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Dr. Thomas

Archives for May 2022

Will I Lose My Tooth If I Don’t Get an Apico?

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Our family spent last week at the beach in FL. A toothache that has been bothering me for the past few months got worse, and my gums around it felt hot. I searched online for a dentist who was willing to see me the same day. The tooth is my lower right first molar that had a root canal two years ago. Although I was taking a chance to find a dentist online, she was pleasant, numbed my gums, and injected a pain reliever. The dentist said I probably need to see an endodontist for a procedure called an apico to save the tooth. The dentist did not give any details about the process but said an apico is like a root canal. Unfortunately, I have only seen a dentist once since COVID, and I moved to Arkansas in July 2021, so I don’t have a dentist here. What is this procedure, and do I need it to save my tooth? Thanks. Walton

Walton,

Thank you for your question.

It is good that the dentist was able to see you right away and relieve your pain. The dentist is referring to an apicoectomy.

What Is an Apicoectomy?

An apicoectomy is a dental procedure that accesses a tooth from its root tip instead of through the crown, as with root canal treatment. If root canal treatment fails, a specialist may recommend an apicoectomy to save the tooth.

A root canal specialist may take these steps to complete the procedure:

  • Numb your gums
  • Make a small incision to expose the tooth’s root tip
  • Use ultrasonic instruments or a dental laser to remove infected tissue
  • Disinfect the area
  • Add bone grafting to fill in areas damaged by the infection
  • Seal the tooth root
  • Close the gum tissue with stitches

The jawbone will heal around the tooth root in a few months.

What Happens If You Delay Treatment?

Delaying an apicoectomy allows the infection to spread further into the bone and possibly to other teeth requiring more complex and costly treatment. If you are unsure whether you need the treatment, schedule a second opinion with an endodontist (root canal specialist) or a dentist with advanced root canal therapy training.

 

Dr. Siny Thomas, a Sugar Land, Texas dentist, sponsors this post. Dr. Thomas is a graduate of the surgical program of the Pikos Institute in Trinity, Florida.

Can I Smoke Now that My All-on-4 Implants Healed Completely?

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I’ve had All on 4 implants since February 2020. My surgeon advised me to quit smoking for the best outcome, so after 22 years of smoking, I quit. I knew it wasn’t smart to invest in implants and ruin them with smoking. My mouth healed after implant surgery, and my teeth look great. Quitting smoking has been a blessing because I can breathe better, and my skin looks better. After golfing with my buddies, we have a few drinks, and they smoke cigars. Smoking was not an issue during the heat of COVID because most of us golfed and went our way afterward. But now that things are calmer, the drinks and cigars are back on. Last month, I started smoking cigars, but I feel unsure about it because of my implants. Am I cheating myself of a good time if I skip the cigars, or am I putting myself at risk whenever I smoke them? Thank you. Joel from RI

Joel,

Thank you for your question.

Will Smoking Affect Healed All-on-4 Implants?

all-on-four dental implant diagram

Avoid smoking before and after All-on-4 implants to promote your oral health

Long- or short-term smoking can affect your oral health and your All-on-4 implants. Smoking narrows blood vessels and the supply of blood and oxygen to your gum tissue. Your gums can get irritated and inflamed. Without healthy tissue around your dental implants, gum disease can result. The long-term success of dental implants requires healthy gum tissue and jawbone.

In April 2020, the Journal of Clinical Medicine published the article, The Long-Term Effect of Smoking on 10 Years’ Survival and Success of Dental Implants. The report notes the following regarding smoking and dental implants:

  • Smokers have a greater risk of peri-implant bone loss and implant failure, especially in the upper jaw.
  • Bone loss was significantly higher in smokers.
  • Implant patients can prevent disease around implants if they remain non-smokers.

What About Social Smoking with All-on-4?

You may be able to smoke in social settings without damaging your gums. But it is impossible to predict when or how smoking may affect your gums over time. Remaining a non-smoker will ensure your gums are healthy and prolong the longevity of your All-on-4 dental implants.

Sugar Land, Texas, implant dentist Dr. Siny Thomas sponsors this post.

Should I Get My New Ugly Dental Bonding Replaced with Veneers?

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I wonder if I should have gotten veneers instead of bonding. My dentist replaced the old bonding on four of my front teeth, and I think the new bonding looks uglier than the old yellow bonding. The color does not match my other teeth. Also, two teeth have a rough matte finish, and one tooth is longer than the others. My teeth with bonding look like they belong to four different people. Despite four tries within the past two months, my dentist cannot correct the color, texture, or length of my teeth. Will I have better success with porcelain veneers? Thank you. Leigh from Elk Grove, CA

Leigh,

Thank you for your question.

Dr. Finley or Dr. Henderson would need to examine your teeth and bonding, but it is unlikely that porcelain veneers are the only way to restore your teeth.

It takes advanced training, skill, and artistic talent for dentists to apply dental bonding and make it match your surrounding teeth. If your dentist lacks the training and skill, they cannot correct your bonding regardless of how many times they try.

Cosmetic dentists stock a selection of composite bonding materials with varying texture, color, and translucence for a perfect match in your tooth color and characteristics.

We recommend scheduling appointments with at least two advanced cosmetic dentists to examine your teeth and discuss your options.

Porcelain Veneers vs. Dental Bonding

One porcelain veneer - available from Sugar Land cosmetic dentist Dr. Siny Thomas

A cosmetic dentist will explain what results you can expect with dental bonding vs. porcelain veneers

Although porcelain veneers and dental bonding treat similar concerns, veneers require more tooth preparation than dental bonding. A dentist must remove a fraction of a millimeter of tooth enamel from natural teeth before fitting them for porcelain veneers. In contrast, a dentist will lightly roughen your teeth before applying dental bonding.

A cosmetic dentist can achieve natural-looking results with bonding or porcelain veneers. During a consultation, the dentist will explain what you can expect from treatment, including:

  • Tooth preparation
  • Cost
  • Longevity of cosmetic work
  • Results

After the consultations, you can compare your options and decide whether you prefer new bonding or porcelain veneers.

 

Sugar Land, Texas, cosmetic dentist Dr. Siny Thomas sponsors this post.

 

Is It Unusual to Need This Many Root Canals?

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Is it unusual to need three root canals, extractions, and implants over four years? I floss and brush my teeth daily and keep my dental cleaning appointments. My dentist put three teeth on watch status, but eventually one by one, he said the tooth needed a root canal. Then, he could not save the tooth and said I needed a dental implant. The last incident was two months ago, and I told my dentist to do nothing with the tooth because I was not sure anything was wrong with it. How do I know whether my dentist’s evaluations are accurate? Can I get compensated somehow? My anxiety level has escalated, and I am unsure whether I can take another root canal. Thank you. JC from Houston

JC,

Dr. Thomas would need to examine your teeth and x-rays for an accurate diagnosis. Still, we will answer your question in general.

Is Three Root Canals Within Four Years Unusual?

Three root canals within four years are unusual for teeth with no significant concerns during the last visit. Decay beneath an old filling can progress rapidly, but that is not the situation you described. When a dentist is watching a tooth, any signs of decay should be minor. For a tooth to progress to requiring root canal treatment or an extraction seems to be negligence. If your dentist saw signs that your tooth might become impossible to save, he should have treated the decay before it progressed to losing the tooth.

Get a Second Opinion

The only way to know if your dentist’s diagnosis is accurate regarding root canal therapy for another tooth is to get a second opinion. You may request your dental x-rays from your current dentist or ask the dentist to transfer them.

Sedation can help you relax during dental treatment

It can be challenging to prove your dentist’s negligence and get a refund. Speak with your new dentist about the possibility of getting compensated if you have a series of x-rays that prove you did not need tooth replacement with dental implants.

We recommend looking for two dentists with advanced implant and cosmetic dentistry training. Request a consultation with each dentist before choosing your new provider. Ask about sedation options to help you relax.

Sugar Land, Texas dentist Dr. Siny Thomas sponsors this post.