Arthur J DeAngelo

You probably have the start of gingivitis-inflammation of the gums. I would recommend start flossing. At least once per day or 3 times a day. For a week. The gums will be sore, bleed, and heal, all at the same time. Healthy gums don't bleed. Floss regularly. You can get those floss picks which are easier and even a floss handle which you attach disposable flossers to. Thank you for the question. Answered by Dr. Art J DeAngelo, DDS

I would see your regular medical doctor(M.D.) if you have one. He can check you out with a routine blood test and so forth. Watch for bacterial endocarditis, a big word for an infection on the heart valve. If not already, you should be on a course of antibiotics (not more than 10 days worth). Don't worry.

First try to save the tooth. Depending on the chip, it can be bonded with a white filling that fills in the chip or you may need a crown (covers the whole tooth). If the nerve has been damaged, a root canal may be needed. Not too complicated on a front tooth--only one canal ( a back molar tooth has 3 or 4 canals). I wouldn't consider extraction at all unless there is a crack lengthwise down the root of the tooth(rare). Don't worry.

The filling is deep meaning it is near the pulp chamber of the tooth (where the nerve and blood supply of the tooth is). What happens in a deep filling is that it can be so close to the pulp that it gets infected from just a few bacteria of the filled cavity. Now one has an infection in the nerve of the tooth -- this is painful and usually a sharp pain as opposed to a sensitive feeling of a cavity. The best treatment is to remove the bad nerve (which is dead or in the process of dying) and SEAL the space in the canal left by the bad nerve with an inert (doesn't react to the body) plastic-like material. This is called a root canal -- saves the tooth. You may have "referred pain" since the nerves connect in the back of the jaw, the upper pain is caused by the lower tooth and visa versa. Antibiotics help, but the SOURCE of the infection (dead nerve inside the canal) has to be removed and sealed as I said before, otherwise it will re-infect. Extraction would mean you would have a big hole and space in the jaw where the tooth was. Not a good choice, I don't think. Sorry, this is a lot of reading, but I can't explain it with less words.

Thank you for asking the question,

Dr. Arthur J. DeAngelo, B.S., DDS

Apply pressure with gauze. Are you taking a blood thinner like coumerin, Warfarin, or the new one, Xeralto? Talk to your medical doctor (MD) as to whether to temporarily stop taking it. The anesthesia is wearing off. Take the antibiotics/pain pills. Don't worry.

Thank you for the question,

Dr. Arthur J. DeAngelo, B.S., DDS

Bonding can be done on the two teeth. If the nerves are damaged, root canals may have to be done at that young age. Permanent crowns can be gotten at age 18.

Dr. Arthur J. DeAngelo, DDS

Greetings,

Some of the causes of this situation are 1) incomplete sealing of the canal 2) cracked tooth -- there might be a crack in the tooth somewhere; sometimes they are hard to detect 3) wrong tooth -- you may have "referred pain " -- pain in one tooth is actually from another tooth 4) crown (or temporary crown) is too high -- you are pounding on the tooth (dentist can lower the crown height). See your dentist again.

Thank you for the question,

Dr. Arthur J. DeAngelo, B.S., DDS

Yes, it does work. In fact, zinc oxide and eugenol, a temporary cement used by me and other dentists, has oil-of-cloves in it. Helps until a dentist can be seen.
Thank you for the question.
Dr. Art J. DeAngelo, DDS

An abscessed tooth is when the tooth gets infected (irreversible pulpitis - usually secondary to caries) the infection is in the pulp and nerve of the tooth. A small circle of pus, sac of bacteria, starts to form at the tip of the tooth in the jawbone. Shows up on an X-ray. Untreated the pressure, infection will travel to the sinus cavity or worse, the brain. Very bad. In the lower jaw, the infection will travel in the jaw to the body. If it crosses the mediastinum (middle of the body), death can occur.

Don't wait. Need antibiotics right away. One can't just take antibiotics though, it has to be treated. Can be treated very successfully before this happens. Get to a dentist. Early signs include: pain -- cavity is forming, sensitive to hot and cold and/or sweets. It will show on an X-ray. Clinical exam; bump on the gum (has fistulated), foul odor. The pain gets you into the dentists office -- worse: if it is a silent abscess (you took the antibiotics, but didn't treat it). The pain is not there to tell you that the abscess is still there and growing. This is why one goes to the dentist to get checked for cavities; and why we have dentists in the first place. Abscesses can be stopped. Mostly reversible with a root canal (saves the tooth) and a crown --- almost as good as a new tooth (except it costs money).

Thank you for the question.

In general, I don't want to go against an orthodontist advise, but an alternative treatment is just to crown the tooth with a twist in the crown preparation(shaping the tooth to prepare it for the crown). At best, the "prep" would allow room for a straight looking crown and a level bite adjustment with the lower opposing tooth. At worst, the prep may get close to the nerve, you would need a root canal(probably one canal). Overall, a lot less time and less money.

Get a "SOFT" bristle brush first off. The enamel stops and the dentin begins at the gumline. Dentin is softer than enamel. Sounds like you may be brushing too hard but don't discourage yourself from brushing. along with flossing its the best thing for you. Keep your teeth.
Dentist do vary; some are more focused on decay, others the gums still others, the overall bite/lesions. We try to catch everything. We are human. I have seen excellent results from plaque build-up with electric toothbrushes.

I understand getting numbing shots is no fun, especially in the mouth, but the dentin and the dej (dental enamal junction) can be very sensitive. A few peoples teeth-usually older adults are not that sensitive and I have done some fillings without anesthesia. It could twinge or you could almost jump out of the chair. Its almost worth it to have the pinch of the needle than to have the drill hit a sensitive nerve area.

Greetings. Baking soda(sodium bicarbonate NaHCO3)- is a base. It has a high pH (pH measures acidity) So it might raise the pH(make it more basic) of the mouth and stomach. This would be particularly helpful to someone who tends to have a acidic stomach or mouth(remember stomach acid(HCL hydrochloric acid has a pH of 1). It might help and sooth the gums by raising the pH (lowering the acid level)

I did caution my patients that it could be slighty abrasive on the enamal but I haven't read the studies to back this up As far as whitening, I can't really say, but it probably does, by cleaning better in combination with toothpastes and other whiteners. Thank you for asking the question. ​