If there is a choice to do root canal treatment to save a tooth, you should consider it over extraction. Although dentures, bridges, and implants are options, many times the best choice is to save a tooth that looks, feels, and functions as your normal natural tooth would.
So if your regular dentist recommends tooth extraction, ask whether root canal treatment is an option. And, if your dentist says it is not, then ask why, and request a referral to an endodontist for a second opinion. Endodontists are dentists who specialize in saving teeth, and have at least two years of advanced training in root canal procedures. They are experts at diagnosing and relieving tooth pain, and use advanced equipment to treat patients quickly and comfortably. Your dentist likely already has partnerships with endodontists in your area.
- Never choose extraction just because you think it will be cheaper! Most of the time, if a natural tooth is extracted, it must be replaced with an artificial tooth to prevent other teeth from shifting, and to prevent future dental problems. The cost of a denture, bridge or implant, plus the extraction, often is higher than the cost of an endodontic procedure that could save your tooth for years to come. Most dental insurance plans do cover root canal treatment.
- Never choose extraction because you think a root canal will be painful! Modern techniques and effective anesthesia make root canal treatment virtually painless. In fact, discomfort after the procedure is generally greater with a tooth extraction. Patients who HAVE experienced root canal treatment are six times more likely to describe it as "painless" than patients who have NOT had a root canal.
Our adult patient asks: "What kind of treatment is needed when the crown of a tooth fractures?"
Did you know that there are many different types of tooth fractures?
One of the most common types of fractures is a fracture in which part of the crown has been broken off. This is most often caused by some type of trauma. It can also occur in teeth that have been weakened by untreated decay.
The most favorable type of crown fracture is one in which the missing piece of tooth exposes only the enamel (outermost layer of the tooth) and the dentin (layer under the enamel). The other important feature is that the root is completely formed in an adult tooth. If the missing piece of tooth is not close to the pulp (the innermost part of the tooth; containing the nerve, blood vessels, and other living cells), then usually a filling will be all that is needed to solve the problem.
But, if the pulp is exposed, or nearly exposed, from the fracture, a toothache may occur, or the pulp tissue inside may die. In either of these cases, a root canal treatment will likely be needed.
Sometimes the pulp tissue inside the tooth dies over a long period of time after the original trauma occurred. It can be painless. A change in color of the crown of the tooth is often an indication that the pulp is dead. Your endodontist wil generally test the tooth to see if it is alive. If not, a root canal treatment is usually needed.
A different kind of procedure may be needed when the crown is fractured (exposing the enamel and dentin) down onto the root surface, below the gum level. Depending on how deep the fracture has penetrated, somtimes a procedure called "crown lenthening" can be done to help salvage the tooth. This procedure is done by our periodontist. The procedure effectively lowers the gum and bone to expose more tooth structure, so that the tooth can be treated wtih a root canal and ultimately restored by your general dentist.
More about fractured teeth next month!
A study published in December 2014 has promising findings on the success of implants placed in patients with Type 2 Diabetes. This controlled study had a year-long follow-up period for diabetic patients who had no teeth, but needed implants to support a denture appliance.
The study compared people who did not have diabetes, but needed denture-supported implants, with Type 2 diabetics whose blood sugar were well controlled. Overall, all 3 groups of people needing denture-supported implants in the study had excellent implants success after one year. The one main difference is that patients with poorly controlled blood sugar took longer for the implants to stabilize due to alterations in the early stages of bone healing.
These findings suggest that Type 2 diabetics can enjoy successful implants for the long term, especially when the blood sugar levels are well-controlled. More studies with longer term follow-up are in the works!
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