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How Can I Save a Front Tooth That Broke Near My Gumline?

How Can I Save a Front Tooth That Broke Near My Gumline?

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My left front tooth broke near the gumline. What are my least expensive alternatives (other than a dental implant) to restore the tooth? Will a crown help save the tooth? Thanks. Spencer from CO

 

Spencer,

A dentist may consider a crown for a tooth broken at the gumline, but only if the tooth experiences minimal stress. A deep overbite or a strong bite would make it difficult to secure the crown. However, a gentle bite might allow for a successful crown placement.

The remaining tooth structure would need a root canal treatment before crown placement. Then, a strong, flexible post, such as a carbon fiber or fiberglass post, would be inserted. A rigid metal post could lead to root fracture due to stress transfer. Two posts placed side by side can help resist rotational forces and improve stability.

For teeth experiencing significant stress, a dental implant is the most durable long-term solution. While more costly and time-consuming due to healing periods, dental implants offer superior aesthetics and longevity. Opting for a crown initially might lead to future implant placement if the crown fails.

The most economical dental solution isn’t always the most practical. A quick fix can lead to more complex and costly procedures later. Investing in a durable solution, such as a dental implant, can save time, money, and dental health in the long term.

San Antonio dentists Dr. Gilberto Tostado and Dr. Karina Acuña sponsor this post. Read what they do to provide some of the best dental care in San Antonio.

Does a Failed Dental Implant Need to Be Replaced with a Bridge?

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My upper left first premolar cracked last summer while I was eating. My dentist pulled the tooth because he said he couldn’t save it. After seven lidocaine shots, I felt burning my tongue, and the roof of my mouth began to burn. My dentist said he would start a bone graft and immediate implant. My mouth healed, although the turning never stopped. My dentist placed the implant crown last November. I could feel the force of him trying to get the crown on, and it hurt so bad, so he gave me three more rounds of Novocain.

Over the Christmas holiday, the implant crown fell off. My mouth was burning, and it still burns. Last month, my dentist told me I needed a bridge instead of an implant. I’ve had 19 dental visits since last summer, and my mouth is miserable. Why would I let this dentist remove and replace the implant with a bridge now? What else should I consider before finding a new dentist besides asking for a refund? Thank you. Tyler

 

Tyler,

High anxiety can prevent achieving numbness during your dental appointment. Anxiety can significantly impact the effectiveness of local anesthesia, possibly explaining the burning sensation you feel. This sensation aligns with symptoms of Burning Mouth Syndrome, which, though its cause remains officially undetermined, has been linked to traumatic dental experiences. The initial diagnosis of thrush by your dentist, which was incorrect as the condition persisted, highlights a misunderstanding of your symptoms.

Dental Implant Failures and Dentist Expertise

Not all dental implant failures stem from improper procedures, yet many do, underscoring the complexity of implant placement. This procedure demands substantial training, which some dentists may lack. Your account raises concerns about the dentist’s competence in placing your implant. The sequence of issues, including the thrush misdiagnosis, the crown detachment, and the implant failure, casts doubt on his proficiency.

Investigating Implant Issues and Potential Actions

Dental implant with crown, abutment, and implant screw tagged

Dental implant success requires advanced training and experience

Questions about handling your implant, especially without mentioning looseness, suggest your dentist overlooked something. An infection typically results in some degree of dental implant looseness. Your first dentist’s attempts to attach the crown caused pain and may have compromised the implant’s integration with the bone, contributing to failure.

You can report the dentist to the state dental board or threaten to inform the insurer if dental insurance paid for some of your treatment. However, asking for a partial refund might be more strategic, considering the difficulty in proving the cause of implant failure.

Challenges in Pursuing Dental Malpractice

Navigating a dental malpractice lawsuit involves hurdles, including an expert witness. The compensation is usually low for such cases. Small claims court offers an alternative path without needing a lawyer, though you will still need expert testimony from a dentist to establish fault.

We recommend scheduling a consultation with a skilled implant dentist for an exam and review of your diagnostic studies. A failed dental implant compromises your oral health.

San Antonio dentists Dr. Gilberto Tostado and Dr. Karina Acuña sponsor this post.

 

What Can I Do for a Tooth Infection If I Don’t Have Insurance?

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The left side of my face has been swollen for over a month. I have three cavities in my teeth on that side of my mouth. While eating something chewier than usual two days ago, I felt the discomfort increase in my teeth, and today it hurts. Unfortunately, I’ve been job searching for the past eight months and don’t have dental insurance. I’ve had several promising interviews, and I should hear back in a few weeks. I am still looking for work, but my unemployment income is not enough to pay my rent and utility bills and find a dentist. I’m unable to get credit because I don’t have a job. Can I do anything at home to manage the infection until I see a dentist? Thanks. Rachida

 

Rachida,

Ignoring a toothache and facial swelling caused by a dental infection is risky. Studies show that five to ten people lose their lives to dental infections yearly. Dead pulp tissue inside a tooth is usually the source of a tooth infection. Although antibiotics may seem like a quick fix, they only treat the symptoms, not the source. Antibiotics can’t reach inside a tooth, so taking them can lead to resistant bacteria and a potentially life-threatening infection.

Even small communities often offer free dental care if you don’t have dental insurance. Search the Internet for a dental clinic, a non-profit healthcare center, or a university dental school within driving distance.

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Dental implant

Dentists often go above and beyond to help. Many dedicate time to charity clinics, especially in areas with limited access to care. In larger cities with dental schools, the students need volunteers for dental cleanings, exams, or extractions. While more complex procedures like root canals might not be available at every location, these clinics can offer temporary or permanent fillings, extractions, and other crucial treatments.

Getting treatment quickly can prevent the tooth infection from affecting your overall health, losing the tooth, and needing a dental implant or bridge.

 

San Antonio dentists Dr. Gilberto Tostado and Dr. Karina Acuña sponsor this post. If you don’t have dental insurance, call to ask about financing or payment plans.

Missing Lateral Incisor – Will a Mini-Implant Work?

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I was born without my upper right lateral incisor. Can a mini-implant replace it? I wore braces as a teen, and our family dentist had a dental flipper made to replace the incisor. Now, I want something more permanent. I have seen the cost of dental implants and wonder if a mini-implant will work since incisors are smaller than other teeth. If not, what other options might I have? – Thanks. Steve from RI

Steve,

Thank you for your inquiry.

Dental implants are ideal for replacing missing teeth. After orthodontic treatment and creating space for tooth replacement, an implant is the only way to prevent bone shrinkage in the area. Also, an implant will last longer than other types of tooth replacement.

Will a Mini-Implant Work for a Lateral Incisor?

A mini-implant can work for a later incisor. Mini-implants are one-third the diameter of standard implants. However, they are not as strong as traditional implants.

Mini-implants have these uses:

  • Replace small teeth
  • Fit spaces too small for a standard implant
  • Stabilize dentures

Mini-implant for an incisor

Dental implant with crown, abutment, and implant screw tagged

Consult a prosthodontist about replacing a lateral incisor with a dental implant

A dentist would need to perform an exam and take impressions and a CT scan of your mouth, many dentists replace lateral incisors with mini-implants. It might work for your case, too. After an exam, a skilled implant dentist will explain which implant size will work best for your case.

Dental Bridge – An Alternative to Replace a Missing Tooth

A dental bridge can replace a missing tooth. It contains at least three adjoined crowns:

  • Crowns on the end of the bridge are anchors
  • A center crown replaces the missing tooth

Your dentist must grind down the tooth on either side of the missing one so the end crowns will fit over your natural teeth. But if your teeth are healthy, why grind them down? Dental implants do not require work on other teeth.

Schedule consultations with at least two prosthodontists or dentists with advanced implant training to discuss your options for replacing your missing lateral incisor.

San Antonio dentists Dr. Gilberto Tostado and Dr. Karina Acuña sponsor this post.

Will I Need a Second Root Canal?

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I had a root canal on my first molar tooth in 2017 and had no problem with it until early this month. Now the tooth hurts every day. The pain is not intense but enough to take a pain reliever to distract me from work. Do I need to see a dentist right away? Will I need a second root canal? – Jared K. from NJ

Jared,

Thank you for your question. Dr. Lane would need to examine an x-ray

What Can You Do About Pain in a Root Canal Tooth?

If you had root canal treatment years ago and now feel pain in the tooth, schedule an appointment to see a dentist as soon as possible. You are probably experiencing root canal failure, and only an examination can determine the cause of your pain.

Is Root Canal Failure Common?

About one in ten root canal treatments fail. The infection will flare up sometime later if a root canal tooth does not heal completely. A dentist cannot see deep inside tooth canals. Sometimes curved, hard-to-reach channels get missed, and infection lingers. Additionally, most general dentists do not have the instruments to reach deep into canals. But a root canal specialist (endodontist) has the required tools.

What Is the Treatment for Root Canal Failure?

The treatment for root canal failure is repeat root canal treatment or surgery. Although some dentists have advanced training in root canal therapy, most will refer you to a specialist. The endodontist will find the infected root, remove the infection, fill the area, and seal it off. Root canal surgery, or apicoectomy, accesses and treats the tooth through the bone and the root tip instead of the crown.

3 dental implant images

Dental implant

Also, your tooth may have cracked. After an examination and x-rays, an endodontist will explain if the tooth is savable or requires extraction and a dental implant or alternative tooth replacement.

San Antonio prosthodontist and cosmetic dentist Dr. Gilberto Tostado sponsors this post.

The top of my old root canal tooth turned blue

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The top of my old root canal tooth turned blue. The tooth had a filling, but my dentist bleached the tooth six weeks ago. That didn’t work, so she put a crown over it. The first crown was too white, so my dentist had the lab redo it. It still does not match my right front tooth, an implant crown. I damaged both teeth in an accident in 2015 but lost one of them. This crown redo process is getting old. How many more times should I let my dentist try to get the color of the root canal tooth to match the implant crown? Thank you. Heather from S. Dakota

Heather,

Thank you for your question.

Matching Crown Color on a Front Tooth

Three phases of dental implant - three components, root form in bone, crown on abutment.

An experienced cosmetic dentist can match your crown to surrounding teeth

Matching color with a single front tooth is challenging for most dentists. You can quickly notice even a slight color difference on front teeth. Dentists who lack cosmetic dentistry training sometimes ask their patients to put new crowns on both front teeth. Here’s why:

  • Each tooth has multiple shades and variations in translucence.
  • An expert cosmetic will use a high-quality camera and detailed instructions to help a dental ceramist match your crowns.
  • An expert dental ceramist in a lab will layer porcelain and add tints to match the other tooth.
  • A cosmetic dentist is willing to try a temporary crown on your tooth multiple times to achieve a perfect match with your implant crown.
  • You and your cosmetic dentist should look at your crown in various lighting conditions to detect any color differences.
  • Your cosmetic dentist should only cement the crown to your tooth when you both are confident of a perfect color match.

We recommend speaking with your dentist to see if she can work with a dental lab to match your crowns. Otherwise, you can schedule a consultation with an experienced cosmetic to discuss your options.

Dr. Gilberto Tostado, a San Antonio, Texas cosmetic dentist, sponsors this post.

Dental Tourism Horror Story from Mexico

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I had a broken tooth that needed a crown. I tried to save money by going to Mexico for the dental work, but this has ended up a disaster. When I got there, they told me I needed four dental crowns. I believed them and went forward with the work. Less than a week later, one of the crowns fell off. I went back and they told me it was because I need a root canal treatment. I did ask why they didn’t tell me about the root canal to begin with and they said because they don’t always work and they were trying to save me money and see if it would work itself out. So, I agreed to the root canal treatment. Fast forward less than another week and my tooth is seriously sensitive to hot, cold, and touch. I called their office and they said I’d need to come in. At this point, I’ve done two trips to Mexico and have ended up worse, so I called a local dentist who does free second opinions. He says the tooth is cracked and I need to extract it and get a dental implant. My question is this. Seeing as the dentist in Mexico misdiagnosed this, should he do the extraction and implant and credit me for the work already done?

Drew

Dear Drew,

Man holding his jaw in pain

Dental Tourism is Risky

You certainly have had a rough go of it. I’m going to file this in one of my many dental tourism horror stories. Every once in a while we hear of a good experience from someone who traveled to Mexico to get their work done at a lower cost, but most of the time something goes wrong.

Here are the things I am concerned about with the dentist from Mexico:

  • How do you know you actually needed four dental crowns? Did you have decay? A tooth infection? It doesn’t sound like it so I think you were taken advantage of there.
  • A crown doesn’t fall off because you need a root canal treatment. A crown falls off because the dentist did it wrong.
  • Did you really need the root canal treatment? If the tooth was infected, yes. But then, they’d have needed to do it the first time.
  • The root canal treatment wasn’t done properly. The root canal is intended to remove all the infected pulp in your tooth so you would have no feeling in that tooth afterward. The fact that you were having pain tells me they did not do the root canal properly.

As to this local dentist. Even if the tooth is cracked that does not automatically mean it has to be extracted. I would want to get another opinion on that before moving forward.

Let’s say you do need the dental implant. That is a much more advanced procedure than any your dentist from Mexico has done thus far, and these easier procedures have been a disaster. Please, don’t go to them for a dental implant, which requires surgery. You need to bite the bullet and see an experienced dentist here in the states.

As to whether you can recoup your money from the original dentist, that depends entirely on the laws in Mexico. You could first ask for a refund and see what happens.

This blog is brought to you by San Antonio Dentist Dr. Tostado.

Her Dentist is Missing it on This Infection

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I had a root canal treatment a few years back. Last month my cheek started to ache near the spot that I had the root canal treatment. I called my dentist and he did some x-rays. It seems that the spot has re-infected. He did another root canal treatment and gave me some Penicillin. Ten days later,  and I actually felt worse. He suggested that I give it some more time because some people take longer than others to heal. It’s been another week and I feel my cheek swelling up. How long should I expect it to take before I start to feel better? Is it reasonable to ask for a different antibiotic? I don’t think this one was working.

Amanda

Dear Amanda,

Woman holding her cheek in pain and in need of an emergency dentist

 

Your dentist is making two mistakes here. the first thing I want you to do is to call a root canal specialist. You have a dental emergency on your hands here.  Let’s start with the antibiotic. Penicillin is not the best choice for a dental infection. These types of infections really need a stronger antibiotic in order to give your body the backup to heal.  I would have suggested he provide you with Clyndimyacin. When you call the specialist, tell him or her what is going on and ask them to prescribe a more appropriate antibiotic.

The second mistake is not paying attention to your symptoms. When a root canal treatment is done, they can fail even when the dentist does everything right. That leads to a re-treatment. The problem is the chances of success go down significantly with each proceeding treatment. If it failed the first time, there is a greater chance it will fail the second time and even a larger chance of the third time. You have all the indications of the second treatment failing and he just wasn’t putting two and two together.

My hope is that your tooth can be saved by getting to a root canal specialist quickly. If it can’t, the next step is a tooth extraction. When that happens, you need to give serious thought to your tooth replacement. You don’t want to leave the space open. The adjacent teeth will begin to shift or tip into the empty space. This will throw off your bite and could lead to more serious issues such as TMJ disorder. The way to prevent this is to replace the tooth as soon as possible. If you’re looking for the best tooth replacement, I would recommend a dental implant. There are other options though which your dentist can go over with you should that become necessary.

First step, call that specialist right away.

This blog is brought to you by San Antonio Dentist Dr. Tostado.
Click here to learn about Holistic Dentistry.

My dentist wants to replace my dental implant with a bridge

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This past spring, my dentist placed an implant in an upper right molar. I lost the tooth in a 2015 accident but didn’t have it replaced. Before surgery, my dentist told me that I didn’t need a graft, and he could place the tooth with no problem. After my recovery, my dentist changed the story and said that he placed the implant, although I had little bone left. I’ve had nothing but problems with the implant, and now my dentist said he recommends a bridge, but he will have to grind down my teeth. I don’t want a bridge. I want a $2675 refund for the implant that he wants to remove. I am incredibly frustrated because now, during a pandemic, I will have to find another dentist. I don’t know what I should ask you. I am looking for advice. Thank you. Fallon from Augusta, GA

 

Fallon,

Legally and professionally, your dentist owes you a refund. We’ll discuss both aspects.

Legal responsibility

An implied warranty is a legal principle that says you should receive what you paid for, and it should be suitable for its purpose. Your dentist failed to meet the agreement for these reasons:

  • A dental implant needs enough bone volume to support it.
  • Before surgery, your dentist explained that you could receive an implant without bone grafting.
  • During surgery, your dentist saw that you don’t have enough bone to support an implant, but he placed it anyway.
  • Your dentist now recommends removing the implant and replacing it with a dental bridge.

Your dentist can’t give you what you paid for, so you are entitled to a refund.

Professional responsibility

Three phases of dental implant - three components, root form in bone, crown on abutment.

Dental implants need enough bone to support them

Before you receive a dental implant, your dentist or oral surgeon must take x-rays—preferably a 3-D CT scan—to reveal your facial and jaw structure and your teeth. Information from the scan helps determine if you need bone grafting. Your description seems to indicate that x-rays were skipped because it was not until during surgery that your low bone volume was noticed.

If that is what happened, you probably have a malpractice case because your dentist violated the standard of care. A malpractice attorney can tell you if your compensation can include inconvenience, trauma, and risk fees.

What about a dental bridge?

If you are a candidate for dental implants, you don’t have to settle for a bridge.

Key points:

  • A dentist must cut down the healthy tooth on either side of the missing one must to accommodate a crown for the bridge.
  • A dental implant does not affect adjacent teeth.
  • Implants are anchored in the bone and outlast and outperform a bridge.

We advise that you look for a skilled implant specialist.

  • Schedule a consultation to get information on how the dentist plans for a successful outcome.
  • Ensure that your new provider will take a CT scan and explain your options for building up your bone if needed.
  • Ask your new dentist if he or she is willing to contact your current dentist to help you get a refund.

Best wishes on a smooth resolution with your current dentist and getting an implant that lasts.

Gilberto Tostato, DDS of Five Star Dental Group in San Antonio, sponsors this post.

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