Can I Save My Teeth?

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I have a filling on two teeth which are adjacent to each other. I started having pain with those teeth. Eventually, the pain got so bad that I went to see a dentist. I will admit to not liking to go unless it is necessary. I do get one cleaning a year, but that’s about all I can handle. The dentist did an x-ray and told me that there is an abscess and the teeth will need to be pulled. I’m sort of a wreck over this. I don’t like the idea of not having those teeth. Is there any way to save them?

Kelly

Dear Kelly,

woman grabbing her jaw in pain

I am sorry you are in so much pain. What I would like you to do is get a second opinion on these teeth. Just because you have an abscessed tooth does not mean that the tooth has to be extracted. Unless the tooth is too far gone to be saved, the typical solution is to do a root canal treatment. This cleans out the infected pulp of the tooth. In most cases, you will also need a dental crown but this allows you to save your tooth.

I’m having some doubts that your teeth are as far gone as to necessitate an extraction. If they were that bad I do not think an x-ray would even have been necessary. To be honest, some dentists are just more willing to put in the work to save teeth than others.

You mentioned that you do not like going to the dentist. That is usually a sign of dental anxiety and is more common than people realize. When you get your second opinion, I would like you to see a sedation dentist. They can provide you with some medication which will allow you to feel completely relaxed in the dental chair.

If it does turn out that you need your teeth extracted, you will want to replace them as soon as possible. If you don’t, the adjacent teeth will drift and tip into the empty space, which can lead to painful TMJ Disorder. If it comes to that, the best tooth replacement is a dental implant.

Don’t put off getting this double checked. You do not want it to turn into a dental emergency.
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Can a Dental Implant Fix Her Triangled Teeth?

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I have a complicated case and I am not sure what to do. I have a baby canine tooth that has finally succumbed to decay. That tooth never fell out because my teeth shifted a bit when I was a child after a dentist pulled a baby molar. Now my canine tooth came in but in front of my first and second bicuspids. They’ve formed a sort of triangle. Not only is it embarrassing, but it is nearly impossible to keep thoroughly clean, though I am as diligent as I can be with it. My dentist feels it is too far away and the root system too tangled to use orthodontics to get it in the right place. I do have to remove the baby canine and I just want to have a normal and hopefully attractive smile.

Kelly

Dear Kelly,

dental implant diagram

I would think most dentists, who love their field, would be thrilled to work on a case as complicated as yours. It is possible your dentist feels in over his head with this one. Every dentist goes into the profession with different goals. He may just love being a good bread and butter family dentist and like keeping people’s teeth healthy but not get into all the complicated cosmetic stuff. That’s okay, we need good family dentists.

The only problem for you right now is you need someone with experience in cosmetics. There are a few ways to handle this, but it would take someone looking at your specific bite and x-rays to give you a definitive answer. Here are some possibilities, though.

Options for Fixing This

First, you could extract the baby and adult canine teeth, then use Invisalign to get the opening the right size, along with giving the other teeth proper alignment, and then have a dental implant placed in the area where your canine goes.

Another possibility, if the canine can’t be moved, is to extract it, then have your first bicuspid shaped to look like a canine in the front. That has been done many times with good results.

The key for you, however, it to make sure the dentist you see has the training, experience, and artistry you need to give you a beautiful finished product. I would make sure you look at their smile gallery, which is a sort of brag book for dentists, to see what type of results they get. Then, if they’re good, trust their instinct on the best way to handle this situation.

When Baby Molars are Extracted

I don’t know if you are currently a parent, but I want to tell you how you can avoid this situation with your children. Whoever your pediatric dentist was made a critical error. Baby molars need to stay in place until a child is at least 12 years old. Otherwise, you risk the teeth shifting, which leads to crowding and a complicated bite such as you are facing now.

There are times, however, that a molar cannot be saved. When that is the case, it is imperative the dentist puts a space maintainer in the area in order to keep the teeth in proper alignment. It sounds like your childhood dentist neglected that. Make sure whatever pediatric dentist you have for your children, doesn’t make the same mistake.

I know finding the right dentist will give you a smile you are proud of.
This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

Should I Wait Until COVID-19 Passes to Get a Tooth Extracted?

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I’ve had a fractured tooth but was putting off getting the crown. Now there is an abscess. I heard we’re supposed to put off dental care until after the quarantine is over. Do I wait on this? I’m absolutely miserable. Now my face is starting to swell. Can I just take antibiotics? What is your recommendation?

Pam

Dear Pam,

Woman holding her jaw in pain in need of an emergency dentist.

The directive is to avoid the dentist for routine procedures, depending on the state in which you reside. However, in this case, you are not dealing with anything routine. This would be in the category of emergency dental care. I wouldn’t put off getting this dealt with. Your face is already swelling, which means it has spread past your gums. If it reaches your heart, lungs, or brain it will become life-threatening quickly.

Antibiotics and Dental Infections

As for using antibiotics as a solution without seeing the dentist, that won’t work. They are used as a temporary means of getting the infection under control, but will not rid your body of the infection completely. Instead, you’ll feel better for a while, but when the antibiotics are completed, your infection will blow back up. This is because as the infection spreads through the pulp of your tooth, the pulp dies and is no longer receiving any blood flow. Without blood flow, there is no way for the antibiotic to reach the root causes of the infection.

The only true way to remove a dental infection is for the dentist to go in there and physically removed the infected tissue. There are two ways to do this. The first is with a root canal treatment. The dentist will remove the infected pulp and usually cover the tooth with a crown because it will become brittle and need protection. The depth and location of the fracture on your tooth may determine whether or not this is a possible solution for you.

Your second option is to have the tooth extracted. However, that complicates the issue because you’ll need to replace that tooth. The ideal replacement would be a dental implant. Given the current pandemic, you’d likely have to wait on that until things calm down. You can temporarily get a dental flipper to hold it in place.

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