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I don’t really think I had five cavities.

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I just started going to a new dentist. I’ve always been really diligent about taking care of my teeth, in part because both of my parents had terrible teeth, with full upper and lower dentures before they turned 60. I don’t want that, so I floss every single day, and I brush at least twice a day, and more often if I’ve had a lot of sugar. I don’t drink pop. My old dentist always used to say what great teeth I have, so imagine my shock when I start with this new dentist and she tells me I have five cavities. Five!

The cavities were all in my back teeth, and the dentist used white fillings to fill them. The problem is that ever since she did that, I have a lot of pain. She tried to adjust my bite, saying it was out of whack, but that didn’t help at all.

I just feel like something is hinky here. I went to my old dentist less than a year ago, and those xrays did not show any cavities. Now with this new one the xrays show five, and that just seems impossible, especially when I take such good care of my teeth. I kind of want to get copies of my old xrays, and copies of the xrays from the new dentist and take them to a different dentist, to see what they think, but I can’t think how to do that without making the new dentist suspicious. Maybe I don’t care if the new dentist is suspicious.

This is really difficult! I never imagined I would have to do something like this.

Anne in Shreveport

Dear Anne,

While being your own advocate is always a good idea in any kind of healthcare, you shouldn’t have to stress over things to this degree. In any case, you don’t seem to have any kind of trust or rapport with this new dentist, so now might be the perfect time to request all your records including xrays so you can switch to a new dentist.

It is possible that the angle of an xray might miss a cavity or two, but five is highly unlikely. The best method for getting an unbiased second opinion is to tell the second opinion dentist that you would simply like an opinion on the dental work that was done. Tell them as little as possible, just let the dental work and the xrays do the talking for you.

The primary concern here is that you are having pain in your teeth. That indicates that the dentist that placed the white fillings may not have used the proper technique and that material has not bonded correctly. A new dentist will work with you to diagnose the exact nature of your pain and work for a solution. A slim possibility is that you have developed a disorder of the temperomandibular joint, and will need to find a dentist experienced with TMJ treatment. The reason this seems unlikely is that your problems coincided with the placement of the white fillings. That would be a pretty strange coincidence.

Seek a second opinion.

Posted courtesy of Grosse Pointe Woods cosmetic dentist Dr. Hadgis.

Fosamax and Dental Implants

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I had to have one of my teeth extracted last month. It was the one immediately next to my left front tooth. My dentist works with an oral surgeon to do dental implants, but when we had a consult with him about doing a dental implant for me, he had strong reservations because I have been on Fosamax for a number of years. So I guess a dental implant is out.

That leave me with a bunch of options I am not very happy about. At the moment I am wearing a dental flipper, and it is driving me nuts. I hate the way it feels and it makes my mouth taste really bad. I Googled “dental bridges” and read about an Encore bridge and a Maryland bridge, but am not sure either of those would work, either. The tooth next to the one that was extracted has a dental crown on it. Would that still let me get an Encore bridge?

My dentist isn’t crazy about the idea of doing a standard bridge because he would have to file down my front tooth to do it. Is that a problem, that you know of? He didn’t really explain why he didn’t want to do that.

Any help would be much appreciated. Thanks,

Gabriel in Vermont

Dear Gabriel,

Taking Fosamax does not necessarily mean you can’t get a dental implant. The risk of local bone problems of a serious nature is slightly elevated when you have oral surgery (involving the bone) and take Fosamax. Though it is a small risk, the problem can be very serious, so you need to take it into consideration. You may be able to work with both your primary care physician and your dentist to suspend Fosamax treatment for a while to get the surgery taken care of.

If you decide not to pursue a dental implant, then a dental bridge is your most viable option. The key with this, as with all dental treatments, is to let your dentist suggest the best type of dental bridge. If you try to push your dentist into doing something he is not comfortable with, you may very well be quite unhappy with the results.

Grosse Pointe Woods cosmetic dentist Dr. Hadgis’ office sponsored this blog post.

Teeth really damaged from bulimia

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I’ve suffered from bulimia since I was 14 years old. Years of counselling have helped me get the disease under control, but my teeth are severely and irreparably damaged. They are only about half the size they should be, and are very thin and chipped. Most of them don’t meet anymore, and where they do, it is not a comfortable fit.

I’ve had a lot of headaches lately, and I noticed that my jaw sticks out when I open my mouth. Is there anything that can be done? The damage just seems so severe. I want to see a cosmetic dentist, to see if he or she can make my teeth look nicer and function better, too. These headaches are really debilitating.

Thanks,

MaryJo in Grand Rapids

Dear MaryJo,

Your instict to work with a cosmetic dentist is a good one. Most experienced, trained cosmetic dentists have the skills to improve your smile. You may have to have bonding done, if your teeth are very thin, so the underlying structures are strong enough to support porcelain crowns.

Your headaches are most likely caused by your misaligned jaw. This is usually called TMJ, or TMJ disorder. Luckily, many trained cosmetic dentists have also pursued training in TMJ treatment. This will involve restoring your bite to its natural position.

The problems you describe are extensive, and will be expensive to fix. You will probably need porcelain crowns on all your teeth. The bright side is literally bright–your smile will be radiant, which is just what you need to move forward into this new part of your life free of bulimia.

Best of luck to you.

This blog post provided courtesy of the dental office of Dr. Hadgis, Grosse Pointe Woods cosmetic dentist.

What is a neuromuscular dentist?

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I am writing because I am a natural born skeptic, and some advice I recently received sounds a little dicey to me. I’ve been suffering for quite some time with headaches and dizziness. I’ve seen three different doctors in the practice I go to, and they’ve each tried something different, and nothing has worked. Now the newest and youngest member of the practice says that I should talk to a neuromuscular dentist.

I don’t even know what that is! He was in such a hurry, and rattled it off really fast, like I should know. I was too embarrassed to ask him to repeat it. Good thing he wrote it on the paperwork. Iwent home and looked it up on the Internet, and all I found was a bunch of letters from people that talked about how badly dentists claiming they did neuromuscular dentistry messed them up! My doctor made this recommendation after he found out that I had lost a tooth shortly before my troubles started.

Is this a reputable field? I don’t even know how to find a neuromuscular dentist. Any help you can offer would be greatly appreciated.

Thanks,

Veronica in Chicago, IL

Dear Veronica,

It is good that you are approaching this with some caution. Neuromuscular dentistry is a legitimate field, but it is not yet recognized as a speciality by the American Dental Association. For this reason, anyone can SAY they do neuromuscular dentistry, whether they have the training or not.

Neuromuscular dentistry is used to treat disorders of the temporomandibular joint, also called TMD or TMJ. This field of study looks at not just the teeth, but the related muscles and functionality of the joints.

It sounds as if your most recent doctor thinks you may be suffering from TMJ. TMJ symptoms include the headaches and dizziness that you are suffering from, and can also include facial and jaw pain, muscle tension in the neck or shoulders, numbness in the fingers or arms, locking or clicking of the jaw, and tinnitus (ringing in the ears).

It is a shame your doctor did not take more time to explain his recommendation and the reasons for it. If you feel comfortable, ask your doctor’s office for a referral to a reputable neuromuscular dentist for TMJ treatment. If you would rather find one on your own, make very sure you check their credentials closely. Look for extensive training in reputable programs, and beware of any that want to offer some kind of quick fix.

This blog post sponsored by Grosse Pointe Woods cosmetic dentist Dr. Hadgis.

Wisdom teeth removal?

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Although I just turned 60 yesterday, up until last week I still had all of my wisdom teeth. The fillings in the top two were broken. My dentist said it would actually be easier to remove the teeth than it would be to repair the fillings, so I went ahead and had them pulled. The procedure went extremely well, with no complications at all.

Now I am wondering if I should go ahead and have the lower two removed before they start causing problems. What do you think? My dentist says I should have an oral surgeon do the removal if I decide to go ahead with it, but I can’t get a good feel for whether she thinks I should do it or not.

Thanks.

Drew in New Brunswick, NJ

Dear Drew,

Your dentist may seem to be on the fence because there should be a reason to remove wisdom teeth beyond them just being wisdom teeth. If your upper extraction went very smoothly under the care of your general dentist, then it sounds like they were not impacted, but normally erupted. This is consistent with you still having them in your 60th year, as impacted wisdom teeth are best removed as early as possible or they can cause complications.

Even normally erupted wisdom teeth can cause trouble, though. As you discovered, it is often easier to remove them than it is to restore them. One consideration you should now think about is whether or not your remaining wisdom teeth could super-erupt and begin to cause problems with the alignment of your jaw. A misalignment of your jaw can cause headaches, and create problems with your temporomandibular joint (TMJ) that will later require TMJ treatment.

In your case, a wait and see approach may be appropriate. If your dentist determines that the lower wisdom teeth are super-erupting and causing alignment issues, or if you start to experience problems like headaches or other TMJ symptoms, it may be best to go ahead with the extraction at that time.

This blog produced courtesy of the office of Grosse Pointe Woods cosmetic dentist Dr. Hadgis.

Porcelain crown work caused inflammation

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My dentist put a couple of dental crowns on my front teeth. Almost immediately my gums were swollen and tender, and nothing he has tried has made them better. It has been months!

I finally got fed up and saw a couple of specialists and another dentist. I saw a periodontist who tried to fix it by treating the gumline. When that didn’t work I switched to a new dentist, who said there was no good way to resolve this issue without causing cosmetic damage to my gums. Today I saw a prosthodontist who essentially said the same thing: that surgery on my gums may or may not fix the problem and that the procedure would probably cause cosmetic damage to the gum area between my two front teeth. He also kept stressing that I HAD to get this treated, and that inflammation of my gums can lead to much bigger problems, and it kind of freaked me out.

I just spent a lot of money to have a nicer looking smile, and now these doctors are all telling me that there is no way out that won’t cause scarring. Can this be right? I am so frustrated!

Amelia in New Bedford

Dear Amelia,

The dental crowns are too deep under your gums. This will not go away, or get better with time. This phenomenon has not been widely publicized in the professional literature, but it is quite disappointing that all of the doctors you have seen have been so timid about recommending treatment.

If at least two professionals are saying there will be scarring, you should resolve yourself that this will likely be the case. That being said, you should get the surgery. This will not improve without treatment, and the prosthodontist was right to issue dire warnings about the consequences of untreated gum disease.

While you are deciding on a course of action, rinsing with an antibacterial rinse like the product Peridex would probably help bring down the swelling, but if you do use Peridex, you should also use Supersmile toothpaste. Peridex causes stains on your teeth, and Supersmile is the only toothpaste we are aware of that is effective in keeping stains from forming.

This blog is maintained courtesy of the office of Dr. Hadgis, Grosse Pointe Woods cosmetic dentist.

No insurance and no job, with serious tooth infection

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I am writing to see if you can point me in the right direction. I am new to the Detroit area, with no job and no insurance, and I have a serious infection in my mouth. I am missing several teeth in the back on the right hand side of my mouth. The one remaining molar seems to be infected. The gum right underneath it has a huge swelling, and is very painful and tender to the touch.

I am a college student, and don’t have any family that could help out with this. Are there resources or agencies that can help with emergency dental care?

Thanks for you help,

Lily in Detroit

Dear Lily,

You are in a challenging position. Before offering some suggestions as to how to proceed, first read through what NOT to do.

Do NOT take an antibiotic for the infection without also having the tooth treated. You are correct that the source of the infection is inside the tooth. Oral or injected antibiotics travel the bloodstream to reach areas of infection, and therefore cannot reach the source of this infection. If you take an antibiotic without also treating the source, you are simply leaving behind drug resistant bacteria and not addressing the source of the infection at all.

Please take this infection very seriously. Infections in the jaw and teeth can migrate to the brain and cause infections there, or to your throat, making eating and even breathing very difficult. Even though you don’t have insurance, you must find a way to get this treated. Begin by contacting local social service agencies, and asking them to give you the names and contact information of local dentists that work with patients in financial need. You don’t say where you are going to school, but a potential source of emergency dental care might be the local dental school. The best solution would be a root canal treatment, but if you can’t afford that, at least have the tooth extracted.

When your fortunes improve, as they will when you complete college, you should strongly consider dental implants to replace some if not all of your missing teeth. Over time, the bone of the jaw at the site of missing teeth begins to be reabsorbed into the body. This can lead to a situation called “facial collapse“, which can make it impossible to wear any kind of dentures.

This blog produced courtesy of the office of Grosse Pointe Woods cosmetic dentist Dr. Hadgis.

Serious TMJ Disorder

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I found this blog because I was looking for information about TMJ. I could really use some expert advice, and unlike some of the dentists I have dealt with in the past, your credentials seem impeccable.

Even though I am only in my early thirties, my teeth are a mess. I have a long-standing teeth grinding habit that forced me to get porcelain crowns on all my teeth 10 years ago. I’ve come to understand that the crowns were not well done. They are ugly and fake-looking, and my bite is completely screwed up. My jaw is crooked, and even my gums are messed up from poor placement of the crowns.

I need help, but my past experience has me really nervous about choosing a professional to work with. From what I can tell, I think I have to choose a cosmetic dentist or a prosthodontist. Now I read about this “neuromuscular dentistry” through your website. Your page says that is not a specialty, but should I look for someone like that to help me with my alignment issues?

I’ve spoken with an orthodontist, and he said that since my case is so complicated I should talk to a prosthodontist. I don’t know what to do at all.

Calvin in Grand Ledge

Dear Calvin,

As you have discovered, there is not a legally distinct speciality in neuromuscular dentistry, and this means that anyone can say that they provide this type of treatment, regardless of their training. You are on the right path, making sure you are checking into details of training and experience. This is the only way to establish whether or not a dentist can provide this type of treatment, which is in fact what will probably help you most.

And you don’t have to choose between the way your teeth look and the way they function – with the help of the right professional, you can have a beautiful smile that works beautifully, too. The key will be to find a dentist that is experienced and educated in both cosmetic dentistry and in TMJ treatment.

Grosse Pointe Woods cosmetic dentist Dr. Hadgis supports this blog as a courtesy service.

Can tooth pain be diagnosed in just a few seconds?

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I am struggling with a lack of confidence in my dentist. She has never had a great chair-side manner, and during my last visit she was abrupt to the point of rudeness. I went in to see her because one of my molars has become sensitive to heat, cold and air. This molar has a really large filling in it that has been in place for about 10 years. I have braces on right now, too, and wondered if this might have somehow caused the sensitivity. I would have asked my dentist about this, but she never gave me the chance.

She walked in, asked which tooth hurt, and then blew air on the tooth in question a few times. She asked if it hurt, and when I said that it did right after she blew the air, but that it didn’t linger. She put some kind of gel on the tooth and said that it would probably heal on its own, but if it got any worse to make another appointment.

I don’t even really know what is wrong with my tooth! She barely looked at my tooth. I thought she would try to determine if the filling was leaking or something, but other than the thing with the air and the gel she didn’t mess with it. What should I do? My tooth is no worse, but it is no better either, and I don’t want to waste my time and money going back to my dentist if she is just going to do the same thing over again. Please help.

Hilary in New Mexico

Dear Hilary,

Dental pain issues are sometimes fairly easy to diagnose, and from what you describe, the probable issue with your tooth was pretty straight-forward. In your case, if the pain had lingered after your dentist blew air on it, that would have indicated that the nerve (also called pulp) of your tooth is irritated, but could possibly heal on its own. If the pain had lingered for more than a few seconds, that would have indicated the need for a root canal treatment. Pain that lingers indicates that the damage to the nerve is irreversible. If you do ultimately wind up with a root canal treatment and the tooth already has a large filling in it, your dentist may suggest a dental crown to protect the remaining tooth structure.

The greater issue here is your lack of trust in your dentist. Good dental care is only possible when you can really trust your dentist, and have an open, communicative relationship. Consider looking for a new dentist, one you can talk to, and one you can trust.

This blog is produced courtesy of Grosse Pointe Woods dentist Dr. Hadgis.

Dr. Hadgis Receives Prestigious IACA Award

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We are pleased and excited toannounce that Dr. Theodore Hadgis has been chosen to receive Aesthetic Eye Best of Show award at the International Association of Comprehensive Aesthetics International Congress, held this year in Boston, MA.

The purpose of the IACA is to better humanity through the exchange of knowledge and expertise of doctors that practice aesthetic dentistry. The organization strives to remain dynamic and serve to fuse contributions from multiple disciplines that strive to assist mankind in achieving health and beauty.

See the page of Dr. Hadgis’ awards and achievements for more information.

Dr. Hadgis is also a preeminent provider of treatments for TMJ issues. See our website for more information.