Emergency Dental Clinics – How They Can Be Beneficial To A Healthy Treatment Plan
Click the player below to listen to this episode of Let’s Talk Dentistry or scroll down even further for a transcription of this week’s show with San Diego holistic dentist, Dr. Marvin.
In this episode Holistic Dentist Dr. Marvin is joined by Dr. Irvin who comes to us from On Demand Dentist, bringing their unique approach to dentistry focusing specifically on treating those with dental emergencies. As a all day all, all night dentistry, their main concern is getting patients out of pain, things like extractions, pain medication, fillings and more. We discuss how this 24/7 pain relief approach to dentistry not only fits in the grand scheme of dentistry, but also can be beneficial to so many with a health conscious mindset. All this and more on this week’s episode of Let’s Talk Dentistry!
——– Transcript Of Today’s Show ——–
You’re listing to Let’s Talk Dentistry with Dr. Marvin. This show is sponsored by The Center for Natural Dentistry in Encinitas where they take a holistic approach to dentistry and your health. Hello you’re listing to Let’s Talk Dentistry. Thanks for joining us today. This is Dr. Marvin. Today we have a great show for you. We are going to talk a lot about toothaches because I have a toothache expert in, Dr. Irvin. How are you Dr. Irvin?
(Dr. Irvin) Good, good. How about you?
(Dr. Marvin) I am doing well. Thanks for joining us today. We have a great topic. People don’t know that not all dentists are 9-5 dentists, like myself. I have at The Center for Natural Dentistry; we are opened 4 days a week for about 10 hours each day. And what we do is we help people. But what happens after hours? What happens on the weekends? What happens after? If you an existing patient obviously you can call us and you will get either myself or Dr. Godes. But if after hours if you don’t have a dentist and you’re not a patient of record in our office where do we send you? We’ll let me tell you about this. There is a new office in town. Been here for almost a year, and Dr. Irvin actually comes from that office. That office is actually called On Demand Dentist, fitting isn’t it?
(Dr. Irvin) Yep.
(Dr. Marvin) What they do is when you need a dentist and you need one immediately, which is what On Demand Dentist is there for. It’s kind of like an urgent care for dentist. Why don’t you tell me a little bit about what On Demand Dentist is?
(Dr. Irvin) Well, On Demand Dentist is a practice and we have a bunch of dentist that are actually on call 24/7. So basically if you have any toothaches, or tooth pain, or anything of that nature you want to give us a call and one of our dentist will come down there and help you out, help you get out of pain.
(Dr. Marvin) So it’s for people that lets say haven’t been to the dentist in a while and they have excruciating pain, right?
(Dr. Irvin) Yes, definitely.
(Dr. Marvin) Ok so, how do people find you?
(Dr. Irvin) So on the, they either go online and they Google search ODD or On Demand Dentist or emergency dentist around the area. We are located in San Diego, Claremont Mesa.
(Dr. Marvin) Great. And then so they have a toothache, can you tell me you know what’s the difference between your practice and just a regular dental practice?
(Dr. Irvin) Well, On Demand Dentist basically again is 24/7 its all the time so a regular dental practice you would call in and they would try to fit you in to the schedule, which is really packed, and the dentist is working constantly bouncing between patients. Really a high rate practice. Here the dentist is available at all times so you call us you get an appointment scheduled, which is usually right after you call us. We come right down there and help you out. So you are the first person in there and you get the one on one service that you deserve.
(Dr. Marvin) I think that is important because a lot of people first of all don’t understand that when you have a toothache that really consumes your whole life.
(Dr. Irvin) Exactly.
(Dr. Marvin) You can’t eat, you can’t sleep, you can’t go to work, and you can’t think about your family, you can’t enjoy life. I mean a toothache if you have ever had one can seriously control your whole life. And On Demand Dentist is there to alleviate people’s pain when they need it most. So when do people call?
(Dr. Irvin) People usually call on the weekends, at night, I would say Thursday night on to Sunday night is pretty much the times where dentist love to take the weekend off in their comprehensive practices.
(Dr. Marvin) Yeah I think most people don’t understand that dentist like the comfortable 9-5 job. Most dentists only work 4 maybe 5 days a week. We only work 4 days a week, 4 long days, but they get tired and they want their time with their families or their free time but what I find in my practice and the practices that I worked in the past and other dentist that I talk to is that these toothaches ok, that people have they usually come after work. They come at the end of the day and what do you think? Do you think most dentists, you know, want to see an emergency patient?
(Dr. Irvin) Defiantly not. This is exactly where we come in. I mean On Demand Dentist we actually love it. I love the fact that I am on call and I can help relive somebody’s pain. Because toothaches happen sporadically. They just kind of pop up.
(Dr. Marvin) Yeah toothaches can come and go and I don’t know if you have ever had a toothache before, you know it can come and it can go. And the first thing is how do you relive the pain? Well, there are over the counter ways or at home remedies that you can use to alleviate the pain, but one thing that I always talk about on this show, Let’s Talk Dentistry, is that you deal with the cause of the problem not just deal with the symptom. And pain is your body’s way of saying that there is something wrong. Now you can alleviate the pain by taking your pain medication or you can alleviate the pain because it the nerve that is in pain, you can take out the nerve and that’s what a root canal does. But just like I talk about all the time, if you are not addressing the root cause of the problem you’re really just putting off a symptom until its worse where the pain comes back even stronger with vengeance and since pain is a motivating factor you know On Demand Dentist can really seriously help people, especially when they need it most. And a lot of times these happen in the middle of the night pain can come on for no reason at all. One of the things that you’ve you told me Dr. Irvin is that the pain that these people are experiencing from a level of 0 to 10 what is the pain level for these patients?
(Dr. Irvin) Average 8 or so, it’s pretty high.
(Dr. Marvin) 8, some 9s, probably 10s. One of the comparisons from my patients when they talk about pain or tooth pain, more specifically, especially from my female patients of course it’s that the pain is so excruciating its worse than child birth. That’s some of the pain. So obviously you and I haven’t experienced that but that, you can imagine having a child you come out of your body versus a toothache and these people are saying that the toothache is worse. So if you are there with they need it most you can be pretty much have a big S on your chest and you’re like a superhero to these people aren’t you?
(Dr. Irvin) I guess you could call it that.
(Dr. Marvin) So what are some of the procedures that you do to help these people get out of pain?
(Dr. Irvin) So basically right when you come to the office we would take an x-ray and do thorough toothache exam on you. Then we would go over your options after that. So we have the x-rays that we actually print out and let you see in hand. Everything is right up front. There are no hidden fees. It’s completely honest 1 on 1 time. So your options after that assuming we can localize the tooth and we can definitely tell you where the pain is coming from. We basically tell you our options are extraction which is taking the tooth out or a pulpectomy which is removing the nerve. We do not do complete root canals but we can get you started, if the nerve needs to be taken out if the patient is scared of the actual tooth being taken out.
(Dr. Marvin) Ok, so you what would you say your number 1 procedure is for a toothache?
(Dr. Irvin) Oh extractions.
(Dr. Marvin) Extractions. And if don’t know what an extraction is it’s where you take out the tooth. And one of the procedures that you mentioned is a pulpectomy. And that, you mentioned that this is not the root canal so let me explain what a pulpectomy is for people that don’t know what a pulpectomy is. A pulpectomy is literally the first step of a root canal. When you have damaged the nerve or let’s say you have a toothache and the nerve is throbbing, one of the things that you can do, or one of the procedures you can do to help get you out of pain is to take out the nerve. Well this procedure to take out the nerve is called a pulpectomy. Can you tell me Dr. Irvin, what’s the difference between a pulpectomy and a root canal?
(Dr. Irvin) Pulpectomy is basically, you know you open up the top of the tooth up and you go down there and you remove the nerve, and that’s it. You literally seal the top of it just to get the patient out of pain so that pain is from the nerve basically toggling like a little pressure switch causing the patient striking pain or even dull and achy pain. We would remove the nerve and that’s it. And let the whole relief happen.
(Dr. Marvin) So what happens to the patient after we remove the nerve? They are obviously out of pain but what’s next?
(Dr. Irvin) They are out of pain but at the same time if they want to move forward with a regular root canal they would have to go to a comprehensive dentist and then do it there.
(Dr. Marvin) Comprehensive dentist or an endodontic, so what is the remaining part of a root canal? What is left to do after you take out the nerve? Because some people think that a root canal is simply they don’t even know what a root canal is, so what is the rest of the root canal?
(Dr. Irvin) The rest of the root canal is cleaning out the canal after you take out the nerve, irrigating it with some special solution basically to clean out all the bacteria in there, and then filling it with a rubber material called guta percha, and then putting a post in it and then putting a crown on the tooth. So it’s a lot of work to go into a root canal further than just going into the nerve.
(Dr. Marvin) So why do you have to put a crown on the tooth?
(Dr. Irvin) Basically in order to seal the margins. Once we drill into tooth you want that margin to be sealed so no other bacteria gets in it after a root canal if that was the choice. Yeah, you just want the margins to be sealed in order for that tooth to be wholesome, so to speak.
(Dr. Marvin) Ok. So back up. We have taken out the nerve, that’s called a pulpecotmy, where you take out the nerve. Then you go in there and you clean and disinfect the canals. Now I am going to tell you as a holistic, biological dentist clean the nerves and disinfecting may work for a little bit but it doesn’t get into all the canals so I personally have some views again root canals and therefore it is not a procedure that we endorse but I do endorse it for people that for a particular instances where A you need to have the tooth and you need to get out of pain. Let me give you an example. If someone were to fly in from our of country and it was their front tooth that hurt and we don’t have a solution to they have a front tooth that is in pain and removing the nerve will get them out of pain and also have them keep the tooth at least temporarily then I would endorse that procedure. You agree?
(Dr. Irvin) Definitely. I agree.
(Dr. Marvin) One of the reasons why I like Dr. Irvin, he is actually works at our office as our sleep medicine specialist at our office. And the reason why I like him is because I have been sharing and mentoring him a little bit about these root canals and you know, at the On Demand Dentist you do clean out the infections and do the first step but do you fully endorse root canals?
(Dr. Irvin) Personally, I do not. I not a big fan of just cleaning something temporarily. I like the more definitive treatment and this is exactly what On Demand Dentist is about, and it’s the way I live.
(Dr. Marvin) So another thing about root canals is once they are out of pain and they go home, what usually happens because when they go to the dentist or if they go to the dentist afterwards are they hit with a shock or a shock at the price tag for finishing it.
(Dr. Irvin) Oh yeah definitely. They just think it’s a quick fit. A cap should always cost a very minimal amount to patients when actually crowns can run the cheapest crown I have seen is $700 and it can run up to $3,000 maybe $4,000. Plus the post.
(Dr. Marvin) There are plenty of procedures that need to happen and a lot of money that has to be invested into a tooth. And one thing that is important when you decide to do a pulpectomy, and we don’t you know, pulpecotmy are not done very often because most dentist go straight forward and do the full root canal but when a root canal is started a pulpecomty is done there is still a lot of procedures and a lot of money that has to go in. So Dr. Irvin, when you talk to patients about the pulpectomy you also talks to them about the next steps and the cost it involves. And people in order to save these teeth literally have to spend 2, maybe $3,000 just to save the tooth and you know. There has to be reason why people come to On Demand Dentist because they haven’t been to the dentist.
(Dr. Irvin) Exactly, exactly.
(Dr. Marvin) And if they haven’t been to the dentist they sometimes they haven’t had a root canal before and crowns and so this is where the thing about dentistry can get very expensive. This is that dentist are expensive is because the procedures are expensive and a lot of people just don’t like going to the dentist. Am I right?
(Dr. Irvin) Exactly, exactly.
(Dr. Marvin) So if you don’t go to the dentist, ok. Then you could have obviously a toothache and you could have a cavity I would say most toothaches are caused by cavities that have gotten too big.
(Dr. Irvin) yes. Deep cavities close to the nerve.
(Dr. Marvin) Close to the nerve. And don’t a lot of people think that they can just put a filling or get a crown on the tooth?
(Dr. Irvin) They do think that, but again after our assessment and our exam and our x-rays, usually the x-rays show that the decay is right on the nerve. This is the reason why they are having pain. It is striking its actually nerve in your jaw bone so.
(Dr. Marvin) Yeah and you said that you take x-rays right?
(Dr. Irvin) Mmmhhmm.
(Dr. Marvin) So what do you see on the x-rays on these teeth that have tooth decay?
(Dr. Irvin) Well what we see in dental terms blown out is the basic way I can say it, but you would have a basically a dark spot in place where it was supposed to be white in an x-ray, lay men’s terms but,
(Dr. Marvin) that is one of the things that at The Center for Natural Dentistry, we have what’s called a 3-D x-ray, a cone beam x-ray. Do you have one of those at On Demand Dentist?
(Dr. Irvin) We do not. We have the panoramic x-ray, the one that goes around your head.
(Dr. Marvin) Ok, so keep in mind that at On Demand Dentist there is just a panoramic x-ray, at our office The Center for Natural Dentistry we take we call it a cone beam or a 3 dimensional x-ray where we get to look at the teeth from multiple angles and actually can see those holes a lot clearer and one thing about x-rays it that it only shows you what it can give. And it’s up for interpretation. So what your actually seeing on the x-ray when you have a lesion or you have a hole at the end of the tooth is that part of the bone has been eaten away by the infection and one of the reasons why we don’t do root canals is because when you do a root canal it does not clean out that infection and it doesn’t fill in with health bone and so one of our focus at The Center for Natural Dentistry is to focus on more definitive treatment which is to not only clean out the infection but sometimes we have to take out the tooth. Is that something at On Demand Dentist, you know, do you do that also?
(Dr. Irvin) Filling wise, no we don’t if that’s what you are getting at. We do not do fillings. Basically, I want to say retract a little bit on the panoramic x-ray, on an x-ray in general you only see 35% of what is actually there. So if something is close to the nerve in terms of the x-ray you are in the nerve and therefore it easier has to come out or take the tooth out.
(Dr. Marvin) That’s a good point because on an x-ray if you see something on the x-ray that means that the process has been going on for quite a while so in dental talk Dr. Irvin and I can be like yeah you see a large cavity on an x-ray but in real life when you take a look at it with magnifying glasses and we look then the cavity is a lot deeper and so if it’s a lot deeper that means that bacteria has actually gotten to the nerve traveled down to the nerve traveled down through the root gone outside of the tooth and one of the clinical signs we see is that if a tooth hurts when you bite down on it, ok. Chances are that you have an infection at the end of the tooth. And if you have an infection at the end of the tooth again cleaning it, doing a filling, or cleaning out taking out the nerve is not going to solve the problem. And so this is very interesting because we want to make sure that we get to the root cause of the problems that’s what The Center for Natural Dentistry does. Dr. Irvin at On Demand Dentist takes care of the root cause too by taking out the tooth and also taking out the infections especially when the tooth aches are pretty bad. So Dr. Irvin tell me about what On Demand Dentist does not do. Because you mentioned that you help people with toothaches. What about people who don’t have toothaches?
(Dr. Irvin) Well the people who without the toothaches we basically do not do any cleanings, we don’t do fillings, we don’t do crowns, we don’t do teeth whiting. So we are strictly, strictly, strictly toothache relief.
(Dr. Marvin) So I can’t come see you for a checkup?
(Dr. Irvin) No definitely not.
(Dr. Marvin) Ok. What about if I wanted dentures?
(Dr. Irvin) No dentures as well.
(Dr. Marvin) Implants?
(Dr. Irvin) No implants.
(Dr. Marvin) Bridges? Crowns? Anything?
(Dr. Irvin) No, no bridges, no bone grafts we just basically get your out of pain and get you on your way.
(Dr. Marvin) Ok so it’s kind of like you are going to the emergency room. You don’t go to the emergency room for a checkup or for someone to just draw blood and see how a physical or anything like that. So that’s an interesting concept. So you are there just to help people basically get out of pain?
(Dr. Irvin) Mmmhhmmm.
(Dr. Marvin) Ok, so at our office at The Center for Natural Dentistry of course we do a lot more procedures. We do take care of people’s toothaches but one of the things that we focus on is getting rid of the source of the problem which can be an infection but also restoring the teeth with good materials maybe it’s a plastic material. Of course we take out toxins that are found in people’s mouths such as mercury fillings, or let’s say it’s a metal crown or maybe it’s an infection around a root canal or metal braces or anything like that so our office is a little bit different kind of tailored more toward people that are more holistic people that want a healthier approach that want a more common sense whole body approach but you know, we help people this way but I am going to tell you, Dr. Irvin, you help people in your own ways right?
(Dr. Irvin) Exactly.
(Dr. Marvin) So tell me what the typical, or tell me a story of someone that went to the office and you know that basically got what they came for.
(Dr. Irvin) Ok, well I guess one of the most common patients that come by is ones that call for an appointment and they say that they were referred from urgent care. I am saying well basically right here at On Demand Dentist go check for us online so you can bypass the whole emergency room or urgent care. They are just going to send you to us anyways. So a patient is highly in pain, the other day I had on an upper right tooth he couldn’t bite down at all couldn’t open his mouth.
(Dr. Marvin) So he couldn’t eat?
(Dr. Irvin) He couldn’t do it; he couldn’t eat and couldn’t do anything. He was really swollen. He was really surprised that at our panoramic x-ray because there is nothing that you have to do to bite down on anything to take an x-ray which is awesome to patients and it’s like a little ride at Disney Land or something. They just kind sit and have their picture taken.
(Dr. Marvin) What I want to tell people is that if you are used to having x-rays done where they put something in your mouth, its either a piece of film with a little piece of paper or it’s a digital sensor. It’s a little bit thicker than film and it has a wire on it you know it can get pretty uncomfortable when you put it into peoples mouth and it could be even more uncomfortable when their mouth is in pain they can’t open their mouth and so this x-ray you don’t have to do that so you don’t really have to sick anything in your mouth to make it uncomfortable then?
(Dr. Irvin) Nothing goes in.
(Dr. Marvin) Alright, so that’s one benefit for going to On Demand Dentist. What else? What happened next?
(Dr. Irvin) Basically so I gave the patient his options and we were going to take out the tooth. He was ok with that he just wanted to get out of pain, so right after we anesthetized basically numbed him up he automatically started feeling better. Took out the tooth, it took about 10 minutes I would say. Popped the tooth right out and he automatically, like you could tell the expression on his face he was so like so much better. Like his livelihood just came back.
(Dr. Marvin) yeah I think its funny when you said that when you numbed him up, because a lot of people their scared of getting a shot. But these people it’s kind of the opposite. They are in excruciating pain without being numb and then they can’t even wait to get the shot or to get numb because the pain will go away the moment that the anesthetic kicks in.
(Dr. Irvin) yeah exactly.
(Dr. Marvin) Isn’t that pretty funny how, how things can change if the circumstances.
(Dr. Irvin) yeah, all your fears are out the window.
(Dr. Marvin) Yeah so you popped it out and you said that he was a new man. How would you explain that?
(Dr. Irvin) Oh yeah. The livelihood came back. I mean literally the color in his face changed. His eyes kind of cleared up. I scrapped out the infection and gave him some sutures, some stiches and he was happy. Just completely happy that the one cause of pain that had been a problem for him, he said it was problem on and off for a couple months. So now the main thing was just getting him to the dentist and now we are able to take care of that. He is good to go.
(Dr. Marvin) That’s a long time a couple of months of dealing with pain. Just imagine if you’re out there listening to this show and you have pain in a tooth. Maybe it comes and goes a little bit there but if it’s been a problem I have got to tell you pain in your body’s way of saying there is something going on. And if this has been bothering him and it kept escalating and it continues to get worse and now the pain is so bad that he has to call in the middle of the night or something like that and have to bring in a dentist in order to do that. It has to be pretty bad.
(Dr. Irvin) Oh yeah.
(Dr. Marvin) I expect, you know correct me if I am wrong. If you, was he a big guy?
(Dr. Irvin) yeah he was.
(Dr. Marvin) Ok. He’s a big guy, going to tough it out, can handle a lot of pain. But eventually he couldn’t handle this pain. So what we did, so you ended up taking out the tooth and he feels a lot better and the best thing about it is that a you were available you took care of his pain you didn’t just patch it up though. And so what do you expect from him moving forward? Do you think that, you know, is he going to be hurting afterward?
(Dr. Irvin) No. His pain is going to be less than before basically. So for about a day afterward you would be a little sore but there will be no striking pain like before he came in.
(Dr. Marvin) So that is pretty much expected. You know you have a surgery where you have to extract a tooth it’s kind of like if you had a fall and you had a bruise or a cut in your knee or elbow or hand something like that it’s going to be sore and throbbing for a few days right?
(Dr. Irvin) Yeah. So that’s pretty much explained. That’s a very cool thing that you are doing. As tying it in to natural dentistry and what we do at The Center for Natural Dentistry this kind of fits in because we realize that there are a lot of people that don’t go to the dentist and your listening to this show and you haven’t been to the dentist for a while and you don’t want to become overwhelmed by all of the comprehensive exams and hitting you with all these things and you have a toothache. You can literally call you know Dr. Irvin and On Demand Dentist and you guys aren’t going to bombarded people with all the treatments and stuff like that.
(Dr. Irvin) Oh no. We tell you what you need; right there just to get you out of pain.
(Dr. Marvin) And so it’s a great concept and I am glad that your around I have got to tell you that if I have a patient that calls our office I am going to call you especially if it’s in the middle of the night, if I am on vacation, or if Dr. Godes because we do not as a patient at our office, as an existing patient at our office we don’t prioritize an emergency patient over our existing schedule. We only see one patient at a time. I am going to tell you that most dentists are like this. They do not want to ruin their existing schedule to see new patients. So if you want to be you know get the attention that you deserve if you want a dentist to look solely at the issue at hand and not tell you about all these other stuff that you have to do in your mouth. If you want an honest person to get to out of pain I highly suggest you give Dr. Irvin a call. So let me give you Dr. Irvin’s number if you have a toothache right now and you want to give us a call that’s 619-342-3577, 619-342-3577. I am Dr. Marvin. Thank you for listening. Dr. Irvin is going to join me next week so if you have any questions feel free to call or give him a number give him a call at 619-342-3577. If you want to schedule a visit with me or Dr. Godes at The Center for Natural Dentistry call this number 760-536-1199. 760-536-1199. You have a great week. And I will talk to you next week. Bye bye now. You’ve been listening to Let’s Talk Dentistry with Dr. Marvin. This show is sponsored by The Center for Natural Dentistry in Encinitas where they take a holistic approach to dentistry and your health.