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Dentistry/chipped lower front lateral incisor

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Question
I am embarrassed to say I am 34 yrs old and have not been to the dentist in 10 yrs. I have a huge phobia now mainly because I know I have a lot of work that needs to be addressed with my teeth. I have let my wisdom teeth grow in because they grew in normal besides a couple tooth aches. Lately I have noticed tho that they have moved my teeth and my two front lower incisor teeth are starting to jam together, I'm assuming from all the pressure from my bottom wisdom teeth that grew in. I am pretty sure I have gingivitis as well. Now the problem...this morning I thought I had food stuck in my lower front lateral incisor and used a toothpick to get it out and I ended up chipping my actual tooth (the part on the bottom of the tooth connecting to my lower gum line# I now can kinda see the root of that tooth and I noticed the tooth next to it has the same bulge there #looks like food..im assuming tooth decay?)so I haven't messed with that one. I can see and feel a little hole there and I am freaking out because I don't want to lose my teeth :( I have finally made an apt for the morning for an exam. I was just wondering what are some options that they might have to do? Also, I only have state insurance (Medicaid) but its full coverage. Is is possible I'm going to lose my teeth? Also, do you know anything about state insurance as far as will they still work on my teeth but could they put me on a payment plan if Medicaid didn't cover everything? I am so scared to go to this apt in the morning. I just feel so embarrassed for neglecting my teeth for so long that it had to come to this.

Answer
Hi Jessica and thanks for your question.

Firstly let me just say well done on taking the first steps to return yourself to routine dental care.  I know full well how difficult is can be, having done extensive work with dental phobia over the past years and until someone experiences the frustration and despair of being held hostage by your own mind, they will never fully understand the concept of phobia.

From what you explained, it really doesn't sound too drastic and I have found that most patients have the ability to blow up the situation worse than what is found clinically, probably as a sub-conscious trick to avoid dental treatment - so don't let yourself be fooled into not going to the dentist because of what you think is wrong.  Let your dentist evaluate the situation and communicate with you over what the diagnosis, what the possible treatment is, what the costs are.  Communication is vital for your successful return to the world of dentistry and please be completely honest with your dentist at all times - about this condition and every other aspect which you feel is important.  If you need to break or want some air, say so - don't just lie there feeling helpless and out of control.  It remains your body and mouth and you have full control over what is being done to it all ALL times.  Find a dentist whom you trust and get along with and with whom you can talk easily with about issues which concern you - and when in doubt, get a second opinion or shop around for other options.

The world of medical insurance is just too extensive for clinicians to stay abreast with all the various plans available today, but discuss your financial issues with your dentist and most will gladly come to some form of agreement - most have payment packages readily available for this reason.

With regard to your immediate dental problem, I feel that it would not be ethical to give you a long list of possible dental diagnosis without be able to examine you personally.  That would only get your mind spirally out of control for no reason.  Have a good rest tonite and put your faith in the hands which are going to heal you, in the knowledge that you are doing the best to help yourself and in getting your oral health optimal again.  Proud of you.

I hope this helps and I wish you all the very best further, especially for tomorrow. Take care

Kindest regards
Dr Craig Peck

Dentistry

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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)

Expertise

I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.

Experience

I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Organizations
Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

Education/Credentials
B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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