Alexander S. Litvinov, DDS Dentist
Practicing since 1999
- Takes Time to Listen: 90%
- Communicates Well: 100%
- Average Wait Time: 2 minutes
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"TMJ Can getting cavities filled trigger previous TMJ symptoms and what's the best way to support TMJ and clenching from stress?"
Anonymous Patient
Yes. Getting new fillings can make existing TMJ condition worse. For one being open wide for prolonged period of time can worsen the condition . Two, if occlusion us not properly adjusted it will make u our jaw sway into a wrong position making the joint more uncomfortable. Having a proper appliance such as a night guard can help. Relaxation of the muscles of mastication with warm compresses special exercises, massage or muscle relaxants can help to eliminate pain and discomfort. Adjusting occlusion properly will help. Anti-inflammatory medications such as Ibuprofen can help.
View all answers to this questionAlexander S. Litvinov, DDS
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"Severe pain, second round of antibiotics Broken tooth on top left, must be pulled.They found the bottom left needs a root canal and I have a deep infection.Dentist prescribes cipro, Motrin and lortab.The pain lowered for 2 days then fully returned.Finished the meds, saw dentist, prescribed more cipro....I've done everything.Pain meds, ice, Vicks vapo rub on my cheek and neck, garlic/pepper/salt salve (homemade), salt rinse....nothing is helping it.Pain still there, when do I go to er? Do I have a bone infection? I have no insurance."
Anonymous Patient
get both teeth out , get a referral from your dentist for an Oral Surgeon and get them both out , may also need different antibiotic if Cipro is not working .
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"Who will help me now? Seven months ago, I had dental implant and bone graft surgery. The pain has been intense, long-lasting and wide-spread, and the non-dental complications extensive, while the groundwork is not even for the type of replacement teeth I agreed to. The dentist has taken $20,000.00, mocks me and denies my problems, and now refuses to complete or correct his work, has "released" me from his practice and refuses to respond to my attempts to even get my records. What do I do?"
Anonymous Patient
If you request your records , your dentist is legally obligated to provide those. You are the owner of your record and the dentist is a custodian and if you request your records the dentist has to provide them. you should find a qualified provider to evaluate your case and continue your care. if you went through any insurance you should contact them and let them know what is going on. If you continue to get resistance from the dentist possibly getting some legal advise would be in order.
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"Black tartar or decay? Hi. I have black line on one of my back tooth.... it has been there for around 6 months. It does not hurt or anything however I tried to remove the black thing on it to no avail even though it looks like it can be scraped off. I have not been to a dentist for 8 years and I'm really scared. Is it just tartar or tooth decay? :("
Anonymous Patient
It could be a slew of different things: 1)surface stain, 2)decay, 3) internal stain 4) tartar/calculus. Best thing to do is to visit a dentist and have it looked at for proper diagnosis and treatment if necessary
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"Hole in Mouth!!! Please tell me what this is.. It causes my slight pain and I thought it was my widsom tooth growing in but today I looked with a flashlight and seena hole in the upper back left of my gum!! I have a sore throat with this hole.. please help."
Anonymous Patient
Looks like trauma caused by the wisdom tooth , you should have your wisdom tooth extracted by either your dentist or an Oral Surgeon. Get in touch with your dentist as soon as you can to make sure its not getting infected and talk to him/her about extracting that wisdom tooth.
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"Tonsillectomy I had a tonsillectomy 4 days ago, and after I had some rice this morning, my throat looked like this. Is it rice stuck in the holes or is it infected? Any advice would be great too. Thanks!!"
Anonymous Patient
Looks like normal healing . If you are concerned you should ask the surgeon that performed the operation. Open wounds like that heal by secondary intention, which means that the tissue will grow from outside in to close the area . In oral cavity this happens relatively quickly.
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"Shaky primary tooth I am currently 14 years old. I have a baby teeth(one of the back tooth) that is shaky since I was 9 years old. When I told my mum about this, she told me that I was probably talking nonsense and said that the baby tooth will not be shaky for so many years. At this age, most or in fact all of my close buddies have none of their baby teeth left. Is this of a concern? should i go the dentist? (even though i've not been to one for 4 years)"
Anonymous Patient
First of all , yes you should go see a dentist , 4 years is way too long without a check up. Second, having a retained baby tooth could be because there is no permanent tooth growing and you will be keeping this one there so maintaining it would be a good idea. You need to have an exam done by your dentist and full mouth x rays taken so that you condition could be properly evaluated. Hope this helps. Happy New Year
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"Teeth wighten Can i use lemon juice with baking power to whiten my teeth. Is there any harm in this procedure?"
Anonymous Patient
Lemon juice is basically an Acid which will break down your enamel, same thing with backing powder which will convert to carbonic acid and also break down your enamel. I would strongly advise against using either one. There are many products on the market that are much safer. Talk to your dentist about it.
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"HELP - Dilemma should i remove lower impacted wisdom teeth I have a huge dilemma. I found out I have 3 impacted wisdom teeth. 1 upper jaw and 2 lower jaw and I am 30 years old. They are all asymptomatic and not giving me any issues. Dentist said not to worry about removing because one is sitting on top of the nerve in lower jaw and removing might cause nerve damage. I need a 2nd opinion because I have heard wisdom teeth should be removed even if they are asymptomatic."
Anonymous Patient
if your wisdom teeth are asymptomatic, they should be left alone, At your age, there is a better chance of them staying that way and you should follow your dentists recommendation and leave them alone.
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"composit filling with crown vs Inlay I did my posterior tooth coomposite filling three years back and it is fractured because of angular tooth shape. I have two options 1) new composite filling with crown 2) INlay"
Anonymous Patient
This kind of situation will have to be treated depending on whether there is enough tooth structure left, occlusal factors, etc. This has to be evaluated by a dentist and the options should be presented to you. crown will cover the whole coronal portion of the tooth and will protect it but more tooth reduction is necessary for that, Inlay is like a filling only its lab made and cemented , onlay is another alternative and may be a great solution as well.
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"Strange white lesion I recently had multiple extractions performed (wisdom and number 13) The next day I felt a burning pain in my cheek and pulled it back. Across from the tooth in my cheek is a white circle with red inflammation and a white line below it irregular in shape. It is painful to touch and is becoming more painful daily. I am currently salt water rinsing and taking ibuprofen but it doesn't appear to be healing. Do you know what this might be? I have never had a canker sour and it has an odd appearance."
Anonymous Patient
Looks like a aphthous ulcer, it is self limiting and usually resolves within 10-14 days, Palliative treatment will help with pain management until it resolves itself. Orabase application 3-4 times a day on the affected area. Kenalog may also be helpful. Have your dentist prescribe those to you. These things happen after a stressful episode or after trauma to the area (injection sites etc), it is best to leave those areas alone and not touch them unnecessarily
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"Tiny white bump underneath my tongue I have tiny white bumps under my tongue that really burn. They have spread over the past few days and I'm worried it will be something worse than a canker sore."
Anonymous Patient
these look like aphthous ulcers and should resolve themselves within 10-14 days, you can use orajel to make them feel better mean time. i would recommend for you to see your dentist to verify the diagnosis as i am just looking at a picture
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"Itchy, numbness & a dull ache Please help. Ive been in non-stop discomfort for months with many trips to the dentist/a lot of money spent. Its an itchy numb kind of feeling in an upper tooth. I was told it needed a filling so i got one. The 'pain' didnt go away so i waited a few weeks then went back and they said i needed a root canal, so i got the nerve taken out last week and ive an app. for next week to get the tooth filled. Terrified that after all of this the 'pain'/irritation still wont be fixed. Can anyone help?"
Anonymous Patient
I am sorry that you have been going through all this. Unfortunately without x-rays , pictures of your soft tissues and a proper examination it is hard to determine the cause or find solution to this problem, if the root canal therapy got rid of the pain/discomfort then you should be at the end of your troubles. If not there may be a sinus issue that exists or allergy to something. All of those should be discussed with your dentist if the problem persists.
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"Teeth pulling after braces Why is my orthodontist pulling my teeth after my braces are put on?"
Anonymous Patient
most likely to make space, teeth are extracted during orthodontic treatment to make space for other teeth to move and align , sometimes that can happen before the treatment sometimes during (after braces are on), and sometimes ( in case of wisdom teeth ) after braces - to make sure that wisdom teeth do not crowd all other teeth again.
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"Does this look like cancer? Hello, I've been chewing my cheeks for a really long time and not too long ago I really went at it and chewed up a lot in a spot where there is now a white patch. Does it look like it could be a scar or cancer? This came to my attention as I've just been told I have acid-reflux which has similar symptoms as oral cancer."
Anonymous Patient
it looks more like a traumatic scar than cancer but you should have it looked at by oral surgeon and possibly have a biopsy of it if you want to know for sure. Its better to be safe than sorry.
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"Is it suppose to grind when you get a front tooth filled? I got a filling in my front tooth it feels like my tooth is bigger and sometimes grinds, is that just cause the filling is fresh?"
Anonymous Patient
The feel of the restoration is not the same as the tooth, that said, if it feels big it probably is and if you feel like it grinds it is probably rough and may need to be polished, i would recommend talking to your dentist and see if he/she can adjust it and polish it for you
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"Pain on the right side of my mouth I been having pain on the right side of my mouth along with headaches, cracking of my jaw when opening, difficulty opening wide, sore thoart, pain when yawning, and right ear pain. Also, I have a wisdom tooth that's been growing in on the right side for a long time. Whats been causing me this pain on the right side of my mouth?"
Anonymous Patient
It is most likely the wisdom tooth and i would recommend having it looked at and most likely extracted as it can cause swelling in the area, infection, increased pressure on the other teeth in that quadrant and soreness of the muscles which can cause pain and difficulty on opening. if you can not see your dentist or Oral Surgeon right away try anti-inflammatory medications such as Ibuprofen ( motrin , advil ) and salt rince (warm glass of water and teaspoon of salt) 3-4 times a day. There is a possibility that you may have TMJ disorder but i would look into the wisdom tooth possibility first
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"White bump on lip I woke up this morning with a white bump on my upper right side of my lip. It doesn't hurt much but it kinda worries me since I've never had it before. Is it serious?"
Anonymous Patient
It may be a variety of different things , sudden appearance usually means its not serious, I would recommend seeing your dentist or physician to have them take a look at it.
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"Implants Are implants safe and do they have side effects after? If they do have side effects what are those and how long does it take ?"
Anonymous Patient
Dental Implants are very safe, the average success rate is 97 %. You have to make sure that you get evaluated by your Dentist to make sure that you are a candidate for implants as there are some contraindications that exist. Implants are the best alternative in tooth replacement provided there is sufficient bone and no contraindicating factors such as poor hygiene, smoking, some health conditions could also be a factor , etc. There are no side effects as they are made of biocompatible material.
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"What could this red mark be? Went to the dentist today to ask a question. She quickly examined my mouth and noticed this red mark where my wisdom tooth used to be. She poked at it and asked it it hurt. I said no. What could this be? Could it be an infection from the nearby tooth? Also two days ago I did have RCT on the tooth above that. Could some of the material from the RCT or the stress of the RCT cause that?"
Anonymous Patient
Could be a small piece of bone that is coming through the gingiva after the wisdom tooth extraction , could be laceration (trauma) from the clasp from when root canal therapy was done, could be just trauma from eating something hard that had scraped your gum. I would recommend your dentist to reevaluate it in 2 -3 weeks to see if its still there, if its trauma related it will heal by then, if not further, more extensive examination will be in order
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"Wisdom teeth How long should I wait after 4 wisdom teeth being extracted to start dipping smokeless tobacco again??"
Anonymous Patient
I cannot recommend to you that its ok to dip, but as a safety precaution you should be ok after a week to 10 days. Tobacco, smokeless or not does lead to cancer, its a proven fact and the smokeless kind leads to oral cancer with a treatment that is a major surgery with jaw resection and major reconstructive surgery. my recommendation would be that if you are going to stay away for 10 days , QUIT for good.
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"Prosthetic Can a Periodontist elect to have a lab install the prosthetic after the original one was installed by the Periodontist, it seems every time the issue of breakage was found the lab came in " Perrin-Young" The lab came in for installation and removal, versus the Dr. Periodontist, is this standard actions taken by most perdontist?"
Anonymous Patient
Periodontist is limited in his practice to just that specialty. Therefore he / she cannot install any prostheses ( final restorations ). A laboratory tech is not licensed to install any restoration directly to patient. You should have your restorations or prostheses installed by a general dentist or a prosthodontist. Hope this helps
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"Micro Neuro - Wisdom teeth extraction So i have emergency extractions my dentist tells me i need a micro neuro surgeon / oral surgeon for my #17 & #32 , that the nerve is too close they need to cut it and re attatch it apparently to remove these teeth and i cannot find such a dentist who does this procedure, does my dentist know what he's talking about?"
Anonymous Patient
To properly diagnose the location and proximity of the nerve to your wisdom teeth you should consult with an oral surgeon and have Cone Beam CT scan done. You can not diagnose what is happening in 3D from a 2D xray. My advise is to seek an Oral Surgeon that offers a 3D scan and have that Dr diagnose and treat as needed.
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"I had a absess on my gum, it burst. Everything taste funny now for a couple of weeks.I now have a dull ache in my left arm that some times moves up into my left shoulder. Could this be from the absess? Could an absess in the mouth result into a heart attack."
Anonymous Patient
You have an infection that is draining into your mouth and you are ingesting it making it possible for your whole body to be systemically affected. You have to have it looked at immediately and will have to take antibiotics. You have to see your Dentist immediately to seek treatment for your infection. As your infection drains your lymph nodes may also get swollen and it can spread to your heart and brain if not treated in time.
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"Can my son almost need a RTC in three months?? My son has three to four cleanings a year. Our insurance pays for three of them. My son had a cleaning in Aug 2013 Jan,July,Oct of 2014.. In august of 2013 the dentist put sealants again on his molars. In Feb of 2014 he had sealants put on pre-molars. He was never once told he had a cavity until Oct 2014. They said he had five. Anyway my son had his braces off in Nov..took him to a new dentist and my son has a huge cavity on #2 DOL with pulp cap. We don't drink soda or sports drinks."
Anonymous Patient
sometimes braces cover up a carious lesion, sometimes dentist do not take necessary x-rays during orthodontic treatment, sometimes a lesion can be small on the surface and very large once you get past enamel and if the small lesion was covered up by the sealant it could have gone unnoticed. there are many possibilities there and its hard to determine anything without a complete record of what actually went on. Most of the time if you have a cleaning every 3 months the doctor will not do an examination at every visit. Sometimes cavities can get large rapidly but not in 3 months, so most likely it went undetected
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"teeth How can i get a nice smile"
Anonymous Patient
Best way is to visit a dentist to have your smile evaluated and talk to him/her about what it is about your smile you don't like and what you do as well as what you would like to have at the end of smile makeover. Many things could be a factor in why your smile looks a certain way and there are also many solutions on how to make things better.
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"just had a crown prep today for tooth #19 dentist and i had a discusion on color. we agreed to have a combination of an a1/2. originally he said a2 what is your recommendations? keep a2 or combination a1/a2?"
Anonymous Patient
Combination of colors is usually more realistic and lifelike. For tooth #19 it may not make much difference though as it is a molar that usually doesnt show much. If it shows in your smile you maybe better off with combo color.
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"tooth ache I have a partial and the anchor tooth hurts. Weird thing is the pain goes away for days at a time, then comes back. The dentist that did my partical tried removing that tooth but realized he shouldn't, so he left it there. I have no dental insurance."
Anonymous Patient
I would recommend to have it examined by a dentist, whether it is your dentists or a different one. It sounds to me that it could be trauma to the tooth or supporting structures that may have occurred during the attempted extraction. If so the nerve and blood supply to the tooth may have been damaged or severed. In this case a proper evaluation has to be done to determine the cause of pain and to come up with ways to treat it. Have you tried talking to your dentist to see if he could help you? Having no insurance should not be a deterrent in seeking help. Do you have any swelling in that area that comes and goes with the pain. If so you may have an abscess that drains once in a while and that may get rid of your pain for a short period of time until the pressure in the abscessed area builds up again. You should have it examined and have an X-Ray taken to diagnose the problem and treat it as soon as possible.
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"had composite placed mo and do on tooth #3 why would a dentist use an "a2" shade and not layer it to more natural tooth color. very disappointed"
Anonymous Patient
There are a few issues to cover here. One, A2 is a common shade to use in posterior teeth as most of the time it not going to show in your smile unless you are missing a bunch of teeth in front of #3. Some dentists like to place a slightly different color in posterior teeth so it would be easier to see during checkups, If you had MO and DO placed, that restoration is between the teeth and you should not be able to see it at all. On the off chance that you can and its not pleasing to you, you should definitely talk to your dentist to see if he can use a more appropriate shade to replace it with. Composite restorations can be matched pretty well to any tooth and layering is one of the techniques to do that. If aesthetics are your only concern and you want a perfect match I am sure that your dentist can replace it for you, but keep in mind, that aesthetics on posterior teeth are not usually covered with insurances and you may need to pay extra to get it done just so. If you are disappointed you should talk to your dentist about it and voice your concerns. I am sure he/she would be happy to help you.
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"should i crown tooth #19? or wait till it breaks down more? it was reccomended 2yrs ago, and still good, little chip on top of tooth, margin. #19 - lower left back - very large silver filling, breaking down should i put this in the wait and see approach, or just get it done now, i have insurance."
Anonymous Patient
I would recommend the same thing your dentist did. You need a core build up and crown. Problem with waiting a lot of times is that your tooth will fail on you in the most inopportune moment and you then will be unha]y that you waited. Having dental insurance is also a plus. Usually you have a yearly max and you loose the benefit if it's not used. Get it done and then you wouldn't have to worry.
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"braces I'm 38 am I too old for braces?"
Anonymous Patient
In short, NO! Anyone can get braces at any age provided your teeth, gums and bone are in good health.
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"sinusitis i have pain under my left cheekbone and my left upper teeth throb. When I last had this my dentist said my teeth were fine and thought I had sinusitis. I took 10mg of phenylephrine over an hour ago and it still hurts"
Anonymous Patient
The symptoms you described could very well be sinus related and decongestant alone may not help if there is an infection in your sinus. Checking with ENT would be warrantied. There also may be a dental ( tooth ) infection that in its beginning stages may not show up on the X-ray and will need to be tested for by other means such as Electric Pulp Test , percussion test etc. It may also be a Periodontal Infection (gum infection ) or a cracked tooth that may not be visible on the X-rays . You may also have a foreign body ( like a popcorn kernel) stuck under your gum which produces inflammation and pain. A thorough examination with all necessary testing must be done on all the teeth in the area , occlusion must also be checked to exclude any possible dental problems. If no dental issues exist a visit to a ENT maybe in order. There is also a possibility that if you grind your teeth you may have similar pain. If its a sinus infection there is one other symptom that can accompany what you are feeling and that is change in intensity of your pain with changing position of your head ( such as when you get up or lay down the intensity will increase or decrease). This happens because of fluid movement in your sinuses. If that is the case you should definitely talk to ENT. Hope that helps.
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"Canker sores and sore/bleeding gums Last week I had a sore gym area in a very defined area. The next morning my throat was swollen and I had several canker sores. A few days I felt very run down and may have been running a fever. The sore gums and canker sores have persisted. I went to the dentist and he prescribed a mouth wash w/ disenfectant and a topical cream for the ulcers. Is there anything else I should do?"
Anonymous Patient
One thing to rule out is Herpetic Gingivostomatitis or Herpes Simplex 1 infection of the oral cavity. If this is the first time this happens the primary infection could be very painful. it runs its course out in 2 weeks and you may get some recurrent cold sores after that. If its not that, it may be aphthous ulcers that will also be uncomfortable and only require topical treatment. http://www.drotterholt.com/magicmouthwash.html - Magic Mouthwash can help with those. They tend to occur with increase in stress and will also be recurrent. Best is to have a definitive diagnosis first so you know what you are dealing with.
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"gum blackness how can my gum get pink again"
Anonymous Patient
I would recommend an evaluation by your dentist to determine why your gums are black and what treatment may be required.
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"upper jaw expansion I was told that my daughter will need upper jaw expansion.. what is that exactly? what is done to her mouth ? how long does is take on average or is it like braces? and is it painful?"
Anonymous Patient
In the event that your child has an underdeveloped palate and the upper jaw is smaller then the lower the palatal expanders are advisable to expand the constricted palate and align it with the lower jaw. the palatal expansion is done gradually with an appliance that is cemented into the mouth with a crank in the middle that will push the two halves of the patients palate apart, widening the jaw. It is usually done in children prior to Orthodontic treatment. this treatment can be a bit uncomfortable and may require OTC pain management. This treatment is done over a period of a few weeks to a few months. The expansion will create spacing between the two central incisors ( two most front teeth) on top as well as change the way back teeth come together. https://www.google.com/search?q=palatal+expander&espv=2&tbm=isch&tbo=u&source=univ&sa=X&ei=Rj7hU-TLHYOgyASSv4KADQ&ved=0CB8QsAQ&biw=1600&bih=775
this is the link to what the appliance may look like
and this a youtube video that illustrates how it is done
https://www.youtube.com/watch?v=BPenw6JtzfU
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"My upper front tooth with a very old root canal, post and full crown porcelain on silver broke from its stronghold. 30 yrs ago my upper front tooth had a root canal & full crown of porcelain over silver. 2 weeks ago I bit into a apple & I heard a crack inside that rooted canal. After examining I realize the tooth moves fwd & backward, & 45 degrees to the L & R. But wont let me pull it out using reasonable force, WHY? I have no Ins. or extra money. What can I describe to a DDS that means fast fix? Can the tooth can be pulled out, washed, dried then re-cemented to last awhile if careful?"
Anonymous Patient
Its hard to determine what exactly is going on with the tooth without looking at it and having an x-ray. From your description is sounds like the root of the tooth may be fractured or the part of the tooth inside the crown broke off and since it is attached to the post it doesnt want to come out possibly due to the post cement being locked. I would advise to have your dentist evaluate it and give you a better idea of what is going on as well as what treatment alternatives you have.
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"Should I get my child a milk tooth filling or wait for the tooth to fall out? Cavity, slight tooth pain"
Anonymous Patient
that would depend on the age of the child , which tooth it is (some teeth are lost earlier then others). if the child reports pain , evaluation and treatment by a dentist should be done. your decision can be made after you talked to the dentist and are given all proper information and options for treatment
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"Are my teeth falling out? They feel loose and can move them a little with my pother teeth."
Anonymous Patient
It is hard to tell what is happening with your teeth without a proper examination. There are multiple conditions that could lead to mobile teeth including Periodontal Disease, Malocclusion, Loss of molar teeth, Trauma, etc. I would recommend to have a Comprehensive Evaluation by a Dentist to figure out exactly what is causing your teeth to be mobile and see what can be done about correcting that.
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"What is the best toothpaste? I have seen lots of commercials for toothpaste and I have been given Crest by past dentists."
Anonymous Patient
Most regular toothpastes are the same , differences are minor and mostly in additives and taste, active ingredient is usually fluoride. Some toothpastes are made for whitening and have stain removing ingredients and more abrasives to get the stains off. Some are made for sensitive teeth like Sensodyne and Colgate for sensitive teeth. If you have cold sensitivity these are great for that. There are some that have no fluoride due to concerns that Fluoride is toxic ( in large quantities ) . There are some that can help with Periodontitis and Gingivitis better than others like Colgate Total Care. So there is no one good answer to your question , it all depends on what you are looking for and conditions you need to treat.
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