Archives for April 2022

What Happens If I Don’t Replace Missing Teeth?

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I have opted for my dentist to pull teeth for the last ten years instead of doing root canals and caps. Now I am missing four upper back teeth. All my wisdom teeth are gone, so the two teeth in front of them on both sides of my upper jaw are missing. You cannot tell the teeth are missing unless I hold my head back and laugh. Now that I moved to Massachusetts, I have a new dentist suggesting that I replace my teeth with dental implants. She says I will regret it as I get older if I do not get the implants when my teeth start shifting around. She can already tell from my x-rays that my teeth are moving, and she showed me the x-ray comparison. I’ve had this dentist for three years, and I trust her. But a second opinion is always good. I am not considering dental implants yet. Why not get a dental bridge? What will happen if I don’t replace my missing teeth? Thank you. William from Springfield, MA

William,

Thank you for your question. Your dentist may be persistent, but she seems to be genuinely concerned about your long-term oral health if you do not replace your missing second and third molars.

What Happens If You Don’t Replace Missing Teeth?

If you do not replace missing teeth, it can affect your long-term oral health in these ways:

  • Tooth misalignment – Teeth are placeholders for proper alignment. Gaps in your smile cause teeth to lean against each other and crowd your smile. When teeth are missing, other teeth will begin to drift toward the spaces.
  • Jawbone shrinkage – In areas of missing teeth, the jawbone shrinks 25 percent within the first three months and up to 50 percent within six months. Multiple missing teeth can accelerate facial wrinkles and sagging.
  • Challenge with oral hygiene – It is challenging to brush and floss between teeth that lean on each other. Crowded teeth increase the risk of plaque and tartar buildup, tooth decay, and gum disease.

Why Get Dental Implants?

Dental implant model with the fixture in the bone

A complete dental implants replace a tooth’s roots and crown

A complete dental implant replaces a tooth’s root and crown. The artificial tooth roots fuse with your jawbone and look and feel natural. A dental bridge requires shaving down the tooth on either side of the missing one. But you are missing second and third molar teeth with no teeth behind them to support a bridge. Although a dentist may offer alternative bridge treatment, other teeth will need to support it. The option will be less healthy than individual implants.

We suggest that you discuss your concerns with your dentist and ask for more information on dental implants and what you can expect with or without them in the long term.

Dr. Steven Brooksher, Baton Rouge accredited cosmetic dentist and Fellow, International Congress of Oral Implantologists, sponsors this post.

Is a Tooth Infection Causing My Fever?

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I’ve had a low fever for two weeks, and I think a tooth infection may be causing it. At first, I thought it was the flu or some virus because I have been running a temperature and am achy. Last night, my temperature was 102.6. I know I have a few decayed teeth that I think might need fillings or root canals, but I have put off going to the dentist. Could the tooth infection be giving me a fever and making me sick? Marcus from New Haven, CT

Marcus,

You may have a tooth infection. Fever alone is not a sign of a tooth infection, but you may be right if you have decayed teeth that need root canal treatment. But please do not guess what is causing your symptoms. It is best to see a dentist promptly because you may have a tooth abscess.

What Are the Symptoms of a Tooth Abscess?

Some of the symptoms of a tooth abscess include:

  • A persistent toothache with pain in your jaw, ear, or neck
  • Sensitivity in the tooth to heat and cold
  • Pain or sensitivity when you chew or bite
  • Fever
  • Swollen face or cheek
  • Swollen or tender lymph nodes in your neck or under your jaw
  • A sudden rush of foul-smelling and foul-tasting fluid in your mouth and toothache relief if the abscess ruptures

What Is the Treatment for a Tooth Abscess?

A dentist can save an abscessed tooth with root canal treatment or surgery (apicoectomy). A tooth infection can poison your system and cause the symptoms you describe. See a dentist immediately to determine if you need a root canal treatment or a different treatment.

Dental implant components, including root form, abutment, and crown

Dental implants imitate natural teeth

Most likely, a dentist can save teeth in bad condition with root canal treatment. In rare cases, a dentist must remove and replace the tooth. Replacing missing teeth protects you from further oral health problems. When several teeth are missing, your body resorbs the jawbone and uses minerals from it elsewhere. Dental implants are the most effective treatment because they fuse with your jawbone and prevent jawbone resorption and facial sagging.

The sooner you seek treatment, the easier it will be to resolve the issue. Contact a dentist right away.

Dr. Steven Brooksher, a Baton Rouge dentist, sponsors this post.

My Dental Crown Feels Weird When I Chew

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My dentist placed a crown on an upper left molar three weeks ago. The tooth touches the opposite bottom molar tooth when I chew, but it feels off. I think the crown needs deeper grooves so the other tooth will match it when I chew. If I ask my dentist to drill down some of the crown’s surface, will it damage it? Although I will need laughing gas or another sedation to cope with my anxiety and get through this, I want it resolved. I already told my dentist about the discomfort, and she said that I need time to get used to my bite. How long will that take? Thanks. Randall from Memphis

Randall,

Your dentist’s request to give your concerns more time means that she does not know what to do. Brooksher would need to examine your tooth and crown to determine what is causing the disharmony when you chew. But the situation could be challenging to correct, or your dentist’s lack of knowledge might be the problem.

Your bite should be perfectly comfortable when you receive a new crown or onlay. But the motions involved in chewing make the occlusion—how the upper and lower teeth fit together—complex. And many dentists lack the training and skill to resolve the issue.

Post-graduate institutes, including the Las Vegas Institute for Advanced Dental Studies, the Texas Center for Occlusal Studies, the Dawson Academy, the Pankey Institute, and others, train dentists in the science of occlusion. Many cosmetic dentists attend the institutes or receive courses from other organizations that teach the same principles. Still, many other dentists feel that basic dental school education is enough, and they do not need occlusion training. Although dentists who bypass additional training might complete single crowns or onlays, they may not be qualified to complete a full-mouth reconstruction with a balanced bite. So, as a patient, a dentist may tell you that it takes time to get used to your bite.

What Is Malocclusion and What Problems Can It Cause?

Malocclusion is the term for disharmony in how your upper and lower teeth line up. The shape, size, or position of your jaw or teeth may cause malocclusion, or misaligned teeth. The shape and size of a dental crown can affect your bite. Although you might adjust to how your bite feels, it does not mean it is aligned correctly. And malocclusion can lead to other issues.

  • Unusual stress on teeth – The stress can lead to bone loss around the affected teeth.
  • TMJ disorder – You might experience symptoms or signs related to TMJ, including jaw, facial, or neck pain, and headaches or earaches.

Face of a woman relaxed during dental treatment for information on sedation dentistry from Dr. Brooksher of Baton RougeMany dentists adjust a new crown or onlay by asking you to bite on bite registration paper. The paper leaves marks where the crown or onlay makes contact prematurely. The dentist will grind down the crown in those places. Your dentist has completed that essential step, and your crown is not high.

The issue with your bite is more subtle. But a dentist—perhaps not your dentist—can adjust the crown to make it comfortable without damaging it. If your dentist does not know how to correct it, you can wait a few months to see if the tooth begins to feel better with your bite. Or you can get a second opinion from an advanced cosmetic dentist. Look on a few dentists’ websites for information about post-graduate training in occlusion from one of the institutes mentioned on this page. You can talk to the dentist about your anxiety and discuss sedation options during your consultation.

Baton Rouge dentist Dr. Steven Brooksher sponsors this post.