooth would need extensive damage in order to need to be replaced. If he had done proper treatment and diagnostic procedures, there is no way you should now need to lose the tooth.

My guess is, and please bear in mind that I haven’t examined you, that you would be better served with a different dentist. It sounds to me like either your dentist has poor diagnostic skills, or he is deliberately suggesting and overtreatment in order to make some money. An extraction and dental implant are much more expensive. If it were necessary, I’d say go for it.

This blog is brought to you by Pheonix dentist Dr. Hillary Peck.

Dental Crowns

Why Can’t I Get Really White Crowns

I had crowns done about ten years ago. I never liked their color but my dentist insisted that anything whiter would not look natural. Now, I am getting them replaced and I told my new dentist that I really wanted them white. He suggested a B1. I can already tell that I will want them whiter. He said that because I have a post in a couple of them, if we go any whiter people will be able to see the post. Is there any way I can have a really white looking smile without people seeing the posts?

Carla

Dear Carla,

A dental crown being placed

I am glad you wrote. It sounds like your dentist is confusing color with translucency. Just because the color of someone’s tooth is whiter does not make it more see through. This is true even if you wanted them to be a BL1. It sounds to me more like he is not comfortable with his cosmetic skills in placing them. He may not have the cosmetic skills you need to get the results that you want.

If you still want to give him a chance at trying it, here is my suggestion. Tell him you want the dental crowns very white. Be specific about the color. However, you need to insist that he places them with a temporary try-in paste and you get to approve them before they are permanently bonded on.

If you don’t like the way they look then he should be willing to redo them. If he is not willing to agree to that, then I would suggest that you find an expert cosmetic dentist to do these.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.
Click here to learn about affordable dental care.

Pediatric Dentistry

My Child Is Sucking His Thumb

We finally got rid of my son’s pacifier, but now he is sucking his thumb. We can’t throw that away! Should I be worried about this? His baby teeth have already started coming in.

Alexi

Dear Alexi,

Young boy smiling holding his toothbrush

I’m glad you wrote. One of the most prominent emotions of good parents is worrying. The good news is that your son sucking his thumb at this age won’t really matter. It is not until his permanent teeth are in that you have to start worrying. In my experience it is best that you don’t make a big deal out of the thumb sucking. Most children give it up on their own by the time they are school age. If they don’t their peers sort of encourage that.

If his permanent teeth are coming in and he is still sucking his thumb you could try using something called Thum. It is a liquid that you can paint on her thumb that tastes bitter.

Those children who continue to suck their thumb after their permanent teeth will likely need some type of orthodontics. Your best bet it is make sure he sees a pediatric dentist regularly. Don’t wait until he has a dental problem. You want his first experience at the dentist to be a positive one. If you wait until he has a dental emergency, then he will always associate the dentist with pain and fear. If the dentist isn’t scary to him, then they will have a healthy relationship and he’d be more willing to listen to advice about handling his teeth.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.
Click here for dental tips for parents.

Pediatric Dentistry

Do I Need to Get My Baby Tooth Pulled?

I have a baby tooth that never came out. Now I have an adult tooth that is sort of coming out just in front the baby tooth. Do I need to get it pulled? If so, will it hurt? I haven’t been to the dentist because my parents do not have a lot of money. I just need to know what to do and what to expect.

Emma

Dear Emma,

happy girl in a dental chair

I’m sorry you are faced figuring this out on your own. Yes, this baby tooth will have to come out. The good news is that baby teeth come out much more easily than adult teeth. If you don’t get it extracted, then the adult tooth is going to come in very crooked. If you go to a pediatric dentist, they are used to doing things for young children and will likely have ways of making things easier.

They should put a numbing medication on your gum before giving you the shot that numbs out the gums deeper into the tooth. Most people hardly notice. However, if your nervous, which you probably will be because you haven’t been to a dentist before, then ask them to give you some nitrous oxide. This is administered by a nose piece and it is a special medicine you just breathe in. It will relax you so that you won’t be tense during the numbing process.

So, your parents know, there are affordable dentists out there who are willing to work with patients in difficult financial situations. You may have your parents look some of them up and see if one of them is willing to work with you.

You may find that you have more work that needs to be done with your teeth, but don’t stress about that. You can have that done a little at a time.

I really appreciate your maturity and how you are proactive about taking care of your oral health. This type of responsible attitude will serve you well in many areas of your life.

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

Root Canal Treatment

Can You Have a Cavity Without Outward Signs?

I went to my new dentist for a regular check up. She suggested that I need a root canal treatment because of a cavity inside a tooth. She wants to send me to a root canal specialist. I should mention at my last dental appointment, in which I had x-rays done, there were no signs of any problems. There is no sign of decay on the outside of the tooth either. Can you have a cavity without any signs? This feels like a red flag to me. I have a second red flag when I saw the name of the specialist was the same as hers. I jokingly asked if all dentists in that area had that last name. She told me it is her husband. So, I feel maybe she is just sending work his way. Can a tooth have a cavity with no signs of decay on the surface?

Natalie

Dear Natalie,

Example of internal resorption
Internal resorption in a lower premolar. X-ray courtesy of East Hill Endodontics, Kent, WA.

When it comes to decay, there must be an external point of entry. The decays starts on the outside working it is way in. Even then, the only time a root canal treatment would become necessary is if the decay get’s down deep enough in order for it to turn into a dental infection.

It’s possible your dentist could have been referring to something different known as internal resorption. Though, if that is the case, she should use more precise language in order to help her patients understand exactly what is going on with their bodies. Internal resorption happens as a result of an inflammatory response, which generally means that there must have been some trauma to the tooth. The result is that the pulp of the tooth begins to eat away at the tooth from the inside. I’ll be honest that we don’t yet know why this happens.

Given the concern about a conflict of interest and a sketchy diagnosis based on the terminology she used, I recommend that you get a second opinion. Your dentist is required to give you a copy of the x-rays when asked for. Take these to another dentist. Don’t tell them who your dentist is or what the diagnosis was. Just ask them what they see and would recommend based on the x-rays provided.

I hope this helps.
This blog is brought to you by Phoenix Dentist Dr. Hillary Peck
Click here to learn about how she makes dentistry affordable.

Dental implants

Missing Lateral Incisor

I have always had a missing lateral incisor. My dentist provided me with braces in order to move the teeth into a proper position. Then, once my orthodontics were completed I was given a dental flipper. It’s been okay, but I would really like something more permanent. My dentist is recommending I get a dental bridge. I’m not crazy about that idea because he told me that it means placing dental crowns on two more teeth. Is there something else you can recommend for me?

Camille

Dear Camille,

A comparison of a dental bridge next to a dental implant

I am glad you wrote. There is definitely a better solution. The best tooth replacement is a dental implant. This puts a prosthetic tooth root into the bone. Then, after a period of time where the bone integrates with the implant, a dental crown will be placed on the implant. This is the closest thing to having a natural tooth in your mouth.

A dental bridge would only make sense if you were not a good candidate for a dental implant, but you didn’t even mention that your dentist brought up implants, so I don’t think that is the problem. There is a possibility that, because of how long that space has been empty, you may need some bone grafting done first because of the mineral resorption. It will be worth it.

The other reason for getting a dental bridge would be if something was wrong with your adjacent teeth. Then, you could take care of two problems at once. If one of those aren’t an issue, then I would stick with the dental implant.

It sounds like your dentist is steering you toward a dental bridge because he does not know how to do a dental implant. Don’t try to push him into doing it. This requires post-doctoral training. You don’t want him doing a procedure because he doesn’t want to admit he doesn’t have the experience. It’s not a recognized specialty, so technically any dentist can do it, but you really want a dentist who knows what they’re doing. There are some dental implant horror stories and you do not want to be one of them. Simply find a different dentist to do this procedure. It doesn’t mean you have to switch dentists completely.

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

Affordable Dentist

Does This Root Canal Need to Be Re-Done?

Can you help me figure out the most affordable option for me? I had a root canal treatment on my upper right canine. Recently the filling came out and I now have an abscess on the gum. I went back to the dentist’s office and he says I need to have a second root canal treatment. If the abscess is not painful unless the area around it is pressed, could I just take an antibiotic? I just paid for this first root canal.

Stanley

Dear Stanley,

Illustration of an abscessed tooth

I am sorry this happened to you. At this point, you definitely need the root canal treatment. When a root canal treatment is done, the filling placed is not meant to be a stand alone. It is just there as a temporary measure. A follow-up appointment should have been scheduled for you to have a dental crown placed. Without that, then your saliva will slowly seep through the filling and it will end up falling out, as yours did. It won’t take long after that for bacteria to build up and cause another infection. Again, as yours did.

An antibiotic won’t be a good solution. The infection has to be physically removed. All an antibiotic will do is hold it at bay for a very short period of time. Then, when the medication runs out, you will be in an even worse situation than you started with.

If your dentist never told you about the need for a second appointment and dental crown or scheduled you too far away for it to be helpful, then he or she should take some responsibility for what happened. If you just didn’t follow through, then you’ll have to bear the brunt of the cost.

If your dentist’s fees are too high, then you could always shop around for a more affordable dentist. That could take some of the pressure off of you. What you don’t want to do is put this off, because then you will end up with a dental emergency.

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