Richard Raymond Pence Dentist - Latest Blog & Articles

How long do cavity fillings hurt?

I had some tooth-colored fillings done that hurt for about 6 months. Not badly, but annoying.

Why do I have to wait 3 months every time my wires are changed on my braces?

My guess is that you’re not going to a regular orthodontist. If you are, I’ve never heard of 3-month intervals either.

How do you keep a bottom partial denture in place?

If you can afford them, implants do a great job of supporting and stabilizing partial dentures. It makes a “world of difference”

Why are my gums changing color?

Decrease in care = less clean teeth = more gum inflammation = change in color

Gag reflex?

Bulimia causes stomach acids to come back up the esophagus into the oral cavity. The strong Hydrochloric Acid can cause permanent scarring of the esophagus, and possibly the posterior READ MORE

Bulimia causes stomach acids to come back up the esophagus into the oral cavity. The strong Hydrochloric Acid can cause permanent scarring of the esophagus, and possibly the posterior portion of the mouth and soft palate, in addition to harming the enamel of the teeth. Have an ENT physician or Oral Surgeon do a good exam of that area, which is where gagging reflex occurs. This is to see if there is any physical damage from the stomach acids.Korean is a beautiful language, and I'm glad you're not having to learn German or a very guttural language, because you'd really be in trouble. It is possible a speech therapist could help you. As far as the dental visits go, some of my patients try lifting one leg when the gag reflex is strong, and that helps. My father would start gagging when I walked into the treatment room, just thinking of having to have his mouth examined.
Good luck with this.

What should I do to permanently resolve my TMJ issues?

Exercises can help, but are annoying to keep up with, as you discovered. A correctly made bite splint is a big help. Problem is that expertise is hard to find. L. D. Pankey Institute READ MORE

Exercises can help, but are annoying to keep up with, as you discovered. A correctly made bite splint is a big help. Problem is that expertise is hard to find. L. D. Pankey Institute helps train dentists for this, and their website can help you find one of their trained dentists near you.

How can I get rid of a tooth infection without antibiotics?

Think of an infected too like an infected finger on your hand. There are 3 choices: 1. do nothing, and leave the infection (but the problem gets worse, infection gets into bloodstream) READ MORE

Think of an infected too like an infected finger on your hand. There are 3 choices: 1. do nothing, and leave the infection (but the problem gets worse, infection gets into bloodstream) 2. have the tooth removed (but usually you'll miss it) 3. have the tooth fixed (have the infection cleaned out of the tooth and a seal put in the place of the infected nerve & blood vessels) when the infection is gone, you can have the canals filled for long term, called a "root canal filling". If the tooth has a lot of damage, a crown can make it strong and long lasting. I had that done to an infected tooth of mine, and that was 45 years ago. Still doing great. You're right, don't take antibiotics unless absolutely necessary (severe swelling, etc.).

Is jaw surgery necessary for an open bite?

Sometimes Jaw surgery is the very best thing for an open bite. My oldest son had jaw surgery and we went out to eat a week later. Your orthodontist and oral surgeon usually talk READ MORE

Sometimes Jaw surgery is the very best thing for an open bite. My oldest son had jaw surgery and we went out to eat a week later. Your orthodontist and oral surgeon usually talk to each other and make the best recommendation. Sometimes Jaw surgery is also the quickest way to correct open bite. Go for it!

Can you get Invisalign with an implant?

Quick answer is "yes," but you must understand that the implant will not move, so you have to plan around the implant's current location.

Dental cleaning?

Just having a deep cleaning can cause the gums to be sore for a couple of weeks. It is difficult to clean biofilm and calculus off the roots under the gums and it can cause soreness...especially READ MORE

Just having a deep cleaning can cause the gums to be sore for a couple of weeks. It is difficult to clean biofilm and calculus off the roots under the gums and it can cause soreness...especially if the teeth haven't had a thorough cleaning in a while. Think about cleaning dried egg yolk off a plate after it's been on the plate a couple of days.

Can braces cause TMJ?

Most pain from “TMJ” is dull, achey muscle pain, unless you’ve had trauma to the joint. Also, “TMJ” problems can be demonstrated by popping or clicking noises from the area in READ MORE

Most pain from “TMJ” is dull, achey muscle pain, unless you’ve had trauma to the joint. Also, “TMJ” problems can be demonstrated by popping or clicking noises from the area in front of the ear, meaning damage has occurred. Not usually any problems just from braces.

What is the easiest way to floss with braces?

Good question, but you won't like the answer. There isn't an easy way to floss with conventional braces. Invisalign allows normal flossing, but having an arch wire in the way means READ MORE

Good question, but you won't like the answer. There isn't an easy way to floss with conventional braces. Invisalign allows normal flossing, but having an arch wire in the way means you don't have a normal way to floss.There are little tricks to it, and your hygienist can show you how to do it. Sorry I'm not much help, but I had them, too, and have been through the annoyance.

Decipher surgical notes; metal implant material?

I would ask an (older) oral surgeon your question. They were using Vitallium and stainless steel back then, which corrode over time, and were switching to titanium, which corrodes READ MORE

I would ask an (older) oral surgeon your question. They were using Vitallium and stainless steel back then, which corrode over time, and were switching to titanium, which corrodes slower, and is more biocompatible. It’s an answer that’s important, especially for MRI machines.

Does drinking water help TMJ?

Staying reasonably hydrated is a good idea, like adequate amount of sleep. Those things help in a general health way, but not specifically for the TMJ, hips, or knees.

How often should I clean my teeth with braces?

When you have braces on your teeth, you will have 40% more bacteria lurking in your mouth than without braces, even brushing 4x per day. Your enemy is the bacteria, and they can READ MORE

When you have braces on your teeth, you will have 40% more bacteria lurking in your mouth than without braces, even brushing 4x per day. Your enemy is the bacteria, and they can do great damage, especially if you drink sodas, (even diet ones), or energy drinks, or anything with high acid content (even flavored water, and milk). So, brush 2/3 times daily, following your orthodontist's directions, and AVOID the acid containing beverages and things with sugar, like breath mints, etc. If you do those things, you should be ok.

How long does it take to fix an overbite with Invisalign?

Sometimes you cannot fix overbite with Invisalign. My son, now also a dentist, had jaw surgery to fix it. Usually goes quickly in that case.

Should a filling be replaced with a crown?

A large filling causes a tooth to be only 60% as strong as an unfilled tooth. If the patient grinds their teeth, they put excessive pressure on the teeth, which is very bad for READ MORE

A large filling causes a tooth to be only 60% as strong as an unfilled tooth. If the patient grinds their teeth, they put excessive pressure on the teeth, which is very bad for teeth already weakened by large fillings. The combination of xs pressure and weakened tooth increases the likelihood of fracture, which in some cases causes loss of the tooth.

Which is better alcohol or alcohol free mouthwash for dentures?

Mouthwash helps breath only for about 20 minutes. To clean dentures, you can use mild dishwashing detergent or commercial denture cleaners an a soft brush. Don’t use alcohol containing READ MORE

Mouthwash helps breath only for about 20 minutes. To clean dentures, you can use mild dishwashing detergent or commercial denture cleaners an a soft brush. Don’t use alcohol containing mouthwash as it dries out the mouth.

Tooth Extraction and Dissolvable Stitches?

It is possible, when removing lower teeth, especially wisdom teeth, to have some nerve damage resulting in numbness. It sometimes gets better and sometimes it doesn’t.

Excruciating pain and severe swelling after routine cleaning?

Your marked enlargement of your upper lip is caused by localized blood vessel change, allowing sudden escape of an excessive amount of fluid into the tissue of your lip. We used READ MORE

Your marked enlargement of your upper lip is caused by localized blood vessel change, allowing sudden escape of an excessive amount of fluid into the tissue of your lip. We used to call this "Angioneurotic Edema" and is probably caused by you having sensitivity to the cleaning agents or gloves that the hygienist used. We've seen this with cinnamon flavoring, and with various cosmetics or food. The swelling usually doesn't last longer than a few days. It could be reduced by the administration of adrenalin, but ordinarily this is not necessary. They only time allergic type sensitivity is serious is when the swelling is in the area of the throat. (If swelling of the throat, requires visit to the ER.) You could try taking some Benadryl, but it will probably get better quickly by doing nothing. You should see what type of "Prophy paste" the hygienist used, and ask if she used Latex gloves (common to causing these symptoms).
Good luck, and sorry you're having to go through this.