Ask the Dental Experts

Sincerely,

The Medical Center Dental Group

Q: I have a broken molar and only the root is left into my gum and was told to extract the tooth that IV sedation is necessary. Is there anything to worry about doing this and does it make one sick when the patient wakes up to go home? Will I feel any pain while sedated when the doctor is working on me?

A: There are times that we cannot save a broken tooth and it must come out. This can be done with local anesthetic alone, or it is often done with the use of intravenous sedation (IV sedation). These are choices you have to make with your doctor. It may be recommended because of the difficulty of what needs to be done, or IV is used oftentimes when the patient is fearful and would rather not remember the experience. Both methods are correct - depends on what YOU want.

Q: My mom is 91 years old. She still has all of her own teeth and they are very, very stained and dark. Can they be whitened? And, if so, without too much discomfort? Even if it''s only the front ones so her smile is whiter? It would most likely be a one-time shot because I know she won''t do it herself at home.

A: Yes! Your Mom can bleach her teeth! She can come into the office and have her teeth bleached with our power light. Ideally,we like to have our patients come into the office and have their teeth power bleached as a jump start and then followed by a 2 week session with bleaching trays. However since your Mom doesn''t want to do it herself, she can do the office bleaching. She may not get as good as a result, but certainly they would be lighter than they are now.

Q: Can a broken cusp be fixed with bonding or resin? It is a tiny chip. How long can the tooth last in that condition? Is crowning the only option?

A: A broken cusp can be fixed if the chip is really small and can be repaired withcomposite resin material. The repair can hold for several years, but don''t forget that cusp is on the chewing surface of your tooth so it can be worn down in time Crowning a tooth when a cusp is broken is another option. The crown will give the tooth strength. When a person breaks a cusp, it may also lead to a fractured tooth. Therefore it is important to crown the tooth. Fractured teeth can affect the nerve of the tooth and a Root Canal may be needed.

Q: What forms of insurance do you use?

A: Many of our patients have dental benefits. We encourage each of our patients to become familiar with the coverage they have. To simplify the process for all of us, we have adopted the following policies. First, we expect our patients to take full responsibility for the payment of our fees. Our contract is with you, not with your insurance company, and we will happily document all your needs and care received in our office, but we do not accept assignment of dental insurance benefits. We will gladly help you with the process of claims submission. We provide all the necessary information, send any required documentation that is requested by insurers, we respond to any information requests, both writing letters of explanation and even having conversations with insurer consultants to try to help you get all the coverage that you deserve. If insurance coverage is in doubt, we will be happy to submit a "pre-treatment estimate of benefits" to the insurance company.

Second, you should be aware that most insurance plans do not cover certain types of dental treatment. The common examples of these are cosmetic procedures; restoration need due to excessive wear on teeth, dental implant treatment, and procedures where the insurance companies feel a cheaper (not better) option is available. For example, an insurance company may substitute the benefit for a silver filling when a superior tooth colored filling is placed. Coverages are arbitrarily downgraded by insurance companies so that they can pay fewer benefits on your behalf. Our office cannot predict when this will happen.

A new smile can range from $32.00 to $400.00 a month depending on your individual needs. When you come in for your cosmetic evaluation we can be more specific regarding your needs. Cost can vary widely on complex dental care - it is impossible to tell you what your needs are without a thorough examination and appropriate dental x-rays. We do have information available for financing of your dental care, and that also is individualized.

Q: How expensive is it to have a full set of implanted dentures? Also, I have had dentures in the past and have had trouble with loose dentures as well as sensitivity and pain. What could your office do to help?

A: Stabilizing lower dentures with the use of dental implants is one of the most popular uses of dental implants. It is almost always possible to place implants for this purpose, but there are some questions that our doctors must consider when planning your individual case. There are times when your existing denture can be used; there are other times that it is best to make completely new dentures. We will be looking at several factors:

· Age and general health status

· Amount of available bone

· Cosmetic demands of your case

· Force considerations - heavy bite, deep overbite, etc.

· Quality and design of existing dentures

· Is there a need for intravenous (IV) sedation when surgery is done?