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Advanced cosmetic and general dentistry

Is This Tooth Worth Saving or Should I Get an Implant?

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I’m 77 and have a dilemma about whether to get a root canal or an extraction and implant. Over the past year, many of my old fillings have failed and need to be replaced. I recently had a crown placed on my upper second molar, and during the procedure, my dentist found a cavity and a crack in the upper first molar next to it. She recommends crowning that tooth, too.

I’m concerned about needing a root canal after going through the process of getting a crown. I’m not sure whether it’s better to wait or consider a root canal now rather than needing one later. When is it better to remove a tooth instead of restoring it with a crown and, if necessary, a root canal? Thanks. Jen from RI

 

Jen,

Replacing missing upper molars helps maintain a healthy bite. Without replacement, even at 77, the opposing lower molars can gradually move upward into the space. The changes can affect how teeth fit together. Even if the bite remains stable, chewing on only one side of your mouth can place extra stress on the remaining teeth. It makes sense to include a replacement plan whenever extraction is considered.

How Do Implants and Root Canals Compare?

Both dental implants and root canal therapy have strong success records. However, dental implants are predictable tooth replacement options. Root canal treatment is highly successful when performed by a specialist using current techniques.

While implants have an advantage in reliability and rarely fail, treating a failed implant is often considerably more complex than treating a failed root canal. A root canal and crown usually cost significantly less than an implant and crown.

What Are the Advantages of Each Treatment?

Understanding the strengths and limitations of each option can make the decision easier.

Dental Implant and Crown

  • Costs about 50% more than a root canal and crown
  • Requires at least three months of healing before the final crown is placed
  • Has an excellent long-term success rate
  • More complex to repair if the procedure fails

Root Canal and Crown

  • Usually, it’s the more affordable option
  • Can often be completed within several weeks
  • Preserves the tooth and surrounding bone
  • Carries a slight possibility of future failure that might require an implant

It Tooth Extraction Worth It to Prevent a Root Canal?

Although there is a small possibility that a crowned tooth could require a root canal later, preserving the tooth is a priority. A more conservative approach is to restore the tooth with a crown and address a root canal only if it becomes necessary in the future. Preserving natural teeth whenever possible generally provides the greatest long-term benefit.

The information you provided does not suggest that these teeth are at high risk of needing root canal treatment. There was no mention of increased sensitivity or other symptoms that would raise concern about the health of the dental pulp.

This blog is sponsored by Lowell cosmetic dentist Dr. Michael Szarek, who has advanced training in complex restorative dentistry, and where we are welcoming our new associate, Dr. Andrea Biondo.

 

Why Is My Bite Off with My New Implant Bridge?

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Man holding the side of his face after biting an appleMy new implant bridge replaced two upper left teeth. Biting on that side of my mouth feels weird, like my bite is off. I did not have the issue before I got the bridge. My dentist tried to correct my bite twice, and after that, she suggested that I need orthodontics. She said that she does Invisalign, and we can discuss it during my next appointment. I feel like my dentist is trying to sell me something that I do not need. I am not sure what to do about it. How should I answer my dentist? Thanks. Luke, Austin, TX

 

Luke

With or without a dental bridge, your upper and lower teeth should touch simultaneously when you bite. If the problem continues, you can develop TMJ disorder.

What Causes Bite Misalignment with a New Implant Bridge?

When your bite is off with a new implant bridge, two possible causes are:

  1. The dentist restored the implants incorrectly
  2. The implant dentist or surgeon placed the implants in the wrong place

Dental implants restored incorrectly

A dentist must correctly attach implant crowns, a bridge, or a denture to implants. Also, the dentist must ensure the new replacement teeth harmonize with your bite.

Dental implants in the wrong place

If a dentist and oral surgeon do not communicate closely, the surgeon may position the implants in a way that makes it challenging or impossible to place your bridge correctly. This problem occurs if the dentist does not give the oral surgeon a surgical guide for your mouth. A surgical guide is a template for your implants’ exact angle and position.

Schedule a Second Opinion

Please do not consider orthodontic treatment. Although your dentist may want you to get Invisalign, it does not seem that orthodontic treatment is the solution to your issue. We recommend getting a second opinion from an implant dentist with advanced training or who partners with an oral surgeon to place dental implants. The implant dentist will determine if the location of your implants, your bridge—or both—must be corrected to fix your bite.

Best wishes for a speedy resolution.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.

How Can I Switch Out a Partial Denture’s Metal Clasps?

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After spending $1925 for a titanium upper partial denture, I still wish I had dental implants. It’s the clasps around my teeth that bother me. I feel like they disrupt my smile. Maybe I’m too self-conscious. Is there a way to replace the metal clasps with gum-colored ones? Perhaps my dentist told me about the clasps, or I didn’t consider how I would feel about them. The two replacement teeth in the partial denture look natural, but what good is that when you can see metal strung around my teeth to keep the partial in place? Thanks. Geno from NJ

Gene,

We understand your concerns about the clasps on your partial denture.

Can You Switch the Clasps on Your Partial Denture?

The metal claps on your denture are a part of the framework, so you cannot switch them out. Too many alterations to the claps will cause them to break. Adding anything over a partial denture’s clasps to hide the metal will make getting them on your teeth impossible. If you could get the clasps on, they would be uncomfortable. Sometimes, a dentist may be able to reduce the shine on the clasps. You can ask your dentist if it is an option for you.

Alternatives to a Partial Denture with Metal Clasps

Clasps made of biocompatible nylon and thermoplastic resin are an alternative to metal. Although not as sturdy as a metal denture, a Valplast partial denture is flexible and less noticeable because the base and clasps are gum-colored.

Dental Implant vs. Partial Denture

Model of a dental implant, including the crown, abutment, and artificial root

A dental implant mimics a natural tooth for optimal function and long-lasting results.

Although a dental implant costs more than a partial denture, consider the differences in longevity, support, and reliability.

  • Longevity – A quality partial denture can last five to ten years. A dental implant can last ten years or longer—even a lifetime.
  • Support – Your jawbone supports a dental implant. It does not rely on or clip onto adjacent teeth, so it will not weaken them over time.
  • Reliability – Dental implants function like natural teeth. Regular flossing and brushing keep them clean.
  • Cost – You will need one dental implant for each missing tooth or an implant bridge for multiple missing teeth in a row. Depending on your needs, a complete dental implant can cost $3,000 to $5,000.

Talk to Your Dentist

Talk to your dentist about your concerns with your partial denture. When it’s time to replace the denture—or before, if you prefer—find a skilled implant dentist to discuss replacing your missing teeth with dental implants.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post. His office is near Dracut, Methuen, Andover, and Lawrence.

Is It Too Late to Switch Dentists for Bridgework?

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African American man thinking - portraying concern over whether to switch dentists for bridgeworkI got a new Maryland Bridge last October and have had it replaced three times. I need more dental work, but I am afraid that this family dentist will be unable to correct the bridge or complete the other work I need. Is it too late to switch dentists in the middle of my bridgework? – Thank you. Patrick from Freeport, Bahamas

Patrick,

We understand your concerns about your dentist’s inability to provide a stable dental bridge. Problems can occur when a dentist lacks training and experience in cosmetic dentistry. It is wise to switch dentists.

What Is a Maryland Bridge?

A Maryland bridge is a tooth replacement option with replacement teeth suspended between two wing-shaped anchors. A dentist bonds the anchors to the backs of each tooth on either side of the missing one(s).

What Causes a Maryland Bridge to Fail?

When a Maryland bridge fails, possible causes include:

  • Flawed design – Inadequate tooth impressions or faulty construction can cause the bridge to fail. Sometimes, the dental lab can re-etch the metal and correct the flaws.
  • Poor bonding techniques – If your dentist’s bonding techniques are flawed, the wing-shaped anchors will not adhere to the backs of your teeth.

When you tell your dentist you want to switch to another dentist, they have an ethical obligation to send your dental history and records to your new dentist. Your new dentist may decide to take X-rays to ensure your anchor teeth are stable. If your new dentist recommends treatment other than a dental bridge, such as dental implants, please consider the reasons and decide what is best for your long-term oral health.

How Can You Find a New Dentist?

Look for a dentist with post-graduate training and experience in cosmetic dentistry. The dentist can determine why your Maryland bridge failed repeatedly and whether the bridge is the ideal solution for your missing teeth or whether a dental implant is the best solution for your oral health.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.

Why Do I Have Radiating Tooth Pain with No Cavity?

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I have radiating pain in my tooth, but no sign of a cavity exists. I think the worst and am concerned about needing an extraction and dental implant. What else could be causing the problem? Thanks. Gavin K.

 

Gavin – Thank you for contacting Dr. Szarek’s office.

Although you may not see signs of a cavity, the pulp of your tooth may be infected. Cavities or decay begin outside a tooth, but internal root absorption destroys tissue inside a tooth.

What Can Cause Tooth Pain Without a Cavity?

Conditions that can cause tooth pain without a cavity include the following:

  • A fractured tooth can cause persistent tooth pain. A dentist will use a bright light to reveal if your tooth is fractured.
  • Inflamed tissue. The tissue surrounding your tooth may be strained. The pain and inflammation in the tissue can transfer to your tooth.
  • Jaw pain. Facial pain, such as pain in your jaw muscles, can refer to your teeth.
  • Sinus problems can refer dull, aching, or throbbing pain in your teeth.
  • Headaches. Migraine and cluster headaches can refer to deep pain in teeth.
  • Cardiovascular problems. Heart problems can refer pain in the shoulder, neck, and even the jaw and cause pain in your teeth.
  • Nerve pain. Specific neurological issues can cause you to feel pain in your face, teeth, or gums.
Model of a dental implant, including the crown, abutment, and artificial root

Prompt care for tooth pain can decrease the need for removal and a dental implant

Schedule an examination from your dentist for an examination and x-rays. Call a dentist for an appointment. Your dentist will determine if your tooth is causing discomfort. Early detection can prevent the need for tooth removal and a dental implant.

Your dentist may refer you to a primary care doctor and perhaps to a neurological for further tests to identify and treat the cause.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.