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

by

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.

When a Dentist Recommends Extraction But You Want to Save Your Tooth

by

I’ve had a crown on a left incisor since I was 15 years old. At my last exam, my dentist told me that the tooth looked like it might be infected. He removed the crown and said there is a white bible under the tooth, and it’s infected. He recommended extraction and said that a root canal wouldn’t work. I haven’t scheduled the appointment yet. Why can’t he try a root canal? Thanks. Josiah

Josiah,

We recommend that you seek a second opinion because some dentists readily extract teeth that can be saved. Burt Press, a 1980s president of the American Dental Association, once said, “You know why so many teeth are lost? Because dentist take them out.”

It takes effort to save a failing tooth, but some dentists think it’s worth it to save them and avoid tooth replacement options, including dental implants. You have the right to know why your dentist recommends extracting your teeth, and he should have explained why root canal treatment won’t work.

Sometimes a Tooth Cannot Be Saved

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

Although dental implants mimic natural teeth, keep your natural teeth whenever possible

Severe decay and little healthy tooth left – Severe decay and limited healthy tooth structure prevent a tooth from being restored with a crown.

  • Not enough space to restore it – When a tooth is worn or broken and doesn’t have a crown on it, the teeth on either side can drift and narrow the area around the damaged tooth. There isn’t enough room for a crown.
  • Extensive damage below the gumline – If there is a severe split or crack below the gumline, it might be possible to save part of the tooth. Often, an endodontist or dentist will extract the tooth.
  • Severe trauma – At times, when trauma fractures the tooth roots—particularly closer to the gumline—it’s challenging to save a tooth.

If you can’t get a satisfactory answer from a second-opinion dentist, you can ask for a referral to an endodontist, a specialist in root canal treatment and root canal surgery.

Steven Brooksher, DDS sponsors this post. He practices in Baton Rouge, LA. Dr. Brooksher is a founding member of the L.D. Pankey Alumni Study Club for continuing dental education.

Unsure If You Need Root Canal Treatment? – 4 Clues from the X-ray

by

In April 2019, I received a filling in a tooth, and now my new dentist is recommending root canal treatment. I relocated, and in January of this year, I went to a new dentist for my yearly cleaning and exam. I also received x-rays, and the dentist said that the x-ray seems to show some decay beneath the April 2019 filling. She recommended root canal treatment, which I declined at the time. Now that I have time to think about the tooth, which isn’t bothering me, I want to get an online second opinion. If there is decay, I don’t want it to get worse and end up needing an extraction and dental implant. – Thanks, Segura from San Antonio

Segura,

X-ray of an invisor tooth with a filling and a dark spot beneath it

Although there is a dark area near the fillng, the tooth doesn’t need root canal treatment, an extraction, or a dental implant

Thanks for sending us a copy of your x-ray. Maybe dental schools need to give more training in x-ray diagnostics. Although Dr. Brooksher would need to examine your tooth, your x-ray doesn’t show inflammation or any reason that a dentist would disturb it with root canal treatment. But what about the dark area beneath the filling?

Facts About a Dark Area Beneath a Filling

  1. Dark areas – Not all dark areas on a tooth x-ray are a result of tooth decay. Decay, a gap in the filling, or a radiolucent material beneath the filling will appear dark on the x-ray.
  2. Location of darkness – The dark area on your x-ray is on the surface of your tooth. In this case, your dentist can use an explorer and poke the area. If it’s soft, there is decay.
  3. Effect on tooth pulp – Tooth pulp includes the living tissue and nerves inside the tooth. Root canal treatment removes infected pulp. When the dark area on your x-ray isn’t near the pulp, you don’t need root canal treatment. On an x-ray, it might seem that the dark area is between the filling and tooth pulp. You can resolve the illusion while looking at the x-ray: Cover the white filling with your finger and look at the remaining tooth structure. You can see the dark area and the distance from the pulp.
  4. Comparison with adjacent tooth – The lamina dura is a thin white line around the tooth root. An infection will break the line around the root tip or pull it away from the tooth. Look at the x-ray on this page. The tooth with the filling, and the canine tooth next to it, has a lamina dura that intact. Both teeth are healthy. You won’t need root canal treatment. And you surely don’t need an extraction and dental implant.

If you still have reservations about the health of your tooth, consider scheduling an appointment for a second opinion. You can take your x-ray with you for a dentist to examine it in person.

 

Steven Brooksher, DDS practices in Baton Rouge, LA. Dr. Brooksher is one of ten dentists in Louisiana accredited by the American Academy of Cosmetic Dentistry.

Three Reasons Your Dentist Recommends a Post and Core Even If Insurance Doesn’t Cover It

by

I have a left incisor that is severely decayed. My dentist recommends a crown instead of a filling, but he wants to add a post and core. The dentist’s office submitted it to my insurance in early March. My insurance will give some benefits for the crown but not the post and core, which costs $420. So now, I’ll be paying for the remaining cost of the crown and the post and core. I’ll have to charge the balance on my credit card, which I am not fond of doing. Are the post and core necessary? Thanks – Russell

Russel –

Although your dentist is interested in your long-term oral health, your dental insurance company’s goal is to economize and save money. Your dentist might have explained the purpose of a post and core, but we’ll review it to help you understand your dentist’s perspective.

Why Are a Post and Core Needed?

Post and crown (top photo) and dental bonding built up around the post (lower photo)

A post and core give a strengthen your tooth and help anchor a dental crown

A dentist might place a post and core after root canal treatment. If there isn’t a lot of healthy tooth structure left, your dentist can’t properly prepare the tooth, and the crown can come off easily. The following steps are involved:

  1. Perform root canal treatment and remove decay and tooth pulp
  2. Insert a post into the canal of the tooth
  3. Bond the post in place
  4. Use dental bonding and shape it around the post to mimic the shape of a natural tooth prepared for a crown
  5. Bond the crown to the built-up post

The post and core are essential for reinforcing the tooth and creating a firm bond for a dental crown that lasts.

What Might Happen without the Post and Core?

  1. If a dentist bonds a crown to your severely decayed tooth, the tooth can further weaken and break. If the break is severe—or if the tooth gets infected—you might lose the tooth.
  2. And your dentist will need to replace it with a dental implant and crown—which is more costly than a post and core. A single implant costs over $1500. And there are additional fees associated with implant placement, including surgery, sedation, the implant crown, and more.
  3. Your dentist is protecting your oral health and limiting your long-term out-of-pocket expenses by recommending the post and core. Listen to your dentist—not the dental insurance company.

This post is sponsored by Steven Brooksher, DDS, a Baton Rouge dentist and a fellow of the International Congress of Oral Implantologists.

He Ordered a Partial Denture Directly from a Lab and Wants a Refund

by

About 7 years ago, I got a partial denture from my dentist that was excellent in quality. I know what lab he ordered it from, so this time I decided to order it myself directly from the lab. I requested the partial in January, and since that time, I’ve had so many complications. I’m beginning to wish that I just replaced my tooth with a dental implant. I was trying to save time and money. The partial denture replaces a front tooth, but it’s is loose and won’t stay fastened to the tooth to the left of the missing one. I can feel the partial rocking. I think there is too much plastic backing on it.

Of course, I returned to the lab to get it corrected. A lab tech ground down a tooth to try to improve my bite, but the clasp on the partial is on that same tooth, which is too small to hold the clasp. The denture plate is too short, and it is irritating the area where my tooth is missing. I’ve returned to the lab five times for this issue. During the last visit, the office manager told me that they would give me a 15% refund if I agreed not to return. I’m ashamed to see my dentist about this issue. I don’t want a 15% refund. I want all my money back. What are my options? – Thanks. Lennox from GA

Lennox,

We understand why you want a refund. But we don’t fully understand your description of the problems you’re having with your bite and discomfort from the plate of the partial denture. Dr. Brooksher would need to examine your partial denture to determine everything that’s causing your discomfort. But there are some issues we will address.

When a Partial Denture Rocks

What causes instability and rocking in a partial denture?

  • The rocking you describe results from a distorted framework in the partial denture.
  • If a dentist or lab tech doesn’t take impressions of your teeth and mouth correctly, the framework, which uses those impressions as a model, won’t fit.
  • A dentist—not a lab tech—has the experience and training to take accurate impressions that replicate your teeth and oral anatomy. Impressions from your dentist help the lab tech make a precise framework for your partial denture. Lab techs are not trained to take impressions, and it’s illegal for them to do so.
Picture of a partial denture witha plastic base and clasps

Partial denture with plastic clasps

Diagram of a partial denture with a metal clasp

Partial denture with metal clasps

How to Get Your Money Back from a Poor-Fitting Partial Denture

The lab tech should not have taken the dental impressions for your partial denture. The solution?

Threaten to report the tech to the state dental board. It may seem unfair to report the lab tech to the dental board because you asked him to make a partial denture and bypassed your dentist. But the technician knew what you didn’t: It is illegal for technicians to take impressions of your teeth and mouth. In addition to threatening to report the incident to the state dental board, you can tell the tech that you’ll volunteer to be a witness for the prosecuting attorney. Likely, the lab will readily give you a full refund.

We hope this is a teaching moment for all patients who are tempted to bypass their dentist and order dental restorations directly from a lab.

What About a Dental Implant?

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

A dental implant is embedded in your jawbone to replace a missing tooth

If you’re undecided about whether to get another partial denture or a dental implant, no other form of tooth replacement is more effective than an implant. Unlike a partial denture, a dental implant has features that make it look and feel natural:

  • It’s a titanium screw that an oral surgeon or implant dentist will embed in your jawbone like a tooth root.
  • Implants fuse with your jawbone to anchor the replacement tooth.
  • An implant stands alone. There are no clasps that put pressure on adjacent teeth.
  • Your implant dentist will attach a dental crown to the top of the implant. It replaces the part of your tooth above the gumline.

But your outcome with a dental implant depends on the skill of the dentist who places it and restores it with a dental crown. Look for an experienced, highly skilled implant dentist. Don’t bypass any aspects of treatment or take shortcuts this time. Dental implant mistakes can be disastrous, and you’ll have to start the entire process again.

 

This post is sponsored by Steven Brooksher, DDS, a Baton Rouge dentist and a fellow of the International Congress of Oral Implantologists.

Where Is The Cost Information on Dental Websites?

by

Hi there,

I need a tooth replacement and want a dental implant. However, I’m looking for an affordable dentist, so I wanted to compare cost information. However, none of the cosmetic websites I’ve checked had any pricing information. How can I find out the cost of my procedure before the appointment? I don’t want to waste my time or the dentist’s time.

Phoenix, from Mesa, Arizona

 

Hi Phoenix,

Most dentists don’t post their dental information online as they think it will make them look unprofessional. Dentists prices vary due to payment plans or the type of insurance patients have. So putting prices of dental care online may not be accurate.

Choosing a dentist is not the same as choosing a car dealership. Picking the cheapest option may not be a good idea when it comes to dentistry. A dentist that is cheaper upfront may use lower quality materials, which may cost you more in the long run. On the flipside, the dentist with the highest fees may not be the best, either.

Whoever gives you a dental implant should use high-quality materials, so it will last a long time and not require any future work. Getting a dental implant from a cosmetic dentist is better than seeing a general dentist. Dental implants take a lot of skill and experience to place correctly. A general dentist may offer a cheaper price, but it may be placed incorrectly, and end up costing more due to increased appointments to fix it.

If you want to know pricing information before making an appointment, call a few cosmetic dentists in the area and ask for the ballpark prices of a few key procedures: a cleaning, a multi-surface composite filling on a molar, and a posterior crown. Any fees that see extremely high or much lower than the others are places to be avoided.

This blog post is brought to you by Baton Rouge affordable dental implant provider, Dr. Stephen Brooksher, of Dentistry by Brooksher.

 

What Can I Expect After Dental Implant Surgery?

by

Are you thinking about getting snap-on dentures? Affordable dental implants are a great option for securing your dentures. But what can you expect after surgery?

After Receiving Affordable Dental Implants

If you’re choosing snap-on dentures for affordable dental implants, you’ll receive minimally invasive surgery and minimal downtime.

Bone grafting procedure

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

Snap-on dentures are affordable dental implants

If all your teeth have been missing for many years and your jawbone has begun to shrink, you might need bone grafting. Bone grafting builds the bone up to ensure your affordable dental implants have enough support. The grafts will heal in three to four months, after which you can receive dental implants.

Minimal pain

Your dentist will make two small openings in your gums to position affordable dental implants in your jawbone. Soft tissue heals quickly, and bone has little sensitivity. And you’ll receive a local anesthetic so that you won’t feel any pain during the surgery.

You’ll also receive mild sedation to help you stay relaxed. Sedation also lowers your sensitivity to pain.

Mild swelling

During three to four days after surgery, you’ll experience mild swelling. Activity increases swelling, so rest as you heal.

Pain management

Your dentist will give you a prescription or recommend ibuprofen to relieve pain. After a few days, most patients can switch to ibuprofen for pain relief.

Follow-up visits

You will have follow-up appointments to check the progress of the healing process and to ensure the implant sites are healthy.

What to avoid

As you do your part in ensuring the healing process goes smoothly, avoid the following:

  • Strenuous activity for the first few days after surgery
  • Smoking and tobacco products because they restrict blood flow and inhibit healing
  • Sucking on a straw, which can loosen blood clots
  • Touching the surgical sites or pulling on sutures
  • Chewing hard or sticky foods
  • Chewing directly over the implant sites

Permanent dentures

After the surgical sites heal, your dentist will secure your permanent dentures to the affordable dental implants.

Schedule a Consultation for Information Tailored to Your Case

Schedule a consultation with a highly trained and experienced implant dentist. He or she will answer your questions. A review of your health history, an examination, and x-rays will be required to determine if you are a candidate for affordable dental implants.

In Baton Rouge, Steven Brooksher, DDS is a fellow of the International Congress of Oral Implantologists. He sponsors this post.

How Long Do Dental Implants Hurt?

by

Dental implants can last a lifetime. If you compare their longevity with the temporary discomfort after implant surgery, you’ll probably conclude that it’s worth it.

Dental Implant Pain – What to Expect

Before

Before dental implant surgery, you will receive mild sedation to keep you relaxed throughout the procedure. The anti-anxiety medication will keep you calm and reduce your sensitivity to pain. You will be relaxed when you arrived at the dental office.

During

Your implant dentist or oral surgeon the appropriate area is numb before the procedure begins. You won’t feel your dentist place the implants in your jawbone. Your dentist will communicate with you throughout the process to ensure it is painless.

After

The amount of discomfort after your implant surgery depends on how extensive it was and how many dental implants your dentist placed. Many patients can manage their pain with ibuprofen. If your dentist anticipates that you’ll feel moderate pain, he or she will prescribe pain relief medication in advance of your procedure.

Your oral surgeon or implant dentist will give you post-op instructions. If you carefully follow them, you can minimize the pain and discomfort you feel at home. Your dentist will provide you with a list of things to avoid, some of which include:

  • Vigorous exercise
  • Smoking
  • Touching the surgical site
  • Chewing hard, crunchy, or sticky foods
  • Chewing on the side of your mouth where implants were placed.

Your dentist will also give you instructions to minimize swelling and maintain good oral hygiene, which will promote healing and prevent infection.

Pain from dental implant surgery usually peaks within three to four days. Afterward, your pain will gradually decrease. Within ten days, if you feel any discomfort, it will be minimal. If your pain is consistent, or if it increases, contact your dentist right away.

You’ll Love the Final Results

After your dental implants fuse with your jawbone, you will receive permanent replacement teeth—dental crowns or complete dentures. They will look and feel completely natural. The freedom and convenience of successful dental implants that can last a lifetime can help you forget about the temporary pain or discomfort during the healing process.

This post is sponsored by Baton Rouge, LA implant dentist Dr. Steven Brooksher, a fellow of the International Congress of Oral Implantologists (ICOI).

Can You Keep a Snap-On Denture in While You Sleep?

by

If you have a snap-on denture, you might be tempted to keep sleep overnight without removing it. It might feel so comfortable that you don’t see the need to remove it. What should you know about sleeping in dentures that are secured with affordable dental implants?

Why Would Anyone Want to Sleep in a Snap-On Denture?

If you’re not familiar with snap-on dentures, they are a type of implant overdentures.

Diagram of snap-on dentures. Dental implants are in the lower jawbone, and a denture with attachments in the base is hovering above the gumline.

A snap-on denture is an affordable option for dental implants

A snap-on denture is secured with just two dental implants, so it’s more affordable than other types of implant overdentures. The denture feels more stable, and it doesn’t slip around or fall out. Some people become so comfortable with the way their dentures fit that they forget to remove them at night—or they want to sleep in them.

Sleeping with Snap-On Denture

A traditional denture rests on your gums. It’s not good to sleep with it on because it puts continuous pressure on your jawbone and accelerates shrinkage. It also promotes the growth of bacteria. But a snap-on denture is different.

A snap-on denture snaps on and off dental implants. The denture rests on the implants, not on your gums. You can sleep while wearing it. But you must be diligent about daily cleaning the denture so you can keep your breath fresh and maintain good oral hygiene. Remember that saliva production decreases overnight, and as we age, so your mouth and dentures will need moisture and cleaning in the morning. Clean your snap-on denture at least once a day.

How to Clean Your Snap-On Denture

  • Remove your denture and clean it with an extra-soft toothbrush and mild liquid soap or non-abrasive denture and gum paste. Avoid using regular toothpaste.
  • Gently scrub the O-rings that snap onto the dental implant abutments (connectors that are attached to the top of implants).
  • Remove food particles and debris and rinse your snap-on denture thoroughly.
  • Clean your mouth with a soft toothbrush and toothpaste.
  • Brush your gum tissue, the roof of your mouth, tongue, and implant abutments.
  • Many patients benefit from using a water flosser, which shoots a powerful stream of water to flush away any remaining debris in your mouth and around the implant.
  • If you want to remove your denture overnight, place it in a water-filled denture box.

The longevity of your snap-on denture and affordable dental implants is partially dependent on how well you clean them. So even if you decide to sleep overnight while wearing your snap-on denture, remember to remove it daily and keep it clean.

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

4 Clues to Recognizing When Dental Implants Are Too Cheap

by

The cost of dental implants varies depending on where you live in the country, as well as the fees of the dentist or oral surgeon. On average, a single implant can cost $1500-$3000.

When Are Dental Implants Too Cheap?

Your dental implants might be too cheap if the dentist:

  1. Doesn’t review your health history and just schedules you for implants
  2. Only takes basic x-rays of your teeth without doing a 3-D CT scan
  3. Tells you about steps he or she will skip to make implants more affordable
  4. Has only completed a few implant cases

Where to Start

You can call dental offices or schedule consultations with two or three implant dentists. As you compare and record the costs from each dentist, find out what services are included in the prices you are quoted. Surgery (including bone grafting, if needed), lab fees, the type and quality of implant fixtures, implant crowns, sedation, and other services factor into the total cost.

Getting the Right Perspective on Affordable Dental Implants

If you want to receive quality implants that last, consider looking for a competitive price from a highly skilled implant dentist. Avoid searching for cheap dental implants. Ask to see before-and-after photos of the dentist’s dental implant cases.

Diagram of snap-on dentures. Dental implants are in the lower jawbone, and a denture with attachments in the base is hovering above the gumline.

A snap-on denture is an affordable option for dental implants

Ask for information on financing, payment plans, and other ways that each dentist makes implants affordable for you. If you need multiple implants, consider having the work done in phases as your budget allows. If all of your teeth are missing, implant overdentures are an affordable way to stabilize your dentures and improve their function.

Details that Matter

Regardless of the cost of your dental implants, ensure your dentist has received advanced, post-graduate training implantology. Successful implant dentists adhere to a strict process for positive outcomes. Your dentist’s process should include the following:

  • Thoroughly reviews your health history to ensure you’re a candidate.
  • Uses 3-D CT scans to accurately capture your oral anatomy and surrounding structures. This ensures accurate implant placement.
  • Uses high-quality implant fixtures.
  • Provides quality dental crowns for the implants. The results will look like your natural teeth.

This post is sponsored by Baton Rouge, LA implant dentist Dr. Steven Brooksher. Dr. Brooksher is a fellow of the International Congress of Oral Implantologists (ICOI), the world’s largest dental implant organization and largest provider of continuing dental implant education.

We have instituted new infection control protocols in response to COVID-19

Please click here to read a message from our office.