Not Again!

Q: Dr. Crapo: Yesterday, my upper left front tooth that has a veneer on it fell out. It was the second time this has happened since it was put in less than two years ago. I saw a dentist other than my own and was informed that the veneer had not fallen off but the whole tooth had broken off with the veneer intact. It was broken right to the gum level. The doctor assessed it and said that I’d have to have a root canal, and then a post put in so that a new crown would have something to attach to. I asked him why this tooth had failed and the tooth beside it, which also has a veneer, didn’t. He said he didn’t know but did say I have a deep bite. He said that people with deep bites tend to wear their front teeth more and put a lot of stress on them. He thought this tooth was getting more stress than the other tooth and had developed cracks that got bigger and bigger, until the tooth snapped off at the gum line. He said the veneer didn’t fail, the tooth failed. I understand that now, but I’m still without a tooth (thank goodness he put it back in) and don’t know what to do. If I do a root canal and new crown will that last? He also said my roots are short, meaning I have less anchorage of the post to hold the crown. What can I do? Is this my only option?

A: You have several options but the cause of the problem needs to be understood before you proceed. Approached from a minimalistic perspective, replacing your veneer with a root canal and crown, is the fastest solution. The great concern is the element, which is causing the breakage in the first place, is still present. Another solution is to splint the new replacement crown with new crowns for the teeth on either side, thus creating three crowns bonded together. This is a much stronger solution but still the cause has not been dealt with. Is it strong enough? Probably, but that could change (especially with a deep overbite) if the element of stress progresses, thus putting even more pressure on the front teeth. Another solution is to remove the root of the broken tooth and place an implant. Again, a very strong solution (costing about the same as the splinted crowns) but one that is easier to brush and floss. These are good solutions for your broken tooth, however the next step is to find the solution that also solves the cause for the breakage in the first place.

If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre 778-410-2080

www.VictoriaImplantCentre.com

You Should Always Keep Your Own Teeth - Right?

Q: Dr. Crapo: I’m in my seventies and in good health. Over the past fifteen years, I’ve been wearing a partial denture that is attached to two of my upper molars. These teeth were root canaled and crowned many years ago. In the last six months, I began to have a foul taste to some acidic foods and fruits. I saw my dentist to tell him about this development. After taking x-rays and examining my teeth, he said that new decay had occurred under the crowns.

A: You may have many options that are satisfactory, especially if your bone structure is adequate. Keeping your upper molars may be a good idea but if there is decay under your crowns, it will be imperative to assess the root canals. Very often decay means leaking. Bacteria-laden saliva gets under the crowns, which often leads to leaking of bacteria past the root canal filling material and into the bone at the end of your roots. If this is the case, a retreatment of your root canals will be necessary. This will add substantially to your costs. Adding implants to the treatment and making a new partial denture will approach the cost of a palateless “teeth-in-a-day” bridge. The disadvantage of keeping your own teeth at this stage of your life to anchor a partial denture is that they may decay again. (Teeth that anchor partials have a higher decay rate). Redoing root canals in those upper molars and then re-crowning them can become quite expensive because of disassembly charges (taking out posts and filling materials after removing the crowns). It would be a shame to lose your investment. Look carefully at your options and their costs before keeping your own teeth. (The taste by the way, is the leaking of decay out from under your crowns). An implant fixed bridge may avoid future decay and completely frees your palate to taste and enjoy your food.

He said they’d have to be redone. He also said that the decay might be too advanced to save the teeth. When I asked him what options I had, he said I might have to get a denture. When I asked him about implants, he said that could be done, but the expense was much greater than the upper denture alone. For some reason the thought of a denture is distasteful to me (no pun intended). I don’t know my options, but I wonder if I do implants and keep my teeth, if I could at least have another partial denture and not have to have a full denture?

If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre 778-410-2080

www.VictoriaImplantCentre.com