Oh, My Aching Tooth – Can It Be Saved?

By Samuel Cho, DDS

Braddock Family Dental

. https://www.braddockfamilydental.com

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Oh, My Aching Tooth – Can It Be Saved?

Having healthy teeth is a blessing but why do people lose their teeth and experience pain? It can be due to many factors.  We will cover three main causes of tooth loss: cavities, gum disease, and cracks/ fractures.  We will also cover the solutions and technology used.

Cavities

When you have a cavity, size is a crucial factor.  If the size of the cavity is smaller than half the tooth, a filling can be attempted to fix it.  A filling can be done with either silver (amalgam) or white (composite).  White fillings are the much-preferred choice by most patients.  If the size is larger than half the tooth, a crown is used to safely restore it.  A porcelain fused to metal (PFM) crown was predominantly done before.  Nowadays, white crowns are predominantly being done, such as zirconia and porcelain, for esthetic reasons as well.

Gum Disease

In the case of gum disease, severe sensitivity, heavy bleeding, and even swelling of the gums can occur.  Depending on the severity of pain, an anesthetic agent may be used to facilitate the cleaning procedure. Aggressive cleaning is called “root planing” and scaling (RP/SC), also known as deep cleaning.  It is usually done in 2-4 visits and frequent maintenance appointments are recommended.

Cracks and Fractures

If you have cracks and/or fractures (CF), we need to look at the extent of the CF in relation to the bone and nerve of the tooth.  If the CF has advanced beyond the bone level and into the nerve, the tooth is not salvageable.  If the crack or fracture hasn’t advanced to the bone level, or to the nerve, a good option to save the tooth is with a crown and, you may want to consider root canal therapy (RCT) if you experience too much sensitivity.

Bridges and Implants

If a tooth is not salvageable, there are two options: a bridge or an implant. Bridges involve the trimming of adjacent teeth so choosing an implant may be a better option.

In some cases an implant can be placed on the same day as the extraction of the tooth. An accurate surgical guide (made before the appointment) can be utilized to aid the accuracy of the implant placement.  Typically, it is advised to wait at least 3 – 4 months for osseointegration (fusion) to take place.

There are many implant systems available today and most implant systems are very effective.  The success of implants not only depends on the implant system but also the practitioners skill and knowledge.  Two popular systems are BioHorizons^® and Versah^®. BioHorizons has a special and unique feature called, LaserLok^®. LaserLok is one of the only surface treatments shown to attract a true, physical connective tissue attachment.  This means that gum tissue will be more stable around an implant, therefore longer lasting implants.  Versah is used for its unique bone expanding capability (great for narrow ridge) and better primary bone stability.

Health is everything and having healthy teeth is very important.  Missing teeth weakens one’s ability to chew well.  One study showed that healthy teeth and eating well enhances one’s life span by 7-8 years.