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Dr. Thomas

What Will Happen If I Pull Out a Loose Dental Implant?

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Last year, in February, my dentist placed three dental implants. I got the final implant crowns in August. Now, the first molar implant on the top left is loose. After I left a message with my dentist, he called back and said he wanted to refer me to a periodontist who could save the implant. But my appointment with the periodontist is not until late next week. If the implant continues to loosen, can I pull it out myself? Or should I call for an emergency appointment with a dentist in the practice? Thank you. Raj from Denver

Raj,

We understand your concerns. However, don’t try to resolve the issue yourself.

Should You Pull Out a Loose Dental Implant?

A dental implant with the crown, abutment, and implant screw labeledWe advise you not to pull out the loose dental implant. If a periodontist can save it, you decrease the chances by pulling it out. As with natural tooth roots, the surgical site will fill in with tissue when an implant is missing. Contact the periodontist’s office for an urgent visit rather than scheduling an urgent appointment with a general dentist.

What Causes Loose Dental Implants?

Loose dental implants can occur after implant surgery or after placing your final crown. A dentist must wait until the implant and your jawbone fuse before placing the implant crowns. But what can cause implants to loosen?

Early dental implant loosening

  • Improper placement
  • Smoking during the healing process
  • Not enough bone volume
  • Gum disease
  • Medical issues that affect wound healing
  • Trauma during implant surgery

Late dental implant loosening

  • Infection
  • Gum disease
  • Poor-fitting or incorrectly placed implant crown, bridge, or denture
  • Faulty implant roots or parts
  • Oral trauma

How Will a Doctor Treat Your Loose Implant?

How a doctor treats your loose implant depends on why it is loose. The periodontist will take x-rays and determine what caused the looseness by examining these areas:

  • Gums
  • Bone
  • Implant root
  • Implant crown
  • Abutment (connector between the crown and implant)

If the issue is with the dental implant root, the periodontist must remove it. You may require bone grafting to support the next implant. Afterward, you can expect three to four months of healing if the periodontist removes the implant and you need bone grafting.

After an examination and X-rays, the periodontist will explain your treatment options.

Sugar Land implant and cosmetic dentist Dr. Siny Thomas sponsors this post.

A Tooth Cracked Beneath My Dental Bridge

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After my last dental cleaning, exam, and X-ray, my dentist said that a tooth beneath my upper left dental bridge is cracked.  She wants to replace the bridge, but I’ve only had it for three years. I don’t have any pain or discomfort when biting or chewing. Do I need the bridge replaced? – Thanks Raina from Chicago

Raina,

Dental bridge with four crowns

Get a second opinion before replacing a relatively new dental bridge

When considering dental restoration options, such as a dental bridge or implant, it’s important to weigh the long-term implications and costs. Each option has distinct advantages and potential drawbacks, depending on the situation.

The Long-Term Cost of Dental Bridges

A dental bridge may initially seem cost-effective, but if any tooth supporting the bridge fails, the entire bridge often needs replacement.

A problem with one of the abutments (supporting) teeth, such as a crack, may require removing the damaged tooth and fabricating a new, longer bridge to span the gap between now two missing teeth.

The Stability of Dental Implants

Unlike bridges, dental implants are independent of adjacent teeth. Issues with neighboring teeth do not affect the implant, making it a more stable long-term option.

Concerns About a Cracked Tooth Beneath a Dental Bridge

A cracked root typically presents with sharp pain upon biting, which you are not experiencing.  It’s uncommon for crowned teeth to crack since crowns are designed to fortify weakened or cracked teeth, preventing further damage.

Studies have shown that even completely fractured teeth can sometimes be saved by aligning the pieces, crowning the tooth, and thus preserving it.

Get a second opinion before agreeing to treatment.

  • Do not disclose the previous dentist’s diagnosis or identity to ensure an unbiased second opinion.
  • Provide minimal information about prior consultations to prevent influencing the new dentist’s assessment.

Sugar Land implant and cosmetic dentist Dr. Siny Thomas sponsors this post. Read how he strives to give patients some of the best dental care in Sugar Land.

Will Antibiotics Work for an Abscess Instead of a Repeat Root Canal?

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After a root canal, the temporary filling fell out of my upper left first molar. My dentist says I need a repeat root canal because the tooth is abscessed. The abscess isn’t painful, though. Why can’t I eliminate the abscess with antibiotics instead of another root canal? I dread going through another round of sedation and a root canal. Thanks. Simon from Huntington, NY

Simon,

It would be best to have a repeat root canal to eliminate an abscess and infection. Antibiotics alone are not enough for root canal failure.

A dentist removes the infected tooth pulp during root canal treatment and replaces the pulp with a dental filling material and cement. A temporary filling protects the tooth from saliva and infection. However, a temporary filling must be replaced with a dental crown. Otherwise, your saliva will wear the seal between the filling and your tooth. When bacteria enter the tooth, infection recurs.

Can Antibiotics Alone Treat a Tooth Abscess?

Model of a dental implant with its parts labeled, for information on root canal failure and implants

An infection can progress without repeat root canal treatment, leading to extraction and a dental implant.

Antibiotics alone cannot treat a tooth abscess. The medicine circulates through your bloodstream to remove the infection but does not remove the infection inside the tooth. When you stop taking antibiotics, the abscess will return. A cycle of starting and stopping antibiotics can breed antibiotic-resistant bacteria, creating the need for increasingly more potent medicine.

In contrast, root canal treatment removes the infection. Antibiotics assist in removing the infection from your system. Infection can spread to your jaw, eye, bloodstream, and brain without repeat root canal treatment. As your tooth breaks down, it may become unsavable, requiring removal and a dental implant.

Please do not allow dental anxiety to prevent you from getting repeat root canal therapy. A repeat root canal with dental sedation is less time-consuming and healthier than allowing a tooth infection to linger. Without treatment, your oral and overall health will worsen, resulting in more dental appointments and possible medical concerns.

Sugar Land implant and cosmetic dentist Dr. Siny Thomas sponsors this post.

Can I Get a Third Root Canal Instead of an Extraction?

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My dentist did a root canal for the second time on one of my top left last March, but the tooth started to hurt in May. My dentist referred me to an endodontist that I saw this past Tuesday. The endodontist recommends pulling the tooth because it keeps getting infected. I don’t want to lose the tooth unnecessarily. What is your advice? – Thank you. Shelby from KS

Shelby,

Thank you for contacting Cornerstone Dentistry with your question.

Can You Get a Third Root Canal Tooth Instead of an Extraction?

Root canals can become re-infected if a dentist does not clean and seal them thoroughly. If the canals become infected twice and a third treatment is needed, a specialist may recommend removing the tooth. Endodontists are specialists in root canal therapy and can accurately evaluate whether a tooth is savable. Although you may request a third root canal treatment, you may still lose the tooth. A dental implant can replace it.

Should You Get a Dental Implant or a Bridge?

Standing, unassembled dental implant with crown, abutment, and screw

A dental implant can last decades

Although a dental bridge can replace a missing tooth, an implant is the most effective way to replace a missing tooth.

Consider these factors:

  • A dental bridge requires work on adjacent teeth—shaving them down for crown on either end of the bridge to fit over your teeth.
  • An implant feels and functions like a healthy natural tooth and does not require work on adjacent teeth.
  • Placing the implant requires surgery and three to four months of healing time. Afterward, you can receive a final dental crown. The process can take eight to twelve months.
  • A dental implant can last decades—even a lifetime. You will only need to replace the implant crown after years of wear.

Will Dental Insurance Cover an Implant?

An implant can cost several thousand dollars, and insurance may provide partial coverage if any. Ask your implant dentist for a pretreatment estimate to send to the insurance company. It will help you anticipate out-of-pocket costs for an implant.

Schedule a consultation with one or two advanced implant dentists to discuss your options.

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

How Long Must I Wait for a Dental Implant After a Sinus Perforation?

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Diagram of a dental implant in the bone and gums

A dental implant needs healthy bone and gum tissue to thrive

After my dentist removed a top left molar, my dentist told me that the tooth root was in the sinus and infected. He also prescribed antibiotics for a week. I finished the antibiotics, but now I have sinus pressure, draining, and some facial and gum pain. Decongestant is not helping.

My dentist said that he would not replace the tooth with an implant until the sinus infection clears. Before I call my dentist about the infection, should I ask for a different antibiotic? How long should I expect this to take? Thank you. Asad from Georgia

 

Asad,

Thank you for your question. Although Dr. Thomas would need to examine your tooth and x-ray for an accurate diagnosis, we will answer some general questions about a sinus perforation and infection.

What Causes a Sinus Infection After Tooth Extraction?

A sinus infection after tooth extraction can occur because of the location of your tooth roots. Consider these factors:

  • Upper molar roots are close to the sinuses.
  • Sometimes, only a thin membrane separates the tooth roots and sinus.
  • When your dentist removes the tooth, can break and cause a sinus perforation.

What Is the Treatment for a Sinus Perforation?

A dentist must close a sinus infection with these steps:

  • Insert a gelatin sponge in the space
  • Apply bone grafting material as needed
  • Stitch the opening closed.

Afterward, the area needs time to heal. So you would avoid blowing your nose or touching the area. Also, you must take an antibiotic to get rid of any infection present. If you take the antibiotics, but the infection lingers, your dentist may ask you to continue taking them for a week or more. Or your dentist may choose a different antibiotic.

What Can Cause an Infection to Linger?

If you take antibiotics and the infection does not go away or lingers, a specialist can x-ray the area. The specialist will check for a bone fragment or another structure that may be lodged in your sinus and requires surgical removal.

How Long Will It Take for a Sinus Perforation to Heal?

A sinus perforation will heal in four to six weeks once the infection is controlled. But if you need bone grafting, it will heal in three to six months.

Please get in touch with your dentist to discuss whether you should continue with your current antibiotic and switch to a new one. After the issue is resolved, your dentist can begin planning for your dental implant.

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

Can this Dental Crown Be Repaired?

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I had a crown done a little over four months ago. Today it not only broke off, but the post broke as well.  Is there any way to fix this or do I have to start over?

Calvin

Dear Calvin,

A dental crown being placed on a tooth

 

I haven’t examined you but will try to be helpful with the information I have. There are a few possibilities I can think of here. First, if the tooth broke off at the gumline, it likely means there wasn’t enough tooth there to begin with for a crown to be a viable replacement. I wouldn’t be too hard on your dentist. It sounds like he was trying to save the tooth, which is the best thing for you. However, if there isn’t enough left to save, the only thing you can do at that point is to have the remainder extracted and replace the tooth.

The best way to do that is with a dental implant. A prosthetic root is placed into your jawbone which makes it the closest thing to having a healthy natural tooth there again. A second option is a dental bridge. This suspends a false tooth between two dental crowns that will be placed on your adjacent teeth. This option makes more sense if one of those teeth already needs a crown. Otherwise, if possible, I’d get the implant. It is the better option.

One note of caution. A dental implant will need to be placed by someone with expertise. That requires post-doctoral training. Look for someone who is a fellow with the International Congress of Oral Implantologists. These dentists are highly trained with a significant success rate. A poorly placed implant can lead to problems such as jaw pain and TMJ Disorder, along with a host of other potential problems.

If the tooth didn’t break off at the gumline, then it could just mean that you had a weak post. That does happen occasionally. If that is the case, your dentist should be able to replace it without too much trouble.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

 

Decaying Tooth with No Money

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I have a wisdom tooth that is rotten and decayed. Now the tooth next to it has decay and holes as well. My jaw is also starting to swell. I don’t have dental insurance at the moment and would rather not pay out of pocket. Is it possible to just take antibiotics until I have insurance again or can I just go to the ER for this?

Brad

Dear Brad,

Man grabbing his tooth in pain.

 

I am worried that you are playing with fire here. If the jaw has started to swell, that is a particularly bad sign. Your decay has turned to an infection and that infection is spreading. Think about how close your jaw and cheek are to your eyes and brain. Or, if the infection goes lower, how close it is to your heart. I would consider this a dental emergency. If you don’t get it looked at, it will quickly become a life-threatening emergency.

Hospital Emergency Rooms will not treat dental issues, so that won’t be an option for you. As for an antibiotic. It can be briefly useful for holding the infection at bay, but that is the best it will do. I cannot heal the infection. Nothing short of a dentist physically removing the infected pulp can do that. This is done either by a root canal treatment or a tooth extraction if the tooth is too far gone to save.

I’m going to suggest you get this treated, even if it means out of pocket. There are dentists who will be willing to work with you on payments if you explain the circumstances. Waiting, at this point, is too risky for your health.

Hopefully, the teeth can be saved. If they cannot they you will need tooth replacements. If you are worried about finances, I would just get a temporary tooth replacement, such as a dental flipper and save up for a permanent one, like a dental implant.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

 

 

Is it Too Late to Get My Tooth Back In?

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I need some advice. I was in a car accident with my family. One of my teeth was knocked out as a result another is still in my mouth. Because my son was rushed to the hospital, I did not get a chance to take care of myself. Is it too late to save my tooth that was knocked out or to do something about the tooth knocked back? I can tell it is leaning toward my nose and it hurts.

Jack

Dear Jack,

Man grabbing his tooth in pain.

First, let me say I am so sorry about your accident and that you had the stress of taking your son to the hospital. I hope he is okay. Now, let’s take care of your needs. As far as the tooth you lost, if you get the tooth to the dentist in close to thirty minutes, you have the best chance of saving it. It is definitely considered a dental emergency. Obviously, that will not work in your situation. While you will not be able to save the tooth, it can be replaced.

The best tooth replacement option is to get a dental implant. This is the closest thing to having a healthy, natural tooth in your mouth again. They are secure as well.

As for the tooth that has been knocked out of place, sometimes a surgeon can get it back in place, but that will depend on the type of damage done and the amount of time since the incident happened. Other times, you need to have it moved into place with orthodontics.  You will probably need a root canal treatment and dental crown on that tooth as well.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

Options for a Tooth Infection

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I had a tooth which had a filling. It had been bothering me for a while so I decided to have it looked at. He told me the tooth is infected and I need to have it extracted. I wanted to know if extracting the tooth is the only option or if there are other things that can be done which will allow me to save the tooth. It a lower second molar.

Philomena

Dear Philomena,

Man grabbing his tooth in pain.

In most cases, you have options as to what to do with an infected tooth. However, if you are on a government-funded dental care plan, they will only allow the cheapest option. In that case, removing the tooth is the only option unless you want to pay it out of pocket.

If the tooth is infected and you want to save the tooth, which is always recommended, then I would suggest a root canal treatment. Not only does this allow you to save the tooth, but because it is likely the inside tissue is dead it will be more comfortable for you than an extraction.

One thing that bothers me about this is your dentist did not give you any other options. He is under an ethical obligation to do so. I don’t understand why he didn’t unless he is just lazy and does not like putting forth effort to save teeth.

After your root canal treatment, it may be recommended that you get a dental crown. This is because a root canal can make a tooth a bit brittle and this will help protect it.

If you decide to extract the tooth, you will want to replace it. There are also many options for that as well. The best replacement is a dental implant. But, you can also get a dental bridge or a removable partial denture.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

Is a Tooth Infection Really Dangerous?

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I need some advice.  My back molar (in front of the wisdom tooth) broke in half. I’ve been in a lot of pain ever since. Now my cheek is swelling. and my eye is starting to hurt. My wife insists this is dangerous and I need to go to a dentist, but I just got back to work after a long time furloughed. I don’t want to have to take off work and spend money unnecessarily. Is this really dangerous or is she overreacting? I am sure I can get my doctor to write me a prescription.

Dan S.

Dear Dan,

Man grabbing his tooth in pain.

 

Yes, this is serious. You do need to see a dentist. Tooth infections are not like other bacteria we deal with under normal circumstances, where you can just take an antibiotic and get better. Instead,  a dentist has to physically remove the infected pulp. This is typically done either by a root canal treatment or extracting the tooth.  All an antibiotic will do is temporarily forestall the infection while you get to a dentist.

This is one of the reasons tooth infections are considered dental emergencies. This infection will continue to spread. If you think about how close your jaw is to your heart, lungs, or brain you can understand why people still die from tooth infections. Yours has already spread almost to your eye.

You need to see a dentist as soon as possible. If money is an issue, talk to your dentist and just be honest. The lockdowns hurt everyone financially and most dentists are compassionate. I am positive you will be able to find a dentist willing to work with you on payments.

Ideally, you will want a root canal treatment, which will save your tooth. If that isn’t possible, and it does sound like your tooth is pretty far gone, you will need to have it extracted. Because of the location of your tooth it will be important to replace it. For now, you can get an inexpensive dental flipper. Ideally, you will want to save up for a dental implant, which is the closest thing to having a natural tooth.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.