second opinion Archives - 5 Star Dental Group

Must a Surgeon Remove a Tooth Root Fragment Broke During an Extraction?

Posted on April 11, 2024 by AllSmiles.

My dentist had trouble extracting my top left first molar, so part of the root broke. She referred me to an oral surgeon, and I am scheduled to remove the rest of the root in late June. Is this necessary, or can I leave the root fragment as is? Will it hurt anything? Thanks. Korey

Korey,

If a tooth isn’t easy to remove, a tooth root may break during an extraction. Your dentist realized she left the root fragment and responsibly referred you to an oral surgeon. Hopefully, in the future, your dentist will anticipate the challenges for an extraction patient and determine when it’s best to refer them to an oral surgeon for tooth removal.

If a root fragment is too long, bone can grow around it, making it more challenging to remove. Follow-up care should be in a few days.

The roots of the upper first molars are close to the sinus wall and can perforate the wall. The surgery requires adeptness to avoid additional complications. Allowing extended healing will increase the risk of perforation.

We recommend getting a second opinion from another oral surgeon about the timing of the root fragment removal. Another oral surgeon may recommend leaving a small fragment that’s close to the sinus wall. Otherwise, they will likely remove it as quickly as possible.

If you are considering a dental implant to replace your first molar, discuss it with the oral surgeon to determine whether you need bone grafting first.

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

My All-on-4s Feel Loose?

Posted on December 11, 2020 by AllSmiles.

Hello,

I used to wear a partial denture but did not like it that much. My dentist recommended the All-on-4 implant overdenture procedure, and I was excited at the prospect of the results. However, my denture is not comfortable to wear. It moves around and food gets stuck under it when I eat. Is this normal? Is there just an adjustment period I need to get used to it? I am not too happy with the results either.

Hifumi, from Waltham, MA

Hi there Hifumi,

It sounds like something went wrong during your procedure. The All-on-4 implant overdenture is not supposed to be loose. On the bright side, it should be easy to fix the problem.

You should go to your dentist promptly, to avoid any more problems or pain. Your dentist should be able to tighten it quickly in the office. If there is something wrong with a screw or denture itself, it could be solved in a few trips to the office. Fixing either problem will be non-invasive.

If something is wrong with the dental implants that support your All-on-4 implant, it will take more time to correct the problem. It will not be clear if the implant itself is the problem until the other possibilities are exhausted.

In any case, it is important to make an appointment to go see your dentist to fix this problem. If you dislike your dentist’s work or bedside manner, you could seek a second opinion elsewhere, but your dentist should be able to help you.

This blog post is brought to you by San Antonio All-on-4 implant overdenture provider, Dr. Gilberto Tostado, of 5 Star Dental Group.

Is it Normal for my All-on-4 Dental Implants to Fail?

Posted on August 14, 2020 by AllSmiles.

Hi,

I was in need of dental implants over five years ago. I’m in my 60s but wanted something that would last a lifetime, so I opted for All-on-4 implant overdentures. So far I have had no problems and feel they were a good investment. I maintain a strict oral hygiene routine with mouthwash and flossing in order to protect my teeth. However, one day I noticed a strange taste in my mouth, but nothing else was out of place. I mentioned this to my dentist at my six-month check-up, and after an X-ray, he determined I had an infection in one of my All-on-4 implants.

I was given some antibiotics, but he warned me that if the infection came back, the implant would have to be replaced – meaning it would have to be removed and I would have to go through surgery again.

I’m not too happy about having to go through this painful and expensive process again. I thought this would last the rest of my life, so why would they fail just a few years in? Is this normal? Will my new implant be likely to fail a few years down the line too? Do I have any other options?

Monty, from Decide, Kentucky

Hi Monty,

Your situation is unique and unfortunate. Studies have shown that All-on-4 dental implants have over a 94% success rate even 10 years post-surgery. However, there are no studies regarding success rates on replacement dental implants.

However, certain things can affect whether these implants are likely to fail. If you have periodontal disease, any pre-existing health conditions such as diabetes or inflammatory disease, or if you are a smoker, your implants are far more likely to fail. If none of these issues affect you, then something else may have caused the infection, and it may be impossible to determine the cause.

Also, any issues with your implants would likely have been noticeable shortly after surgery. Since your implants are several years old, your body has likely adapted to having them in your body.

Going through the process again is up to you. If the infection is only sourced in one implant, then likely the rest of your dental work will likely hold up for the rest of your life. If you are not sure, you can consult with a periodontist for a second opinion.

This blog post is brought to you by San Antonio All-on-4 dental implant provider, Dr. Gilberto Tostado, of 5 Star Dental Group.

Are My TMJ Problems and Diabetes Related?

Posted on July 3, 2020 by AllSmiles.

Hi there,

I have been having jaw pain for months. I tense my jaw when I’m stressed, and I grind my teeth at night. My dentist made a night guard so I would stop grinding, but still no relief. I have tried cold compresses and ibuprofen to reduce the pain and inflammation, but still nothing. My dentist also ground down some teeth, as a misaligned bite was likely causing TMJ pain. Still no help.

My insurance has not been covering this, so I am out a lot of money and no closer to finding an answer to my pain. I feel like my dentist has given up, as his latest idea is that my diabetes is responsible for my pain. Is that correct? He knew I had diabetes when I first walked into the office, so why did it take him so long to mention a link between the two?

Since he thinks it is linked to my diabetes, he says there is nothing he can do for the pain. It is interfering with my daily life; I can barely eat or sleep because of the pain. What can I do? Or will I be in pain for the rest of my life?

From Alphonse, in Columbus, Ohio

Hi Alphonse,

You are correct, your temporomandibular joint, or TMJ, is likely the cause of your pain. However, if your dentist knew you were diabetic, he should not have prescribed you ibuprofen, as it is contraindicated for diabetics, meaning you could be at higher risk of side effects.

Diabetes can cause oral health problems, such as dry mouth, which can lead to gingivitis. It can also cause diabetic neuropathy, or nerve damage to your nerves near the surface of your skin. This usually affects a patient’s feet but can affect other parts of your body, and very rarely affects your face.

Despite the link between the two, there are still ways to options. If your dentist is not willing to treat your pain, you should seek a second opinion. A dentist more skilled in treating TMJ will likely be able to provide you some relief.

This blog post is brought to you by San Antonio TMJ dentist, Dr. Gilberto Tostado, of 5 Star Dental Group. Please note that TMJ is not a specialization or certification, but dentist who pursue continuing education courses pertaining to TMJ will call themselves TMJ dentists or TMJ specialists.

Is It Normal to Need Root Canals after getting Porcelain Crowns?

Posted on June 5, 2020 by AllSmiles.

Hi there,

I decided to get porcelain crowns a few years ago. My dentist said I needed a full-mouth restoration, and that there would not be any negative side effects. However, after the long intense process of getting extractions and crowns, a few of the crowns started hurting. I went back to my dentist several times for adjustments. When the pain went away, an abscess formed! An X-ray showed I needed root canals because of nerve damage. If I’d known about the risk of nerve damage, I may not have gone ahead with the crowns…

My dentist agreed to do several of the root canals I needed free of charge. However, more teeth have started hurting and even abscessing. I know they will most likely need root canals too, and I’m worried about the future. Will I need root canals on every crowned tooth? This whole process has been a nightmare. What can I do?

Thank you,

Stari, from Chicago, IL

Hi Stari,

When your dentist made your crowns, he ground down a lot of your natural teeth. If your dentist is not skilled at placing crowns, there is a rise of exposing the pulp inside your tooth. Exposed pulp can cause pain or become infected. If this happens, a root canal is the only way to remove the infection. Any teeth with decay or heavy fillings can increase the risk of infection as well. Teeth in poor condition may not be suited for crowns, and an extraction followed by a dental implant may have been a better course of action.

Your dentist should have definitely informed you of the risks prior to your smile makeover, so that you could make a fully informed decision. Since he did not, paying to fix the damage is the least he can do. It seems that by offering to pay, he feels some degree of responsibility for your situation.

Any problems with your crowns will have likely become apparent a few months after surgery. Since you’re a few years post-surgery, you are probably done with needing root canals. Should you need any more root canals, your dentist should continue to pay for them. If any of those crowns need replacing, opt for another cosmetic dentist for a second opinion.

This blog post is brought to you by San Antonio cosmetic dentist, Dr. Gilberto Tostada, of 5 Star Dental Group.

Will My All-On-4 Dental Implants Fail Eventually?

Posted on May 8, 2020 by AllSmiles.

Hello there,

About 10 years ago, my dentist recommended getting All-On-4 dental implants done. I was in my 50’s, but interested in a long-lasting smile. It was a rather intense and expensive process, but I was happy with the results in the end. However, I started noticing a bad taste in my mouth, despite no changes to my established brushing, flossing, and mouthwash routines.

When I mentioned this to my dentist, he said there may be an infection in my mouth and ordered X-rays. He was right – one of my implants was infected and I needed antibiotics. However, if the infection comes back, I may need to get surgery all over again.

I thought these implants would last me the rest of my life, so I’m blindsided by having problems only 10 years in. I do not want to pay for the entire procedure again, especially if there’s a risk an implant could fail again. Is it common for All-On-4 implants to fail after 10 years or so? Should I just opt for a set of dentures at my age? Any advice would be much appreciated.

Daniel, from Trenton, New Jersey

Hi Daniel,

All-On-4 dental implants are a type of implant overdenture. Your situation is rare, but unfortunately All-on-4 does not work for everyone. If you have any risk factors, such as previous periodontal disease, chronic health conditions, or are a smoker, the risk of possible failure is higher.

Determining the cause of your implant failure may prove difficult. It likely was not caused by a placement issue during the initial surgery. If it were, the problems would have cropped up in the first few months after surgery. Any of the aforementioned risk factors could have contributed to the implant’s failure. However, if you did not have any risk factors, then the cause of the infection or implant failure will likely remain a mystery.

All-On-4 dental implants, also known as Teeth in a Day, frequently have a very high success rate among patients. Studies have shown that even 10 years after surgery, the implants still hold strong at a 94% success rate, meaning only a handful failed over the course of the decade.

If you cannot determine what caused the implant to fail, it’s understandable that you would be hesitant to get it redone. Also, there is not any data available on how long All-On-4 implants last after being redone. However, you still have options besides dentures; you still have 3 successful implants, so if you were to get the fourth remade, it would likely hold well. The decision is up to you. To help you decide, see a periodontist, cosmetic dentist, or oral surgery specialist for a second opinion.

This blog post is brought to you by San Antonio implant overdentures and All-On-4 provider, Dr. Gilberto Tostado, of 5 Star Dental Group.