His Dentist Messed Up this Root Canal

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My husband was in an accident that landed him in the ER. There was damage to one of his teeth, but the dentist wanted to wait two weeks to treat it. By that time there was some tooth discoloration. When he finally got to it there was not any pain, but the dentist did feel some dried blood in there. No treatment was done except to fit him for a temporary crown, which was then replaced by a permanent one a few weeks later. About seven weeks after that, he was in severe pain and we ended up with an emergency dental appointment. The dentist started a root canal treatment and then gave him a 5-day course of amoxicillin, which eased his pain for a few days. However, the pain returned and by the time the root canal was completed about eight days later, he was in massive pain again. A couple of weeks later, my husband is still in pain and barely able to work. This is a man who LOVES his job. I was concerned and took him back to the dentist, who thought the problem must be the tooth next to the one he’d treated. He did a root canal on that tooth. Again, no resolution. What do I do to help my husband? I feel like he’s being tortured.

Agatha

Dear Agatha,

Man grabbing his cheek in pain

What a horror story! I am sorry that your husband was put through this. I am also a bit flabbergasted by your dentist. He handled this situation wrong from the beginning. I’m going to be blunt and tell you that you are not with the best dentist for your family and you’d be better served looking for a new one.

The fact that the tooth was discolored along with the dried blood he encountered were very clear indications that this tooth needed a root canal treatment. Had he done it then, there would have been much less of a chance of post-operative complications. Why he just crowned a tooth that needed a root canal is beyond me. This is emergency dental care 101.

Next, after your husband had an infection blow up on him, your dentist started the root canal treatment, but only gave him enough antibiotic to last a few days. The antibiotic should have been enough to last until a few days after the treatment was completed. Otherwise you risk a bigger blow up of the infection, which is exactly what happened to your husband. Additionally, amoxicillin is not the ideal antibiotic for a tooth infection.

Then, when your husband is still in pain, he unnecessarily does a root canal on another tooth. At this point, I would get an emergency appointment with an endodontist. They are root canal specialists. Yes, a general dentist can handle this, but you don’t have time to look for another one. This needs to be seen right away. Explain to their office what happened and see if they can get you in that day. If they can’t, they should at the very least provide him with pain relief and an antibiotic to last until they can. By opening the tooth to take the pressure off of the infected pulp, your husband should feel almost immediate relief. Hopefully, this tooth can still be saved.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.
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CEREC Crown is Bulky

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I recently had a crown break after 4 years. Obviously, I had to get it fixed and I wanted it done right away. My dentist doesn’t do same-day crowns, so I went to another dentist. I have had seven other crowns so I know what they should feel like. Maybe this is a CEREC thing. This one is way too bulky. It feels like I’ve got a wad of something stuck on a back tooth.  I am even biting my tongue with it. She’s filed it, but it still is a problem. Should I have her keep filing it?

Brandon

Dear Brandon,

Block of porcelain for a CEREC crown

 

It is not because it is a CEREC crown. These should actually fit better because they are milled more by a computer, which increases the precision. The problem you are facing here is the dentist. Don’t let her do any more grinding of your teeth. It really just needs to be replaced. Aside from being uncomfortable,  it can cause problems. Consistently biting your tongue can lead to a developing tumor.

Here is what I think happened. In most cases, the CEREC software is used when the tooth is already intact. It will scan the existing tooth to determine how to build the new one. Because you had already had a crown and it was broken, she didn’t have that. The software is able to be used to build one from scratch. However, she doesn’t seem to know how to do that. This crown needs to be reshaped. Don’t let her try to do this while it is cemented in your mouth. It is nearly impossible to do it correctly that way. For example, how will she shape the between your teeth?

What needs to happen is she needs to remove this one and make another one. I’ll be honest, I don’t think she is capable of doing this properly with the CEREC software. She doesn’t have the knowledge and skill with it yet. You need to ask her to do this the traditional way. I know it will take longer. You’re probably thinking you could have just stayed with your original dentist and gotten a traditional crown. While that is true, I will say, your crown that broke should have lasted MANY more years than it did, so I have little confidence in that dentist as well.

My advice, give this dentist a chance to get it right the traditional way. If she can’t, get a refund and find a better dentist who can.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

Why Do My Porcelain Veneers Look Fake?

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I have a set of porcelain veneers done. I was so excited about finally getting the smile I have always wanted. While they are the right shape and color, something about them looks fake. I’m sending a picture, but I ask that you don’t publish it. My dentist is a friend and I don’t want him to know I wrote another dentist about this.

Name withheld

Dearn Anonymous,

Thank you for sending the photos. I know exactly what went wrong here. I’m going to start by showing you an image of a smile that looks natural. One of the teeth in this image is fake. I suspect you will not be able to tell which one that is.

Beautiful teeth

Notice that on this smile directly above has texture to the teeth. There are smooth grooves. Notice also that the color isn’t the same all the way from the top to the bottom. There are parts that are ore more translucent than others.

When I looked at the photos you sent, the teeth were flat. The color was white. The outlined shape of the tooth looked good, but because your dentist didn’t add any texture, they looked too shiny and fake. It was almost like you had chicklets put on your teeth instead of porcelain veneers.

I know this dentist is a friend, but you will be doing him a favor by letting him know this isn’t the smile you wanted. You can also show him this post, so he’ll understand what went wrong with this smile makeover.

There is no shame in this. Every dentist has to learn and improve. Cosmetic dentistry is an art form and all artists improve over time and learn new techniques.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.
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Tooth Replacements for Hockey Players

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Can you tell me what the best tooth replacement is? I’m a hockey player and have lost two teeth this season. I want something pretty sturdy in case I get hit in the mouth again. This just hasn’t been my season.

Bran

Dear Bran,

hockey player with a missing tooth

I am sorry to hear you have been having a rough season. Hockey is a tough sport as it is. When it comes to replacing teeth, the usual answer is the best tooth replacement option is a dental implant. However, your circumstance is a tad more complicated than most because your replacement tooth is likely to get hit again.

A dental implant is the premiere tooth replacement because it mimics your natural tooth’s engineering with a root form and a crown. However, when you break a tooth you are not as likely to take the root of your tooth with it. A dental implant, because of the way they are bonded with the crown is the opposite. If you lose the crown there is a good chance the implant will do some damage to your surrounding bone. We don’t want to risk that.

However, you do want the root form there in order to ensure you don’t start having bone resorption in the area, which will make it harder to get an implant later.

My suggestion is you have the root form of the implants placed, which will preserve your bone in that area, but delay the dental crowns until you are done with your hockey career. Some dentists even do same day crowns, which will speed that process up when the time comes. That doesn’t mean that you have to keep gaps in your smile.

I’d like to suggest you get something inexpensive, such as a dental flipper. These can fill in the gaps, but will come out easily if you are hit in the mouth again. This way there is no serious damage done to your jaw, which could require reconstructive surgery.

Best of luck to you and I hope next season is a winner for you!
This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Dentist Won’t Give Me a CEREC Crown on a Front Tooth

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I have to get a dental crown on a front tooth. My dentist has the CEREC machine but tells me he won’t use it for front teeth. I don’t understand that. Shouldn’t that be my choice? I’d really like to have it done in just one day.

Carol

Dear Carol,

porcelain block for CEREC crwons

I think what your dentist is trying to tell you is that it will not look the way you want if you do it on a front tooth. CEREC crowns are milled from a single block of porcelain. That means the crown will be uniform in color. If you look at your front teeth in the mirror, you will notice they are not uniform. The level of translucency changes as you go from the top to the bottom of the tooth.

More light hits your front teeth than others. This means all those subtle differences are more noticeable. If you want a beautiful front tooth, that matches the one next to it exactly, you will be better off letting your dentist do a traditional crown. These are made from several varieties of porcelain, which enables the dentist to shape it with all those varying changes in translucency.

Dental Crowns and Tooth Color

One other thing you need to be aware of is the permanency of color with dental crowns. While they can be made any color you’d like, the color is permanent. Your natural teeth may pick up stains, but the porcelain on your crowns is more stain resistant.
The color they are made is the color they’ll stay.

If you like the current color of your teeth, then no worries. You can move forward, confident you will be happy with the color your dental crown was made. However, if you are considering getting your teeth whitened, the time to do it is before you have your crown made.

If you decide to do teeth whitening later, your natural teeth will whiten, but the dental crown will not. The only way to get it to match your new color is to replace it. Having the whitening done ahead of time will save you money.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.