X
Dr. Thomas

Why Are My Dental Deep Cleanings So Long and Painful?

Posted on by .

My deep cleanings at the dentist are too long and painful, so I decided not to return to that dental practice. I am concerned because I know the cleanings are for gum disease, but I cannot take them. My sister recommended asking for sedation, but I don’t want to return to this dentist. I have two recommendations from coworkers who like their dentist, but I would like to ask about sedation first. Will a dentist be willing to sedate me before a deep cleaning? Also, my appointment seemed so long. How long should a deep cleaning take per appointment? Thank you! – Wendalynne

Wendalynne,

Thank you for your question. Your description of the pain you have experienced sounds like it may have another cause, and we are concerned. Untreated gum disease can cause loose teeth and even tooth loss. It is good that you will continue deep cleaning despite your negative experiences.

Can You Get Dental Sedation for a Deep Cleaning?

Woman resting in a field of flowers portraying relaxation from sedatiion during a dental deep cleaning

Dental sedation relaxes you during dental deep cleanings

Yes, you can get dental sedation for deep cleaning. Before selecting a new dentist, ask the scheduler about the types of sedation offered. You may prefer to schedule a consultation with a dentist first to discuss your concerns, pain, and anxiety level.

How Long Does a Dental Deep Cleaning Take?

A deep cleaning at the dentist takes an average of 45 minutes. Depending on the extent of gum disease, you may have separate appointments for each side of your mouth. Scheduling two visits instead of a prolonged session can make your treatment more comfortable.

Why Are Your Deep Cleaning So Painful?

Deep dental cleanings can be painful if the treatment provokes an active infection. A dentist can calm your symptoms from an aggressive infection with the following steps:

  • Prescribe antibiotics for you to take throughout your treatment
  • Shorten treatment sessions to promote your comfort
  • Offer sedation to help you relax and have less sensitivity to pain during treatment

Second Opinion for Gum Disease and Deep Cleanings

If you cannot find a dentist experienced in treating gum disease, you can visit a periodontist (gum specialist). Explain your experiences to your new dentist and ensure you are comfortable with the dentist’s response to your concerns and willingness to provide sedation.

 

Sugar Land, Texas, dentist Dr. Siny Thomas sponsors this post.

 

What Are the Side Effects of Dental Sedation?

Posted on by .

Woman lying in a field of daisies portraying the relaxing effects of dental sedation

Dental sedation is relaxing

I have an appointment for an apicoectomy next Wednesday. Since I already had two failed root canals on the tooth, I have become anxious. I accepted the dentist’s offer of sedation, but I am afraid of that too. What side effects can I expect with dental sedation? – Thank you. Minou from Michigan

Minou,

Thank you for your question. A dentist determines whether you are a candidate for sedation and which medication to use based on your medical history, procedure, and anxiety level. What can you expect?

Readers: See our October 2021 blog post for information on how root canal therapy and apicoectomy differ.

What Are the Side Effects of Dental Sedation?

The side effects of dental sedation depend on the sedation type. We will discuss nitrous oxide, oral conscious sedation, and IV sedation.

Nitrous Oxide Side Effects

Nitrous oxide (laughing gas) is an odorless, colorless gas that wears off quickly after you stop inhaling it. After your procedure, your dentist will give you oxygen to reverse nitrous oxide’s effects. Side effects include:

  • A tingling sensation
  • A sense of well-being
  • Nausea

You can minimize nausea risks by avoiding large meals before your appointment.

Oral Conscious Sedation Side Effects

Oral conscious sedation is medication in pill form. A dentist may prescribe Valium, Ativan, or Halcion for you to take before your dental appointment.

Side effects vary by medication but may include:

  • Sleepiness
  • Nausea
  • Headache

IV Sedation

Intravenous (IV) sedation is more potent than nitrous oxide and oral conscious sedation and quickly relaxes you.

Side effects may include:

  • Drowsiness
  • Dry mouth
  • Nausea
  • Headache
  • Amnesia

Your dentist will explain which type of dental sedation will work best for you and your procedure. Follow the pre- and post-procedure instructions to maximize your comfort.

Dr. Siny Thomas, a Sugar Land, Texas dentist, sponsors this post. Dr. Thomas is a graduate of the surgical program of the Pikos Institute in Trinity, Florida.

 

 

Is My Sinus Perforation After Wisdom Tooth Removal Healing?

Posted on by .

Young woman portraying sinus perforation after wisdom teeth extraction and possible sedation dentistryAfter an oral surgeon removed all four wisdom teeth in early August, my nose started running with yellow mucus, and my cheek was swollen. I expected some swelling, but I called the oral surgeon when the yellow discharge came out of the tooth socket. The doctor said that I had a sinus perforation and prescribed Augmentin. I returned for a CT scan, and the doctor said my sinus was still infected, so I began a Z-pack.

Now I still see draining and have some sinus pressure and pain. It all feels better, but the issue is not gone. I rinse the extraction site with a prescription product and use Flonase for my nose. Is the infection improving, or should I see an ENT? I would hate to need another surgery and am nervous about it. I require sedation, and getting sedated again makes me nervous. I don’t want my body filled with medication. Why won’t this infection go away? Thank you. Renae from Flint, MI

Renae,

Thank you for your question. Dr. Thomas would need to examine your x-ray and extraction site, but you have described some unusual concerns.

Does a Sinus Perforation Lead to Infection?

Although a sinus perforation is not uncommon after upper wisdom tooth extraction, the perforation does not automatically lead to infection. Consider factors that may have led to a sinus infection:

  • An infection in the tooth was likely lingering before the surgeon removed it.
  • Augmentin helped with the swelling, but you needed a Z-pack for the sinus infection.
  • Infection from your tooth may have entered your sinus and created another issue.

Why Do You Still Feel Sinus Pressure After Wisdom Tooth Removal?

If you feel persistent sinus pressure after wisdom tooth removal, you may need a Z-pack refill. Your surgeon may advise taking the Z-pack to prevent antibiotic resistance until it eliminates the infection. Flonase will reduce sinus inflammation, so continue taking it.

Although we do not have your dental records, your oral surgeon’s treatment seems effective. Therefore, you should not require an ENT visit or another dental surgery that involves sedation. If your situation does not improve, your oral surgeon will pursue other options or refer you to an ENT as needed. Be sure to finish any medication that the surgeon prescribes.

We wish you a steady recovery.

Dr. Siny Thomas, a Sugar Land, Texas dentist, sponsors this post. Dr. Thomas is a graduate of the surgical program of the Pikos Institute in Trinity, Florida.

 

Do I Need Another Surgery to Remove Tooth Roots?

Posted on by .

I had two extractions in 2019 from a previous dentist. After my new dentist took x-rays last month, she saw large amounts of tooth roots left for a lower right premolar and the tooth behind it. She wants to refer me to an oral surgeon to remove them because the bone around the roots did not heal correctly, and she is concerned that the neighboring teeth are at risk. I had some anxiety when I got the extractions but knowing that a surgeon needs to go deep into my bone scares me. I am worried about nerve damage. Do I really need a second surgery or is it okay to leave the roots alone? Thank you. William from Sioux Fall, S. Dakota

William,

Thank you for your question. We understand why a second oral surgery would cause anxiety. Dr. Thomas would need to examine your x-rays and take a CT scan for an accurate diagnosis, but we will provide general guidance.

What Should You Do About Tooth Roots Left After Extraction?

Treatment for tooth roots left after an extraction depends on these factors:

  • Root size
  • Root location
  • Condition of your bone and gums in the area

Lower premolar teeth are near the mental foramen, which transmits the mental nerve and artery. The mental nerve transmits sensation to the inside lining of your cheek, lower lip, and chin. Oral surgeons are skilled at removing teeth and roots without nerve damage. Dentists with oral surgery experience can remove the teeth, too, but if your new dentist refers you to an oral surgeon, it is best to respect her recommendation.

Man relaxing in the grass, portraying sedation dentistry and relaxation

Sedation dentistry relaxes you during oral surgery

When your jawbone fails to heal in areas of teeth removal, you risk damaging neighboring teeth. An oral surgeon will examine your x-rays and take a CT scan to look for anything that puts your oral health at risk and to determine the location of the teeth roots near the nerves.

Remember to ask about sedation options to calm your anxiety during your consultation with the oral surgeon.

Dr. Siny Thomas, a Sugar Land, Texas dentist, sponsors this post. Dr. Thomas is a graduate of the surgical program of the Pikos Institute in Trinity, Florida.

Is It Unusual to Need This Many Root Canals?

Posted on by .

Is it unusual to need three root canals, extractions, and implants over four years? I floss and brush my teeth daily and keep my dental cleaning appointments. My dentist put three teeth on watch status, but eventually one by one, he said the tooth needed a root canal. Then, he could not save the tooth and said I needed a dental implant. The last incident was two months ago, and I told my dentist to do nothing with the tooth because I was not sure anything was wrong with it. How do I know whether my dentist’s evaluations are accurate? Can I get compensated somehow? My anxiety level has escalated, and I am unsure whether I can take another root canal. Thank you. JC from Houston

JC,

Dr. Thomas would need to examine your teeth and x-rays for an accurate diagnosis. Still, we will answer your question in general.

Is Three Root Canals Within Four Years Unusual?

Three root canals within four years are unusual for teeth with no significant concerns during the last visit. Decay beneath an old filling can progress rapidly, but that is not the situation you described. When a dentist is watching a tooth, any signs of decay should be minor. For a tooth to progress to requiring root canal treatment or an extraction seems to be negligence. If your dentist saw signs that your tooth might become impossible to save, he should have treated the decay before it progressed to losing the tooth.

Get a Second Opinion

The only way to know if your dentist’s diagnosis is accurate regarding root canal therapy for another tooth is to get a second opinion. You may request your dental x-rays from your current dentist or ask the dentist to transfer them.

Sedation can help you relax during dental treatment

It can be challenging to prove your dentist’s negligence and get a refund. Speak with your new dentist about the possibility of getting compensated if you have a series of x-rays that prove you did not need tooth replacement with dental implants.

We recommend looking for two dentists with advanced implant and cosmetic dentistry training. Request a consultation with each dentist before choosing your new provider. Ask about sedation options to help you relax.

Sugar Land, Texas dentist Dr. Siny Thomas sponsors this post.

Are Dental Crowns the Only Way to Adjust My Bite?

Posted on by .

Dental crown for a molar tooth

Dental crowns fit over shaved-down natural teeth

I wore braces until I was 17 years and wore a retainer nightly for ten years. I am 32 years old now and no longer wear a retainer. My teeth look and feel fine. After a dental exam, x-rays, and cleaning three weeks ago, my dentist said that my bite was off, and he could fix it with crowns on all my teeth. I was shocked and asked my dentist to give me time to think about his recommendation.

Now I wonder if my dentist is trying to make money because I told him that I want teeth whitening. My dentist knows that I need sedation to get my teeth cleaned because I am so anxious. But I really want my teeth whitened. Why would he think I would agree to crowns? Now, I distrust him to sedate me because I am worried that he will begin preparing my teeth for crowns when I do not want them. Is it possible that my dentist gave me a fake diagnosis and wants me to get crowns instead of teeth whitening because crowns cost more? – Thank you. Kraig from Phoenix

Kraig,

Thank you for your question. Dr. Thomas would need to examine your x-rays for an accurate diagnosis, so we will not speculate about the reason for your dentist’s diagnosis. But if you do not grind your teeth or have teeth or jaw pain, earaches, or other TMJ symptoms, getting a second opinion is best.

Do You Need Crowns to Correct Your Bite?

Placing dental crowns on all teeth to correct your bite is a highly aggressive treatment. A dentist must shave the entire circumference of a tooth to prepare it for crowns. Although some dentists taper teeth conservatively for crowns, placing them on all your teeth (full-mouth reconstruction) is aggressive for correcting your bite on otherwise healthy teeth.

How Can a Dentist Adjust Your Bite?

If your bite is off, a dentist will determine the cause before recommending treatment. Adjusting your bite corrects its alignment, evenly distributes it, and eliminates pressure. If the issue is not complex, a dentist may take these steps for an occlusal adjustment:

  • Place articulating paper between your teeth and ask you to bite down on it
  • Mark the points of contact where your teeth bite and grind
  • Look for irregularities
  • Smooth only the necessary teeth to adjust your bite

Depending on the severity of misalignment, you may need braces or another form of orthodontic treatment. But you will need a second opinion to determine if your bite requires adjustment and what is causing misalignment. Schedule an appointment with a dentist trained in occlusion and bite function. Explain your anxiety during dental appointments, and the dentist will discuss your anxiety triggers and how sedation can help.

Dr. Siny Thomas, a Sugar Land, Texas dentist, sponsors this post.

Could Burning Mouth Syndrome Feel Like an Allergy to Crowns?

Posted on by .

Young woman portraing concern over burning mouth syndrome vs. zirconia crown allergiesIn February 2021, a cosmetic dentist placed zirconia crowns on two of my molar teeth. He used a lot of water to protect some of my surrounding teeth. It was hard for me to breathe, I was throwing up water, and the dentist had to stop the procedure for 30 minutes until I was calm again. The whole ordeal strained my throat and affected my speech. And I had lingual nerve damage that lasted almost a year.

Since that time, my tongue has gotten dry and sticky, and my throat burns. Within the past two months, the dryness and burning have worsened. I thought I might have an allergy to zirconia, but my dentist said there’s no way I am sensitive to zirconia because it’s a ceramic. I have seen three ENT doctors who agree that I don’t have acid reflux, nor is the problem from a reaction to mouthwash or toothpaste. One ENT says I might have burning mouth syndrome from all the trauma.

I need more cosmetic dentistry, but it’s not happening soon. I’m still nervous after the experience I had last year. I’m starting to get depressed because I wonder whether I’ll never be able to finish my cosmetic dentistry work. I’ll have to start all over with another dentist because I’m afraid that my dentist will drown me with his sloppy tooth isolation and irrigation techniques. How can I be sure that I’m not reacting to the zirconia crowns? – Thanks. Rebekah from Seattle

Rebekah,

Thank you for your inquiry.

Are You Allergic to Zirconia Crowns?

Although it is rare to have an allergic reaction to zirconia crowns, it is not impossible. And no dentist should tell you that you cannot be allergic to zirconia. You will need an allergy test to confirm if zirconia causes an adverse reaction.

Although Dr. Thomas would need to examine your crowns and oral tissue, it seems that the ENT specialist who suspects you have burning mouth syndrome has an accurate diagnosis. We have consistently heard and read about patients who have experiences like yours. And we see a connection between burning mouth syndrome and traumatic dental experiences. You were choking and vomiting during your dental procedure with the zirconia crowns. And you had lingual nerve damage. The ongoing strain on your throat, speech issues, and depression are enough to keep your anxiety level high.

Other people have experienced a dry mouth or burning tongue after stressful dental experiences. You are already uncomfortable with your current cosmetic dentist, so look for an advanced cosmetic dentist who offers conscious sedation. In our experience, conscious sedation can treat a high level of dental anxiety. Anti-anxiety medication will help you arrive relaxed for your dental appointment, stay comfortable, and remember little about your procedure the next day.

You do not have to forfeit cosmetic dentistry because of your anxiety. A skilled cosmetic dentist, along with sedation, will help complete your smile makeover so you can feel good about smiling again. If you get allergy testing and learn that you are sensitive to specific dental materials, look for a dentist who will use alternative materials.

 

Sugar Land, Texas, cosmetic dentist Dr. Siny Thomas sponsors this post.

 

My mouth is swollen, and I feel weak

Posted on by .

I’ve had a toothache for 2 weeks. I felt it bothering me in my sleep last night, and my mouth was very dry. I woke up this morning, and when I went to the bathroom, the whole left side of my face was swollen, and my eye was almost swollen shut. It hurts so bad to open my mouth to brush my teeth, and I have to sip water from a straw because I can’t open it wide enough for a cup. I am starting to feel weak, too. I am terrified of the dentist, so I am in this mess. Is there anything at all I can do to make the swelling go away without going to a dentist? – Delia

Delia,

Dr. Thomas would need to x-ray and examine your tooth for an accurate diagnosis. But your description seems to reflect a severe tooth infection that will adversely affect your health without root canal treatment. And your symptoms show that the condition is getting worse. You cannot treat the tooth yourself.

Will Antibiotics Get Rid of a Tooth Infection?

Although some patients take a pain reliever or antibiotics to get rid of an infection, those medications only mask the problem. A root canal treatment is the only way to clear the infection from your tooth.

ReWoman asleep in the dental chair

Find a dentist who accepts emergency visits and explain your anxiety. A dentist who offers sedation will understand your fear and get you the help you need right away. The dentist can give you sedation to calm you for your dental procedure. They will also relieve your pain before root canal treatment and ensure you have a painless process.

If you need assistance, ask someone for help finding a dentist who takes emergency issues who is also a sedation dentist.

You didn’t mention your location, but we welcome you to give us a call if you are near our office.

Dr. Siny Thomas, a Sugar Land, Texas dentist, sponsors this post.

Should My Root Canal Tooth Still Hurt?

Posted on by .

Woman portraying root canal tooth painAfter getting three new crowns last month, my bottom left second molar became so painful that it caused headaches. My dentist took an x-ray and said the tooth was infected, and I would need a root canal. After the root canal, my dentist said she found four canals. Despite antibiotics, the tooth continues to hurt.

My dentist asked me to take antibiotics for another ten days. I feel that something is really wrong, and I do not know if the pain is referring, but now my upper tooth is sensitive. I’m getting so anxious that I do not think nitrous oxide will be enough to get me through this appointment. I am embarrassed, but I need something stronger. Could my tooth still be infected? – Kate from N. Dakota

Kate,

Thank you for your question.

Dr. Thomas would need to examine your teeth and x-rays for an accurate diagnosis. He would also need more information, including what triggers your pain, when you feel it, and whether it is improving a little.

What Are Possible Causes of Post-Root Canal Pain?

If you have pain after root canal treatment, possible causes include:

  • Lingering infection in a canal
  • Referred pain
  • Post-operative inflammation

Lingering infection in a canal

Although most molar teeth have three canals, sometimes a tooth has four or even five. If any of the canals are angled, or your dentist missed a canal, a lingering infection would cause tooth pain.

Referred pain

Another tooth may be the origin of the pain that you feel. If the tooth that hurts is sound, your dentist needs to look at nearby teeth that might refer to pain.

Post-operative inflammation

Root canal treatment can cause inflammation and swelling. When you bite or chew, the opposite tooth (upper or lower) will hit the inflamed tooth, making it hurt even more. It takes time for your body to fight the inflammation.

If the pain is not decreasing or getting worse, schedule an appointment with your dentist. Do not wait until you finish all the antibiotics. Talk to your dentist about finding a level of sedation to match your anxiety.

 

Dr. Siny Thomas, a Sugarland, Texas cosmetic dentist, sponsors this post.

How Can I Handle My Pushy New Dentist?

Posted on by .

Senior woman smilingI’ve had to find a new dentist due to several issues with the previous dental practice where I was a patient. I’m 65+ with limited income and feel that my new dentist is trying to upsell me. How can I handle my pushy new dentist? I have all my natural teeth and never had a cavity. I agreed to an oral cancer screening during my exam and cleaning, which I paid for out of pocket.

After the exam, the dentist recommended deep cleaning and filling two teeth with small cavities. I talked to the dentist about my surprise with two cavities, and she said they are tiny but need to be filled right away before they grow. I also asked why I needed a deep cleaning, and the dentist said she recommends it every few years to prevent gum disease. Then she said that if I am hesitant because I have dental anxiety, she can do the work with sedation. I am not hesitant about dental appointments, but I am suspicious about this dentist. How do I know if this extra work is necessary? – Thank you. Angelina

Angelina,

Thank you for your question.

Your concerns are valid. You’ve switched dentists, and now the new provider seems pushy about adding more treatment that you probably do not need.

Although screening for oral cancer is a reasonable precaution, a deep cleaning when you do not have periodontal (gum) disease makes us suspicious, too. And if you have tiny cavities, your dentist can use fluoride treatments or preventive resin sealants to repair them rather than placing dental fillings. Then, your dentist recommended sedation if you are anxious—another red flag for treatment that works well for dental anxiety, but you are not nervous about dental appointments.

What Can You Do If Your Dentist Is Pushy?

If your dentist is pushy and you do not trust them, we recommend looking for another dentist. As a patient, you cannot verify everything your dentist is telling you. But you can look for another dentist and get a second opinion. Ask acquaintances or family members for recommendations on a trustworthy dentist, but please do not continue with a dental practice that makes you feel uncomfortable.

 

Dr. Siny Thomas of Sugarland, Texas, sponsors this post.