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Porcelain Veneers While Pregnant

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I found out I was pregnant a few days after getting my porcelain veneers. When I went to see the doctor they’d asked a whole bunch of questions about what I’ve been drinking and what medical procedures I’d had done recently. When I told them about the porcelain veneers, they told me I should not have dental work done in the first trimester. Is there a chance something is wrong with the baby because of my porcelain veneers?

Carlee

Dear Carlee,

Pregant woman at the dentist

I want to give you peace of mind right away that getting your porcelain veneers did nothing to harm your baby. The reason they tell expectant mothers to wait until the second trimester for dental work is because they are trying to avoid any medication that may be used during the most vulnerable part of the pregnancy for your baby.

The good news is the only medication that is used in placing porcelain veneers is Lidocaine. This is a numbing medication that has been proven safe to use on pregnant women and is even routinely used in the delivery room.

While they told you to avoid dental work in the first trimester I want to make certain you understand if there is a dental emergency, such as a tooth infection, it is important you get seen. Dental infections have been linked to low birth weight. As long as your dentist knows you are pregnant, he or she can make certain they only use medications that have been proven safe for pregnant women.

You will want to schedule your cleaning in the second trimester. This is mostly for your comfort. You should be past any nausea by that time, though not all women are, and you are not so large that you’ll be uncomfortable in the dental chair the way you may be in the third trimester.

If you deal with morning sickness and end up vomiting, I’m sure you know to brush your teeth. However, don’t just immediately brush your teeth, make sure you rinse your mouth first. Vomit is acidic and you want all of that acid gone before brushing it into your enamel.

Congratulations on your upcoming baby.
This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

She Needs a Second Opinion

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I had a toothache for about a week. I know I should have gone sooner, but just to be honest, the dentist makes me quite nervous. When I arrived, he did an x-ray and discovered a tooth that already had a filling had become re-infected. He said only 10% of the tooth is viable and wants to extract it and replace it with a dental implant. I have to admit this idea terrifies me. Is there no way to just do another filling?

Kellie

Dear Kellie,

person hiding behind chair in fear

How would you like to never fear the dentist again?

There are a couple of things going on here that concern me. To answer your question, if your tooth were really that far gone, then an extraction would be the only avenue left to you. Replacing a lost tooth with a dental implant is the best option in that case. However, and this is a big however, I don’t think that is your case. If your tooth were truly that far degraded, he would not have needed an x-ray to determine it. Such a substantial amount of decay would have been visible with the naked eye. In addition to that, the filling you currently had would have fallen out and there would be a gaping hole there. In all honesty, I think you need a second opinion before moving forward.

Let’s say that by some crazy set of circumstances your dentist ends up being right. I doubt it, but let’s just roll with it. Then, you would need the tooth extracted. Leaving it in, turn a dental emergency into a life-threatening one as the infection spread throughout your body.

Dealing wiht Dental Anxiety

It distresses me to see patients in your situation. You want dental care, yet that anxiety keeps you from getting it. The good news is there is a solution, which will enable you to get past that anxiety, caught up on your dental care, and even look forward to going to the dentist.

When you get that second opinion, look for a sedation dentist. This isn’t a specialty, but rather a dentist who offers at least two levels of dental sedation. For a check-up and cleaning, using nitrous oxide is usually enough to relax you. If you need a more extensive treatment, such as a root canal treatment or tooth extraction, you can request oral conscious sedation. This is so powerful, you will need someone to drive you to and from your dental appointment. You will be so completely relaxed that you could sleep through your appointment if you wanted to.

This blog is brought to you by Hilton Head Dentist Dr. Bonnie Rothwell.

CEREC Crown Hurts

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I had a dental crown but it broke. I needed a super quick fix because I needed to leave town for a conference. I looked up CEREC dentists because I knew that could get me a same day crown that way. I did, but it doesn’t feel right. I mentioned that to the dentist and she tried to shave down the uneven parts, but now it is rough and my tongue hurts when it is on it. I’ve even been biting my tongue which is causing some pain and swelling. I can’t do anything about it until I get back. I thought CEREC crowns were supposed to be better. What do you recommend?

Callie

Dear Callie,

Block of porcelain for a CEREC crown

Because CEREC crowns are milled by a computer, they usually fit more accurately. So, you’re right that they are better in that sense. It sounds like your dentist may be new to this technology. Normally, it could map a tooth and create the restoration to fit over it. She didn’t have that advantage because you had a broken dental crown. It’s still possible to do this correctly, though. The software used for CEREC makes it fairly easy to create a correctly shaped crown even without the tooth as a guide if you know what you’re doing. Your dentist didn’t.

You need to insist this dentist fix this. A properly fitted crown is not noticeable at all. The correct overlap between the upper and lower teeth should keep you from biting your tongue. I’m concerned about this. Obviously, there is unnecessary pain you are experiencing as a result, but you’re also at risk of developing a tumor as a result.

One other thing which concerns me is the fact your other crown broke. These are actually meant to protect teeth from breaking and shouldn’t be breaking themselves unless they’re quite old. For some reason, though you didn’t say so, that is not the impression I got from you.

When you get back from your conference, I want you to see the dentist who did your CEREC crown and tell them this needs to be re-done completely. Then, when you have that perfect crown, I’m hoping you’ll tell your original dentist about how the crown broke and you had to go elsewhere for an emergency visit for the sake of time. They need to know their work failed.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Is It Normal to Not Get Numb at the Dentist’s?

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I think there’s something wrong with me. My poor dentist felt so bad about what happened that he didn’t even charge me for the last two appointments where he’s tried to get me numb. He really tried too. After ten shots. TEN. I still wasn’t numb and the pain was excruciating. I was crying. He even teared up because he didn’t like seeing me suffer. He said in all his years he’s never had that happen. I don’t know what to do and neither does he. Do you have any idea?

MaryAnne W.

Dear MaryAnne,

A woman giving a thumb's up in the dental chair

First, let me say how sorry I am you went through such a disastrous experience. However, I absolutely love the empathy your dentist showed. It warms my heart to hear about members of the dental community showing they care what a patient is experiencing. Please tell your dentist he has my respect. My respect doesn’t take care of your problem though, does it?

To put your mind at ease, I believe I know exactly what was going on. I suspect, though you may not realize it, that you have some pretty substantial dental anxiety. For some patients, like you, they may have the anxiety but are used to doing things that frighten them and just put on their big girl clothes and do what needs to be done. Others, though, are so frightened they can’t even get through the door.

Even though you are extraordinarily brave and move forward when frightened, it doesn’t stop your body’s response to fear. Your metabolism jumps through the roof. When that happens it burns off the numbing medication before it can take effect. Your dentist could have given you shots all day long and it wouldn’t have worked.

Dental Sedation Helps Patients Who Can’t Get Numb

What you need is something which will help you relax enough to allow your local anesthetic to work. Dental sedation is likely the perfect solution for you. There are several levels of sedation available. The first is nitrous oxide. It’s also known as laughing gas. It relaxes you a bit and could be all you need. You wil be right back to normal by the end of the appointment and able to leave on your own.

If that’s not enough, you could get oral conscious sedation. This is quite strong and will make you groggy. You’ll still be awake, if you want to be, but will be so completely relaxed you could sleep through the entire procedure if you wanted to. However, you will need someone to drive you home and stay with you throughout the day until the medicine wears off.

You’ll also find you can get more work done at each appointment than you normally would too. I don’t want you to have to put off your necessary work and then it blow up into a dental emergency.

This blog is brought to you by Dr. Bonnie Rothwell.

Can I Take an Uber Home From a Dental Sedation Appointment?

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I’ve moved to a new city. I don’t know anyone yet and don’t start work for two more months. I’ve come early to get settled. There’s a tooth I’ve needed to be crowned for a while because of teeth grinding, but I keep putting it off. Now an upper tooth has a toothache. I’m going to find a dentist, but I want to get all this work done before I start at my new job. I always use dental sedation for these type of appointments and I know the drill; you need a driver. Because I just moved here, I don’t know anyone. Will they let me take an Uber home, seeing as I’ll have no one to drive me?

Rebecca M.

Dear Rebecca,

You’re in a tough situation. I can see why you’d want to get the work done before starting your job. Plus, with a toothache, you don’t want to put things off and end up with a dental emergency. Those can be life-threatening.

Not knowing someone to take you is the stickler. While an Uber driver could bring you home, your dentist is going to want to know there is someone to stay with you throughout the day. The reason for that, as I’m sure you’ve noticed in the past is you won’t be too steady on your feet for a while. You’re at risk for a fall. The preference is you spend the day resting either in bed or on your sofa.

But, let’s say you find a dentist that’s fine with Uber. You’re not going to be too coherent. Are you willing to trust an Uber driver to help you into your home? Will they even be willing to escort someone who’s medically handicapped? Those are things to consider.

I don’t know if you hold to any particular religious faith, but I’ve often found that if you call a bishop, priest, or rabbi from your area and explain your situation, they’re usually very good at helping you meet people and getting you some assistance in an emergency. This could be considered an emergency situation.

This blog is brought to you by Dr. Bonnie Rothwell.

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