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broken tooth

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Summertime dental care: the story of how I broke my tooth 3 times in 3 months

girl reaching up at a treeLet me tell you a story about the girl who loved summer. The year I turned nine years old I gained most of my height. Since I am now six feet tall, I was, shall we say, awkward that year. I towered over my friends and siblings and my third grade teacher, who was five feet tall in two inch heels.  I stubbed every toe I have, badly, repeatedly. I possibly needed stitches, but it happened so often that I never bothered to tell my mother. We’d have been in the hospital daily if I had told her, so I just never did.

To try to help me get over this awkwardness, my mom signed me up for soccer. Her best friend was the coach. It did help with stubbed toes, but I was still a major klutz. Oh, it was embarrassing. I dropped things, ran into open cabinet doors, tripped over completely flat surfaces, barked my shins on every single piece of furniture, and hit my head on all kinds of surfaces while getting used to my height. In short, I accidentally hurt myself a lot and occasionally others all summer long. I also broke my front tooth three times in three months, that summer. Yes, you read that right. Three times in three months. Broken. In half. My dad was pissed.

The first time I broke my tooth, I was swimming. There was a big community pool not too far from where we lived and mom would get us all (there were five kids in my family, plus we usually took half the neighborhood kids too) together and we’d walk down with a picnic lunch to spend the afternoon someplace that wouldn’t mess up the house.

Girl wearing swimming goggles missing front teethThis is the first time I used ever the words ‘Hey you guys! Watch this!’ My awesome trick dive took me from the diving board straight into the cement on the side of the pool. I can’t remember the particulars because I might have scrambled my brains along with breaking my tooth. It takes a certain amount of talent to be that klutzy. I can remember that was the first time my mom said, “Well, it’s just your tooth, God watches out for fools and children.” I knew she thought I was both. The first time the dentist fixed my tooth, it looked perfect. You couldn’t even tell that it had ever been broken.  He did such a good job. It was painless too. I wasn’t scared at all. Little did he know, muahahah.

The second time that I broke my tooth, I was at the park. I mentioned that I have four siblings, right? Well, as the oldest it was my job to help my mom keep track of the babies. That meant that mostly, I kept the three and four year olds entertained. As part of my big sister duties I usually helped them to go down the slide. Since this was in the eighties, the slide was a big, burning hot, sheet-metal monster. If you didn’t put a towel down to protect your legs, you could get third degree burns from going down it.

That never stopped us from wanting to play on it though,so I was trying to get my little sister situated on her towel at the top of the slide. There was a bar across the top of the slide that you had to duck under to go down it. I think the bar was supposed to be for safety, so that if you were standing at the top you would have a railing to hold onto so you wouldn’t fall. As I bent over to help my sister, I totally hit that bar with my face. I’m lucky that I only broke the one tooth, because I nailed it like a martial arts guy breaking a stack of bricks with his head in a cartoon. My dentist was disgruntled, but still did a good job fixing my tooth. I barely remember going.

Girl sliding down a slide, missing front teethThe third time that I broke my tooth, I was at a friend’s house. Her parents had just bought a giant trampoline to keep their kids occupied over summer vacation. It was my first time on a trampoline and I had a blast. We played all kinds of games, including ‘Crack the Egg’. Crack the egg is a game where one person curls up in the fetal position in the middle of the trampoline and all of the others jump around that person trying to get them to unfold.

Now, it wasn’t the game that got me, but in retrospect, I shudder to think what could have happened. At one point I realized that I needed to, um, relieve myself, so I announced that I needed off the trampoline and then proceeded to disembark. Bad idea. I should have waited until I got everyone’s attention so that they could stop jumping first. I didn’t do that though.

No, while everyone else was occupied trying to get one of my friends siblings to ‘crack’ and jumping with all their might I sat down on the edge in preparation to jump off. Just as my feet touched the metal edge of the trampoline someone bounced right behind me. My body moved but my feet didn’t. I did a face-plant right into my knee. My friend’s parents were horrified and the doggone dentist was so upset with me that he gave me quite a talking-to and fixed my tooth with the warning that this had better be The Last Time.  My parents were on his side. I was no longer allowed on my friend’s trampoline. I felt very put upon to be excluded from the fun because of the tooth.

The moral of this story is: You don’t ever need to do anything that starts with the words “Hey you guys! Watch this!”, watch out for things that you might hit your face on at the park or elsewhere, and for heaven’s sake, when getting off a trampoline, get everyone to stop jumping first. Your dentist will thank you. Have a safe and fun summer everyone!

Guarantee on my work

LawyersUm, there are no guarantees in dental work. This is why we have you sign consent forms at the beginning of every appointment. If you read the consent forms before you sign them, then you know that they say that unforeseen things happen sometimes and we can’t be held responsible if it does. Of course, that’s the lawyers-eye view, right?

The customer service view on guarantees is the exact opposite and a lot of the time that’s all that you hear from a company, until you need to use that guarantee and get told to take a hike. Since we all know that neither position is strictly the truth, finding out if what you need fixed is covered can be a pain. Especially since a lot of doctors are doing their best for you, and just don’t want to think that their work could possibly cause you any problems at a later time. Denial, it’s not just a river in Egypt.

ClockThis subject has been on my mind recently, because we had a patient call back and accuse doctor of not doing a good job on a filling and wanted it fixed for free. The problem that we have, though, is that she had this filling done three years ago. In the last three years we haven’t seen this patient. She never came back for a cleaning or a check up or an x-ray. She never called to say she was having a problem. Since we can’t control your dental hygiene, what you eat, or random accidents that you may have, we really don’t feel responsible for any problems that you have after this length of time.

So what is a reasonable time frame for free-of-charge replacement dental work if something goes wrong? Generally, at our office, if you had a filling, crown or denture break within one year after we made it, then we’ll replace it free of charge with no argument.  Even if we think that it’s your fault that your dental work broke, we know that one year isn’t a very long time and we’d rather that you be happy than be right.

If you want something replaced after one year, but earlier than two years after the original date of service, then you need to have a really good reason why you think this was our fault. You also need proof (such as an x-ray taken around the time of the original placement). We’re not trying to cheat you, we just can’t give away our valuable services for free every time someone has a dental problem that has been to our office before and doesn’t want to pay for replacement work.

Business man wearing remindersWe know that you paid a lot of money for your dental work the first time around and it can feel like a raw deal if something goes wrong with it in just a few years. The problem that we have with this view point is that it doesn’t take into consideration that you have some personal responsibility here too. You don’t get more than a one year warrantee on even major purchases such as a TV or other appliance. Like dental work, they can be very expensive to replace. However after about a year, you can no longer say that it was the fault of the manufacturer that it broke down. It’s the same with dental work. You’ve had it, you have used it, you haven’t complained of a problem. After a certain amount of time…well. I’m sure you get the idea.

If you have a problem with your dental work before your year is up, you need to contact your dental office right away. If you wait until after the year is over then as far as your dental office is concerned everything was done right and you broke it. You need to call the office, tell them, schedule an appointment, get an x-ray and then have it fixed. Saying that the problem has been going on for a long time will not cut it if you waited for three years. You’re going to have to show proof. This is one area where communication is key. Don’t wait to tell your dentist what you need fixed on your dental work until you are having severe pain and discomfort. Waiting too long might mean the difference between you paying or not.

 

Easter Eating

Girl with an Easter basketEaster is another one of those fun holidays that revolves around eating and eating candy (who doesn’t get a bunch of candy for their kids on Easter?). Just like at Halloween it is very important to keep good dental hygiene when candy consumption is increased.

Three things to keep in mind are:

Don’t bite down on hard candies. Hard candies break teeth every single year. There is always at least one person that shows up the Monday after Easter at our office with a broken tooth. Don’t let that be you.

Jelly beans are yummy, but they also have the consistency of glue. Be very, very diligent about your brushing and flossing after eating gummy candies.

Brush your teeth about half an hour to an hour after eating candy. This will reduce the amount of sugar that rests on your teeth feeding harmful bacteria and creating cavities. If you brush your teeth right after eating, especially if you are eating something high in sugar or acid content (such as lemon, soda, tomato, salad dressing, etc.) you could be brushing away your enamel. So wait a little while to brush, but not too long.

Following these simple steps can help you maintain a healthy mouth through the holiday and throughout your life. Remember that a healthy mouth is a happy mouth. Happy Easter from all of us at Dr. Chae’s dental office!

What to do when you have a toothache (part 3)

dental check upAct

In part three of this series, we are discussing the final step to take when you have a toothache.  There are really only three options that you have once you have had your consultation. You can choose to do nothing, you can choose to get a second opinion, or you can choose to begin treatment either in full or in part. Sometimes due to fear of dental treatment  or financial concerns people choose not to move ahead with the treatment that the dentist prescribes, but also do not get it done at another office.

Occasionally, when people come for their consultation, the dentist will prescribe a course of antibiotics to be completed before dental work is begun. When the antibiotic takes effect and the pain goes away, the patient assumes that the problem is taken care of and then they don’t come back to complete treatment.  This is a mistake. Yes, dental work is uncomfortable and sometimes costly. No, you should not ignore your problem just because you have a co-pay or a fear.

prescription for antibioticsWe know. The antibiotic took care of any pain or swelling, BUT this is a temporary effect. If you need a tooth extracted/filling/root canal/crown the problem will not be solved by taking antibiotics it will only be delayed. These treatments are typically needed when a patient has decay.

Decay means that your tooth is compromised and additional treatment is needed to fix the problem. Antibiotics take care of infection only and if you put off treatment because you are feeling better, you could cause yourself serious harm. Teeth and bone do not regenerate. Cavities don’t spontaneously heal. Broken teeth won’t recover no matter how long you wait. You must go to the dentist and have him fix the tooth if you want to keep the problem from getting worse. There is no way around this.

The consequences of not acting on the dentists recommendations is that you could lose your teeth. When you leave an infection or decay alone and take no steps to fix the situation you open the door for further damage to your teeth and health. Maybe you think that this is just dental office rhetoric and you won’t have the problems that I’m describing. You would be wrong. I’m not overstating the problem. If anything, I’m understating it since decay and infection have a tendency to spread.

I can’t tell you how many times a patient has come in and the dentist says that they need a cavity filled. The patient never comes for their filling appointment and then a year later when they are having pain again, they come in and need a root canal and crown on the tooth that originally needed a filling and fillings, root canals and/or crowns on the teeth surrounding the originally compromised tooth.

Jar of MoneyFillings run between $150 and $250. Root canals run around $800 and crowns run around $1200. The patient could have saved themselves pain and 10-20 times the money by getting the filling done. If you need a payment plan, ask for it. If you need a Valium to calm your fears, ask for it. Do what it takes to get your teeth taken care of while the problem is small because the problem will only get larger the longer you wait.

If you are not sure that you trust your dentist’s diagnosis, then for heaven’s sake, go get a second opinion. Or even a third opinion. Every dentist has a different degree of talent. Some do very well at one thing and suck at another. If you have ever been to more than one dentist then you know what I’m talking about. The point is that you take care of the problem and that you are comfortable that your treatment plan is the best fit for your health and your wallet.

If you find that you are getting the same treatment plan from your regular dentist and a new dentist, but the cost is less at the new dentist, you can ask your original dentist if he will be willing to price match. As long as you bring in a written copy of the treatment cost estimate by the second dentist and it is for the exact same treatment, often we are willing to meet or beat their pricing.

We want to preserve our good relationship with you.   Like any other customer service based organization, the patient may not always be right, but you are always important. What you think of us matters. Because you matter we will sometimes take a hit to our bottom line if it means that you are satisfied with our service. Without you, we would not be here. We know it and plan accordingly.

 

 

What to do when you have a toothache (part 1)

healthcare workersPersonally, I hate to go to the doctor. I do not like to pay for healthcare. It’s not really fear of what the treatment will be or even the cost to my budget, although there is a small element of that. It’s more that I’m certain that I should just be healthy and not have to put up with sickness and I don’t have time to be sick anyway.

I think this attitude goes back to my childhood. Mom was always angry with any of us who got sick. She took any failure to remain healthy personally. One time, my brother waited 2 weeks to tell her that he had broken his ankle because he didn’t want to upset Mom. The crazy part is that he walked to school each day. He’d rather endure the pain than the lecture. Mom’s lectures were both infamous and endless.

Because of this I tend to wait until there is absolutely no other choice than to go to the doctor. The benefit to this is that emergency room personnel see you immediately. No hours-long waiting for me! The down side is that I’m usually in a lot, a lot, of pain by the time I get there.

Assess

hot cup of teaThe thought of going to the dentist only to be told that there is nothing wrong with you is so very frustrating. To make sure this doesn’t happen, you can ask yourself the questions that the dentist will ask before you come.

This does two things. First, it causes you to think about whether you need to go to the dentist or not. Second, it gives you a good idea of what you actually need and enables you to clearly communicate it to the dentist. If your pain is quick to come and go, then you might just have sensitive teeth. If you have pain that lasts longer than five minutes, then you might need to see your dentist.

Does the pain come with hot, cold, sour or sweet foods? This could be sensitivity, which you can resolve by using Sensodyne toothpaste. It could also be an indication that you need a cavity filled or a root canal. Your dentist will know which treatment is best for you.

Which tooth is the origin of the pain? Since the nerves in your jaw are connected to the nerves in your teeth, this question can sometimes be hard to answer correctly. You should think carefully and try to discern which tooth is the one that is hurting because if you come in and have a tooth x-rayed that is not the one that is painful, then of course the x-ray isn’t going to show what is wrong. Did your recently break or fracture your tooth? Is there an abscess? The location of a broken, fractured or an abscessed tooth is a good indication of where your pain is coming from.

sick girlDo you have a sinus infection or cough? Sometimes these conditions aggravate the nerves in your teeth, without actually causing an infection or damage to your teeth. If you have a sinus infection or a cough that is affecting your teeth, then you should see your medical doctor to take care of the symptoms before rushing to the dentist. The dentist cannot prescribe you an anti-biotic for any reason other than tooth infections. Only your medical doctor can correctly diagnose and treat a sinus infection or cough.

By clarifying what exactly is the problem in your mouth you will know whether you need to see a dentist or not. You will also know what you need to talk to him about. It’s better to go into the office with a clear idea of what is going on.

On a final note, if you have severe swelling, pain or both then you should go to your dental office immediately as these are signs of a serious and life threatening infection.

Movie star smiles

star ornamentEveryone wants great teeth. A beautiful smile can add so much to your appearance. People who have white, straight teeth tend to smile more which makes them look younger and happier. Not everybody was born with a perfect set of choppers though. There are all different kinds of things that can cause you to smile with your mouth closed.

Diastema

A diastema is a space between your teeth that is extra wide. Usually found between the two front teeth. Some people like their diastema and feel that it gives their face character (think Lawrence Fishburn), but others don’t want their friends to notice. This can be fixed a couple of different ways. The first and easiest way is for your dentist to do a cosmetic filling on the separated teeth. This works pretty well if you have relatively small teeth. However, if your teeth are already large then you might not like the look of the filling which widens the appearance of your current teeth. This is the most inexpensive way to fix a diastema.

girl with bracesThe second way to fix this problem is with orthodontics. Braces move your teeth into the optimum position. This is less invasive than fillings or veneers because it doesn’t change the shape of your actual teeth. This works well only in certain circumstances and only your dentist can tell you if it right for you. Financially this is the middle of the range, but this procedure cannot be done for all patients.

The third way to fix this problem is through veneers or crowns. Without trying to move the teeth your dentist creates a cap or veneer to cover the tooth. This works a little better than the fillings because it involves reshaping your current teeth to fit within the space in your jaw and can decide the size of each crown with you before placing them. The drawback to this way of fixing a diastema is that it is expensive and since it is cosmetic, your insurance will likely deny payment. This is the most expensive way to fix a diastema.

Crooked or crowded teeth

Crooked or crowded teeth can be embarrassing. Orthodontic treatment smiling manis the way that this problem is fixed. Since ortho treatment typically takes years (as in, more than one year and usually more than two years) it is very important to choose the right orthodontist for you and your family. We recommend that you visit at least three orthodontists before committing to treatment. Many orthodontic offices also have payment plans to make the expense of getting braces easier to bear.

Yellow or stained teeth

If staining and yellowing of the teeth is the only thing holding back your hundred watt smile, then hey! Lucky you! This is a very easy fix! Make your cleaning appointment at your dentist and then choose your method of whitening after that. There are a number of great options to whiten your teeth including Crest Whitestrips, at-home whitening trays, and in-office whitening treatment.

Smiling womanVisible cavities

Ooo, ouch! Get those cavities filled, friend! If you have insurance then cavities are likely covered at 80%. If you don’t have insurance, you could try applying for CareCredit to make payments on your health expenses. If neither of those options works for you, then call your dental office and ask what your payment options are to get your teeth fixed.

Chipped, missing or broken teeth

So, this is a bit more expensive than the other options. If you have insurance it might partially cover this work. Chipped and broken teeth can sometimes be fixed with fillings, but more often you need a crown to cover that. And if you broke your tooth down to the gumline or are missing a tooth, you could do either a bridge or an implant. These treatments can wander over into Big Money territory, depending on what you need and what you choose to do.

Phantom pain

crying baby

photo credit: Nathan Phillips via Flickr

When you have pain and go to the dentist you expect that he will be able to do something for you. It’s so frustrating when your teeth hurt and the dentist can’t find anything wrong in the x-rays! But what can you do? You can’t make the dentist work on your teeth if he doesn’t see anything wrong!

There are some things that you can do to make sure that doesn’t happen. The first thing is to think carefully about where the pain is. Sometimes you feel pain in a generalized area and mistake which tooth is actually hurting. The nerves of your teeth are connected in your jawbone and when one becomes inflamed, it can cause the other nerves to give you pain signals as well. If you have the dental assistant x-ray the wrong tooth, then of course, it’s not going to show a problem. Or even worse, maybe it does show a problem, but since it’s the wrong tooth you still have pain! You got the work done and no relief.

phantom of the opera

Photo Credit: Monique Wingard via Flickr

The second thing that might be causing you trouble is your sinuses. If you are prone to sinus problems, when they start to act up you could have pain in your upper teeth. It can be particularly bad pain when your tooth is embedded in the sinuses. An x-ray will show if any of your teeth are overlapping your sinuses, but usually, there is nothing wrong with the teeth themselves. The way to resolve this sort of toothache is to take sinus medication (This happens to me all of the time. I speak from experience.).

If you have a bad cough, this could also cause you tooth pain in your lower teeth. The reason for this is that there is a nerve at the base of your throat which connects to your lower teeth. When you cough hard and repeatedly this nerve sends a pain signal all along its connections. There is likely nothing wrong with your teeth in this situation. As with the sinus problems, taking care of your cough will stop the tooth pain.

hot coffee can cause sensitivitySensitivity to hot, cold, sweet or sour foods could also cause you teeth pain. If you have sensitive teeth, we recommend that you use Sensodyne toothpaste and avoid foods that might trigger pain. Sensodyne’s Pronamel toothpaste remineralizes your teeth which is how it reduces your sensitivity. As your dentin is built up, your nerves are less exposed to temperature and sweet or sour foods. Over time you should be able to add these things back into your diet.

Sometimes if you have a filling or crown that has fractured but didn’t break, you could have pain. This might or might not show up on an x-ray. If it doesn’t show up on an x-ray, sometimes it will show up visually but often times you only have your pain to go by. Talk to your dentist about whether or not it could be a fractured filling or crown.

Another thing that could cause your teeth to hurt is grinding and clenching your teeth in your sleep. Eventually, this will cause you to have teeth problems due to breakage. It might not show up right away, but this will eventually put enough stress on your teeth to cause fractures, grinding down of the chewing surface and cavities. If this is the cause of your dental pain, then you can have your dentist make a mouth guard for you. You wear it while you are sleeping and unable to stop yourself from grinding your teeth. It protects your teeth and keeps them from breaking.

ice water can cause sensitivitySensitivity can also be caused by using a whitening treatment. Even if you didn’t have sensitive teeth before whitening your teeth, you could have sensitivity afterward. Typically, this sensitivity will only last a few days, but it can linger depending on the depth of your treatment. Those who already have sensitive teeth should avoid whitening their teeth as they will have pain afterward.

Finally, you should trust your body. If none of the scenarios I’ve mentioned fits the description of your pain, don’t give up. If your dentist can’t figure out what is wrong, get a second opinion. Dentistry is an art as much as a science and it involves a lot of trust on your part. You shouldn’t feel that you have to just live with pain. Sometimes if your doctor just can’t see what’s wrong, someone else can. It all depends on what sort of dentistry the doctor was trained in and what he usually sees in his office appointments. One dentist might be perfect for fillings, but terrible at extractions. And vice versa. Just like there are varying degrees of ability for singing, there are varying degrees of ability for dentistry. As a final thought, some things are negotiable and some things aren’t. If your dentist uses words like ‘must’, ‘have to’, and ‘unavoidable’ then you are likely to get an estimate that is similar, if not exactly the same, from another dentist.

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