All posts by kkzeluff

A sedation dentist can help with treatment during addiction recovery

I need a lot of dental treatment, and I have a problem. I am in treatment for drug addiction, and when I told my regular dentist this, she refused to give me any pain medication during treatment. We were supposed to do two root canal treatments, and I couldn’t even make it through one whole procedure. I had to have her stop, and though she seemed sincerely sorry, she refused to give me any kind of medication.

What should I do? I have to get these root canals done, and I am pretty sure I also need to decide if I want dental implants, but for sure that is off the table if I can’t find a dentist who will sedate me. I’ve read about the procedure, and no way can I have those root forms implanted without meds.

I appreciate any pointers you can give me. I am trying to turn my life around, and this needs to be done.

Marcus from New England

Dear Marcus,

You need to find a sedation dentist, a dentist who is trained in how to treat pain and anxiety during dental treatment. A dentist who has undergone training in sedation dentistry will understand how to best work with your treatment plan. The dentist who is overseeing your treatment plan might be an excellent resource to point you toward a dentist that will work with you.

Post courtesy of Dr. Malone, Lafayette Louisiana cosmetic dentist.

For more information about Cerec crowns, see our website.

What can be done about damage to teeth from bulimia?

I am a recovering bulimic. I’ve been pretty stable for the last two years, and have a great counselor, so I feel like I can really beat this illness. I am having this issue, though, and it seems kind of vain in light of all the other health problems I’ve been dealing with, but here it is – my teeth are an embarrassment. I’ve had bulimia for more than half my life. My front teeth are worn, and really thin and chipped. They are shorter than they should be, too.

I know this might sound like something that should be low priority, but I feel like I am finally starting to live again, and my total lack of smile is holding me back. I am not capable of smiling without my hand over my mouth. I mumble. I always look tight-lipped, because I am.

What can be done? Are the teeth too damaged for porcelain veneers? What about porcelain crowns? I have even considered just having them pulled and getting a bridge. I don’t think dental implants are an option I can afford.

Thoughts? I appreciate your help.

Patricia in Erie, PA

Dear Patricia,

Congratulations on working so hard to improve your health and well being. It is absolutely normal to want to express your new-found joy with a radiant smile.

The best recommendation is to seek the services of a skilled cosmetic dentist. Porcelain veneers or porcelain crowns could work for you, but you want to make sure you have someone who is experienced and highly artistic do the work. Generally speaking, a cosmetic dentist will also be more sensitive to your cosmetic concerns.

Lafayette Louisiana cosmetic dentist Dr. Mike Malone’s office sponsored this post.

Fosamax and tooth replacement – special considerations

I recently had to have one of my teeth taken out (the left incisor). The dentist that did the extraction is leery of a dental implant to replace the tooth because I have been taking Fosamax for a decade. As a temporary fix, I’ve been wearing a dental flipper, which is extremely annoying and leaves a bad taste in my mouth all the time.

I’ve been reading about different kinds of dental bridges, like an Encore bridge or a Maryland bridge. Couldn’t either one of those work for me? My dentist seems hesitant because he would have to anchor it to one of my front teeth, but this flipper is not going to work forever. What would be my best course of action?

Carson in Topeka, KS

Dear Carson,

Several things should be considered. Getting a dental implant is not out of the question when you are taking Fosamax, though there is a slightly increased risk of local bone problems of a serious nature. The the likelihood of problems is small, those potential problems can be severe, so you need to carefully consider this. It might also be possible to have your oral surgeon and your doctor coordinate so that you temporarily stop taking the Fosamax so that you can have the dental implant root form surgery done.

If that all sounds too risky, certainly a dental bridge would be a perfectly feasible option. You should, in this case, definitely let your dentist chose the type of bridge that would best serve your particular situation.

Talk all of this over carefully with both your doctor and oral surgeon or dentist.

The office of Lafayette Louisiana cosmetic dentist Dr. Malone has authorized this blog post.


My tooth really hurts, but I don’t have any money

I’ve got pretty bad teeth. I am missing several of my back teeth, and now I have an infection or something in one of the only molars I have left. The swelling along my jaw looks terrible! It is really embarrassing.

I don’t have a job right now, or any insurance. I am estranged from my family, so there is no one I can ask to help with any kind of medical or dental expenses. Is there anything I can do on my own to treat the infection? I am in a lot of pain.

Maria in Grand Haven

Dear Maria,

Before we offer advice on what to do, we want to make very sure we tell you what to avoid. Don’t take oral antibiotics to try and get rid of the infection without FIRST having the tooth treated. Here is why that is so important: the infection is inside a tooth, where antibiotics can’t reach it. If you treat the tooth without addressing the source, you will simply make sure that the bacteria that survive are stronger and more resistant to treatment.

An infection in a tooth is a potentially serious situation. An untreated infection could spread to your brain, or cause dangerous swelling in your throat. You really must have this addressed before it becomes far more serious and even potentially life threatening.

The infected tooth needs a root canal treatment, after which it may need to be protected by a dental crown. If that is too expensive, or if the tooth is too damaged, it may need to be extracted. When your fortunes improve, you might consider a dental bridge or dental implant to replace the missing tooth.

Ask at your local social assistance agencies if they know of a clinic where you can get this work done. Many communities have a method of connecting people in dire need like yourself to dentists who will complete the work for free or at a greatly reduced price with a payment plan. Be persistent – it is very important that you get this work done!

Good luck to you.

This blog posted courtesy of the office of Lafayette Louisiana cosmetic dentist Dr. Malone.

Can I get all this work done in one setting?

I’ve got a lot of dental work to get done. I have to get at least four root canal treatments, and I need to have a couple of teeth ground down as TMJ treatment. I also may need to have a dental bridge placed, though my dentist is still considering the best course of action in that case. I also need some dental bonding done on a chip on my front tooth. The problem is that I seriously freak out in the dentist’s chair.

I’d like to get this all done at once. I don’t have much time off of work, and I just want to get it over with. My question is, how much can be done in one sitting?

Frank from Escanaba

Dear Frank,

Time of treatment is determined by the patient’s ability to tolerate treatment. The placement of the teeth that need root canal treatments will affect the amount of time necessary for treatment.

The amount of treatment you need will probably require the services of a sedation dentist. This would have the added benefit of easing your anxiety. If you can’t locate a sedation dentist, or don’t want to go to one, then the length of treatment is largely decided on your ability to tolerate treatment. Your anxiety will probably lessen your ability to spend long hours in the chair, so consider this when you are deciding whether or not to go with a sedation dentist.

If you can’t locate a sedation dentist, you may want to consider going to an endodontist. A specialist will reduce the amount of time you need to spend in treatment.

This blog post created for Lafayette Louisiana cosmetic dentist Dr. Mike Malone.


TMJ and Neuromuscular Dentistry

I’ve got quite a story to tell. I hope that maybe other people can avoid making some the of mistakes I made, and save themselves a lot of pain and A LOT of money.

I have a long standing teeth grinding habit that caused me to have porcelain crowns placed on all of my teeth about 10 years ago. At the time, I went with the dentist who quoted me the best price, and I’ve paid for it ever since. The crowns were not placed like they should have been, and they have worn down over time. I also have a lot of pain when I chew, and have been told I have a “posterior crossbite”. I’ve been struggling with gum disease off and on for years because of the placement of the crowns, and they are just plain ugly.

I’ve determined that my biggest mistake was in not choosing the right professional to help me the first time around. Because of the pain in my jaw and the complexity of my case, I have consulted with a neuromuscular dentist who also has a lot of experience in cosmetic dentistry. I asked for his credentials in both, and he directed me to his website where I read about the extensive coursework he has had in treating TMJ, and saw pictures of his cosmetic work in his Smile Gallery. His prices are a little higher than those of the general dentists I have talked to, but looking at those pictures and reading about his education and awards really made me realize that he is worth every penny and then some.

We are currently working on addressing the TMJ issues that are likely at the cause of all my issues, and he has given me a phased treatment plan that I can afford. We’ll eventually replace the old crowns with new porcelain crowns, and if his Smile Gallery photos are anything to go by, my new smile is going to be stunning.

I just wanted to share my story, so that other people don’t make the same mistake I did and then pay for it for years to come. Don’t price shop for a dentist!

Lucy in Chicago

Dear Lucy,

We hear stories like yours every day, and it really speaks for itself. We hope to hear soon that your smile has joined all the others in your dentist’s smile gallery!

Lafayette Louisiana cosmetic dentist Dr. Malone’s office sponsored this blog post.

For more information about CEREC crowns, which are dental crowns that can be done in a fraction of the time of standard porcelain crowns, see our website.

Did my dentist rip me off?

I switched to a new dentist because mine retired, and got the shock of my dental life when I went in for my first appointment. I’ve always been really diligent about my dental care. I floss every day, and brush morning and night. The dentist and hygienists in the old office always said I had great teeth, and they’ve never given me any trouble. So imagine my shock when I went in and was told I have six cavities! SIX!

I set up an appointment, and had him fill them all. He used the white filling material. Ever since he filled the cavities, suddenly I have a lot of pain. I’ve gone back in, but he just says I have to adjust to the new fillings.

What is going on? Does this sound for real? I feel like I’ve been ripped off. I now suspect that I never had any cavities at all. Is there any way to tell from my xrays? I mean, I just had xrays done a year ago – could it really be that my dentist missed SIX cavities?

Thanks for your help,

Harriet in Reno, NV

It is possible to have cavities that were missed by your former dentist – if the hygienist doing the x-rays was doing them at the wrong angle, some cavities could be missed. But SIX. That is unlikely. You should ask for a copy of your x-rays to take to another dentist for a second opinion.

The post filling pain is worrisome, though. It sounds as though the white fillings might not have been bonded correctly. Another slim possibility is that the white fillings have changed the alignment of your jaw, and you are now having issues with TMJ. You are not specific about the nature of your pain, so there is little further speculation possible. This is another situation that needs a second opinion. When you go in to the new dentist, try to be very specific about the nature of your pain and when it occurs (during chewing, all the time, etc.).

Good luck to you.

This blog and this post were sponsored by Lafayette Louisiana cosmetic dentist Dr. Mike Malone.

For more information about dental bridges, see our website.

Choosing between Lumineers and porcelain veneers

I’ve been thinking about getting my teeth fixed for a long time, and have started looking into what that will involve. My top middle teeth are poorly shaped, with one being really thin and almost triangular, and one that looks as if it had a big chip out of it, though it hasn’t. My other top teeth are not as noticeably weird, though I think if I get the middle ones done, they will look really bad in comparison.

I haven’t talked to my dentist about this yet, and have just started trying to look stuff up on the internet. There is so much information! I am having a hard time even figuring out what to look for.

As far as I can tell, probably Lumineers or porcelain veneers would work for me. But I read a lot of criticism about Lumineers, and wonder if I should maybe chose porcelain veneers. What would you suggest?

Philip in Louisville, KY

Dear Philip,

For best results, you’ll want to change your thinking a little bit. First, Lumineers are a brand of porcelain veneers, so it is kind of like asking if you should buy a Dell or a laptop. There are many brands of porcelain veneers, and trying to figure out what would work best for you would be both time-consuming and ultimately a little pointless. Rather than focusing on the materials you want for your smile makeover, concentrate your energy on choosing the right dentist.

Cosmetic dentistry is not a legally recognized sub-specialty, so anyone can say they do cosmetic dentistry procedures, regardless of training. Check references and credential carefully, and look for evidence of specialized training beyond dental school in the procedure that you wish to investigate. Look for before and after pictures on the dentist’s website.

Though we do want you to focus on choosing the dentist and letting the dentist choose the materials, we do have a word of caution about Lumineers. Many cosmetic dentists refuse to use them, because they can appear pasty and opaque, and the no-prep technique can result in a bulky look and feel. That being said, some dentists have used them to create really beautiful smile makeovers. The choice will be up to your dentist.

One of my teeth is turning dark

When I was a kid I got hit in the mouth by a wooden swing. It chipped the corner of my tooth off, and for all these years I’ve had a small filling that was apparently very well done, according to all the dentists I have seen. Now that I am considerably older, though, that tooth is starting to get dark. I noticed it starting several years ago and it has been happening very slowly, but now it is quite noticeable.

This is making me pretty self-conscious. I talked to my dentist about Lumineers, but he said there have been problems with that kind of porcelain veneer. He also said that he was reluctant to do a porcelain crown, because the canal has calcified and the structure wouldn’t be strong enough.

He really told me all about what he didn’t want to do, and didn’t offer a solution. Do you have any suggestions?


Cody in Los Angeles, CA

Dear Cody,

From the sounds of it, your dentist is uncomfortable with cosmetic procedures. It is actually a good thing that he is not offering to do procedures that he is not comfortable with, as that could have an unhappy result. Ask your dentist to refer you to a cosmetic dentist, one who has the training and experience necessary to do a really beautiful job for you.

A single porcelain veneer or even direct dental bonding would be very viable solutions to your problem, in the hands of the right cosmetic dentist. There is no reason you can’t go to a different dentist for this cosmetic procedure, and stay with your regular dentist for cleanings and regular care.

Lafayette Louisiana cosmetic dentist Dr. Mike Malone’s office provides this blog as a courtesy.

Months of sensitivity in tooth after white filling

More than six months ago I had a large cavity filled with a white filling. Almost immediately following, that tooth became really sensitive to cold temperatures. Heat is OK, but cold just sends me through the roof. I went back to see my dentist because of this, and she said that the cavity was very large and deep, and might be simply irritated. She wanted to wait it out, but I insisted she do something to further protect the tooth. She agreed (reluctantly) to cover the tooth with a temporary dental crown.

Now all these months later the tooth is still bugging me. The dentist says that we further irritated the tooth by placing the crown, and now I may need to have a root canal treatment. Does this sound right to you? She is pretty young, and I am not sure I really trust her judgment.

Mary in Lowell, MI

Dear Mary,

You probably should have listened to your dentist and waited out the initial sensitivity. She is likely right, also, that placing the crown did not help the situation.

One of the most important rules of thumb in dental care is to never, ever push a dentist into doing something they are not comfortable in doing. You state that your dentist is young, so she may not yet have developed a good skill set for firmly and respectfully refusing to do treatments that are against her better judgment but that the patient is insisting on.

A real concern here is your lack of confidence in your dentist. If you cannot trust her, you should seek the services of a different dentist. It sounds as if she knows what she is doing, but everything hinges on your comfort level with her and her care.

Posted as a courtesy for Lafayette Louisiana cosmetic dentist Dr. Mike Malone.