root canal problems

I had a root canal treatment for an infected tooth. After I finished treatment, my dentist gave me a prescription for penicillin. A week later I was still in pain. He wrote me a prescription for Vicodin and said if it still hurt after another week he’d give me a different antibiotic. I don’t think I can wait that long. Plus, the Vicodin makes me feel weird. What do you recommend?

Barry

Dear Barry,

man grabbing the side of his jaw in pain

Your dentist is missing the boat here. First, the antibiotic prescription. While penicillin can work, it wouldn’t be my first choice after a root canal treatment. Instead, I’d try a stronger antibiotic such as clindamycin.

Second, the amount of time he’s waiting to get you on the correct antibiotic is way too long. You should have been feeling better after a couple of days and he wants you to wait over two weeks! No.

There’s a good likelihood you still have a dental infection because something was missed here. You don’t want the infection to spread any more than it already has.

Where to Go From Here

I think you need to see a root canal specialist and have this re-treated. When you call the office, let them know what is going on so they can get you on the right antibiotic.

To give you realistic expectations here, a root canal re-treatment is usually successful only in 50-75% of the time.

If it turns out, the re-treatment doesn’t work, you may need to extract the tooth in order to get rid of the infection. If that happens, you’ll want to discuss your tooth replacement options with your dentist. If you want the top of the line replacement, then getting a dental implant is the best bet. Your next best option is a dental bridge. However, it does require crowning the two adjacent teeth.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

medical insurance & dental implants

I had to remove all my upper teeth due to extensive gum disease and decay. I’ve gotten the gum disease back under control, though it cost me a small fortune. I’ve been trying traditional dentures, but that dental plate has made things impossible for me. I have too strong a gag reflex to even keep it in. This has made eating almost impossible. I’ve already lost ten pounds and I’m not a big woman to begin with. My dentist suggested I get implant dentures. Is it possible to get medical insurance to pay for this because I can’t eat? I would think that would count as a health issue. My dentist didn’t think it would.

Beth

Dear Beth,

upper implant overdentures
Implant overdentures

Implant overdentures will be a great solution for someone in your position. The extra hardware in your mouth which comes along with traditional dentures is a problem for most people.

Using dental implants to support them, not only makes them more secure, it also removes all the extra material over your palette which causes so many gagging problems. Not to mention the food that can get under there.

Medical Insurance for Dental Implants

Unfortunately, your dentist was right. It is highly unlikely medical insurance with cover you getting the dental implants you need. This is a shame because it does have a negative impact on your health when you can’t eat and get the nutrition you need.

Most medical insurance comes with a dental exclusion clause. There is sometimes an exception where if you had a car accident and lost your teeth. Then, it COULD be covered through the medical portion of your car insurance.

Affording Dental Implants

There are a few ways to make this more affordable. First, you should know you don’t have to pay for the entire procedure at once. Instead, you pay for the implant portion before that is done. Then there is a period of healing, which also allows for osseointegration. When that is completed, it is time for the denture portion. That is when you’ll pay for the second half.

Even then, things can be broken up for you. Many dentists work with a company called “Care Credit“. This is a medical credit card of sorts which will pay for your procedure and then allow you to pay them back.

The interest is much lower than traditional credit cards. If you have good credit, you can even get a zero-interest payment plan. I would talk to your dentist. Their business office can usually find options for you.

If they’re not willing to show you options, then this isn’t the best dentist for you. Find a better dentist. One who is more compassionate.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Are dental implants possible for me?

I haven’t been able to afford dental care for years. Now, I finally have dental insurance. Because of advanced periodontal disease, I’ve lost several teeth. Is it possible for me to get dental implants instead of dentures?

Cathy

Dear Cathy,

Abutment and crown being placed on dental implants

Dental implants are the best tooth-replacement option you can get, while dentures have many problems that come with them. For instance, even the best fitting dentures will reduce your chewing capacity by 50%. However, that’s not the worst part.

Your body recognizes when your teeth are gone. In an effort to be as efficient as possible with its resources, it begins to resorb the minerals in your jawbone to use elsewhere. This begins to shrink your jawbone. After about ten years, it becomes difficult to even keep your dentures in. This is known as facial collapse.

Getting dental implants prevents that because the implants serve as prosthetic teeth roots. Your body recognizes their presence and leaves the jawbone intact.

Gum Disease and Dental Implants

You will need to deal with your gum disease to be a good candidate for dental implants. Periodontal disease leads to bone loss, which may have been a contributing factor in your losing teeth.

Your dentist can help you get that under control. Once that is, you want to find a well-trained implant dentist. They need post-doctoral training in the procedure. You can look at Dr. Delaune’s credentials to get an idea of the type of dentist you want to find in your area.

He should run diagnostic tests, including a CT scan to make sure you have adequate bone and to plan the ideal positioning of the dental implants. Don’t be discouraged if you’ve lost too much bone. There is a procedure to repair that. You can have bone grafting done to restore the missing bone. Then you’ll be good to go on your implants.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

matching teeth to eyeballs?

I wanted to know if it is possible to use teeth whitening to match my teeth to my eyeballs?

Luke

Dear Luke,

custom-fitted teeth whitening trays

I want to give you points for the most unique question I have received. There are two factors in answering this question.

First, a lot of the answers will depend on one how white your eyeballs are. While teeth can be bleached exceptionally white, there are limits to its whitening ability.

The second factor is that teeth whitening results vary quite a bit. This is why when someone is getting a complete smile makeover we have them bleach their teeth first. You get much more accurate results when you are matching porcelain veneers to a color, than when you are using teeth whitening.

If it is just a color you are going for, then you can attempt to do it with teeth whitening and see if it gives you the color you want. It is the least expensive way to give yourself a mini makeover.

However, if there was more you wanted to change about your teeth, such as their shape or size, in addition to the color, then the way to go is with porcelain veneers.

As I mentioned above, they can be made to any color you desire. But that isn’t all. A great cosmetic dentist can lengthen and widen your teeth, completely changing the character of your smile. Depending on how the dentist shapes your teeth, he can change the appearance of your smile to look youthful, sporty, authoritative…whatever you want.

However, it does require some expertise and will be more expensive. Unlike teeth whitening, which any dentist can do equally well, to do truly beautiful smile makeovers takes advanced technical and artistic ability.

This is only developed after extensive post-doctoral training. Doing smile makeovers isn’t taught in dental school. In your place, I’d look for an AACD accredited dentist. They are in the top 1% of cosmetic dentists in the country. Any smile they create for you will be absolutely stunning.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.