Q: I’m nearing retirement- that’s good! However, some dental issues have reared their head. In the last four months, a tooth that had a root canal on it began to hurt like it did when it was first done. I have a family member in another part of the country who is a dentist. He helped me get the kind of antibiotics I needed. I also had a molar break off that had been root canaled and crowned on my lower left. The molar in front of it had been pulled years ago and my dentist said I would need grafting for an implant. He also said the tooth that was hurting looked fine on the x-ray. At that point I decided to get another opinion because I felt that my teeth were deteriorating in a way that needed a fresh look. I saw another fellow who listened to my history then took another look at the x-ray of the tooth that had been giving me grief and at the lower left side that feels like a disaster. He used a special x-ray machine that sees in 3D. It gave him a cleaner picture he said and told me that one of the roots of the tooth that had been killing me had not been found and fixed so it was abscessing. He also told me that I might not need a bone graft on the lower left side if a certain kind of short implant was used. I don’t remember what kind it was but that seemed promising. He then said the tooth that was broken couldn’t be fixed because the decay was down too deep. How do I proceed?
A: Every once in awhile a dentist will start a root canal and find that the anatomy of the tooth coupled with a buildup of calcification inside the tooth make finding, cleaning and filling too difficult. Most of the time a referral is made to a specialist to finish the job. You may have to take that route.
When a molar tooth breaks off it’s simply getting too much pressure during eating or nighttime grinding or both. To remedy the problem, it’s important to get the whole mouth analyzed. Often time a break in the back means teeth in front of the mouth are not doing their designated task to protect the back teeth from harsh grinding forces.
Short implants are a great remedy to inadequate bone length problems. Bicon implants are short implants that have a very attractive, long-term success rate.
As for your tooth that needs extracting make sure a bone graft is placed at the time of extraction so good bone preservation is assured. Then in six months an implant can be placed and three months later crowns can be made.