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Advanced cosmetic and general dentistry

Archives for January 2021

My dentist is violating my tooth-extraction rights

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I asked my dentist for teeth whitening, but he doesn’t want to do it because he recommends a root canal and crown on a second molar. My point is that teeth whitening is much cheaper. If I can’t afford a root canal and crown, why should I do it? I have dental insurance, but it will only cover half of the cost. And then if the root canal doesn’t work, my dentist will have to extract the tooth anyway? Why not just get rid of the tooth, eliminate the future problems, and whiten my teeth? I’m thinking about switching dentists. – London

London,

Thank you for your question. We understand your concerns about your budget and want to improve your smile without creating debt.

Extracting a second molar tooth

Extracting a second molar tooth causes the least complications. A second molar does not have a tooth behind it that will drift after the extraction.

Some facts to consider:

  • Lower second molar – The upper molar opposite to the tooth you want your dentist to extract will have no tooth to meet it. It will begin to drift, bite into your gum, and eventually require extraction.
  • Chewing efficiency – If you have your premolars and front teeth, you can chew adequately without your upper and lower second molars.
  • First molar – If you later lose a first molar, it will disrupt your bit on that side of your mouth and reduce your chewing efficiency.

It’s Still Best to Save Your Teeth

But we understand your budget is limited. If your dentist is skilled with root canal treatment and crowns, the risk of it failing is minimal.

We recommend that you have another discussion with your dentist about the pros and cons of keeping the tooth or removing it. Ask about the urgency of root canal treatment and determine if you have a little time to save money. Some dentists offer no-interest financing that allows you to pay for care over time.

Photo of teeth whitening trays in a case, for information on DIY teeth whitening from Lowell, MA dentist Dr. Michael Szarek.

Resolve dental issues before whitening your teeth

If you and your dentist cannot reach an agreement, you can get a second opinion on your second molar and teeth whitening options. Some dentists offer free or discounted whitening to patients who keep regular dental cleaning and exam appointments.

 

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.

New dental crowns for a gap make my jaw and neck hurt

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I received a dental implant on a left incisor and crowns on all front six teeth. I received the other crowns to close a large gap between my front teeth. Now my speech is slurred and lispy, and I have neck and jaw pain, dry mouth, and numbness in my lips. I regret closing my gap. Are the crowns causing this problem? If so, I want them removed, and I will keep my gap. – Dahlia from CT

Dahlia,

Closing your gap is not the issue, but the quality of your crown placement is the problem. Correctly sized and seated crowns do not create the symptoms you described.

When Dental Crowns Cause Symptoms

When dental crowns cause symptoms, including pain, numbness, or dry mouth, it could be that the crowns are too thick, too long, or both.

  • Oversized crowns – Oversized crowns can prevent your lips from closing naturally and effortlessly.
  • Lip incompetence – When your bite is correct and you put your teeth together, your lips should close naturally without thinking about it or trying to close them. Your lip numbness and dry mouth suggest you have lip incompetence—the ability to close your gaps naturally.
  • Thick crowns – Too-thick crowns can disrupt your bite (the way your upper and lower teeth fit together) and cause jaw and neck pain. Speech problems can result, too.

What to Do About Faulty Crowns

When dental crowns cause pain and dry mouth, you must find a cosmetic dentist to correct the issue. A dry mouth and lack of saliva breeds bacteria and promotes rapid tooth decay. Saliva contains antibodies to help fight decay, so don’t let the problems linger.

Diagram of three phases of dental implants, for information on implants and diabetes from the office of Lowell, MA dentist Dr. Michael Szarek.

Get a second opinion to check your implant crown and crowns on your natural teeth

We recommend that you find an advanced cosmetic dentist—preferably accredited—for a second opinion. It is challenging for a dentist to place multiple crowns simultaneously and balance your bite correctly. But a trained cosmetic dentist who understands occlusion and bite (how your teeth fit together and come in contact when you bite) can evaluate your case.

The cosmetic dentist will do the following:

 

Unfortunately, you may need new crowns. But your oral health is essential to your well-being.

Best wishes.

 

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.