Archives for September 2022

Why Are My Dental Crowns Sensitive to Heat?

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I got three dental crowns in 2004, two of which are sensitive to heat. I began Invisalign in August, and now I am having trouble with crowns. This is frustrating because if I need new crowns, it will throw off my treatment. Is Invisalign causing problems with my crowns? My dentist says I probably need root canals, but he will take x-rays next week. Do I need to see another dentist? Why do I suddenly need root canals? – Thank you. Liya from Chicago

Liya,

Thank you for your question. Dr. Brooksher would need to take x-rays and examine your teeth, but we can provide general guidance.

Why Are Dental Crowns Sensitive to Heat?

When your crowned teeth are sensitive to heat, it may mean that the tooth pulp is dying. Root canal treatment removes infection and can save the teeth. Consider the facts:

  • Tooth pain and sensitivity – Periodic tooth pain and sensitivity do not mean that the tooth pulp is dying. When pain lingers and sensitivity is consistent, usually the tooth requires root canal treatment.
  • Effect of an infection – When your body sends antibodies to fight infection in the tooth pulp, the tissue begins to swell. Lack of space in your tooth causes the tissue to swell and die, releasing gases that increase pressure and cause pain and sensitivity.

Invisalign movement puts gentle pressure on a tooth and can aggravate an infected tooth; however, Invisalign is not the cause of the irritation and infection.

Root Canal for a Crowned Tooth

A dentist can make a small opening through your dental crowns to perform root canal treatment. If you have had the crowns for 18 years, replacing them is the most practical option.

What Causes Infection Beneath a Crown?

Trapped bacteria and decay can cause infection beneath a crown. If the margin between your gums and the crown leaks, bacteria can seep in and cause decay.

Can Your Tooth Sensitivity Wait?

Invisalign upper and lower aligners

Invisalign treatment will be more comfortable after resolving tooth crown sensitivity

Delaying treatment allows an infection to spread. Your pain and sensitivity will increase without treatment. Your dentist recommended root canal treatment, and x-rays will confirm the condition of your teeth. You are welcome to get a second opinion, though. After a dentist resolves your tooth sensitivity, your Invisalign treatment will be more comfortable.

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

 

 

Should a Dentist Repair a Gold Onlay with Silver Filling?

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I’ve had a gold onlay for one of my molars for about 20 years. It is wearing out. My dentist wants to save as much gold as possible and fill the damaged portion with a silver filling. I don’t like amalgam. White fillings look better, and I’m into holistic care anyway. Why would he even suggest silver? I am already anxious, but this treatment recommendation is making things worse. Thanks. F. Turner  – San Jose

Dear F. Turner,

Thank you for your question. Dr. Brooksher would need to examine your tooth and onlay to determine the best way to preserve your tooth.

What Is a Gold Onlay?

A gold onlay is a custom tooth restoration that covers one or more cusps or points of a tooth. Unlike a dental crown, it does not cover the entire tooth. Did your dentist explain why he does not want to use composite in the tooth?

Should a Dentist Repair a Gold Onlay with Silver Filling?

Photo of woman sitting back in a dental chair with her eyes closed; for information on Baton Rouge sedation dentistry during tooth extraction.

Sedation can help you relax and get the dental care you need

Repairing the tooth with white composite filling is preferable to amalgam (often referred to as “silver”). If your dentist uses amalgam, two dissimilar metals would be in the same tooth, creating a slight electric current that could cause the amalgam to corrode faster than usual. Also, the gold will absorb some of the mercury from the amalgam.

A dentist who recommends amalgam might be uncomfortable placing composite fillings. Insisting on having composite fillings from the dentist may give you an undesirable result that needs to be replaced.

If you want composite fillings, find a cosmetic dentist who regularly uses them on back teeth. Call the office and ask if the dentist does many silver fillings. If the office representative says that the dentist does very few of them or does not use them, it is likely that the dentist is comfortable placing composite fillings on back teeth.

If your dentist is not answering your questions to your satisfaction, look for a skilled cosmetic dentist and request an exam. Tell the dentist about your anxiety and ask about sedation options.

 

Dr. Steven Brooksher, an accredited cosmetic dentist in Baton Rouge, sponsors this post.

Loose Dental implant – Is a Bridge My Only Option?

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A dental implant I’ve had on my top left incisor for 15 years is beginning to feel loose. My dentist of 8 years says he needs to remove the implant because I have an infection around it. He recommends replacing the implant with a bridge. I don’t understand why I can’t take antibiotics and get another implant instead of a bridge that requires grinding down the teeth next to the incisor. Could the bridge be my only option? Should I see another dentist? – Thank you. Patrick from Oklahoma City

 

Patrick,

Thank you for your question. Dr. Brooksher would need to examine your implant and gums and take a 3-D CT scan of the bone around it to determine why the implant is loose. Afterward, he could explain your treatment options.

Can You Replace a Loose Dental Implant?

A dental implant with the crown, abutment, and root form identified, for information on loose dental implants due to infection

An implant root form needs healthy gums and enough jawbone volume to stay in place

An implant dentist may replace a loose dental implant with or without bone grafting. After a 3-D CT scan, the dentist will explain whether you need a bone graft to support another implant or if you need a dental bridge or an alternative.

What Causes Infection Around a Dental Implant?

A buildup of bacteria around an implant can cause infection in the gums and bone supporting the implant. The infection causes bone deterioration, and the implant will loosen. Practicing diligent oral hygiene, getting regular dental checkups, and not smoking promote healthy gums and jawbone.

Will Antibiotics Get Rid of an Infection Around Dental Implants?

Antibiotics may eliminate the infection around an implant but will not resolve bone loss. The bone will not grow back over time, and only a grafting procedure can rebuild it.

Schedule a Second Opinion

If you lack confidence in your dentist’s recommendation for replacing your dental implant with a bridge, look for an oral surgeon or dentist with advanced training in implants. An accurate diagnosis requires a thorough oral exam and 3-D CT scan, so expect the dentist to recommend those procedures. After the second-opinion implant dentist explains your treatment options, you can decide whether you want a bridge from your current dentist or to switch to a new provider.

Dr. Steven Brooksher, a Baton Rouge dentist, sponsors this post. Dr. Brooksher is a Fellow of the International Congress of Oral Implantologists.