Archive for the ‘Dental Implants’ Category

Should I have the root canal or an extraction?

Tuesday, January 12th, 2010

I had a cracked lower second molar, which, when the broken piece was removed I was directed to go to an Endodontic specialist. I have now started a root canal for that tooth. It has been brought to my attention that the broken segment of the tooth is partially below the gumline and there is some concern about whether I should go ahead with the root canal and then getting post and crown to attempt to save the tooth or to just extract the tooth and have a dental implant and permanent tooth put in place. Besides the spiraling costs to be considered, I have no way to determine what to do. Please advise.

Thank you,
-Stan from New York

Stan,
There is no way we can tell from this distance if your tooth will hold up or not. But let me try to be helpful.

If a tooth is broken below the gumline, yes, it does cause some concerns about whether the tooth will hold up. But often a dentist can do a crown lengthening procedure and the result will hold up just fine.

And then another thing that may be going on is defensive dentistry. The dentist wants to be sure you are fully warned about every possible thing that could go wrong, in order to protect himself or herself legally, and sometimes this causes more worry than is necessary.

I would just go back to your family dentist who sent you to the endodontist and ask the question: what are the long-term prospects for this tooth, and what would you recommend? Then make a decision based on what you’re told.

In general, it is better to try to save your own natural tooth when you can.

Posted in Dental Implants, Root Canal Treatment | Comments Off

How soon should I replace my missing tooth?

Friday, December 11th, 2009

I just had an extraction on #3. How soon after an extraction is it recommended to have some kind of replacement? I’m concerned about the surrounding teeth shifting or any other issues that arise from a missing tooth.
- Melissa from Texas

Melissa,
Once a tooth is extracted, I would get SOMETHING in the space right away, even if it’s a temporary “flipper” removable partial. The teeth can start moving significantly within a week or so.

Yes, you’re right that the missing tooth can cause problems. You had an upper first molar extracted. This is a key tooth. When it is missing, the second molar tends to tip forward, the tooth in front will tend to tip backward, and the opposing molar on the lower will drift upward into the space. A missing first molar can completely disrupt your bite and lead to TMJ disorder, or gum disease.

With a single missing tooth, your reasonable choices would be to replace it with a three-tooth dental bridge, or to place a single dental implant in the space.

Click here to read our page about the pros and cons of a dental implant vs a dental bridge.

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I’m 30, scared of the dentist, but don’t want to lose my teeth.

Friday, December 4th, 2009

I am 30 years old and I am terrified of going to the dentist. When I was younger I went every 6 months. When I was 18 years old I had a tumor growing on the right side of my mouth. A specialist had to do surgery and reconstructions as well. I’ve been a couple of times after but now I know that my teeth needs some work on them but I dont know how much it will cost and what exactly I would need done. I know for a fact that I have gum disease because I have all the symptoms that you describe on the website. Please help. I dont want to be 35 without any teeth. I thank you in advance for your response.
- Jean from Atlanta

Dear Jean,
You’re on the right track if you want to save your teeth as you say. That’s a healthy attitude, and once you have that, the other problems can all be resolved.

I see you’re near Atlanta. I would recommend that you find a dentist in Atlanta who does sedation dentistry or sleep dentistry. There are a number of them there. They should be able to help you with your fear of the dentist. If you need it, they can give you a  medication which will make it so you may not even remember your appointment.

Usually, people who have trouble with dental care have had some traumatic experience at the dentist, and that sounds like your situation. Dentists who become trained in sedation dentistry often do so because they are especially concerned about people who have dental fears, and they want to help them.

It’s nice that you’re catching this problem at age 30. If you go ahead and take action now, I think they will be able to solve all your problems. If you do indeed have gum disease, at age 30 it is much less complicated to treat. And if there are some teeth that can’t be saved, yes, dental implants can replace them. But there will probably be some less expensive options that would also work. I’d be sure to ask the dentist to explain all of your options, which should include trying to save the teeth, replacing missing teeth with removable partial dentures, using dental implants, or using bridgework. Look for a dentist who gives you various options and doesn’t seem to be trying to push the more expensive radical work on you. Expect him or her to give you pros and cons of various treatments and lets you decide. Then, once you have had your examination, if you have a bad feeling about the office, you have the right to have your records sent to another office and transfer to another dentist. Don’t be afraid to make that move, because there is a lot at stake here for you.

Good luck.

Posted in Dental Implants, Sedation Dentistry | Comments Off