Tag Archives: Phoenix Dentist

Pediatric Dentistry

Can You Help Me Understand a Pulpotomy?

My son’s dentist says he needs something called a pulpotomy. I tried to ask him questions about it, but he gets annoyed and feels like I’m questioning him. I know he’s the dentists, but this is my son. I don’t want to just have a procedure done on him without understanding it.

Laura L.

Dear Laura,

I hate to hear that your dentist has you afraid to ask questions. Yes, he’s the dentist, but part of his job is to make sure you understand why he’s recommending certain procedures and gives you all the options. Especially as a pediatric dentist, you’d think he’d understand that. There’s nothing more precious to you than your child. If he can’t understand that, you need another dentist. You’re not stuck having to go to a pediatric dentist if your options are limited. There are general dentists who are great with children. Whoever you go to, I’d love for you to be able to ask as many questions as necessary for you to feel at peace.

Now, onto your question. Think of a pulpotomy as a mini root canal treatment for baby teeth which are infected. It’s usually done on molars which need to last until your son is around twelve years old. Otherwise, if he loses a molar, his teeth will shift causing crowding with his adult teeth. If his molar is infected, it does need a pulpotomy.

The procedure is fairly simple and your son won’t think of it any worse than a normal dental appointment. The pulp is removed from the roots of the tooth. Then it’s daubed with a disinfectant such as formocresol. When that’s completed, the tooth will be sealed. Usually, they’re covered with a stainless steel crown.

If it turns out the tooth has to be removed, make sure the dentist puts a space maintainer in its place so the teeth don’t shift.

I hope this helps you. Feel free to ask as many questions as you need.

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

Affordable Dentist

Dentist is Humiliating Me Because I’m Broke

I felt like a total failure when I went to the dentist. I hadn’t been able to go for two years, because I don’t have insurance and I have to save up for this kind of thing. It turns out those were two bad years for my teeth. I need five fillings and two crowns. First, the dentist derided me for not coming in sooner. Then, when I told him I couldn’t afford all the work he lectured me and said if I didn’t I would lose all my teeth or die. I was so humiliated because he said all this in front of his staff. But what is a patient supposed to do if they can’t afford something? I can’t produce money out of thin air.

Louis K.

Dear Louis,

That was bad form on the part of your dentist. It was unfair of him to lecture you for something you have no control over. It’s even more unfair that he humiliates you for needing to do this in stages. And, you should know, it is totally fine for you to do this in stages. Not everyone can afford to do all their work at once. You need to find a dentist who is willing to work with you financially.

In the meantime, have this dentist list out the work which needs to be done in order of priority. Which cavities or infections are further along. Do those first, giving yourself time to save up for the other procedures. There are also dentists who work with Care Credit. It’s a medical credit card, which will allow you to have all the work done at once (if you’d like), then pay it out. Often, depending on your credit, you can choose your terms. Some have zero interest.

Your dentist is right about one thing, though not the way he handled it. People do still die from tooth infections. In fact, a father in his thirties passed away this past February from not getting to the dentist in time. Some patients make the mistake of thinking just taking an antibiotic will be enough. It won’t. It will stave off an infection for a while, but because there is no blood stream in a tooth, there’s no way for the medicine to reach it. A dentist has to physically dig out the decayed material. So, while you can put this off for a bit, don’t wait too long. That’s why I asked you to have the dentist list out the work in order of urgency.

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

Affordable Dentist

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.

Pediatric Dentistry

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.

Lumineers

My Dentist Is Trying to Force Lumineers on Me

I am feeling really pressured by my dentist. I told him I wanted to deal with my tooth gap, but don’t want braces. I’m too old for a mouth full of metal. He keeps insisting I get Lumineers. Six of them! That’s incredibly expensive. The tooth gap is only between my two front teeth. Is that really my only solution?

Lisa W. – Indiana

Lisa,

Wow! Dr. Peck does Lumineers, but just for smile makeovers. There are much less invasive and less costly solutions for something as simple as a tooth gap. First, though, let’s address braces. I certainly understand you not wanting a mouth full of metal, especially as an adult. I don’t know if you’re aware, but dental technology has improved significantly. We now have much better options available for orthodontics. Invisalign, for instance, can straighten your teeth with aligners people can’t see, even at a conversational distance. They can also do it in half the time of traditional braces.

But, if you’ve got your heart set against any form of orthodontics you still have another option. In fact, the typical solution for a tooth gap is to use dental bonding. Bonding uses the composite resin, like what you’d get in a white filling. This will not close the gap, like orthodontics, but it will fill it in so it looks closed. You’ll need to be certain to go to a cosmetic dentist, so you’re sure they know how to match the material to your tooth. You want it to be seamless.

While Lumineers are a massive overtreatment for what you’re trying to do, there is an exception. If there are other things about your smile you want to change, Lumineers can do anything you want. They can make your teeth longer or wider. They can change the color of your teeth. They can even change the shape. It truly can re-make the entire character of your smile.

If you get either of the last two options, their color is permanent, so if you’re not happy with the current brightness and color of your smile, now is the time to change that. Get your teeth whitened, then your dentist can match your bonding or Lumineers to the new spectacular color of your teeth.

Never let a dentist pressure you into a procedure, especially a cosmetic procedure. Lumineers are pricey. They can be worth it for what they’re designed to do, but using them for a simple tooth gap is an overtreatment. It sounds to me like your dentist is just try to make a quick buck at your expense.

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

Affordable Dentist

Am I Being Ripped Off By My Affordable Dentist?

I intentionally chose an affordable dentist out of a directory because I do not have dental insurance. I’m a little behind on my regular checkups, so I expected to run into some snags, but I was totally unprepared for the total bill. First off, they charged me for a more expensive “deep” cleaning and for some kind or rinse or medication that was applied during it. On top of this, they hit me for two different kinds of x-rays, and then they recommended I get a fluoride treatment and come back in a few weeks for a follow-up visit with the hygienist, which also has a charge. I’m already out a few hundred bucks, and this doesn’t even include the fillings I need to have done. Does this sound right coming from an “affordable dentist?”

Celia

Dear Celia,

Affordable dentist can mean a different thing from one dentist to another. There isn’t an objective, standard fee for anything where someone who’s below that is considered more affordable. He could just mean he finds the most affordable solutions to your case. Or maybe he’s slightly lower than other dentists in the area.

However, you’re more concerned with the specific procedures. Most of these are fairly common if it’s been a while since you’ve gone to the dentist. The two types of x-rays are standard care. One is a panoramic, only done every few years. The other, the bitewings, are annual. These help the dentist detect decay between your teeth.

If it’s been a while since your last cleaning, a deep cleaning may have been necessary. If your gums were inflamed and you had a lot of build-up, the hygienist probably did what’s known as a full mouth debridement. IF a patient has gum disease, they also often do scaling and root planing. In either case, a follow-up appointment is fairly typical. The reason for that is to be certain your situation is improving. They’re trying to forestall anything serious happening and keep you out of an emergency dentistry situation.

The cleaning solution and the fluoride aren’t always necessary. But, with gum disease, killing all the bacteria with a medicated rinse is helpful. Some offices charge for this service and some do not. The fluoride was likely recommended to help prevent decay, though it’s sometimes offered to adults with sensitive teeth, too.

Many offices that advertise as affordable will almost always have some form of payment plan available. I’d talk to the office and see what they had to offer. Ask them also to give some details on your prognosis and what to expect for future care.

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

Emergency Dentist

My Face is Swelling Near My Dental Implant

My dental implant has been feeling odd lately. It started hurting and now the surrounding gum feels bouncy. Now my jaw is hurting and it’s painful to eat. The dentist who did my implant is out of town. Do you have a recommendation on how I can take care of this?

Lucy D. – Montana

Lucy,

I’m a bit concerned about the situation you’re in. You’ve got an infection at your dental implant site. If this isn’t dealt with immediately two very bad things can happen.

1. You could die. I know it sounds ridiculous in the twenty-first century, but it still happens that people die from tooth infections. In fact, just this past February a 40-year-old man in California died when his tooth infection spread to his lungs. An equally great risk is your heart or brain, because of their proximity to your teeth.

Don’t think this can be treated just by taking antibiotics. Many people make that mistake and end up in quite the dental emergency pickle. Antibiotics will forestall the infection, but the only way to truly get rid of it is for the dentist to get in there and remove the infected portion.

2. Your implant can fail. If the infection really gets hold, you could lose the implant. If that happens, you can’t just get a new implant. You’ll need to have bone grafting done, then start all over with surgery and healing time, then finally get your implant crown again.

This needs to be dealt with right away. I do realize your dentist is out of town, but I”m sure he has some procedures in place for dental emergencies. If not, then you can just do a Google search for an emergency dentist.

If you get the care you need soon, you’ll have a much better chance of saving your implant.

Now that I”ve likely completely depressed you (sorry about that), let me cheer you up. Once your implant site is healthy, you’re going to love having it as a tooth replacement. Nothing comes closer to having a healthy, natural tooth back. I’m sure your dentist has told you this as well, but you’ll be able to eat, brush, and floss normally. No restrictions.

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

Pediatric Dentistry

What the Real Reason My Toddler Can’t Get a Dental Flipper?

My son lost a tooth prematurely. He’s only three and it’s a front tooth. I’ve been told children’s teeth shift if the spaces are left open. I asked my pediatric dentist to provide him with a dental flipper. Instead, the dentist started shouting. He said it was the most ridiculous thing he’d ever heard. No child can sit still for a flipper. I’m not only offended, I’m sure with sedation it could be done. Unless you give me a better reason, I’m going to a different dentist.

Marilyn H. – Michigan

Marilyn,

I’m sorry your dentist was rude. That’s not a great way to build trust with patients, especially when you’re talking about their child’s dental health. While I’m sure you could work with sedation, the pediatric dentist is right, a dental flipper is a bad idea. Here’s why.

1. A child’s mouth is constantly growing. The flipper won’t fit for long. You’d have to keep making a new one.
2. It’s a choking hazard. Flippers are removable appliances. Even if he didn’t pull at it, which is highly unlikely, it could just slip out and he’ll partially swallow it.

I have some great news for you, though. The only teeth where you have to worry about shifting are the back teeth. In those cases, we’d place a space maintainer to prevent the shifting. Also, your child’s age means he won’t be self-conscious about the tooth loss. In fact, he might be proud he’s the first among his friends to lose a baby teeth.

You didn’t mention how he lost his tooth. If it was due to trauma, it might be a good idea to have the adult tooth checked for damage. In the unlikely event the adult tooth is damaged, don’t panic. There are plenty of options for his adult tooth. Dentistry has developed tremendously. Even if he completely lost the adult tooth (and again, unlikely, so don’t panic), we now have dental implants that mimic having a natural tooth exactly, even down to the tooth root.

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

Lumineers

Lumineers or Crowns for a Tooth Gap?

I have a gap between two of my teeth. I’d done some research. Before you roll your eyes I did go to my dentist with an open mind. My research said that Lumineers were the best solution. The teeth are healthy, so I figured something that didn’t require removing tooth structure was best. My dentist felt that Lumineers are flawed. I told him I was married to the brand. He could use any brand he wanted. He said all veneers have t he same problem. He suggested we do crowns and we do it right away. I’m hesitating because it means grinding down healthy teeth. What would you do?

Macy L. – Colorado

Macy,

There’s nothing wrong with doing research. In your case, you had a good idea. Why remove healthy tooth structure? Your dentist was being honest too. If he says Lumineers or other brands of porcelain veneers will be problematic, it’s likely true— in his case. Not all dentists are skilled in cosmetic work. When that’s the case, they tend to go directly to porcelain crowns.

You have a couple of choices. 1. You can go along and do the procedure your dentist is comfortable with. Don’t press him to do the Lumineers. He won’t know what he’s doing and it won’t turn out the way you want. 2. You can go to a different, more skilled, cosmetic dentist. Then you can get the procedure you want. There’s another option that hasn’t been mentioned. Dental bonding is a good solution to a tooth gap. It doesn’t last as long as Lumineers, but dental bonding is significantly less expensive.

I would get Lumineers if you were interested in fixing more than just the gap. It can change the shape, size, and color of the teeth, completely remaking your smile. To me, that would make the expense of Lumineers worth it. Other than that, I’d likely go with the bonding procedure. Though, it’s up to you. Maybe you’d just rather have a procedure that won’t have to be re-done every few years.

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

Affordable Dentist

Affordable Dental Care for Domestic Violence Victims

I don’t know if there is a program available to help me, but I’m just hoping. I was in a difficult relationship where there was physical abuse. Most of my teeth have been broken or damaged, so my smile is ugly. I’ve left the abuser, but that puts me in the predicament of having to provide for myself. I’m having trouble getting a job because of my appearance. I can’t even get an entry level job such as working in a fast food place or a mall shop. I’m sure it’s my appearance keeping me from being hired, but I have no money to do anything about it. Are there any affordable ways to help people in my predicament?

Eileen K. – Washington

Eileen,

I’m sorry for what you’ve had to live through. Let me say, however, that you’re brave and strong for getting out of that situation. You’re likely right that the damage to your smile is keeping you from being hired. Though it is unfair, we’re an appearance driven society. I have a few things I want you to try out.

1. Do an internet search for an “affordable dentist” in your area. Dentists often go into the field because they want to help people. Dentists who advertise as affordable tend to be even more compassionate. They charge less because they want to help people without resources. If you explain your situation, you’ll likely find a dentist willing to work with you.

2. Another option is a longshot, but it’s worth trying. The Give Back a Smile Program is designed to help victims of domestic violence. Dentists donate their time to repair the smiles of victims who’ve suffered domestic violence. Obviously, they don’t have unlimited resources, but it’s worth applying.

3. Dental schools will treat patients at discounted prices. Bear in mind that those treating you are still learning, but they are well supervised by their instructors.

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