Archive for the ‘Missing Teeth’ Category

Will the gum grow back after an extraction?

Thursday, June 24th, 2010

About a year and a half ago I had a root canal (on tooth #7) that failed and my gum was damaged in the process so that a small part of the root of my tooth is exposed. Because the root of the tooth was also damaged I am unable to get a crown. It was recommended that I have the tooth pulled so the gum grows back and then have a bridge placed. I am extremely worried about how this is going to look, as well as having to have two other front teeth ground down for the bridge.

My question is, will the gum grow back once the tooth is removed? And once it does is a cosmetic dentist the best type of dentist to see to achieve the best look? Is there a way to place a bridge without destroying the two surrounding teeth?

Thank you so much for your help, this issue has caused me much anxiety.
Ariel from New Jersey

Ariel,
I’m guessing somewhat at what your clinical situation is. Since you don’t know the clinical terminology, it’s probably hard for you to describe what has happened and what you’ve been told. But let me try to be helpful.

Root canal failure happens sometimes, and when it does, sometimes the only option is to take the tooth out. But the gum doesn’t really “grow back” after the tooth extraction, it actually shrinks some because the body senses that the bone that used to support that tooth is no longer needed, and it takes those minerals to use elsewhere in the body, causing a sunken-in look.

You’re talking about tooth #7, which is your upper right lateral incisor, and you say you’re worried about how this will look. That suggests to me that you may have a high lip line where the gum shows when you smile. If that is the case, you need to be aware that if you have a bridge, this tooth #7 will look longer and the gum will look shorter. And yes, if you have a bridge, the adjacent teeth will need to be ground down some and crowns put on them. While this doesn’t destroy those teeth, it does compromise them.

The other option is that you can have a dental implant placed. A dental implant will stimulate the bone in this area and prevent your body from resorbing that bone and will help preserve the natural look of your gums. If your dentist hasn’t suggested this option, it could be that he or she is not comfortable with dental implant work and it may be wise to seek a second opinion.

A further point. If you have the bridge or if you have a dental implant, and the appearance of the gum is a big concern for you, it may be desirable to have some minor gum surgery to “plump up” the gum in this area so that it looks natural.

If you need a second opinion, I would strongly recommend finding an excellent cosmetic dentist. Yes, only a true cosmetic dentist would have the passion to create a beautiful result, and replacing a single front tooth is difficult to get to look natural, especially in a case like yours. The vast majority of dentists would not likely do a good job with this and would not get it to look natural.

Links: Read about how Dr. Thein tries to be the best LA cosmetic dentist.
He also provides sedation dentistry for his patients.

What to do in place of my Maryland bridge?

Wednesday, January 20th, 2010

I am wanting to replace a Maryland bridge I have had since I was 18 years old (I am 42 now). It replaces my tooth #10. The replacement front tooth is too dark or yellowed and I am wanting to have my teeth bleached. I am also unhappy with the gray that shows thru on #9 and #11. My general dentist suggested a conventional bridge to replace the Maryland bridge and possibly a lumineer on #8 so it would look more symmetrical. Does this sound like a good idea to you?
- Lori from Missouri

Lori,
So you have an existing Maryland bridge replacing one of your lateral incisors. As is typical with a Maryland bridge, the metal framework that holds in the false tooth darkens a little bit the natural teeth that it is attached to.

If you want something nicer, in my opinion you have two options. One would be to have a conventional bridge, which would involve crowning the two adjacent teeth and suspending the false tooth between them. The other would be to have a single dental implant replacing this tooth. To read about the advantages and disadvantages of these two treatments, you can read my implant vs bridge page on my implant dentistry website.

It worries me that your dentist wants to put a Lumineer on your front tooth just for the purpose of matching the bridge. I’m worried that this indicates that your dentist doesn’t have confidence in his ability to match the porcelain to your natural tooth. Porcelain can be tinted and shaped to match a natural tooth, and my opinion is that this would be the way to go, if you choose the bridge.

But if he or she can’t match the bridge to your natural tooth, then I wonder how your dentist plans to match the Lumineer to the bridge. That is just as hard, maybe harder. Unless there’s something particular about your case that I don’t know, on the surface this seems like unnecessary treatment.

Other links:
Check our Los Angeles gentle dentistry page.
Read about Los Angeles white fillings.