Questions answered by our expert: Arvanitis and Associates 2008-11-20 05:07:28 http://koolfm.com/experts/view/all/ 2008 Kool FM First of all you must see a dentist and have your situation addressed. Don't worry too much about the cost. Let the dentist know you are on a tight budget and I'm sure they will be able to work out something affordable for you. To date I have rarely if ever treated anybody with gum disease who was not a smoker or previous smoker. A dentist knows from the minute they see periodontal disease that smoking is involved. So as a previous smoker now is the chance to clear up the damage of the past and begin anew. Congratulations on kicking the habit. http://koolfm.com/experts/view/dental/arvanitis-and-associates/ http://koolfm.com/experts/view/dental/arvanitis-and-associates/ 2008-04-28 08:00:00 EDT Up until the re-treatment of the root canal it seems that everything has been tried to save this tooth. At some point a frank discussion should be had regarding what other options you have. It would seem that this is that point. Please keep in mind that I am commenting without seeing a radiograph or having examined the tooth in question, but you do have other options. How much money do you want to spend on one tooth when no one will guarantee you that even with a second re-treatment you will still have this tooth in 5 years? Sometimes treatment options come down to a matter of money. If cost is no object and you want to try every possible treatment to save the tooth then by all means treat it again. If however you want the treatment that has the highest probability for long term success then you should ask specifically whether a second re-treatment will meet this objective or is it a maybe. If the answer is maybe then it is my opinion you should consider other treatment options. http://koolfm.com/experts/view/dental/arvanitis-and-associates/ http://koolfm.com/experts/view/dental/arvanitis-and-associates/ 2008-04-28 08:00:00 EDT Whitening may even out the difference between the white spots and the adjacent tooth areas. There are times though where the white spots whiten further and the effect is white teeth with whiter spots. There are other non invasive treatment also available to help deal with these hyper-calcified areas. One treatment is enamel abrasion. A light buffing of the surface can eliminate the spots that don't go too deep. If none of these things work then you may have to consider some conservative bonding or porcelain veneers. http://koolfm.com/experts/view/dental/arvanitis-and-associates/ http://koolfm.com/experts/view/dental/arvanitis-and-associates/ 2008-04-28 08:00:00 EDT There are many options available today to help apprehensive patients. There is Nitrous Oxide sedation which involves breathing in this gas. The patient becomes lightly to moderately sedated and can then have treatment completed. It's benefit is that it works immediately and also stops working immediately so you leave the office feeling normal. For more extensive work there is oral sedation, administered as a pill. This generally takes time to wear off so adult supervision is required after the appointment as well as a ride home. This form of sedation is slightly deeper than the Nitrous Oxide. Also available are deeper forms of sedation such as Intra-venous and general anesthetic. It is best to seek out a dentist who works with sedation to find out which type would be best for your daughter. As for dental insurance it is currently illegal for a dentist to accept only the 80% without collecting the 20% co-pay. The reason this is considered to be fraud is that if a dentist bills insurance $100 and they pay 80% or $80 of it and the dentist fails to collect the 20% or $20 then it is assumed that the dentist only meant to be paid $80. Therefore he must have over-billed the insurance company in order to get them to pay 100% of his charge. This is clearly considered fraud as he billed $100 for an $80 procedure. If all he wanted was $80 he should have billed the insurance for $80 and they would have paid 80% of that. The law does not consider his 20% gift to the patient as doing them a favor but as a fraudulent cash grab from the insurance. This is why it may seem like only a couple of dollars to you that the dentist could surely afford to not collect but to the dentist it means the difference between committing a crime or an honest charge. So be prepared to pay the 20% co-payment. Beyond this there are many ways to deal with financial issues. Once a full exam has been completed the full extent of treatment can be determined and all associated costs. Insurance estimates can then be made so that you clearly understand what will be covered and what won't be. Then a payment plan could be set up to deal with the amounts not covered by insurance. There are always solutions that can be worked out so don't let financial or anxiety concerns interfere with seeking care. The longer you leave the problem the more costly it will become. At my office we offer both nitrous-oxide and oral sedation and have access to specialists who perform intra-venous and general anesthetics if necessary. We also offer a dental card that allows three months with no interest to pay for all treatment. This allows you to not have to pay out of pocket and to be able to apply insurance payments to your bill once they come in. Longer term low interest payment options are also available if needed. Your daughter doesn't need to worry and neither should you. There are solutions. http://koolfm.com/experts/view/dental/arvanitis-and-associates/ http://koolfm.com/experts/view/dental/arvanitis-and-associates/ 2008-04-28 08:00:00 EDT A common thinking process is that since baby teeth are unimportant since they are just going to fall out anyways. The reality is that those first teeth are very important. Not only does your child need them to in order to be able to eat, smile and talk they also are used to hold space for the permanent teeth that will eventually replace them. Premature loss of the first teeth allows adjacent teeth to shift into the spaces creating crowding when the permanent teeth start to come in. Additionally allowing your child to suffer with a bad tooth and then finally going to the dentist to have it pulled, sets your child up for a bad dental experience which can lead to a lifetime of fear. This can lead to a lifetime of dental trouble and eventual loss of their teeth. Regular checkups is the key to prevention. http://koolfm.com/experts/view/dental/arvanitis-and-associates/ http://koolfm.com/experts/view/dental/arvanitis-and-associates/ 2008-02-26 08:00:00 EDT A root canal procedure is a treatment used to clean and disinfect the nerve or pulp tissue from the inside of a tooth if that tissue has become diseased. There are many reasons why this might occur. Decay, trauma, dental work, long term sensitivity, and aggressive clenching are some of the most common causes. When the pulp becomes inflamed and swollen the pressure created can disrupt the blood flow to the tooth resulting in the death of the pulp. Alternatively bacteria from a cavity or advanced periodontal (gum) disease can infect the pulp chamber and cause an abscess. In either case the treatment is called Root Canal Therapy. A tooth is held into the jawbone by 1-3 roots, depending on the tooth. Inside each root, is an area called the pulp chamber. Once diseased your dentist will have to clean this area, disinfect it and then seal it with a special filling material. This in a nutshell is what is involved in root canal therapy. The root canal procedure is a relatively painless procedure and many patients are relieved when the tooth no longer hurts them anymore. This procedure is also a necessary procedure in order to save the tooth. If an abscessed tooth is left untreated, other dental problems can occur such as bone loss, swelling, and severe toothaches. http://koolfm.com/experts/view/dental/arvanitis-and-associates/ http://koolfm.com/experts/view/dental/arvanitis-and-associates/ 2008-02-26 08:00:00 EDT Implant treatment is one of the most life changing treatments in dentistry. For people who have lost their teeth, implant therapy provides a second chance to take eating and smiling for granted again. For those who have lost even a single tooth, the ability to replace it without damaging adjacent teeth is a modern day miracle. Studies have shown that when implant patients were asked if they had to do it all over again, over 90% said they would. What are Dental Implants? Implants are titanium root replacements that are surgically placed into the jaw bone and used for supporting prosthetics. Usually they are shaped like the root of a tooth and placed in bone but implants can also be custom fabricated to fit over the jaw bone. They are not a new or experimental procedure as hundreds of thousands of implants are placed every year and the procedure has been around for over 30 years. Can anyone have implants? There are very few contra-indications to implant placement. They can be placed in elderly people as well as young people. They are indicated wherever a tooth has been lost. If the tooth has been missing for a long time the volume of bone required to place the implant may not be sufficient and reconstructive bone re-growth surgery will also have to be performed. How long do they last? The exact longevity will vary from person to person, but most studies show average survival rates in excess of 90% after 15 years. How much does it cost? Implant costs vary depending on how many are required and what type of prosthesis they are supporting. Two implants holding down a denture can start as low as approximately $3500- Replacing a single tooth compares favourably to the cost of a porcelain bridge. A custom treatment plan tailored for your specific requirements can only be discussed after a full examination. http://koolfm.com/experts/view/dental/arvanitis-and-associates/ http://koolfm.com/experts/view/dental/arvanitis-and-associates/ 2008-02-26 08:00:00 EDT Many people experience a toothache late in the evening, the middle of the night, or just before they are about to leave on vacation. This is why it is absolutely crucial that you have regular examinations and cleanings so that the toothache can be prevented in the first place. However even with the best of care and intentions toothaches still happen. So what can you do? First of all don’t wait until a small toothache becomes a big one. Call your dentist right away and have it checked out. It is much easier to treat a dental problem when it is diagnosed earlier than later. If you ever find yourself in a situation where your tooth is hurting and you are not able to see a dentist right away, you can relieve the toothache by placing clove oil on the tooth. Clove oil is available at most pharmacies and is a natural sedative for the nerve in your tooth. You do not need to drown the tooth in clove oil for it to work. All you need to do is take a Q-tip and dip it into the clove oil. Dab the Q-tip on a piece of sterile gauze to get the excess oil off the end. Then place the Q-tip on the tooth and swirl it around the tooth. You should begin to feel some relief. Repeat as necessary. You will also want to take some over the counter pain reliever, such as extra strength Acetaminophen (Tylenol) or Ibuprofen (Advil, Motrin, Excedrin) at the recommended dosage even if the toothache is not too bad. It is very difficult to get a roaring toothache under control when it is at its peak. By taking the pain medication early, the medicine will work throughout the day and evening to keep the toothache at bay. If you are away from home and a dentist is not available then it is a good idea to at least call your dentist from wherever you are. Prescriptions can be faxed or phoned in to a pharmacy near to you, even if you are in a foreign country. Most dental infections require treatment with antibiotics and the sooner you get started the faster the toothache will go away. http://koolfm.com/experts/view/dental/arvanitis-and-associates/ http://koolfm.com/experts/view/dental/arvanitis-and-associates/ 2008-02-26 08:00:00 EDT