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Old 11-14-2020, 11:01 AM
 
44 posts, read 30,414 times
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Quote:
Originally Posted by StcLurker View Post
What is the average airspeed of an unladen swallow?

Seriously though, I need a tooth crowned and I'm just wondering what effect that will have on me donating plasma? Let's assume my dentist will use a local anesthetic

Thanks Doc

I haven't had any patient's with this concern. Off the top of my head, I would say very minimal. The half life of lidocaine, which is the local anesthetic dentists TYPICALLY use, is 2 hours. That means that half of it already gone from your blood stream in 2 hours 75% of it is gone within 4 hours and 87.5% of it is gone within 6 hours. So within 6 hours of getting administered local anesthetic, almost 90% of it is gone from your blood stream anyways. I doubt that it's an issue but speak with a phlebotomist to get a better answer.
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Old 11-14-2020, 11:06 AM
 
44 posts, read 30,414 times
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Quote:
Originally Posted by Parnassia View Post
Your teeth are three dimensional and they are divided into "surfaces". For example. the lingual surface refers to the side of a tooth that faces your tongue. One larger cavity on a tooth could involve more than one surface so the filling would extend to more than one as well.

A 2 second Google search found this:

https://www.dentalcare.com/en-us/pro...s-of-the-teeth

No idea what a filling should cost. Call a dentist there and ask what they charge if you don't have insurance. They may charge a different rate and it won't necessarily be lower with insurance.

Sorry to wade in on the OP's offer to help posters. I'm sure we're lucky to have you and your offer is very kind! Its just that some of the answers to these questions are so basic they are really easy to find if you expend a little effort.

Thank you for helping out. It's difficult to gauge just how computer savvy people on these forums are. They are clearly very able as they could subscribe to this forum (something my parents would have a difficult time with), but I'm still trying to answer as best as I can.
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Old 11-14-2020, 11:21 AM
 
44 posts, read 30,414 times
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Quote:
Originally Posted by Rosepetals95 View Post
Okay, so I'm just going to ask a couple questions in response to this, because that is what this topic is for.


If I go in for this root extraction process, are they going to give me antibiotics beforehand? I ask because I have a mild heart condition and am prone to infections in my heart. I think, though I'm not really sure, that antibiotics are given to patients with heart problems. The only problem is that the last time I took them, I had an allergic reaction that caused my face, neck and throat to swell up. So I'm not sure how they would deal with this.

The other thing is that I'm not good with medication in general, or pain medication. I'm sensitive to medication and require a children's dosage, even if it's something as simple as the allergy medication I take. I've also had bad reactions to pain medication such as Tylenol, which caused me to have tightness in my chest and trouble breathing. So I'm not too sure about any of this either and how the situation would be dealt with in terms of anesthetizing the area and pain management afterwards.

I ask because I probably need to get both of my wisdom teeth out. I confess the one on the right has been crumbling away for the last couple of years, and is probably rotten if I'm being perfectly honest with myself. I've never had any kind of surgery before, or sedation (which is a must if I go through with this), and with my history of heart problems I honestly wonder if there is a risk of complications from the surgery.

And yes, I know these are things that I should probably discuss with my doctor seeing as how it involves my health and medication. But I figured it wouldn't hurt to seek information from more than one source before making my decision.

For your first question, the rules for giving antibiotics before treatment (called prophylactic antibiotics) have changed over time. Some patients that used to have to take them before treatment don't have to take them anymore due to new evidence based guidelines. I would have a nice discussion with your dentist and cardiologist. You also appeared to have an allergic reaction to the antibiotics given to you. It's important that you remember and note these things so that in case they do have to give you antibiotics before treatment, they give you antibiotics that you are not allergic or sensitive to. Very important.

For your second question, anesthetics have changed over time. Before, dentist used to use Novacaine, but no dentist uses this now as it had higher rates of allergic or negative reactions. Now, we use Lidocaine or several other anesthetics which are extremely rare to have an allergic reaction too. I wouldn't worry about that. As for pain management afterwards, you need to talk to the dentist that is going to be working on you. I typically don't prescribe Tylenol, but rather Advil (ibuprofen). Again, you need to not have allergies to this and a conversation with your dentist is essential.

I understand your worries, but keep in mind that an infection is never good, specifically for someone with heart problems. It's important that you address active infections and abscesses. I see many patient's with pre-existing heart issues and it's not a problem as long as there is due diligence. For example, the dentist may want to get a medical clearance from your cardiologist or primary care doctor and your physician might recommend using local anesthetic without the use of epinephrine. There may be other precautions as well, but if everything is done right beforehand, I'm confident you will be better off.

- Dr. S
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Old 11-14-2020, 11:28 AM
 
Location: Boydton, VA
3,297 posts, read 3,966,497 times
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Why did the dental industry retire the mini sandblaster that my dentist used on cavities when I was a kid in the 50's. I recall there was zero pain, no drill sound. Baffles me.

Regards
Gemstone1
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Old 11-14-2020, 11:43 AM
 
44 posts, read 30,414 times
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Quote:
Originally Posted by Starry_eyed View Post
Hi there, I wonder if you might be able to provide some insight. I had an amalgam filling in a premolar on my upper jaw changed after 15+ years to a white composite filling. It cost me $240. I have had an xray done in the past by a dentist for this tooth and it was quite deep. The dentist who changed the filling didn't have an x-ray done but I told him it was deep. The tooth seemed to heal fine and two weeks later I was chewing on something and suddenly I got a quite sharp pain. It only happens when pressure is applied on the tooth. It's not sensitive to hot or cold. I thought the filling cracked. I couldn't eat anything on it for about 4 days until I saw my dentist. He applied cold air to it and couldn't find any cracks. He thinks it is a malocclusion so filed it down. It has been 3 days and I have tried to eat just soft foods but today I tried something a little harder and I'm scared to fully bite down because I can feel sensitivity/slight pain already when applying a little pressure. I feel like my cheekbone and surrounding area of this tooth is a little sore and I'm worried, I've been getting really upset from the stress of not knowing what's going on. Is it possible with a malocclusion that the pain comes 2 weeks after the filling is done? And secondly, if it ends up being more serious and I need a root canal for example, how can I try to ensure this tooth lasts a lifetime if possible? I've heard different things about getting a crown and I just don't want to do something and later find out something I wish I knew before. Thank you

Hello. I'm sorry for your situation. Sounds tough. Great questions though. In regards to the pain after 2 weeks being due to malocclusion, it is possible that it would take that long. Typically, with pain from a filling that is too high, the patient feels a sharp, electrifying pain when biting on that tooth. It can take 2 weeks because the "shock absorbers" of your teeth that we call the periodontal ligament can get inflamed over a period of time and cause that pain. If that was the cause of the pain, then filing it down should essentially get rid of the pain in couple of days after filing down the filling. If you are still sensitive, there is a possibility that it could be something else. Your dentist can check to see how sensitive your tooth is to something cold to determine the need for a root canal. We call this the endo ice test and it is a very helpful tool to determine if a root canal is needed. Your dentist can also use a probe and check around this tooth to see if there is a sudden drop. This is a bit complex to explain but it lets the dentist know if there is a possible fracture of the tooth.

As far as the lifetime of a tooth goes I have some general advice that I've come up with during my own time a dentist. Don't replace amalgam fillings unless there is a clinical problem with them. In other words, don't fix something that isn't broken. Sometimes patient's want to replace amalgam fillings because they read somewhere that the mercury is bad for you. That's very misleading and unfounded information. Others want to replace amalgam fillings because they don't want silver colored fillings. I understand this more, but I still don't recommend replacing them unless the filling is visible during smiling or the patient is extremely unhappy with the look of them.

The lifespan of a tooth that I personally think of is this. Filling -> Inlay/Onlay -> Crown -> Root canal -> Extraction. This means, for example, if a cavity is small, you can do a filling. If a cavity is everywhere around a tooth you may need a crown, but you cannot go back to a filling afterwards. If you get a root canal and the root canal fails, yes you can get another root canal. If it fails too many times, then there is no other thing to do than to have it extracted. It's mostly a one-way path. So if you want to extend the life of a tooth when you have a filling that hurts, then maybe another filling may do the trick, but it may not work. This assumes you have the money, time, and patience for this.


-Dr. S
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Old 11-14-2020, 04:27 PM
 
906 posts, read 322,944 times
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Quote:
Originally Posted by stresslessdds View Post
With all of my patients I always think in my head for a second, what would I recommend to my sister in this case assuming my sister was a millionaire. Looking at things like this is not realistic as patient's typically have financial concerns, but it gets me the best treatment option. In your case, if it were my sister, I would say do a root canal retreatment. I wouldn't call it agony, the nerves are already gone from the first root canal anyways. Also, since I'm assuming the whole millionaire thing for a second, cost isn't an issue.
That is a good advice, especially if one is still young and working, and has dental coverage.
In our case, a root canal that may last a couple of years the most is in the region of 2 to 3 thousands. A dental implant is around 5000+, in addition to what has been spent already (Endodontist $300+$260 for two visits, and tooth extraction $242). For retirees with no dental insurance, this is a choice between a rock and a hard place.
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Old 11-14-2020, 04:31 PM
 
Location: northern New England
3,857 posts, read 1,915,711 times
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Glad to see you back. A few questions.


1- If I had my teeth whitened, but I have composite fillings that were made to match my teeth, would they stick out visually and need to be re-done? Not planning on doing this, just curious.


2- I seem to remember hearing dentists a long time ago talk about putting a lining in before filling a tooth with a deep cavity, to protect the nerve. I may not be using the right term. Is there such a thing, and what is/was it?


3 - when I was about 12, I had a molar extracted and noticed that afterwards, when I smiled that half of my face did not move, due to large novocaine injection. I feel I have had lasting slight paralysis on that side, is that possible from an anesthetic injection? (this was over 50 years ago).


Thanks in advance.
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Old 11-14-2020, 06:08 PM
 
Location: Tampa, FL
323 posts, read 222,039 times
Reputation: 814
I'm glad the doctor's in! Thank you for doing this.

I am in my late thirties and had three orthodontist evaluations. All recommended invisalign for my bilateral posterior open bite. I actually have "two" bites. I wear a thick custom clench/grind guard at night. Invisalign will take the place of the guard.

1. Am I the only person out there with two bites?

2. How do you prevent your bite from going back to the way it was with retainers (clear trays)? I get they keep your teeth straight, but what about keeping your jaw straight?

I'm about to sign a contract with an invisalign top 1% provider with 20 years experience so I'm hoping this helps me. These were just questions I forgot to ask.
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Old 11-15-2020, 12:03 AM
 
44 posts, read 30,414 times
Reputation: 121
Quote:
Originally Posted by VTsnowbird View Post
Glad to see you back. A few questions.


1- If I had my teeth whitened, but I have composite fillings that were made to match my teeth, would they stick out visually and need to be re-done? Not planning on doing this, just curious.


2- I seem to remember hearing dentists a long time ago talk about putting a lining in before filling a tooth with a deep cavity, to protect the nerve. I may not be using the right term. Is there such a thing, and what is/was it?


3 - when I was about 12, I had a molar extracted and noticed that afterwards, when I smiled that half of my face did not move, due to large novocaine injection. I feel I have had lasting slight paralysis on that side, is that possible from an anesthetic injection? (this was over 50 years ago).


Thanks in advance.

Hello.

1) When you get teeth whitening, the whitening works on your natural teeth and not on the composite work or crowns that you may have. Naturally, the color difference of your natural tooth versus the composite matters. Some dentists recommend to get composite after teeth whitening is done for this reason. There is a counter argument to this as well though which I won't get into. Do remember that if you wanted to whiten your teeth first and then get composite done, the research says to wait at least 2 weeks after the whitening as it can affect the bond strength of the composite.

2) You are correct. When a cavity is very close to the pulp/nerve, we place a liner and sometimes a base. What is used varies dentist to dentist and also it has differed over time. A typical example of a liner is CaOH (calcium hydroxide). This promotes healing in the area near the pulp and hopefully prevents the possible need for a root canal. Usually a base is placed over it which can also vary wildly from dentist to dentist.

3) We don't typically use Novocain anymore but it I believe it was used more often 50 years ago. With lower wisdom teeth and possibly lower molar teeth extractions there is something called parasthesia that can occur. A patient would see the affect of it if the nerve in the jaw (called the inferior alveolar nerve) is bumped, pulled, pushed, or severed during an extraction. With that the patient would lose sensation in the lower right or lower left side of their face. This is more common than what you are experiencing but it's good to differentiate because with parasthesia you lose sensation but your muscles move perfectly normally and you wouldn't be able to look at someone and know they have parasthesia.

What you experienced and are experiencing may more likely be a mild form of something called Bell's palsy. There have been many, many reports over several decades regarding how dental work can indeed cause this to occur. It's not anything that the dentist did wrong, but simply a case of bad luck. You can go on google and find tons of information regarding Bell's palsy. It is rare but I have seen it myself. In the same year I was about to start dental school, I used to tutor kids. I remember the father of the boy I used to tutor come to me with half of his face practically drooping. He explained to me that it had recently happened and it was after a dental procedure he had. The reason it stuck with me was because I got scared thinking what if one day I cause this for one of my own patients. I learned later in dental school that the boy's father most likely had Bell's palsy and that it is extremely rare. Luckily, I haven't seen it with any of my own patients.
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Old 11-15-2020, 12:14 AM
 
44 posts, read 30,414 times
Reputation: 121
Quote:
Originally Posted by submart View Post
I'm glad the doctor's in! Thank you for doing this.

I am in my late thirties and had three orthodontist evaluations. All recommended invisalign for my bilateral posterior open bite. I actually have "two" bites. I wear a thick custom clench/grind guard at night. Invisalign will take the place of the guard.

1. Am I the only person out there with two bites?

2. How do you prevent your bite from going back to the way it was with retainers (clear trays)? I get they keep your teeth straight, but what about keeping your jaw straight?

I'm about to sign a contract with an invisalign top 1% provider with 20 years experience so I'm hoping this helps me. These were just questions I forgot to ask.
Hello there.


1) Absolutely not. There is every variation you can think of.

2) Your teeth tends to move but not your jaw. After you reach the age of physical maturity, the jaw stops growing for the most part. If a patient's bite has severe malocclusion that orthodontic treatment cannot help with, then oral surgery would be needed to move the jaw. The jaw doesn't end up moving back to the way it originally was.

Good luck to you. If three orthodontists recommended invisalign, then that's a very good sign. Stick to it and enjoy the results.
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