Archive for the ‘Single Implants’ Category

Should I save my tooth or get an implant?

Tuesday, May 25th, 2010

Thank you for taking my question. I had a root canal done 10 years ago on my last lower left molar. Recently I have had pain to heat. I went to my dentist who found a small pin prick size hole in my filling. he repaired it and I was pain free for a week. I could eat all the hot foods I wanted. Now I have the pain again, not as bad, but if I tap on the tooth it is sensitive. doesn’t hurt all the time just a a little sensitive.

Question, 1st how can I have pain after a root canal? And 2nd should I have the tooth extracted and then have an implant? I am at a loss as to what to do. we were getting ready to put a crown on it but I don’t want to spend the money if I am going to have problems with it. thank you.
Frances from New York

Frances,
You’re smart to be concerned about this tooth. The root canal question needs to be settled before you put a crown on it.

A root canal treatment removes all the living tissue inside a tooth. After it is completed, there will be no sensation to hot or cold, because those sensations come from the nerve that should be gone. There can be sensations of pressure or pain to pressure, because those sensations come from the ligament that attaches the tooth to the bone, and that ligament is still alive.

So that means that there was living tissue still inside your tooth. That could possibly be from an extra root that the dentist missed when the root canal was first done. This isn’t uncommon for a lower second molar. The “standard” number of canals in a lower molar is three, but there are often four, and in rare cases there can be more. The pain to heat indicates that the tissue was still alive, but barely. The pain to pressure now could indicate that this tissue has died and now infection is spilling out into the ligament that attaches the tooth to the bone.

I would ask your dentist to refer you to a root canal specialist. My advice would be to save the tooth. After all you’ve invested in the tooth already, it would seem a shame to give up on it now. Yes, you could have it extracted and do a dental implant. But fixing this tooth shouldn’t be complicated. This is the kind of work that root canal specialists do all the time. And I wouldn’t be too hard on your dentist for missing this fourth canal, if that’s what your problem turns out to be. Root canal failure isn’t that uncommon a problem.

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Tooth replacement for a 10-year-old

Monday, April 12th, 2010

My ten year old son had an accident and his right front tooth (adult) had to be pulled. The dentist in the hospital told me that the tooth could not be saved due to a fracture in the root. I am devastated about this. My son has taken it very well though. To him its just another tooth to put under his pillow. I decided to follow up with a cosmetic dentist and not return to the clinic at the hospital. The cosmetic dentist told me that he would not fit him for anything for a year or more. He said that his canines were loose and needed to fall out and his adult canines had to grow in before he did any work on my son. He explained that a flipper would not be fitted properly due to this. I asked him about a Maryland or Encore bridge. He told me that the bridge would also not be fitted properly and would fall out as well. He also stated that he does not do this type of work, which I then felt I was wasting my time and money in his office.

I am very upset by this and do not want my son to go without a front tooth this long. He is in the fifth grade and will be entering middle school in the fall. Someone at school has already called him a hillbilly. I live in Fort Lee, NJ and I am right next to NYC. Could you possibly recommend someone to me. I have many well intended people telling me to go to their dentists, but I do not want to put my son through unnecessary visits, if the Doctor is not qualified. I would love to know your opinion. Thank you in advance for your help.
Maureen from New Jersey

Maureen,
You’re smart to look for an expert cosmetic dentist, and that’s what I would choose here. You don’t want a general, family dentist. This is an esthetically demanding situation and I believe that your son needs to be brought back to normal as much as possible. You are sensing that, and your instincts are good here.

There are options. The dentist you were visiting at least admitted that he wasn’t interested in helping your son. I think that’s the reason that, in his mind, every possible solution had too many negatives so that he didn’t even want to try. Yes, your son’s age and the status of his other teeth add some challenges, but this is a very treatable problem, and there are several good options for you.

And then you need to understand that when he gets older, you’ll probably need to have this re-done. His permanent teeth are coming in, and they aren’t all in yet. Their positions are going to change over the next ten years, so what looks right now won’t look right when he’s 20.

I would recommend finding an accredited cosmetic dentist near you. Any dentist that has passed those accreditation examinations of the American Academy of Cosmetic Dentistry will be expert enough to do very well for your son. Dr. Cohen is accredited by the AACD, and I know it is a very difficult test. So you can be confident that a dentist with that credential knows what he or she is doing.

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My bridge fell out.

Thursday, February 11th, 2010

I currently have crowns on all of my upper teeth. My problem is that on the right side I have a bridge. But the 3 teeth it is attached to have now decayed and I am having to polident my bridge back on daily. I am going to see about getting implants but do not want to go without those 3 teeth while the process is taking place. Not that I cannot do without them but for cosmetic reasons. What is the best temporary fix I can do while I am waiting to have all this other work done to prepare for the implants?
- Loraine from North Carolina

Loraine,
You can use Polident, which is a denture adhesive, for keeping your dental bridge pasted on temporarily. But the problem in doing that is that you’re trapping microscopic food particles and decay bacteria under your bridge every time you stick it back on your teeth. And this will speed up the decay process. I wouldn’t want you to lose these teeth, too.

Not knowing more about your teeth, I don’t know whether this bridge can be made serviceable for you, or if the teeth involved will have to be re-crowned or what. But I can give you some suggestions.

The best would be to have your dentist clean out the decay from these teeth so that it doesn’t grow any more and then reline the bridge with either permanent cement or temporary cement. This will seal those damaged areas of these teeth so that they don’t decay further.

Another possibility which is less desireable but you could do if you really insist on having this bridge on, is to make sure you brush those teeth very thoroughly every time you put it back on, and then rinse with a little hydrogen peroxide before putting the bridge on. Be careful with this, though. If you rinse every day with hydrogen peroxide for two weeks or more, you will foster the growth of yeast in your mouth and you could end up with a yeast infection.

So my advice is to get started with these dental implants to get the process going. Depending on your situation, it may take weeks or months to finish you treatment, so you have to keep these teeth healthy for that amount of time. Spending a little to have your dentist give you an adequate temporary fix for these teeth will save you money in the long run.

Other links:
Read about the options for replacing missing teeth.

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Should I have the teeth replaced, or have braces?

Monday, October 19th, 2009

My question is regarding some potential orthodontic work I would want to have if it’s feasible to do so. I am having some wisdom teeth removed very soon along with teeth numbers 5 and 12, which need removing as a result of a long period of having no dental access and many years of soft drink consumption. My last dentist wasn’t the most honest man so I didn’t trust his judgment. Anyhow, I was wondering if braces would still be advisable in my case or if I would need something like an implant on each of the sides where there will be an extraction. I also have two crowns (one from an injury and another cavity that got too big) and I was wondering if that would impact my ability to have braces as well.
Ivan in California

Ivan,
You can still have braces even if you have crowns on your teeth.

However, you need to be sure you’ve conquered your decay problem before getting braces. If you’re drinking a lot of soft drinks or snacking a lot, putting braces on could ruin your teeth, because they catch food and can lead to decay unless your mouth is kept pretty clean.

Teeth numbers 5 and 12 are your upper first premolars. You definitely don’t want spaces left there. Implants could be used to replace your missing teeth. Or dental bridges. If the adjacent teeth have a lot of decay, bridges would actually probably make more sense than dental implants.
Dr. Hall

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A long dental bridge vs. dental implant – which is better?

Saturday, April 18th, 2009

Dr. Cohen,
Can I do long porcelain bridge without dental implants?
- Alma in Massachusetts

Alma,
Yes, you can do a long porcelain bridge and not have to do dental implants. That used to be the best way to replace missing teeth. But there can be serious problems with a long porcelain bridge. Let me explain.

A long dental bridge will have a metal framework, and then porcelain is baked over the top. The longer the bridge, the more it will flex. And there is a lot of pressure on a dental bridge when it is in function. We generate a huge amount of force when we chew. So if you have this long bridge that is flexing during function, this puts a great stress on the teeth at the ends of the span. It can cause a tiny gap to begin to form where the bridge is cemented to the tooth. Or it can weaken the tooth itself and cause it to lose bone support.

When you have only one tooth to replace, it is generally better to have a dental implant than a dental bridge, though there are times when a bridge will be better. The more teeth that are being replaced, the less desirable the bridge becomes and the more desirable the dental implants. Click here to read our implant vs bridge page in our website. There you can see pictures to help you understand what a bridge is and what an implant is.

Another problem with a long dental bridge is that there are many teeth involved. If there is any significant problem with any of the teeth, then the entire bridge needs to be replaced. That doesn’t happen with implants – you can just treat the problem tooth or the problem implant and leave the rest alone if there is any difficulty later.

Links:
Chicago Dental Implants
Clear Choice Chicago complaints

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A dental implant just feels better than a bridge

Tuesday, April 7th, 2009

Here is a testimonial from a patient who had Dr. Cohen replace her bridge with a dental implant. She explains how much better it feels:

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Are implants the only option?

Thursday, March 5th, 2009

I know you can’t give specific advice on individual cases, but I am wondering if I should seek a second opinion. I had two broken decaying teeth that I had neglected and I recently went to a dentist who insisted that they both had to be pulled. He also seems to think that implants are the only treatment. My Grandfather was a dentist and I was raised to hang onto all my teeth if possible! The second tooth has a great deal of the tooth still left. Why not a root canal and crown? I had one before several years ago on a bottom left molar and he says xrays show it is fine.

Please help,
Cynthia in Virginia

Dear Cynthia,
I’m suspicious when patients are given only one option for involved treatment. There are often two or three options for dealing with dental problems. It’s not clear to me why your dentist is so intent on extracting and doing dental implants.

If a tooth is broken and decayed, it can almost always be saved with a root canal treatment and a dental crown. I would encourage you to get a second opinion on your situation.

There are some cases where a tooth is unrestorable. If the decay goes all the way through the tooth to the underside, it is often unrestorable and has to be extracted. But even if the tooth has to be extracted, in most cases you could still have a dental bridge. It doesn’t have to have an implant. You may want to read our page about a dental implant vs bridge.

A dental implant is a nice alternative. Implants have become predictable, and, unlike a bridge, they don’t require having the adjacent teeth prepared for crowns. But I tend to encourage saving teeth where possible rather than having them extracted and placing an implant.

Chicago implant dentist

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