Thanks, Clara

Dear Clara,

New guidelines were released over the past few years regarding antibiotic use for dental procedures with a joint replacement. Antibiotics should at least be taken for the first two years following a joint replacement procedure. Those patients with total joint replacements who are immune compromised should most likely take antibiotics before dental procedures for a lifetime. It is definitely vital to avoid situations, like invasive dental work, where bacteria can enter the bloodstream causing an infection unless antibiotics are taken. We recommend you discuss this matter with your orthopedic surgeon to determine your risk factors. Over the last couple of years some orthopedic surgeons have allowed some of their patients to discontinue the use of antibiotics before dental work while others have made it mandatory for the patients to continue to pre-medicate before their dental work. The reasoning is based on the patients’ health and risk factors.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist

Thanks, Madison

Dear Madison,

We can’t tell you how important it was for you to wear your retainers’ right after getting your braces off. Our teeth tend to want to go back into their original position after braces and this is why a retainer is necessary. Even though you are attempting to wear your retainer we advise you to see your orthodontist because you may be causing some improper movement. If your teeth have shifted just a little your orthodontist may be able to put you in some different retainers and correct your bite once again. On the other hand if your teeth have shifted a lot you may be needing more then just a retainer to fix the problem.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist

Thanks, Pearl

Dear Pearl,

Laser whitening is a quick way to make your teeth several shades lighter. If whitening products were to cause damage to the enamel dentist would not offer this type of treatment. Bleaching the teeth can cause some sensitivity however the sensitivity it may cause subsides overtime. Now there are those who overuse bleaching products to the extreme causing tooth erosion and making the teeth highly sensitive, however if you have your teeth laser whitened and touch up with bleaching gels from the dental office every couple of years you will not cause any damage.

Many dental offices offer laser whitening which can cost anywhere from $350 to $600, depending on your location. We recommend you consult with a dentist who offers this type of treatment and to see if you are a good candidate for laser whitening.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist

Thanks Michelle,

Dear Michelle,

The first thing we would recommend is for you to take your son to the doctor because he may need stitches and you don’t want the wound to get infected. There are a lot of bacteria in the mouth that can infect the wound so getting your son on antibiotics is important. It would also be a good idea to take him to the dentist and have an x-ray of his teeth even though he is not having any pain at the moment. A hard fall like your son experienced can cause teeth to die gradually over time.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist

Thanks, Neal

Dear Neal,

Sorry to hear about your tooth pain. Due to the fact that your tooth has not caused any problem in the past until now there could be a possibility that the nerve of the tooth has an infection. However, it could also be referred pain from another tooth next to the one with the dental crown. Whenever tooth pain is experienced with pressure while eating it’s a sign that the nerve in the tooth is dying or that the bite may need adjusting. If the nerve of the tooth is dying and infected it would require a root canal to stop the infection and tooth pain. We recommend you see your dentist as soon as possible to have the tooth looked at and determine what the cause of your tooth pain is.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist

Thanks, John

Dear John,

There is a correlation between periodontal disease and diabetes however the exact reasoning is still not known. What is known is those with diabetes have an increased risk of periodontal disease especially if their diabetes is out of control. It’s important to know that the blood sugar level is what determines ones vulnerability to gum disease. Studies have shown that those with a reduced risk to gum disease have good control A1C<7 compared to those with an A1C>8.5.

The risk of gum disease is increased in diabetics when the immune system is not functioning properly and when one has excess body fat causing the gums to inflame. Diabetics healing process is impaired so gum healing is also reduced. We recommend you follow through with your dentist recommendations regarding your gums. Going in regularly for your dental cleanings, daily brushing and flossing, as well as keeping your blood sugar under control may also help in the prevention of further problems regarding your gums.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist

Thanks, Daryl

Dear Daryl,

A typical apicoetomy cost anywhere between $900 and $2000, however it depends on which tooth is affected and your geographical location. If you have the tooth extracted and decide at a later date to get a dental bridge the cost can be anywhere from $2100 to $3000. If you choose not to get a bridge and do nothing the teeth next to the extracted tooth shift over time and could affect your bite. Also the tooth below or above the extracted tooth site will erupt and slowly move towards the empty space possibly causing you to lose another tooth in the future. Having the apicoectomy completed can possibly prevent you from having other dental complications in the future. Remember if a skilled endodontist is performing your apicoectomy the success rate is high, however with any surgery there is always a risk of complications and failure.

Ask your endodontist about payment plans. Another option is Carecredit, a special financing option used widely within the dental field, with low monthly payments and no interest as long as you pay it off within a year. We advise you to consult your dentist as well as your endodontist about your dental concerns for they will be able to give you more guidance on what your dental options are and may also be able to address  your financial concerns.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist

Thanks, Ken

Dear Ken,

When we get a root canal the nerve is removed from the tooth, therefore cutting off all blood supply making the tooth very brittle. For this reason, crowning the tooth is the standard of care in dentistry to prevent the tooth from breaking or getting another infection. If the tooth breaks below the gum line or you fracture the root of the tooth it will most likely have to be extracted. Leaving the tooth unprotected can also cause another infection within the tooth if it wasn’t sealed properly and will need to be retreated with another root canal. We highly recommend you make an appointment with your dentist to have a crown put on the tooth to prevent you from losing it in the future.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist

Thank you, Darcy

Dear Darcy,

Periodontal disease is very treatable especially in the early stages of the disease process.  It’s good to hear that you are keeping up with your daily oral hygiene which will greatly improve your chances of having the progression of the disease stop, however you will also need to maintain your dental health by having your teeth cleaned at least every three to four months as well or as often as your dentist and dental hygienist recommends.

Smoking is one of the risks factors in the development of periodontal disease and studies show that smokers are 300% more likely to develop the disease then non-smokers. Even though you had smoked after your treatment for a while you did not destroy any treatment that was done, however continued smoking decreases the effectiveness of any periodontal treatment over time. As you are well aware smoking is bad for your general health and weakens the immune system therefore making it difficult to keep a healthy smile so if you continue to smoke you are more likely to develop a more severe case of periodontal disease with the possibility of losing your teeth.

Smoking is a very difficult habit to break but with some will power anything is possible. If you find yourself having difficulty quitting on your own we recommend asking your dentist or your family physician about nicotine replacement therapy, prescription drug therapies, hypnosis, and Acupuncture. These are just some of the methods used by people who have kicked the habit. Best of luck Darcy, we know you can do it.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist

Thanks Barb

Dear Barb,

One of the risks from orthodontics is root resorption, especially if you had very crowded teeth and wore them long-term. Most teeth that have root resorption can usually last many years and function properly, however if your teeth are mobile you risk the possibility of losing them in the future. Many studies show that root resorption stops after orthodontic treatment has ended, however trauma to your teeth or active retainers after braces can cause further root resorption over time.

Once a tooth has root resorption, it cannot be repaired. If your teeth become slightly mobile your dentist may recommend a dental bridge or some type of splint to help stabilize your teeth, however if teeth become moderately to severely mobile you may be looking at extractions in the future. Permanent restorations like porcelain bridges or dental implants can restore your smile if you lose your teeth. Root resorption cases vary by degrees therefore we recommend you consult your dentist to see what treatment is best for you. Brushing and flossing on a daily basis as well as going to the dentist for your dental cleanings will help you maintain your teeth longer.

Post courtesy of Dr. Goldstein, Cleveland Cosmetic Dentist