Dealing with Dental Anxiety and Bad Dentists

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I have quite a bit of anxiety when it comes to going to the dentist. When my tooth first started hurting, I put it off because the pain was only coming and going. However, I grew concerned when the pain seemed to move from place to place. So, I went to the dentist. He did an x-ray and said that I had a cavity and infection on a tooth that already had a filling. He also said he didn’t think there would be much chance that he could save the tooth because only 10% of it is still viable. Once he goes in he’ll figure it out and probably extract the tooth. Then, he’ll need to schedule me for a dental implant. I have to tell you my anxiety is kicked into overdrive. I don’t know if I can do this. Are there alternatives?

Missy

Dear Missy,

woman holding jaw in pain from TMJ

I would like you to get a second opinion on this situation before you move forward. I am very suspicious of what he is telling you. If your tooth were truly that far gone, he would not need an x-ray to know it. In fact, your filling would have fallen into the cavity. You would have noticed this and been in pain for a long time. When you do get a second opinion, make sure it is a blind second opinion. By that, I mean do not tell the second opinion dentist who your dentist is and what his diagnosis was. Just tell him or her you want an unbiased second opinion.

I also wanted to address the anxiety you have been dealing with. You will have your life changed if you see a sedation dentist. They can provide you with medication that will relax you during your appointment and allow you to have a pain-free/anxiety-free dental appointment. If you just need a mild relaxant, you can ask for nitrous oxide. However, if you want something that will relax you so much you sleep through the appointment, look for someone who offers oral conscious sedation.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

Missing Teeth and Invisalign

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What do I do if I have crooked teeth, still have baby teeth, have two missing teeth, and am 41 years old? I feel I am too old for traditional braces. However, I’ve been told by my dentist that Invisalign doesn’t work with missing teeth. So, what do I do?

Kyra

Dear Kyra,

Invisalign aligner

Actually, Invisalign can work with missing teeth. My guess is your dentist doesn’t have a high comfort level with Invisalign in general. You’ll just need to find an Invisalign dentist who is willing to work with you. The baby teeth will need to be dealt with. I’m guessing, at your age, the baby teeth have congenitally missing teeth. In that case, those (along with your other missing teeth) will need to be replaced.

My suggestion is to use temporary tooth replacements, like a dental flipper. Then, when all your teeth are in their correct alignment you can get a permanent replacement. The best tooth replacements are dental implants. They are the most like having healthy, natural teeth in your mouth.

However, if you are going to straighten your teeth you might as well take advantage of this opportunity to give yourself a mini smile makeover at a fraction of the cost.

Your Invisalign aligners can double as teeth whitening trays. All your dentist will have to provide you with is the whitening gel, which doesn’t cost much. This means you can straighten and whiten your teeth simultaneously.

One other thing. If your missing teeth are visible when you smile, make sure it is a skilled cosmetic dentist so that the implant crown will look natural.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan. An AACD accredited dentist.

Novocain Resistance

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I have a high resistance to Novocain which has made my dental appointments a nightmare. This has led to me avoiding the dentist like the plague. Now my smile is in serious need of work. I’ve got at least three teeth that need to be extracted and replaced. I want to replace them with dental implants because I heard those look the best and one of the teeth is a front tooth. However, I’m not sure what to do about my Novocain resistance. I don’t want to feel like I’m being tortured.

Beth

Dear Beth,

woman asleep in the dental chair

Sleep dentistry changes lives

I’m sorry you have had such painful experiences. The fact that you are still trying to persevere shows how much you care about your oral health. First, let’s address your Novocain resistance. Most patients and even many dentists do not realize that dental anxiety affects the way your numbing medication works. The higher the anxiety, the faster the medicine is burned off. After the experiences you have had, I am sure your anxiety is through the roof. Fortunately, there is a solution to this situation, though.

I’m going to suggest you see a dentist who offers dental sedation. Most sedation dentists offer two different levels of sedation. The lightest is nitrous oxide, nicknamed laughing gas. However, because of the experiences you’ve had and the amount of work you need done, I’m going to suggest you use oral conscious sedation. This is so strong you can even sleep through your appointment if you choose to do so. In addition to giving you an anxiety-free/pain-free appointment, it also allows you to get more work done in each sitting which can significantly reduce the number of appointments you will need to get your mouth back in shape.

Choosing Your Implant Dentist Wisely

Dental implants are a great solution for missing teeth. They are the closest thing to having healthy, natural teeth in your jaw again. The thing to be aware of is it is an advanced procedure. You’ll want a dentist who has had extensive post-doctoral training in implants.

You mentioned that you wanted dental implants because they look the best. How their appearance turns out depends entirely on the skill of the cosmetic dentist doing the restoration. Because one of your teeth that need to be replaced is a front tooth, this will be especially important.

In your place, I would look for a dentist who has been accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country, so you can be certain they will provide you with a beautiful result.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

Dental Sedation when Novocain Fails

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I had a nasty toothache and went in to see my dentist for an emergency appointment. He gave me antibiotics to keep the infection at bay and scheduled me for a root canal in two days. I went in and for some reason he couldn’t get me numb. He’s now giving me a referral to a sedation dentist. Why will that work if the Novocain doesn’t?

Catherine

Dear Catherine,

A woman holding the side of her jaw in TMJ pain

Your dentist is right on target with what he’s suggesting. It’s very common when a patient has some level of dental anxiety. Your metabolism jumps up with anxiety. The theory is, depending on the level of anxiety, the higher metabolism causes you to burn off the numbing medication so quickly you don’t get the effects.

How a Sedation Dentist Helps

Ideally, you should get oral conscious sedation. Your sedation dentist will give you a pill before your appointment, which will completely relax you. In fact, you’ll be so relaxed, you won’t be able to drive yourself to your appointment.

Your dentist will expect you to have a ride to and from his office. Additionally, you’ll want someone who is able to stay with you for a few hours after your appointment until you are lucid and steady on your feet again.

This form of sedation is so strong, that most patients completely sleep through their appointment. This will help you get your root canal treatment done no problem.

Please don’t put this off or you’ll have another emergency dental appointment without being able to save your tooth. Then, you’ll need to invest in a great tooth replacement option such as a dental implant.

I know you are nervous, but believe me when I tell you sedation dentistry has changed the lives of even the most fearful of patients.

This blog is brought to you by La Jolla Dentist Dr. Stephen Doan.

I’m Having Trouble Chewing with my New Dentures

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I have recently been fitted with a new denture. They seem to fit well enough, and my dentist says they are tight against my gums, but I am really having a hard time chewing. Is this something I will just have to get used to?

Greg – Phoenix

 

Greg,

Your dentist may have done an excellent job getting your dentures seated snugly over your gum and bone structure. By simple nature, however, chewing capacity is reduced by 50% when natural teeth are replaced with dentures. This does not mean that you have to “get used to” instability.

There is something you can do to heighten your chewing capacity, even if you are interested in keeping your dentures. One of the latest techniques in tooth replacement is called the implant-supported denture. This may help you gain the comfort and confidence you seek.

Implant supported dentures combines a few dental implants, small cylinders that replace teeth roots. These posts become secured in the jaw bone, and provide the necessary support to a full denture. With this treatment, you should find that you can chew a variety of foods, even those that are crunchy or chewy.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Doan.

Introducing Dr. Marie Moeckel

Dr. Doan is retiring and Dr. Moeckel is taking over the practice. 

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