Archive for June, 2010

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 about lots of cavities all the time.

Monday, June 14th, 2010

I am 22 years old and have had just about every one of my top and bottom molars drilled out by dentists over the years. What can I do to not lose all these teeth that have been deeply drilled? Each time I go to the dentist they tell me how beautiful my teeth are and that I’m doing a great job of brushing and caring for my teeth. X-rays are next and then the dentists show me some shadows and tell me I have many cavities under my enamel. When they drill, it is always very deep, with them digging out a lot of soft white tooth enamel out. As a result I have very few molars left without extensive fillings. My teeth have never hurt, nor have I had dark spots or any areas that look like decay.
- Mary from Texas

Mary,
I get frustrated with some in the dental profession who perpetuate this idea of “soft teeth” and who can’t seem to explain aggressive decay.

Aggressive tooth decay is almost always caused by too frequent eating. There are some disorders that aggravate decay, such as enamel hypoplasia, or cancer treatments that destroy the salivary glands, but those disorders are rare. To understand this better, there is an excellent page on tooth decay on the mynewsmile.com website that you can read.

So you have several things you can do to protect your teeth and keep you from losing them:
1. Minimize continual decay by limiting between-meal snacks to one or two a day.
2. Protect existing teeth with large fillings by doing crowns. Some dentists are reluctant to suggest crowns and subject patients to patchwork dentistry. But this is false economy and subjects your teeth to risk.
3. Have frequent checkups – certainly every six months. And if you have a tendency to be surprised by large cavities that only show up on the x-rays, then I would advise having more frequent x-rays. Don’t limit yourself to what your dental insurance covers – get the care you need.

I hope this is helpful.

Link: See our Los Angeles emergency dentist page.