Dr. Doering's Blog
May 08, 2017
Category: Uncategorized
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Second Opinion


When you are given only one treatment plan to correct or solve a problem whether dental or medical, it's time for a second opinion. This process is normal and acceptable in all circumstances. Most health care providers welcome the opportunity and provide the service without cost, especially if you supply existing radiographs and other relevant documentation from your current provider.





























Tooth extractions or other oral surgical procedures are similar to other surgery; your own care in following the doctor's instructions will speed recovery. Read and follow these instructions carefully and call us the day following the surgery.


HEALING: Do not disturb the wound by touching it with your fingers, a toothpick or your tongue; irritation, bleeding and infection could result. The blood clot, which forms over the area, is nature's method of first stage healing and should not be disturbed.


BLEEDING: Some bleeding is expected. If the bleeding fails to stop within a reasonable time, place a folded sterile gauze square over the wound and bite down firmly for 30 minutes or hold in place. Repeat if necessary.


DIET: No food or liquid for 2 hours after leaving the office. This allows the blood clot to form. After that, you should follow a soft diet for 24 hours. Avoid hot, harsh or abrasive foods until the wound has healed.


RINSING MOUTH: Avoid all rinsing for 24 hours after leaving the office. Then, to help relieve soreness and reduce bacteria, rinse mouth gently with mild warm saltwater. Please note, the salt must be completely dissolved before rinsing. Do not use mouthwash. Alcohol in all its forms can destroy a blood clot and will interfere with healing.


SWELLING: To relieve and help prevent swelling, apply ice against your cheek adjacent to the site for 15 minutes. Repeat 10 minutes later. Swelling after extraction is normal and not cause for alarm. Ice application is effective during 48 hours following treatment. In addition to controlling swelling it also diminishes bleeding and pain.


DISCOLORATION: There could be some external discoloration of the cheek area following surgery.


PAIN: Take ibuprofen. Please call if ibuprofen does not help.


























1. They fit tighter than any other crown. (See comparison research published in JADA)

2. They have the thinnest cement lines when the preparation of the abutment is less than 10 degrees of taper.

3. They can bind a cracked tooth together.

4. They are unbreakable.

5. They do not chip or crack.

6. Gold is malleable and therefore the functional surface of a crown will distort slightly in response to continuous use which can identify areas needing adjustment.

7. They can be altered, repaired and re-cemented.

8. They never corrode.

9. There is no allergy to gold.

10. They wear at the same rate as tooth enamel. (Porcelain abrades enamel)

11. They can be polished and re-polished.

12. Adjacent gum tissue will be healthy when the axial anatomy is correct.

13. They require the least removal of tooth structure. (Worst alternate--shoulder preparation for milled crowns, especially same day service) 

14. They are less costly than white crowns, such as porcelain fused to metal.













Blog #2--Addendum


If once daily you have thoroughly cleaned the gumlines surrounding each of your teeth but missed most of the remaining enamel surfaces you will have succeeded. Alternately, if the reverse is the result, you will have failed miserably. Reason—all periodontal problems which result in damage to gums, connective tissue and bone support begin at the gumline. Because the enamel is a fraction of a millimeter thin at the gumline, compared with several millimeters thick on the functional surfaces, many carious lesions (decay) begin at or near the gumline and rapidly progress. Also sensitivity to various stimuli is traceable to this same region. Usually later in the aging process, the root surfaces that can be exposed because of natural recession or incorrect brushing, toothbrush bristles that are too stiff or both often lead to a restart of the decay process. See blog on xerostomia and importance of anatomic accuracy when extensive repair work is needed.


Because of the importance of the above, you will receive a new toothbrush whose unique design aids all of us in succeeding in this important region. At your next visit we will provide a demonstration as to how to beneift from its shape.























Avulsed tooth (knocked out but intact)


Our expectation—that someone who has read the following instructions will be present when this occurs. More likely when spectating at a childrens basketball, soccer, baseball or other type of team sport where headgear isn't usually worn.

  1. Take charge/find the tooth/ instruct all others to stay away.

  2. Carefully pick the tooth up by grasping only the crown—enamel. Beware, saliva will make the crown slippery. Hold the tooth vertically—root up, crown down.

  3. Carefully inspect all root surfaces to verify no soil is attached.

  4. If soil is visible, rinse off with bottled water. Saliva from the child, saline, distilled water or skim milk are better choices but access is time consuming. Total time out of the socket is inversely proportional to overall success. The small tags of connective tissue seen on the root surface will survive if tooth out of socket time is very short.

  5. Push the root firmly into the socket, without regard to proper rotation. The child will be in early stages of shock and will not suffer significant pain during replantation.

  6. Parent, guardian or possibly the child must stabilize the tooth en-route to their dental office.

  7. Dentist should verify rotation without removing the tooth and then fabricate a stabilization system, as well as checking condition of surrounding bone and gum tissue.

  8. After initial healing has taken place, endodontic tmt (root canal) will be needed. In case the tooth is mandibular (lower arch) the root is narrow from side to side and long from front to back, therefore requires more attention (can only fit 2 ways) when replanting.
















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