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.

What’s the Cheapest Fix for a Tooth Broken at the Gumline?

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My front left tooth broke below the gumline. I am looking for a cheap, fast way to fix it. I don’t know if there is anything like an affordable implant. Will a mini-implant work? If not, I am interested in something that is not expensive. I suppose there are not many options, but what is the least expensive? Thanks. Bart from WVA

Bart,

Cheap options do not last. You can ask a dentist to bond the tooth back with composite as an inexpensive fix, but it will not look good, nor will it last. Two treatment options can restore your tooth, but neither is cheap or fast.

Restoring a Tooth that Broke at the Gumline

Depending on the severity of the break, a dentist can restore a tooth that breaks at the gumline a dental crown or a dental implant.

Dental crown

If you do not have a strong bite or deep overbite, a dental crown might be able to restore your tooth. Treatment steps include:

  • Root canal treatment
  • Inserting two strong, flexible post in the tooth to absorb stress on the crown and prevent tooth root fracture
  • Building up the tooth and post with composite
  • Bonding the crown to your tooth

Dental implant

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

If you need a dental implant, it will mimic a natural tooth.

If your tooth broke at the gumline, weak and you have a strong bite, a dental implant is the only solution. You will need a standard dental implant—not a mini-implant. Although mini-implants are more affordable, they are not durable enough for front teeth, molar teeth, and most teeth. A mini-implant might support a small upper or lower incisor. And some dentists use mini-implants to secure a denture.

An implant and crown cost about twice as much as a root canal, two posts, and a crown, and it takes longer to heal. But a dental implant will last longer because the implant fixture fuses with your jawbone like a natural tooth root.

You can choose to get a dental crown, but understand the risk of failure if you have a strong bite or underbite. It is usually best to get the most effective option and avoid spending more time and money in the long-term.

We recommend scheduling an appointment with a dentist who has advanced cosmetic and implant dentistry training to discuss your options.

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

Do I Still Have an Infection Months After Tooth Extraction?

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After seeing my dentist for a broken crown, she took an x-ray of the tooth and said it was infected. My dentist referred me to an endodontist for the root canal. Months after the root canal, I felt referred pain in the tooth in front of the root canal tooth. I reported the issue to my dentist during my next cleaning appointment. An x-ray showed the tooth was still infected.

I called the endodontist, and she prescribed penicillin. I’ve had a series of family health issues and could not return to the endodontist as life would have it. Two months ago, an oral surgeon extracted the tooth. Still, I have jaw pain below the area of the tooth extraction. I was planning to get a dental implant to replace the extracted tooth, but I am concerned that something is not healing correctly.

I do not trust my dentist’s opinion. Could I still have an infection? And why is it lingering? – Thank you. Juliana from NM

Juliana,

Dental implant model with the fixture in the bone

A dental implant helps preserve bone and prevent your teeth from shifting

Unfortunately, you could not return to the endodontist to save your tooth. Still, you are wise to pursue getting a dental implant. An implant will preserve your jawbone in the space and prevent other teeth from shifting, disturbing your bite, and creating orthodontic issues.

Although it is rare to have a lingering bone infection after tooth extraction, it can occur. If you have an infection, a potent antibiotic can get rid of it. We recommend that you return to the oral surgeon for an examination.

Also, a post-operative infection can result from an antibiotic-resistant infection. So, you would not want to retake penicillin to get rid of the infection. Ask the oral surgeon to try different antibiotics to help you progressively heal.

Dr. Steven Brookser, a Fellow of implant dentistry in Baton Rouge, sponsors this post.

Are Dental Implants Permanent?

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Dental implants outlast a bridge or a partial denture. But how long can you expect your implants to last? Are dental implants permanent? We will explain whether implants are permanent, which parts you must replace, and how you can preserve your implants.

Are Dental Implants Permanent?

Engineers designed dental implants to be a permanent form of tooth replacement—lasting a lifetime. The article, What Is the Success Rate of Dental Implants?, published by the American Academy of Implant Dentistry, confirms that dental implants can last many decades if you take care of them. However, the permanency of dental implants refers to the screw or artificial tooth root. The prosthesis, or artificial teeth, attached to implants will require replacing over the years.

What Are the Parts of a Dental Implant?

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

Dental implants imitate natural teeth

Dental implants are artificial tooth roots. Your implant dentist will attach a connector (abutment) to each implant fixture. And after three to four months of healing, your dentist will attach artificial teeth to the abutments. Meanwhile, you can wear temporary replacement teeth.

Types of artificial teeth, also called prostheses or restorations, include:

  • Crowns
  • Bridges
  • Dentures

What Is the Lifespan of a Dental Implant Restoration?

Dental implant crowns, bridges, and dentures can last longer than restorations not attached to implants. Estimates for their lifespan are below:

  • Implant crown – An implant crown can last up to fifteen years if you take care of it. Gold crowns are sturdy and last longer than ceramic crowns.
  • Implant bridge – An implant bridge can last up to twenty years before you need to replace it.
  • Implant denture – A well-made implant denture can last ten years or longer.

What Can You Do to Help Your Dental Implants Last?

Your dental implants can be permanent if you take precautions. Your choice of an implant dentist and diligent home care make a difference.

Below are five tips, including several recommendations from the American Academy of Implant Dentistry for protecting your implants:

  1. Choose an implant dentist or surgeon who uses 3-D x-rays for planning implant placement
  2. Avoid tobacco use because it hinders healing
  3. Avoid alcohol
  4. Practice good oral hygiene
  5. Maintain good overall health

Summary

The artificial root of a dental implant can last a lifetime. But you will need to replace the dental crown, bridge, or denture attached to the implants over the years. Select your implant surgeon wisely. And take good care of your implants to help them be a permanent form of tooth replacement.

 

Dr. Steven Brookser, a Fellow of implant dentistry in Baton Rouge, sponsors this post.

How Long Can I Delay Root Canal Treatment?

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For the past two months, I have had cheek and jaw pain from an upper right tooth in front of where my wisdom tooth was. My sinuses and noes are achy, too. Late last week, I woke up with a sore neck, and that pain radiates into my right ear and temple. I’ve been taking antibiotics until I can afford to see a dentist. I cannot afford a root canal and certainly not a dental implant. My dental coverage only covers routine exams and cleaning. Could all these symptoms be related to my tooth? I am afraid that I will lose my tooth. I know your doctor has not seen me, but how much longer can I wait? Thank you. Joziah from TN

Joziah,

We are glad that you asked the question! You cannot afford to wait any longer. You are describing a tooth infection that is spreading. If you act quickly, a dentist might be able to save your tooth with root canal treatment. Otherwise, a dentist might need to remove the tooth.

What If You Cannot Afford a Root Canal?

If you cannot afford root canal treatment, look online for a nearby university dental school, a dental clinic, or a local dental society. Any of those organizations can direct you to dentists who treat patients that require prompt, serious care.

If you go to a hospital emergency room or an urgent care facility, they may give you pain medication or a more potent antibiotic. But eventually, you must see a dentist for root canal treatment even if you do not have dental insurance.

Are Antibiotics Enough to Treat a Tooth Infection?

Diagram of root canal treatment instead of a dental implant - from Baton Rouge denitst Steven Brooksher, DDS

The root canal process can be an alternative to tooth removal and a dental implant

Continually taking antibiotics for tooth infection can promote an antibiotic-resistant infection that becomes worse. The American Dental Association confirms that the infection can even spread without root canal treatment into the bone supporting the tooth.

The only way to treat an infected tooth is with a root canal procedure or tooth removal. A dentist will not recommend a dental implant knowing that you cannot afford it. Please do not let the cost of treatment prevent you from getting help.

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

My new dental crown keeps coming off

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After my dentist replaced my 15-year-old crown over a root canal tooth, the crown will not stay on. My dentist has reattached the crown four times since March. That’s like once a month. Why did the old crown stay on, but the new one will not stay in place? If this becomes a problem, will my dentist need to extract the tooth and place a dental implant? Thank you. Sienna

Sienna,

Thank you for your question.

A crown can continually detach if it doesn’t have enough tooth structure to help it stay in place. But your dentist—or another dentist—can take steps to keep it in place.

Securing a dental crown that keeps coming off

If your dental crown keeps coming off, it is probably due to stress on the tooth as you bite, tear, chew, or grind—depending on the tooth position. If the problem is due to a lack of tooth structure left, your dentist can take these steps:

  • Remove some of the root canal filler material
  • Cement a flexible fiberglass post about 2/3 deep into the tooth
  • Fill in the tooth with bonding

The process bonds the tooth into the canal and builds up a core material around your tooth. The dentist will shape the bonding to look like a natural tooth after preparing it for root canal treatment.

Afterward, your tooth will hold the crown easily. You can suggest this process to your dentist. If your dentist is hesitant about treating your tooth, we suggest scheduling a consultation with an advanced cosmetic dentist.

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

Saving your tooth is the priority over a dental implant.

Saving your tooth is the priority. Although a dental implant is almost effective as a natural tooth, preserving your natural tooth is the priority.  If any dentist recommends tooth extraction and a dental implant, it should be after an attempt to save your tooth with a post.

 

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

No pain in my canine root canal tooth, but my dentist recommends a crown

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In 2002, I had a root canal on a canine tooth. My dentist of 3 years suggests putting a crown over the tooth to prevent it from breaking. The tooth does not hurt, so I asked my dentist if something is visibly wrong with the tooth. He said no, but the crown is preventive care. Do I need a crown on the tooth? I do not want to refuse treatment and end up with extraction and dental implant. Thank you. Leland from GA

 

Leland,

Thank you for your question.

Root canal weakens a tooth and increases the risk of breaking. But differences between molar teeth and front teeth causes some cosmetic dentists to avoid placing crowns on front root canal teeth.

  • Molar teeth – The stress of biting and chewing pushes the four cusps (the biting points) of molar teeth apart. The teeth are at risk of breaking after root canal treatment.
  • Front teeth – Designed for biting and tearing, front teeth are affected by horizontal shearing stress. Canine teeth absorb horizontal pressure to protect molar teeth. The long roots of canine teeth help them absorb stress.

Does a Canine Root Canal Tooth Need a Crown?

Unless your canine root canal tooth is already missing most of its structure, you do not need a crown. Additionally, a dentist may recommend a crown if the tooth is dark or poorly shaped and detracting from your smile.

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

If your canine root canal tooth is weak, a skilled dentist can reinforce it and hopefully prevent the need for a dental implant

Shaving a canine tooth for a crown requires reducing about one millimeter of tooth structure all around the tooth. The tooth may be left with as little as 50% of its initial fracture resistance.

Many cosmetic dentists strengthen canine teeth by placing a flexible fiberglass post in the tooth and filling in the tooth with composite. This process can protect the tooth from stress and minimize dark discoloration after root canal treatment. The added strength of a fiberglass post helps prevent breakage and the need for tooth replacement options, such as a dental implant.

You can get a second opinion from a cosmetic dentist to see if your tooth is weak and needs a post to support it.

 

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

Odor from new dental implants annoys my multiple chemical sensitivity

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I have multiple chemical sensitivities and never anticipated a problem with dental implants. I am in the middle of dental implants and wearing temporary dentures. But when I open my mouth to talk or eat, I smell a distinct rubbery smell. I asked my dentist about the implants. And it was everything I  know already. The implants are titanium, the temporary denture is acrylic, and my final teeth will be porcelain. But I was not expecting a chemical smell. My dentist says that the odor is probably coming from my acrylic teeth and will go away when I get my final denture. But the strong smell is annoying. Will the scent really go away? – Thank you. Daniella

 

Daniella,

Thank you for your question. Although Dr. Brooksher would need to examine your implants and temporary dentures, several elements could be causing the odor.

Odor with New Dental Implants

We will discuss whether titanium posts, temporary acrylic teeth, or food debris can create an odor in new dental implants.

New titanium dental implants and odor

A dentist embeds titanium implants in your bone. They are beneath the gumline, so they are unlikely to produce an odor that you can smell. You can ask your dentist to let you smell an implant like the one he placed in your bone. But if titanium posts must be replaced, your dentist or an oral surgeon must remove the implants surgically. Afterward, you need bone grafting. And after the bone heals, your dentist must make new implant holes for zirconia implants.

Acrylic implant denture and odor

Acrylic has a slight smell, so the odor from your implant denture may be coming from the denture itself. If that is the case, it will probably resolve when your dentist places your new denture.

Odor from food debris

I food debris collects in your mouth—perhaps beneath your temporary denture, you could be smiling it. You may benefit from a water flosser to clean beneath your denture. You can also rinse your mouth with hydrogen peroxide to clean out food debris and neutralize odor. But do not use peroxide for more than two or three weeks because it will promote an oral yeast infection.

Does the odor cause a reaction?

You mentioned that the strong smell is annoying, but we wonder if it causes a sensitivity reaction. Does it make you tired or cause a reaction that you usually get with strong smells? Your answer is another clue to the source of the odor.

Consider getting a dental implants second opinion

If the odor causes a reaction and your dentist cannot identify the source, you can consider getting a second opinion from a skilled implant dentist.

 

Dr. Steven Brooksher, DDS of Baton Rouge, a Fellow of the International Congress of Oral Implantologists.

Can a dark tooth be saved?

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Last year I fell during my morning run and fractured my right front tooth, and now the tooth is dark. My dentist did a root canal on the tooth, so I wasn’t expecting it to turn dark. My dentist didn’t mention that I should expect it either. I had an exam two weeks ago, and my dentist explained that sometimes root canal teeth turn dark. How do I know that the tooth is not decaying and that I will eventually need a dental implant? My dentist says she can put a veneer over the tooth. I don’t want to say that I do not trust my dentist, but I am skeptical because she didn’t warn me that it might turn dark. Although my smile is not perfect, I like it. And people compliment my smile. Should I be concerned about my dark tooth, or is it okay to proceed with a porcelain veneer? And what if the veneer doesn’t match my other teeth? Thank you – Emery, from Jackson, MS

 

Emery,

Although Dr. Brooksher would need to examine your tooth for an accurate diagnosis, a porcelain veneer can conceal a dark tooth.

Why Does a Tooth Turn Dark After Root Canal Treatment?

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

An extraction and dental implant are not necessary for a dark tooth

A tooth turns dark after root canal treatment due to dentin (the layer beneath the enamel) staining or leftover root canal filler material.

  • Dentin stain – When the pulp—living tissue, nerves, and blood vessels—inside your tooth dies, it can stain the dentin. And dentin is the layer beneath your tooth enamel. If a dentist does not thoroughly clean out the infected tooth pulp during root canal treatment, it will stain the dentin and how through your tooth.
  • Leftover root canal filler material – Some root canal filler materials accelerate tooth darkness if a dentist leaves the material in the tooth crown. But a skilled cosmetic dentist knows to clean filler material to slow the darkening process.

Treatment for a Dark Root Canal Tooth

Photo of the tip of dental forceps holding a single porcelain veneer; from the Baton Rouge office of accredited cosmetic dentist Dr. Steven Brooksher.

A single porcelain veneer can conceal a dark tooth

Internal bleaching will lighten a dark root canal tooth. After bleaching, a cosmetic dentist will work with a skilled ceramist to craft a porcelain veneer that perfectly matches the characteristics and color of your natural teeth.

Unless you have an advanced tooth infection or new trauma to the tooth, your dentist should not suggest aggressive treatment. Instead, a dentist will recommend a dental implant if they or an endodontist (root canal specialist) cannot save your tooth.

Get a Second Opinion for Your Dark Tooth

If your dentist does not have advanced cosmetic dentistry training, you can check the credentials of a few cosmetic dentists in your area. Schedule a consultation with one or two cosmetics to discuss your options for whitening your dark tooth.

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