Archives for July 2020

Will Invisalign Work If I Have Missing Teeth?

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My bottom teeth are crooked. Two of my second bicuspids are primary teeth. One was painful, and my dentist extracted it. I’ll probably lose the other one soon. Also, I have a lower right molar that’s missing. I’m concerned about underbite and lack of space between my top and bottom teeth. Will Invisalign work if I have several missing teeth? I’m 47 years old, and I don’t want metal braces. Will I need dental implants too? Thanks. Joel from MO

Joel,

If you have missing teeth, Invisalign, and other types of invisible braces, will still work. But other factors determine if you’re a candidate for clear aligners.

Underbite and severe crowding can be obstacles to receiving Invisalign. Dentists vary in their willingness to take on those challenges with Invisalign. Orthodontists are more conservative and often shy away from the new technology. But expert orthodontists are on the Invisalign staff, and if they approve a case, Invisalign will work.

Visit two or three dentists who offer Invisalign or similar types of aligners to get their opinion on your case. Invisalign might close the spaces in your lower law and prevent the need for dental implants. Clear aligners might move your upper teeth out. It depends on the position of your teeth, though. Your dentist will take panoramic x-rays and send details about your case to the lab. You’ll get a treatment plan and learn what to expect. It can help you determine if you want to proceed with clear aligners or opt for low-profile braces.

Steven Brooksher, DDS, of Baton Rouge sponsors this post.

 

Extract Remaining Teeth for Dentures? 6 Facts to Help You Decide

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I have advanced tooth decay and gum disease. My two center front teeth are healthy, and after a visit with the periodontist, he says that those two teeth are likely the only ones he can save. I have a cheap bulky partial, and I have an underbite. My dentist thinks that removing the two teeth and getting a complete denture would be healthier than partial dentures. I got a second opinion, and the dentist said that he could do either option, and it’s up to me. I guess that a full denture would look better than a partial. I’m asking a couple of dentists online for their help. My budget is limited, and I’m concerned about that too. But I’ve learned my lesson about neglecting my teeth, so although I’m not too fond of debt, if I need a loan to correct the situation, I’ll apply for financing.  Is it best to have my center front teeth removed or to get partial dentures around them? Thanks. Timothy from Huntsville, AL

Timothy,

For an accurate diagnosis and treatment options, Dr. Brooksher would need to examine your teeth personally and do x-rays.  We’ll give some principles based on your description of your oral health. But we can give you some principles that might help.

Save Your Teeth or Extract Them for Dentures?

The factors below and talking with your dentist can help you decide if you want to keep your teeth or get full dentures.

1. It’s usually best to save healthy natural teeth

When your natural teeth are healthy and won’t compromise your oral health, it’s usually best to save them. Replacing teeth with a removable appliance—a partial or full denture—has many disadvantages. The denture can move or slide if it’s not anchored, and it won’t be comfortable.

2. When few teeth remain, they are under stress

If you only have two upper teeth that are healthy, the force from your lower teeth when you bite and chew puts stress on the upper teeth. Pressure on the teeth can weaken them internally, even if they appear healthy on the outside.

3. A full upper denture increases comfort

Suction keeps a full upper denture in place, and it moves less than a lower denture. It’s more comfortable than a partial denture, and it’s easier to eat and chew with it.

4. A well-made upper denture is healthy for other teeth

A well-made upper removable denture is gentle on lower teeth. If you have a severe underbite, the force or impact of chewing can put stress on lower teeth.

5. When all your teeth are missing, your jawbone is affected

Teeth stimulate the jawbone, so when all your teeth are missing, the stimulation stops, and your body resorbs the bone. After 10 to 20 years, you’ll lack enough jawbone to support your facial muscles, and your face will sag and make you look older. The missing bone will make it difficult—if not impossible—to keep a lower denture in place. But you will still have some suction for an upper denture.

6. Implant-supported dentures increase function and comfort

Diagram of a snap-on denture. The denture is hovering above the jawbone that has two dental implants in it.

Affordable dental implants will secure your dentures

Your dentist can tell you if you’re a candidate for an implant-supported partial denture or an implant-supported denture. Either option might exceed your budget, but implants stimulate your jawbone to prevent further shrinkage. Your denture won’t slip around, and it will be comfortable to eat and speak with it.

Again, Dr. Brooksher hasn’t completed your oral exam or seen your x-rays, so you’ll have to rely on a local dentist for accurate diagnosis and treatment options.

Steven Brooksher, DDS of Baton Rouge sponsors this post. Dr. Brooksher is an accredited cosmetic dentist and a fellow of the International Congress of Oral Implantologists.

Pregnant and Need a Repeat Root Canal? 3 Facts to Consider

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I’m in my second trimester of pregnancy at 22 weeks. I experienced sensitivity in an upper left molar tooth that my dentist did a root canal on about six years ago. The sensitivity got worse and became painful, so I went to the dentists. My dentist did an x-ray and found an infection. My options are to do another root canal, try an apicoectomy, or get the tooth extracted and replace it with a dental implant. My dentist said that there is more than a 50% -60% chance that my root canal treatment will be successful.

Since I’m pregnant, I have several concerns: the anesthetic and how it might affect my baby, a second root canal failure, and needing an apicoectomy or extraction anyway, discomfort, and a long process with a dental implant. And if something goes wrong with the treatment, I might need a pain killer or antibiotics, so I’m concerned about how that will affect the baby, too. Will you please tell me whether a root canal or an apicoectomy requires more anesthetic? How long does it take to determine if a root canal is successful? I’ve been with this dentist for about three years, so another opinion will increase my comfort and help me decide on a treatment option. – Thanks. Miriam from Tulsa, OK

Miriam,

We recommend that you repeat the root canal treatment because it’s the least invasive treatment. If you can avoid an apicoectomy or dental implants while you’re pregnant, try to do so. But only have the treatment completed by a root canal specialist (endodontist). Endodontists have advanced training and specialized tools that will produce predictable results. An endodontist will reduce the risk of root canal failure.

1. Reasons to Get Root Canal Treatment During Pregnancy

  • The tooth is infected, and removing the infection protects you and your unborn child.
  • An untreated infection will spread.
  • Allowing the infection to linger might create a dental emergency at the most inconvenient time.

2. Local Dental Anesthetic During Pregnancy

Diagram of the phases of a dental implant for a comparison to a partial denture.

If you can get root canal treatment instead of a dental implant during pregnancy, choose a root canal

Repeating root canal treatment requires a minimal amount of anesthetic because the tissue and nerves inside your tooth are dead. Root canal surgery, or apicoectomy, requires ore anesthetic because the tooth is accessed through your gums. Although dental anesthetic is generally safe during pregnancy, it’s best to limit it with a procedure that requires less of it.

3. Evaluating the Success of Treatment

An endodontist can quickly tell if treatment is successful. A canal often leads to unsuccessful therapy if ledges, curves, or blockages are challenging to navigate. Your endodontist will know if there were difficulties or not. If the endodontist’s instruments can get to the root tips and successfully seal them, the treatment will likely heal well. Otherwise, the endodontist will recommend root canal surgery.

We hope you have a smooth root canal treatment, recovery, and delivery of your new baby. Congratulations!

Steven Brooksher, DDS of Baton Rouge, LA, sponsors this post.