Blog | Optima Dental Spa

What to Do for a Dental Emergency

July 13, 2019 by Optima Dental

Drawing of a man in a teal suit clutching his forehead in panic due to a dental emergency

Although dental emergencies can be stressful, Optima Dental is here to help you find a solution. The first thing we recommend is to remain calm. Panic will only make the situation worse! Then call us for emergency dental care. But to prepare beforehand, here’s a helpful guide about a few common emergency situations:

Broken or Chipped Tooth

Unless there is pain present, you may not need to be seen immediately, but we will get you scheduled so we can fill or repair your tooth soon. Tooth damage can happen from a variety of causes, such as while eating something hard, falling down, or getting hit in the mouth with a person or a ball when playing sports. Avoid eating hard foods like popcorn kernels, jawbreakers, sticky candy, and ice; wear a helmet when riding a bike, rollerblading, and skateboarding; and get a custom-fitted athletic mouthguard to protect your teeth during contact sports.

Knocked-Out Permanent Tooth

Call us as soon as this happens! We may be able to save your tooth if you make it to our office with your tooth within one hour after your injury. But sooner will increase your tooth’s chance of survival! Keep it moist in a glass of milk or a tooth preservation kit. If you don’t have those available, use your saliva. If there is a lot of blood after your injury, apply a cool compress like a washcloth to help stop the bleeding. You may need to visit an emergency room for stitches if you have a lip laceration. To help prevent a knocked-out adult tooth, always wear a protective mouthguard during activities that can involve contact with other people, equipment, or the ground.

Mouth or Tooth Pain

A toothache can be caused by a variety of issues, like a stuck piece of food, an untreated cavity, an infection, or thin tooth enamel from chronic teeth grinding. First, try brushing your teeth, flossing, and rinsing your mouth with a mixture of one teaspoon salt and one cup warm water. If you’re experiencing intense tooth pain, we want to see you as soon as possible before the issue gets worse. For example, tooth decay can lead to tooth loss; an abscess or infection can cause fever, swelling, and severe pain upon eating; and nighttime teeth grinding can increase your risk of decay and chronic sensitivity. Don’t put off giving us a call about your tooth pain! However, if you have trouble breathing or a high fever, go to the emergency room.

Emergency Dentist In Lake Oswego, OR & Portland, OR

Call our expert Optima Dental team ASAP if you have a dental emergency, which can range from the aforementioned issues to broken dentures, a lost crown, and more. Don’t put off fixing your dental problems, as they will only get more painful, serious, and expensive over time. We are here to answer any questions you may have. Call us today!

Dental Sedation with Blood Sugar Issues

May 21, 2019 by Optima Dental

I struggle with dental anxiety. I’ve been told dental sedation is a good solution for people in my position. However, I have been told you can’t eat if you have dental sedation. I have low blood sugar which sometimes requires me to eat at inconvenient times. Would I be able to get dental sedation?

Kami

Dear Kami,

patient asleep in dental chair from sedation dentistry

Dental sedation has changed the lives of people with anxiety. I think it would be a great solution for you. Most sedation dentists offer two types of dental sedation— nitrous oxide and oral conscious sedation.

Nitrous Oxide

With nitrous oxide, your dentist will place a nosepiece on you to breathe through. The gas will make you feel floaty and relaxed. It is best used for people with mild dental anxiety, but it does have some great benefits.

You can get on with your day as soon as your procedure is completed

When your dentist has is done with your procedure, he or she will switch the gas from nitrous to oxygen. You’ll be back to yourself and ready to tackle your day with no restrictions.

You can eat before getting nitrous

Very few people have any nausea when it comes to this type of dental sedation. Because of that, there are no eating restrictions.

Oral Conscious Sedation

This is usually recommended for patients with more severe dental anxiety. It is administered by you taking a pill before your appointment. However, it is so strong you will not be able to drive yourself to or from your dental appointment. You will be completely relaxed. Way too relaxed to drive.

Most patients end up sleeping through the procedure and have little to no memory of what happened. You are still conscious, though, and can respond to things if you want to.

The propensity for nausea goes up with oral conscious sedation. Most dentists will ask you not to eat before this appointment. However, given your situation, you may be allowed a small meal ahead of time. Each dentist has different guidelines.

Worst case scenario, just make sure your sedation appointment is first thing in the morning so you are not having to go very long without food.

This blog is brought to you by Lake Oswego Dentist Dr. Mo Saleh.

Tooth Turning Gray after Dentist Visit

May 9, 2019 by Optima Dental

I’m wondering if something has gone seriously wrong with my tooth. I had some pain in a tooth which bothered me consistently. I finally sucked it up and looked up an emergency dentist in my area. He did some x-rays and poked around. He concluded that it was a small crack in a tooth. He did admit there was no diagnostic evidence for that but he was going based on my symptoms. He prepared my tooth for a crown right then, for which I was very grateful. However, it’s been a few weeks and it still hurts some. Now I’ve noticed the tooth right next to it is turning gray. What’s going on? Did he treat the wrong tooth?

Mira

Dear Mira,

A woman holding her jaw in need of an emergency dentist

There are a few things which can be going on here. First, I want to address the gray tooth. When a tooth is turning gray, it means the tooth is either dead or in the process of dying. This will need a root canal treatment. I noticed you mentioned you looked up an emergency dentist. Usually, that means you don’t have a regular dentist. If that is because of dental anxiety, I want to take that worry off of your list.

In your place, I’d look for a sedation dentist moving forward. They can provide various levels of sedation depending on how much anxiety you face. They can provide you with anxiety-free/pain-free appointments. The biggest benefit of this is it will allow you to get the regular preventative care you need, preventing the need for an emergency dentist altogether.

Three Possibilities with this Emergency Dentist

Possibility One: He misdiagnosed you

It may be that the graying tooth is the one which was damaged the entire time and he just misdiagnosed you. The only way to know that with certainty is to get a second opinion with the original x-rays from your first visit. If they can see he was in error, that means you can get the money back on your dental crown. Without the x-ray, there’s really no way to know.

Possibility Two: Two Separate Incidents

This is very unlikely, but still in the remote realm of possibility. You could have cracked the tooth the dentist crowned and then later damaged the adjacent tooth.

Possibility Three: Delayed Symptoms

The more likely scenario, if your tooth did need the crown, is that both teeth were damaged simultaneously and the adjacent tooth didn’t start showing symptoms until recently. This does happen. Sometimes the trauma doesn’t show evidence for a while.

This blog is brought to you by Portland Dentist Mo Saleh.

Dental Implants and Teeth Whitening

April 30, 2019 by Optima Dental

I have two dental implants that are visible when I smile. If I want to whiten my teeth is that still possible or will it damage the dental implants?

Kathy

Dear Kathy,

Dental Implant Illustration

You can absolutely whiten your teeth if you have dental implants. The only unfortunate thing is teeth whitening only works on natural tooth structure. That means your teeth will whiten but the implant crown will not. To make the teeth match, you’ll have to have the implant crown re-made.

Obviously, that is a smidge easier if you have a screw-retained porcelain crown rather than a cemented crown, but you can replace either one.

It’s important you get your teeth whitened first. This way when your cosmetic dentist creates the porcelain crown, he or she will be able to match it correctly.

Options in Teeth Whitening

Traditional Take-Home Teeth Whitening

This will use a tray that your dentist will custom-fit to your bite. You’ll take that home and place the professional strength whitening gel he’ll provide for you and wear the tray for a minimum of twenty minutes a day. You’ll do that until you reach the level of whitening you want.

One Appointment Teeth Whitening

If you are in a hurry, you should consider in-office whitening. One well-known brand is Zoom Whitening. This will whiten your teeth completely in just one appointment with your dentist. It uses a special light to activate the whitening gel to work faster.

You’ll want to wait a week after the procedure to have your porcelain crown made because the color will “calm down” a bit and reach its permanent state in about a week.

I hope this helps. I wish your implant dentist would have warned you to whiten your teeth before getting your dental implants so you wouldn’t have this added expense of replacing your crowns.

This blog is brought to you by Portland Dentist Dr. Mo Saleh.

Xanax for Dental Anxiety

April 24, 2019 by Optima Dental

I have horrible dental anxiety, but have been getting a tad embarrassed about my teeth. I’ve recently developed what I think is a cavity in between my front teeth. I don’t want something so ugly showing when I smile. I know I need to go in but my phobia is killing me. What I need is something to relax me. Is it okay to take a Xanax before I go?

Melissa

Dear Melissa,

There are dentists who Cater to Cowards

You are not the only person who is afraid of the dentist. Many patients feel the same way. Most of the time, anxiety stems from a time they had a traumatic experience in the dental chair as a child.

While Xanax is good at relaxing people. I have a better option for you which I’ll share in a moment. If you take a Xanax before your dental appointment, it could interfere with whatever your dentist needs to do and possibly even any numbing medication he has on hand.

Cater to Cowards Dentists Have Just What You Need

What will be most helpful to you is to see a dentist who is compassionate with patients who suffer from dental anxiety. They go under several terms if you are doing an internet search:

Dentists used to working with fearful patients are more compassionate. They’re usually better at going slow and explaining things as they go, if that helps ease your anxiety. But, for people in your position, the best part is they have drugs.

They can give you medication which will not interfere with anything they’ll need to use on you. Most sedation dentists provide two levels of sedation medication. The lightest is nitrous oxide. This has been dubbed laughing gas in the past because it makes you feel a bit floaty. It’s often used on children who need to relax in the dental chair. It’s best for people with mild anxiety. It has the additional benefit of letting you get on with your day as soon as your appointment is completed.

The next level of sedation would be oral conscious sedation. This is a simple pill you will take before your appointment. This will make you seriously relaxed. Way too relaxed to drive. You’ll need a ride to and from your appointment, as well as someone to stay with you after your appointment until you are lucid and steady on your feet.

This will make your appointment a breeze. In fact, most patients sleep through their appointment.

This blog is brought to you by Portland Dentist Dr. Mo Saleh.

How Do I Know Which Dental Sedation to Get?

April 17, 2019 by Optima Dental

I’ve always been a bit uneasy in the dental chair. My dentist told me I needed a filling and I broke down crying. We scheduled for the following week, but I had a panic attack and canceled. I did that two more times and now my dentist just asked me to come in so he could look at it. He was worried it will turn into an infection and he didn’t want me going untreated. When I went in, he said the decay has grown and now I need a crown, but it’s not an infection yet. He’s suggesting I get dental sedation. He gave me two options and I just can’t seem to figure out which is best. I can’t remember everything he said and I’ve caused enough trouble so don’t want to bother him again. But, I don’t want to make the wrong choice. Can you help me?

Lindsey

Dear Lindsey,

patient asleep in dental chair from sedation dentistry

It sounds like you have a very caring dentist who is looking out for your best interests. He’s a keeper. He’s also correct that dental sedation can make a huge difference for you. I’ll go over the two levels of sedation with you now.

Sedation Level One: Nitrous Oxide

Nitrous is sometimes referred to as laughing gas. Your dentist will put a nose piece on you and put on the nitrous oxide gas. It will make you feel floaty and relaxed. This helps the most with people who have minor anxiety and just need to take the edge off their fear.

Then, when the procedure is finished he’ll turn off the nitrous and on the oxygen. You’ll be clear-headed again and able to get on with your day as normal.

Sedation Level Two: Oral Conscious Sedation

This is for people with a higher level of anxiety. You’ll take a simple pill before your appointment. This will make you quite loopy and relaxed. You won’t have a care in the world. Most people using oral conscious sedation sleep through their appointment and have little memory of the procedure itself. However, if you don’t want to sleep, you don’t have to.

You’ll be so completely relaxed you’ll need someone to drive him to and from your appointment. They’ll also need to stay with you after your appointment for several hours until you are completely lucid and steady on your feet.

Some dentists, Dr. Saleh included, have a third level of sedation known as I.V. Sedation. This is for patients with debilitating anxiety.

Don’t Put Off Your Treatment

I’d pick the level of sedation that makes you not worry about your appointment anymore. It’s very important you get this decay taken care of. Your dentist is right that it could blow up into an infection. These are considered dental emergencies and can turn life-threatening if you don’t deal with them right away.

I hope this helps.
This blog is brought to you by Portland Dentist Dr. Mo Saleh.

My CEREC Crown Doesn’t Match

April 9, 2019 by Optima Dental

I’ve had crowns before. I used to go to a dentist in another state. I’ve since been relocated and am seeing another dentist. He’s got this CEREC machine which allows patients to get crowns in one appointment. The problem is it doesn’t match my other teeth at all. I’ve never had the problem before. Is it because it is CEREC? Is it okay to ask him to switch to the regular crowns?

Danny

Dear Danny,

Porcelain crown being placed on a tooth

Whether or not a crown matches your other teeth is a combination of the materials used and the skill of the dentist. If your dentist was using a porcelain fused to metal crown, those are harder to make look natural. That’s because the crown has to be made more opaque in order to cover the metal base. They also develop an unsightly gray line at your gum line.

Fortunately, most dentists these days know better than to put those type of crowns on visible teeth and only use them for back teeth. When it comes to visible teeth a good dentist who understands aesthetics will only place all-porcelain crowns.

Both traditional (but non metal based) and CEREC crowns are milled from all porcelain are can be made to look more natural. Porcelain mimics the natural translucency of your teeth be reflecting light.

When the Problem is the Dentist

If he or she is using all porcelain, than the problem is the skill of the dentist. It wouldn’t matter if he used CEREC or sent it out to a lab. His skill wouldn’t change. You have two choices in this case.

First, you can give him another chance. Explain the crown doesn’t match and you’re unhappy with it. If he cares about the satisfaction of his patients he’ll re-do it. This is no guarantee he’ll get it right the second time around.

Another option is just to ask for a refund and get the crown done by a more skilled cosmetic dentist. Unfortunately, if the crown functions properly and the only problem is you don’t like how it looks, your dentist is not legally obligated to give you a refund. It’s completely at his discretion. Hopefully, he’ll care about how you feel and will be willing to work with you.

Finding a Dentist Who Can Do It Right

I’d check out the smile galleries of some dentists in your area to see what type of results they had with the crowns they’ve made. Be sure to ask them if the photos show their actual work and are not just stock photos. If you like what you see, check out their reviews to see what experiences other patients have had with them.

Best of luck to you. Remember the most important factor in a beautiful smile is the skill of the dentist.
This blog is brought to you by Portland Dentist Dr. Mo Saleh.

7 Reasons You Shouldn’t Expect an Emergency Dentist to Extract Your Wisdom Teeth

March 27, 2019 by Optima Dental

A man holding the side of his jaw in need of an emergency dentist. Do you have a dental emergency related to your wisdom teeth? An emergency dentist can relieve your pain, examine the teeth, and make treatment recommendations. But extracting wisdom teeth can be different from extracting a single tooth that is too damaged to preserve. Wisdom teeth are easier to extract when you’re younger. There are several reasons that an emergency dentist might refer you to an oral surgeon to have your wisdom teeth removed.

Why an Emergency Dentist Might Hesitate to Remove Wisdom Teeth

An emergency dentist’s first priority is to relieve your pain. After that, the cause of your pain will be determined. Unless there is immediate danger for your oral health, dental procedures will likely be performed at a second appointment.

Other than the above factors, why the hesitation?

As teeth continue to develop, the roots get longer and your jawbone becomes more dense.
Removing impacted wisdom teeth in a mature adult can be complex.
Post-surgery recovery can be more difficult than ordinary extractions.
Many emergency dentists are not equipped to handle difficult extractions.

The combination of your age and the fact that your teeth are impacted and infected makes wisdom teeth extraction more complicated.

Complications that Can Result from Wisdom Teeth

There are several complications that can result from impacted wisdom teeth. The possible complications are a good reason to have a consultation with an oral surgeon. You might need to be referred to an oral surgeon by a general dentist.

Infection – Pericoronitis is the dental term for a gum infection that can result from impacted wisdom teeth. Impacted teeth put pressure on your gums and cause them to become irritated and infected. As time passes the pain and swelling can make it difficult to chew and swallow.
Crowding of your other teeth – Impacted teeth can cause crowding. Depending on the position of your wisdom teeth, they can push other teeth out of alignment and damage your gums or jawbone. Orthodontic treatment might be needed.
Cysts in the jawbone – Impacted teeth can put pressure on the jawbone and cause a cyst to form. The cyst can spread and damage the jawbone and adjacent teeth.

What to Expect When Your Teeth Are Extracted

If your wisdom teeth are significantly impacted, you wouldn’t want to insist that an emergency dentist to attempt to remove them. The risks and complications are too great. The process of removing your teeth can be quite painful. An oral surgeon will assess the complexity of the surgery and recommend the right level of sedation dentistry. Sedation dentistry, in addition to local anesthetic, will ensure your comfort throughout the procedure.

Your oral surgeon will give you instructions for post-operative care. In about a week, you’ll return to the oral surgeon’s office to have the stitches removed and to have the extraction sites examined for proper healing.

It’s best not to pressure an emergency dentist to remove your wisdom teeth. If you see an emergency dentist, follow his or her recommendations for safe extraction and a good outcome.

This post is sponsored by Portland, Oregon dentists Dr. Mo Saleh and Dr. Rima Shaer. Dr. Saleh has advanced training in oral surgery and extractions.

6 Causes of Dental Implant Failure and How You Can Avoid Them

March 21, 2019 by Optima Dental

Are you concerned about dental implant failure? You shouldn’t be overly concerned. Dental implants have a 95% success rate. How does that compare to other types of replacement surgeries?

Knee replacement – 90%
Hip replacement – 90%-95%
Shoulder replacement – 90%-95%

So what causes dental implant failure?

1. Shortcuts

Some patients insist on keeping fees low. And that can put pressure on some dentists to look for ways to meet patient demands. If shortcuts are taken with diagnostics, only two-dimensional x-rays will be used. But there are potential problems with using two-dimensional x-rays to place dental implants:

They won’t sufficiently reveal bone density and bone quality.
The location of nerves and blood vessels won’t be clearly visible.
It’s risky to have a limited view of oral tissue and structures.

Three-dimensional images are needed for optimal implant placement. And the most conscientious implant dentists use them.

2. Cheap dental implant fixtures

Some dentists use sub-standard fixtures because they are less expensive than high-quality fixtures. High-quality implant fixtures are FDA approved. FDA approval requires:

Costly research
Published juried research
Documented test results

But cheaper fixtures can have defects in their design or be made of low-quality materials. If you want quality implants, expect to pay more for them.

3. Trauma

Trauma can cause dental implants to fracture or break. Trauma can be caused by a number of factors, some of which include:

Impact to your face or teeth
Bruxism (teeth grinding)
Improper bite that puts extra stress on the implants
Improper placement of the restoration (dental crown) can put stress on the implant
Poorly positioned dental implants

4. Inadequate medical history

Some medical conditions can affect the success of dental implants. If shortcuts are taken in obtaining a patient’s medical history, the dental implants might not heal properly, and dental implant failure can occur.

5. Other factors

There are other factors that can prevent implants from healing properly. Some of them include:

Smoking
Periodontal disease
Playing contact sports
Excessive drinking of alcoholic beverages

6. Lack of communication between the implant surgeon and restorative dentist

The restorative dentist, who provides the dental crown, should provide the oral surgeon with a guide for implant placement. If the guide isn’t followed, the fixtures might be improperly placed. This can prevent proper healing and lead to implant failure.

A diagram of the dental implant process with four side-by-side phases, including placement, healing, abutment, and crown; from Portland, Oregon dentist Dr. Mo Saleh.

Phases of the dental implant process

How to Avoid Dental Implant Failure

As a patient, you can ensure you maintain good oral health and avoid the habits that can prevent proper healing, including smoking, playing contact sports, and excessively drinking alcoholic beverages.

Much of the success of dental implants depends on the skill of the implant surgeon and the restoring dentist. What can you do about that?

Find dentists with extensive training and experience in implantology.
Before you select providers, research their credentials.
Schedule consultations with at least two dentists to discuss your options.
Don’t base your selection on cost alone.
Take your time to weigh your options. Don’t rush.

Dental implants are the healthiest way to replace missing teeth. And they can last a lifetime. Careful planning and placement will give you results that will improve your oral health and your quality of life.

This post is sponsored by Portland, OR dentist Dr. Mo Saleh of Optima Dental. Dr. Saleh has advanced training in implantology. All phases of the dental implant process—including surgery and restoration—are completed in his office.

Did Emergency Dentist Damage My Tooth?

March 15, 2019 by Optima Dental

I don’t usually go to the dentist. I know it’s stupid, but they are never good experiences so I keep finding reasons not to go. I had a toothache, so I had to go in. I called a dentist who sees people in emergencies. He saw me that day and did x-rays. He said he didn’t see anything wrong, but if he just went by the symptoms I was describing, he thinks I have a small crack on a tooth and offered to crown it. I would have done anything at that point to get out of pain and agreed. It’s been two days, I’m still in pain and now the tooth next to the crowned tooth is turning gray. Did the dentist damage it while crowning my other tooth?

Amelie

Dear Amelie,

A woman holding her jaw in need of an emergency dentist

It’s great that you were brave enough to see an emergency dentist. Tooth pain can often mean there is an infection somewhere. You don’t want to leave those untreated. That brings me to your gray tooth. When a tooth turns gray it means it is either dead or dying. A dead tooth will harbor bacteria until it is cleaned out with a root canal treatment. It’s important this is taken care of quickly or it can blow up into an infection. I know it sounds crazy in 2019, but people still die from tooth infections. They are easily treated, but many people avoid the dentist until it is too late.

I do realize you’ve had bad experiences with dentists and likely have dental anxiety. Because of that, I want you to have a positive experience which can change the tide of your regular dental care. I’d like you to see a sedation dentist. With dental sedation, you can take a simple pill and sleep through your appointment. Many people who struggle with dental anxiety find it changes their life. Going to the dentist becomes a breeze.

Did the Emergency Dentist Damage Your Tooth?

It’s highly unlikely the dentist damaged your tooth during treatment. I can think of three possibilities.

A misdiagnosis: It could be the gray tooth was the problem all the time and it was referring pain to the tooth your dentist crowned. Maybe the damage wasn’t visible on the x-ray yet, so he had no way of knowing. If you think it may have been visible, you can ask for the x-ray and take it to another dentist for a second opinion. If he messed up, you can get your money back on the crown.
The teeth were injured simultaneously: Whatever traumatized the crowned tooth could have also damaged the gray tooth, but it took longer for that one to show symptoms.
Later damage: This possibility is much less likely, but still potential. You could have injured the first tooth, then later something injured the adjacent tooth.

Truthfully, the first two options are much more likely.
This blog is brought to you by Lake Oswego Dentist Dr. Mo Saleh.