Do I see a general dentist or oral surgeon first for dentures?

I have had a fear of the dentist all my life. It all stems from one bad experience as a kid. I just turned 52 and most of my teeth are broken or missing and it really affects my quality of life because I am so embarrassed by them. I want a confident smile back so I think I want to get dentures. Do I need to see a dentist or an oral surgeon to remove the rest of my teeth? — Michael

Michael,
Find a dentist who can do the extractions, surgery and dentures. There are typically dentists out there who do all three so it’s just a matter of calling and asking a particular dentist what he or she usually does. You’ll also want to address your dental fear and find a dentist who also offers sedation. You’ll take a pill that will enable you to have “amnesia” or a state of sleep during the entire procedure.

There is a certain amount of coordination that is needed between the surgery and the denture – particularly if you choose to get an immediate denture which is placed the same day. If you go the traditional denture route, there are still certain things a dentist can do during surgery that will help your dentures fit better and an oral surgeon would not be as familiar with that.

If you do decide to have an oral surgeon take out the teeth, go to your dentist first so that he can coordinate the procedures.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Can mercury-free dentist help get my blood pressure in check?

I’ve never been a health nut, but I stay pretty healthy and active. At my last medical checkup, the doctor told me that I have high blood pressure, and that he wants me to go on medication to control it. I don’t have a family history of it, and, like I said, I’m healthy. I don’t smoke, and I don’t do anything else that could contribute to it. So, I started researching what options I could try before going on a medication and one thing I came across was my fillings. I have a ton of silver fillings, and I read that those can contribute to high blood pressure. I’m considering booking with a mercury-free dentist to have them all removed. What I want to know is whether it’s really worth it to try it, and whether this is a pseudo-science, or if it’s backed by evidence.  –Joseph

Joseph,
Most agencies say that amalgam fillings are completely safe. The American Dental Association (ADA) still recommends them for most people, and they provide a listing of other authorities who agree with the long-held belief. The Alzheimer’s Association, The Environmental Protection Agency, The Food and Drug Administration (FDA), The Mayo Clinic, and even the American Academy of Pediatrics are listed and quoted on the ADA’s website.

With that said, there is some evidence that seeing a mercury-free dentist may benefit you. Despite the fact that the FDA says they’re safe, they have also printed research that indicates they might not be. “Amalgam fillings have been found to be related to higher blood pressure…” is included in one paper. It also mentions, “The level of mercury released by amalgam fillings is often more than the levels documented in medical studies to produce adverse effects and above the U.S. government health guidelines for mercury exposure.” The very same document discusses how many people who have their amalgam fillings removed feel relief from various conditions afterward.

Taking it one step further, the research also mentions what various agencies believe safe levels of mercury are. The World Health Organization says 300 ug per week or 42 ug per day, the EPA says 2ppb in water is safe, and yet cognitive effects, as well as increases in blood pressure occur at just 1 ug per liter. A standard amalgam filling releases 1-3 ug per day of mercury vapor, though some studies have shown it may climb as high as 27 ug per day.

This is why so many people today are choosing a mercury-free dentist. If you opt to have your fillings removed, there isn’t a guarantee that your blood pressure will drop. There haven’t been enough scientific studies to prove the effectiveness of amalgam removal in regard to blood pressure control. Whether it’s worth a try anyway is truly a personal decision that you will have to make on your own.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Insurance coverage for TMJ treatment

Is a TMJ specialist covered by my insurance?  — Marcus

Marcus,
When you’re in pain, it’s unfortunate that most of us have to worry about how cost will dictate a method of treatment, or if you even decide to get specialized treatment. If it was simple, we would all just be able to see who we want and be on the road to a pain free life. But, it’s not that simple.  And, if you have seen many TMJ “specialists” in the past, it’s important to remember that while those doctors may market themselves that way, there really is not a true, recognized TMJ specialty.

There are many types of recommended treatment. Conservative methods such as relaxation techniques, medications, or night guards are more common with many dentists and much more widely accepted when it comes to insurance (night guards are covered with a report by the dentist saying it’s for Bruxism, or grinding). On the other end of the spectrum, there are dentists who call themselves “neuromuscular dentists” (usually LVI trained) who skip the night guard all together and go for Transcutaneous electrical nerve stimulation (TENS) which uses a low-level electrical current to relax facial muscles in combination with an orthotic device to find the optimal position for your jaw, by detecting your malocclusion and then making a treatment plan to correct your bite. Plan to pay out of pocket a least a few thousand dollars for this because it is not a covered benefit. Then there is bite correction. Crowns, composites, and possibly orthodontics can be recommended for that. You’ll pay at least 50% of crown work and orthodontics, if you have coverage for that.

Always check your coverage before undergoing any TMJ treatment because most insurance plans do not have TMJ coverage. Paying more doesn’t always mean that you will get better results, so first try more conservative treatments and make some changes in your diet, exercise and stress relief. All those things can make a measurable difference and you definitely don’t need insurance for that.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Can a teenager get dental implants?

My teenage son has a tooth that over the last few months has gotten darker in color. He hasn’t really been too concerned how it looks and it doesn’t seem to be causing him any pain. I didn’t think someone so young could have a dead tooth, but I guess he must have hit it on something. I’ve also heard that when you have a dead tooth it is painful. I’m taking him in to have it looked at and if the dentist confirms that it is dead, can he get a dental implant? It’s summer right now, but I don’t want him to go back to school with a big gap in his smile. — Eileen

Eileen,
Anyone at any age can have a dead tooth. Most often, trauma to the tooth is the cause, but you should have it looked at by a dentst to confirm.

In most cases, a dead tooth doesn’t need to be removed. It can actually be saved by a root canal.  It can’t be brought back to life, but it can look almost good as new again when treated.

If your dentist would happen to determine that the tooth needs removed, an implant is not the best option at this time because his jawbone still has a lot of growing to do. He could be well into his early 20’s before it actually stops growing.  Some dentists will place mini dental implant in teens, however there are concerns that the implant won’t be esthetically pleasing as the jaw grows and other permanent teeth move into place around it. For now, don’t worry about how to replace the tooth, just get him in for an exam and go from there.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.