missing tooth Archives - Dr. Rick Lane

My tooth broke off, now what?

Posted on November 4, 2021 by goodtooth.

I have had a crown on my right, lateral incisor for over 40 years. All those years ago, the dentist talked about a root canal. But, he never ended up needing to do one. At my last check up appointment, the dentist told me that now the tooth needs a root canal treatment. He said there is decay that has gotten underneath of the crown. It doesn’t hurt or anything and it isn’t showing any signs of infection.

Well, the dentist tried to do a root canal through the back of the crown. He was struggling big time! After two hours, he gave up. He told me that the canal is calcified and he cannot find it. So, he put a temporary filling in the crown and said he will refer me to an endodontist to get the root canal done. When I called the endodontist, he booked me out four weeks since I wasn’t in pain and there was no sign of infection.

Two weeks have passed, and my crown broke off. Even worse, some of the tooth came off with the broken crown. So, now I don’t know what to do. I can’t afford all of this expensive dental care and I’m wishing the original dentist would have just left it alone and not messed with it. What do you think I should do now? Is it safe to try to get the root canal done or am I better off with a dental implant at this point?

I am wondering if there is enough of the natural tooth left to do a new crown, which is what will be needed for a successful root canal, if I’m understanding all of it correctly. I went down the street to the pharmacy and am considering using some over-the-counter dental adhesive to reattach the crown.

I would welcome any advice you have on the situation. I don’t know what to do at this point, and am feeling frustrated at the situation.

Benjamin in Kentucky

Benjamin,

Well, at this point it is understandable that you are feeling frustrated. And I’m guessing you are wondering, whose fault is it that the tooth broke off?

Here is an example of when a root canal is typically required. In this instance, the decay has taken place under the crown.

The dentist spent an incredible amount of time drilling the tooth and searching for the root canal with no luck. Two hours of drilling is pretty invasive for any patient, so it is likely that the tooth became even more weakened. That may indeed be the reason it broke off, from all the stress. Although, the blame cannot be entirely placed on the dentist, because we don’t know how much decay was under the crown or the integrity of the crown. Also, the endodontist didn’t do you any favors by scheduling the appointment out so far. In the meantime, there could have been some measures implemented to strengthen the tooth. Hopefully, the dentist has learned from your situation. Unfortunately, it doesn’t make it any easier for you now. It is possible the dentist would be willing to accept some of the responsibility to help you fix it. So, it would be in your best interest to ask about that possibility.

Since there is decay present under the crown, it sounds like the best course of action would be to remove any portion of the remaining crown. Then, the decay can be addressed, and a root canal would be much easier to locate. Even though you don’t feel any pain, it is possible that there is infection that penetrated the canal. So, without the old crown in place, it will be much easier to establish a baseline to see what is going on .

It is also important to realize that it is difficult to give you specific recommendations without having seen you in person. But, if the tooth is damaged or compromised, then it may be difficult to place a new crown. A dental implant is a legitimate option to replace the broken tooth. You mentioned that budget may be an issue. But, a dental implant is a permanent solution to replace a missing tooth.

Now, if you don’t have an aggressive bite that causes a lot of stress, then a dental post may be used to help support a crown. Even if there isn’t that much of the natural tooth left, it is possible that a post could help support it.

Thank you for reaching out with your story, and I’m sorry to hear you are having to go through all this. It is also important to mention at this point, that you may need to find a reputable implant dentist in your area. Most general or family dentists don’t have the necessary skills or training to successfully place a dental implant. Also, placing a post in your situation is also something that needs to be given special attention. The post would need to endure and support rotational forces, and that can also be tricky. Posts are round, and lateral incisors are also somewhat round, so if there is any twisting force, it may end up loosening the crown over time. All that to be said, it would be wise to get a second opinion, after meeting with an implant dentist so you can weigh out all your options.

Thank you for reaching out. Hopefully, this information will be helpful as you determine what the next steps are, and what is best for you.

This post is sponsored by Petaluma dentist Dr. Rick Lane.

My teeth are shifting after getting a tooth pulled. Now what?

Posted on October 24, 2021 by goodtooth.

I have noticed that my front tooth is shifting out of place. I think it is very noticeable and I’m wondering if it has something to do with the fact that my dentist pulled one of my back molars. It was the upper, second molar in back that was removed about a month ago now.

Do you have any recommendations at this point? Also, is the shifting related to the tooth extraction?

Thank you for any information you have about the matter.

-Paul in Ohio

Dear Paul,

Thank you for your question. Here is what is happening with your case. Whenever a tooth is extracted, the bone that surrounds the area will start to be resorbed. This occurs because the body realizes that the bone isn’t required at the extraction site any longer to keep the tooth root in place. So, it takes the minerals and redistributes them for use in other parts of the body. Typically, the bone loss and degeneration will start to take place after approximately six months. When the tooth is no longer in place, the surrounding ones may shift as a consequence. But, it sounds like your shifting is taking place much sooner.

The best way to explain the process is that our teeth work together as partners. So, if one is removed, the other teeth shift. The bulk of the shifting occurs within the first few years after an extraction. Then, the teeth will likely stay put. The distance of the shifting varies between patients. Some patients don’t experience any shifting. While others will experience shifting teeth, especially for the teeth adjacent to the extraction site. The teeth may drift into the empty space, but it all depends on your bite and occlusion. Occlusion is how your teeth come together, when we swallow or chew, and even while we are sleeping. So, all of those factors play a role in how far and where the teeth may shift.

One way to prevent any shifting is to have the missing tooth replaced. This will prevent shifting of the teeth and any occlusion problems. Also, if the tooth is replaced it will prevent the teeth surrounding the extraction from shifting laterally, which may cause them to become loose over time. The best treatment to replace a missing tooth is with a dental implant. It is a permanent solution and is surgically implanted into your jawbone. A dental implant looks, feels and functions like a natural tooth.

Since you are dealing with a back molar, it is also important to realize you may need a sinus lift as well, since you may not have enough bone in the upper jaw to successfully place the implant, without it penetrating the sinus. In some cases, patients don’t get a second molar replaced since it is all the way in the back of your mouth. However, since you are already experiencing shifting after only a month, you should discuss your options and the best course of treatment with your dentist. It may also be in your best interest to get a second opinion from an implant dentist. Not every general, family dentist has the extensive training and experience to be successful with dental implants.

Thank you for reaching out. Hopefully, this information is helpful as you move forward and is helpful to others who are weighing out the pros and cons of getting a tooth extracted, as well as the benefits of dental implants.

This post is sponsored by Petaluma dentist Dr. Rick Lane.

What are my options for a missing tooth?

Posted on October 26, 2020 by goodtooth.

Hi,

I am hoping that you can give me some advice. I put off getting a broken molar treated several years ago and now I think I’m going to pay for it. When I finally had it looked at, half of it was already missing. I knew I should probably do something about it but it never hurt or anything. So, I kept putting it off. Then, after awhile longer, the rest of the tooth fell out. There is still the root and some of the tooth left under the gum line and now I’m starting to deal with some pretty serious pain. It starts down in the area of the broken tooth and then moves into my jaw. It isn’t constant and kind of comes and goes. But, when it hurts it is starting to interfere with my daily life. Do you know what can be done to get rid of the pain? Is it an issue to leave it alone at this point? I assume it probably needs to be removed or something, but I wanted to check with you to see how serious you think the situation is and if there is risk for infection?

-Gerald in Washington

Gerald,

I’m so sorry to hear you are in tough spot and are starting to deal with some severe tooth pain. The bad news is that it sounds like your molar is infected, which is what is causing you the pain. You need to have the tooth extracted before you are dealing with a very serious situation. If infections are left untreated, they can spread very quickly. An infected tooth where the infection moves to the jaw is bad news because the area is so close to your brain. You don’t want this to become a life threatening situation, so please don’t wait around any longer.

You need to get in to see a dentist as soon as possible. And while you are there, you should have a complete exam done on your other teeth too. The reason this molar broke so long ago is likely due to an untreated cavity. This is sadly a perfect example of what happens when you neglect to keep up with regular, routine dental exams. A small cavity many years ago would have been very inexpensive to treat. When issues like this are left untreated, they can turn into a much more invasive dental emergency, which means it will likely be exponentially more expensive.

What could have been addressed with a small filling, turns into a dental crown. Then, if it becomes infected, a root canal treatment and a crown is required. If it is still left untreated, you will need to have the tooth extracted. Then, if the missing tooth isn’t replaced the surrounding teeth will move in to crowd the space. This can throw off your bite, which can lead to complications with your bite and TMJ problems. So, in order to fill the space you will need a major restoration like a dental bridge or a dental implant. The best treatment for a missing tooth is a dental implant because it is a permanent solution and it looks, feels and functions just like your natural tooth. The issue is that dental implants are nearly 40 times more expensive than a simple filling would have been.

So, hopefully others are able to learn from your situation. From now on, you need to keep up with regular dental check ups. And for your sake, hopefully this is the only issue you need to have addressed so urgently. Thank you for sharing your story.

This post is sponsored by Petaluma dentist Rick Lane, DDS.

Is it OK to get a Maryland bridge bonded to two dental implants with crowns?

Posted on February 10, 2020 by goodtooth.

Hello,

I would like to know your thoughts on the possibility of placing a Maryland bridge in between to porcelain crowns that are anchored onto dental implants?

Here’s the deal. I have a missing first premolar and molar on top. There was a tooth between them. But, I was just told that it will need to be extracted. So I was wondering if a Maryland bridge will work to fill the space between the two dental implants?

-Shawna in Washington

Shawna,

There are many factors to consider for any dental treatment. Also, it is difficult to give you specific recommendations without having seen you in person. However, the answer to your question is yes. A Maryland bridge can be attached to porcelain crowns on each side. It is complicated and it should be evaluated very carefully, since it may not hold up very well in the long term.

Diagram of how a Maryland bridge is placed.

Unfortunately, not all dentists do a good job with Maryland bridges, which means they may not last the whole lifespan. They can be illusive because they seem easy to put into place. The teeth need to be prepared by grinding the adjacent teeth so there is space for the metal framework. Then, dental bonding is used to set it. It really does sound and seem straightforward. However, it really isn’t that simple. An experienced dentist that places a Maryland bridge will be sure to place grooves in order to resist against the inevitable force that comes with chewing and biting. If this important step isn’t done correctly, the Maryland bridge will likely end up coming loose.

Also, since you already have porcelain crowns and dental implants on the surrounding teeth, it may present some complications when the Maryland bridge is bonded in place. This is because the appliance is typically bonded directly to teeth enamel, which will provide the strongest bond. When a bridge is bonded to porcelain, the bond may not be as strong. Even if it is technically done correctly, the bond simply will be weaker. Not too many dentists know how to successfully bond to porcelain.

Then, regarding the grooves that were mentioned above, there are complications when preparing the crown in that way. It requires a great deal of skill to get the retention and resistance done properly in order to avoid any issues with it being loose in the future. If the grooves are done too deep, it may compromise the framework that lies underneath the crown, which could end up compromising the dental implants. Also, that means that the bond must be made to the metal underneath for the grooves, if it becomes exposed.

So, to reinforce the answer to your question. Yes, it can be done. Is it recommended? No, it wouldn’t be ideal since it is such a complicated, difficult procedure to do it properly.

In a perfect world, your dentist would have realized that when the original dental implants were placed, there was a possibility that the one remaining natural tooth that sits between them may require further treatment in the future. At some point, the tooth may have been at risk. If this would have been the case, the implants that were placed to replace your missing teeth could have been placed so the abutments were parallel. Then, a screw-retained crown could have been done. Then, when you are facing your current situation in losing the tooth in between, the dentist would have been able to unscrew the crowns and then install a dental bridge.

An alternative treatment at this time could be to go ahead and get a third dental implant done, as long as their is enough bone density left at the implant site.

Again, it is always difficult to provide recommendations without seeing you in person. So, please proceed with caution if you decide to try the Maryland bridge. It is always a good idea to seek a second opinion from a reputable implant dentist in your area. Hopefully, it will either confirm the treatment plan you are considering, or it will provide you with some further justification to reconsider some other options.

Thank you for sharing your story. Best of luck!

This post is sponsored by Petaluma dentist Dr. Rick Lane.

How soon do I need to get dental implant treatment?

Posted on January 7, 2020 by goodtooth.

I learned recently that I have a dead tooth that is underneath a broken porcelain crown. When my dentist examined the tooth, he didn’t think that all of the decay could be taken care of from a root canal. So, his recommendation for treatment was to have the tooth pulled and then come back in a few months to get a dental bridge.

I decided to get a second opinion from an endodontist to see if they agree about the root canal. From what I’m learning, if the tooth is pulled, it sounds like a dental implant is the better solution over the long term.

Knowing all this now, I just started dental insurance. I understand that the crowns will not be covered for a year. And I haven’t had a chance to learn if dental implants are covered by my dental insurance.

My questions are more about the timing since I just got dental insurance.

How soon do I need to get the tooth pulled?

If I delay, will I run into other complications?

If I get the tooth pulled, can I wait a year to get follow-treatment?

If it helps, I am in my fifties and have overall healthy teeth. I have just had a lot of issues with this one tooth where the crown came off. That treatment took place 10 years ago. I was supposed to get a root canal done on the tooth then. But, the dentist placed the crown too quickly and didn’t want to do a root canal through the crown. The pain went away, so I didn’t think about it much after that. They never did anymore tests after that to see if it really needed one or not.

-Pam in Texas

Pam,

Unfortunately, some dentists recommend to pull teeth too soon. Saving your natural tooth should always be priority. Something isn’t sounding accurate regarding the dentist’s reasoning. It is unclear why the decay couldn’t be removed from the tooth. So, it’s a good thing that you are seeking a second opinion. Hopefully, the endodontist will be able to provide more information and some other treatment options.

Regarding your research on dental implants. Yes, dental implants are a permanent solution to replace a missing tooth. They look, feel and function just like your natural tooth. If you end up going that route, you need to make sure you find a reputable implant dentist in your area. Not every general dentist has the skills to be successful with dental implants. Check out the dentist’s credentials, ask to see examples of their work and find out how many successful cases they have done.

As for the question about how long you can wait to get treatment after the tooth is pulled. This is something you don’t want to put off. In fact, it wouldn’t be wise to wait any longer than a couple of weeks to get the space filled. The teeth shift around quickly and will cause all sorts of other problems. However, based on the what you have shared, it doesn’t sound like you need to feel too rushed to get the tooth out. If you aren’t in pain and it’s not bothering you, then it is okay to explore your options. You never want to feel rushed into any type of dental treatment.

If you did move forward with a dental implant, there is a healing period between when the implant is placed and when the permanent crown is placed on the implant. While you wait, there is a temporary piece that will fill the vacant space, so your teeth don’t shift.

As mentioned before, it would be wise to seek a second opinion. There are dentists out there that work hard to explore all possible options to save your natural teeth. That is the kind of dentist you should try to find. There are situations where a tooth cannot be saved. But, some dentists seem to jump to extraction sooner than others.

Here are my thoughts regarding what you shared about the original treatment of the tooth and how the root canal treatment wasn’t done many years ago. If that is indeed what happened, and the tooth really did require further treatment, than that dentist didn’t do the right thing. In dentistry, if there is decay present, it needs to be treated. It won’t get better. The rational of not drilling through a crown isn’t a sufficient reason for not getting it treated during that original treatment time. Root canals after a crown are not uncommon. And if the problem would have been addressed right away, it likely would have avoided these issues you are experiencing now.

But, that doesn’t help you. Hopefully, this gives you some more information and encourages you to get another opinion or two other opinions. Best of luck to you.

This post is sponsored by Petaluma dentist Dr. Rick Lane.

How to replace a missing tooth for a hockey player?

Posted on September 9, 2019 by goodtooth.

I know it sounds cliche, but my son had a tooth get knocked out while playing for his college hockey team. His tooth didn’t stand a chance when the puck hit him square in the mouth.

Anyway, we went to see an implant dentist and started the process. However, he has had some teammates tell him to hold off on the dental implant until he is done playing hockey. They said that since the risk of re-injury is possible, it’s probably better to wait until after college sports. At this point, the natural tooth has been removed and he has a plug in.

Do you know if there are any other options? They mentioned an Encore Bridge or a Maryland bridge as possibilities. He doesn’t want to have an ugly smile for his upcoming wedding. So, it would be nice to get something that looks nice, even if it isn’t a permanent solution to replace the missing tooth.

-Michael in Minnesota

Hi Michael,

Thank you for reaching out about your concerns. Even though I haven’t dealt with hesitation in placing dental implants in hockey players before, what your son’s teammates are saying is a valid concern. As you know, hockey injuries are common, especially when it comes to dentistry. It’s not a bad idea to hold off to avoid another trauma, especially since your son is a college athlete. It wouldn’t be pretty if the dental implant was ripped out after it was placed permanently. It could potentially mean a much more serious procedure, including the possibility of requiring bone grafting to keep the implant in place.

At this time, I wouldn’t anticipate any issues with getting the root fixture placed. But, holding off on placement of the porcelain crown is a good idea until he is done playing hockey. It is also understandable that he doesn’t want to have a gap in his smile for his upcoming wedding. An Encore bridge, Maryland bridge or any type of bridge is not a temporary solution. It wouldn’t be advised since it does require shaving down the surrounding teeth to prepare them to hold the false tooth in place to fill the gap. Since his other teeth sound like they are healthy, it wouldn’t be good to compromise them too. That would mean three teeth would be treated, when the dental implant takes care of only one.

It sounds like the best fit for your son to accommodate his situation is a removable dental flipper. This is more of a temporary solution and will get him through the wedding, as well as the remainder of his hockey career. It would be in his best interest to meet with a cosmetic dentist so it blends in naturally with the surrounding teeth. If it is done by an expert cosmetic dentist, no one will be able to tell he is missing a tooth.

Thank you for your question. Hopefully, this will help point you in the right direction. Congratulations on the wedding!

This post is sponsored by Petaluma dentist Dr. Rick Lane.

Why did the dental implant surgery fail?

Posted on July 9, 2019 by goodtooth.

I needed to get a dental implant to replace a missing tooth. My dentist sounded like he knew what he was doing and told me he had done them hundreds of times.

He said that the first step was bone grafting so the implant would work better. So, I did it and then waited for it to heal. When I went back in to get the dental implant surgery he refused to place it because he says the bone wasn’t thick enough.

This has been such a bad experience. I still don’t have a dental implant after multiple surgeries. Now, he is recommending a dental bridge instead of a dental implant. What am I supposed to do? Should I have seen a special implant dentist instead?

-Elise in Oregon

Elise,

Well, the bad news is that it sounds like your dentist wasn’t as experienced with dental implants as he told you. Implant dentistry is not a designated specialty within dentistry. However, implant dentists that are successful have pursued extensive coursework and advanced training. Not just any family dentist can be successful with dental implants. If you would have seen a reputable implant dentist, you likely wouldn’t be in this tough situation with dental implant failure.

Bone grafting is a difficult procedure for any dentist. So, it is safe to assume your dentist was trying his best and really did have your best interests in mind. If the experience of the dentist isn’t there, it is not uncommon to run into issues with the placement of the implant. Maybe he has done dental implant cases for less complex patients and is still learning the bone grafting. It does sound like he is trying to do the right thing because many dentists without the skill would have moved forward and placed the implant anyway. It may have done okay for a short time and then it would have likely failed. So, at least he was honest that it wasn’t going to work.

This may be a scenario where your dentist needs to keep practicing in order to hone his skills. He is being honest with you. But, that doesn’t help you out of this difficult situation. By offering a dental bridge, he is providing a solution that is feasible for one missing tooth. That will be up to you if you want to move forward with the bridge instead of the implant.

If indeed you do want to get the dental implant, which is the best, most permanent solution, it would be wise to find an expert implant dentist. It sounds like your bone grafting case and requires an oral surgeon or periodontist with much more experience in dental implant surgery.

You could ask your dentist if he has a referral of an oral surgeon or an implant dentist that is more experienced with bone grafting in your area. It sounds like he has integrity and really wants to do the right thing. You can stick with him for your regular preventative exams and cleanings. But, if you decide a dental implant is right for you, it is time to look around and find one that is much more experienced in the field.

Dr. Rick Lane is an implant dentist in the Petaluma, CA area. He is an implant dentist that helps patients with all kinds of solutions for missing teeth.

My crown broke off after only three months!

Posted on January 21, 2019 by goodtooth.

I had a root canal done three months ago and a porcelain crown. Well, last night the crown came off and ended up breaking completely off the post. Is there anything that can be done? I can’t believe it’s only been a few months since the work was done. Is the dentist responsible for something like this? I’m freaking out because I feel helpless right now!

-Jake in New Hampshire

Jake,

This is an unfortunate situation. It is difficult to give you specific recommendations without having more information or seeing your case. However, from what you have described, it sounds like the crown may have broke off at the gumline. This is of course speculation. But, based on what you said, if the crown came off and the post is broken, there is a good possibility that your tooth is also broken. If these assumptions are correct, you are in a tough spot. There probably wasn’t a lot of your natural tooth left to start with. Also, if the crown and post have failed, there is a good chance that the tooth is not salvageable.

Now, it is possible that the post was weak. That would be the best case scenario. If that was the case, the post was weak and can be redone.

There are some patients that have a condition that is referred to as “gorilla bite” where one bites down with excessive force. Then, after a certain age, the teeth begin to suffer. Patients with gorilla bite tend to break any restoration a dentist puts in their mouth. Now, it sounds like the dentist was trying to do everything possible to save the tooth by doing the root canal treatment in the first place. So, let’s assume he didn’t do anything ill-intentioned. If that is indeed the situation and the treatment only lasted a few months, most dentists will feel obligated to take care of some of the cost to repair or replace it.

To begin, contact your dentist and explain the situation. Be prepared that you will likely require a more extensive treatment plan than originally intended. For example, you may require a dental bridge or the ideal treatment would be a dental implant to replace the tooth. Hopefully, the dentist does the right thing and credits you toward your new treatment plan.

Now, the only way a dentist has legal responsibility is if he or she did something wrong. Based on what you’ve shared, it isn’t clear one way or the other.

Lastly, if you are someone with “gorilla bite”, then you may need a night guard to help protect your new restoration. A night guard is a hard plastic appliance that is worn overnight to protect you from subconscious clenching, biting or grinding.

Hopefully, this gives you some insight into what’s going on here.

Good luck!

This post is sponsored by a Rick Lane, DDS, a dentist in Petlauma.

I’m sick of dental implant problems.

Posted on October 7, 2018 by goodtooth.

My dentist convinced me to get a dental implant because he told me he has been doing them for years. The first part of the procedure required bone grafting at the dental implant site. I waited for the healing and went back in for the dental implant surgery. Well, the implant placement failed and had to be removed because the bone proved to be too thin. He wasn’t able to find a place to put it. So, I have had three surgeries now and I still don’t have a dental implant. Now, he is recommending I get a bridge. Does this sound normal?

-Christina in Oregon

Christina,

This is unfortunate to hear. There are far too many dentists that think they can do dental implants and get in over their head. There is no recognized specialty area within dentistry for dental implants. This means that any dentist can make the claim to be an implant dentist. However, it takes extensive training and experience to be successful at them. Also, there are some dentists that specialize in oral surgery, called periodontists.

Even though it doesn’t sound like things went according to plan, it does sound like your dentist is trying to do the right thing. Bone grafting is a complicated procedure. At least he didn’t place the implant and forge ahead. That would have ended up creating a lot more difficulty down the road. So, he may have been new to bone grafting. These types of things are not uncommon when a dentist is trying something new.

diagram of a dental bridge to replace a missing tooth

This image demonstrates how a dental bridge is placed.

The bottom line is that your dentist sounds like he has integrity. And according to his skill level, a dental bridge is a sufficient treatment option for a missing tooth. But, they come with many pros and cons. Dental implants are the best, most permanent solution to replace a missing tooth. So, if you really want to get a dental implant, you need to do some more research and get a second opinion.

You could your dentist for a referral to a periodontist or oral surgeon that is more experienced in dental implant surgery. At least you will be able to get a second opinion about the bone grafting and what is the best treatment option moving forward.

This post is sponsored by Petaluma dentist Dr. Rick Lane.

When should I get a dental implant?

Posted on June 3, 2018 by goodtooth.

Unfortunately, I just learned that I likely will need to get a dental implant since I have a dead tooth under a crown. The tooth needs a root canal now and the dentist wanted to have the tooth pulled since he wasn’t sure he could get all the decay out of the tooth. Then, he wanted me to come back after several months to get a dental bridge.

Now, I’m waiting to hear back from an endodontist to see if the tooth can be salvaged. In the midst of all this, I’ve found out that a dental implant may actually end up being the best course of action. I just got dental insurance and it sounds like there are some waiting periods before I can have larger procedures done. So, I’m wondering how long I can wait until I start to have more serious problems from a missing tooth. If I have to wait a year, how bad it that?

The rest of my teeth are pretty healthy and I’m in my fifties. The tooth should have had a root canal nine years ago because the dentist placed the crown too fast. He didn’t want to do a root canal through the crown, so I’m surprised it’s taken this long to have so many issues. Back when it was done, the pain went away after the crown was done, so we just let it be.

-Sandra in Indiana

Sandra,

It is always best to save a natural tooth if at all possible. Some dentists can be eager to extract a tooth. Also, it is unclear why the dentist felt the decay could not be successfully removed. It may be in your best interest to get a second opinion. Or at the very least, wait to hear back from the endodontist.

If the tooth cannot be saved and must be removed, a dental implant is a permanent solution to a missing tooth. It will look, feel and function just like a natural tooth and it prevents bone loss at the implant site. However, you don’t want to wait longer than a couple weeks with a missing tooth. It will begin to influence the surrounding teeth and they may move into the open space.

Is there a rush to remove the tooth? Are you in pain? If not, you may be able to wait a couple more weeks before having it extracted, if indeed that is what is required. Also, it is important to realize that the dental implant process can take months since it will require healing time after it has been surgically implanted into the bone. This also ensures that the implant properly fuses with the bone.

Also, it is difficult to understand what you meant about this tooth possibly requiring a root canal treatment years ago. If that is correct, then the dentist didn’t properly treat the tooth. If there was an infection in the tooth, it should have been addressed immediately. There is no benefit in waiting, even if you aren’t in a lot of pain. Drilling through a crown to repair the crown is not uncommon and shouldn’t have been a deterrent to properly treat you the first time.

At this point, a second opinion would be a good idea. Good luck!

This post is sponsored by Petaluma dentist Dr. Rick Lane.