tooth extraction Archives - Cornerstone Dentistry

Do I Really Need 17 Teeth Extracted?

Posted on March 17, 2024 by AllSmiles.

I lost several teeth due to bone loss from gum disease. After gum disease treatment, my dentist wants to extract my 17 remaining teeth and replace them with upper and lower dentures. Some of my teeth are stable, and I don’t have any problems with them. Is my dentist’s recommendation overtreatment? Is it risky to keep my teeth since I have a history of gum disease? Thanks. Wynn from Georgia

Wynn,

Dentists with a conservative approach strive to preserve teeth whenever possible. However, saving a tooth can be challenging for some dentists. You are not at risk by saving healthy teeth.

Replacing only the unsavable teeth may be better to reduce the stress on your remaining teeth and help them last.

You can get a second opinion from another dentist without revealing your dentist’s recommendation to remove your remaining teeth. It’s better for your oral health if your dentist or another dentist is willing to try to save as many teeth as possible.

Maintaining healthy gum tissue requires a dental hygienist to clean your teeth and roots to remove tartar accumulation thoroughly. Some dentists recommend more frequent dental or deep cleanings for patients with a history of gum disease. Your dentist and hygienist will also closely monitor your teeth and gums. You must also commit to diligent oral hygiene and regular dental cleanings and checkups. Floss between your teeth daily and brush at least twice daily to protect your remaining teeth.

If you need complete dentures, consider stabilizing them with dental implants to preserve your jawbone. Otherwise, individual implants can restore the function of your missing teeth and your smile.

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.

Antibiotics for Tooth Infections

Posted on July 25, 2021 by writeradmin.

I went in for a toothache and my dentist said I have an infected tooth. He prescribed me an antibiotic, which I took diligently. While the infection started to get better, it has now flared back up. Do I need to have him call in a second round of antibiotics or do I ask for a stronger antibiotic?

Madison

Dear Madison,

I think there was some miscommunication here. While antibiotics are sometimes prescribed for tooth infections to either get them under control before treatment or hold it at bay until treatment, it is not enough on its own. What will happen, as you have experienced, is the infection will improve a bit but then flare back up once you are no longer taking the medication.

There are two viable treatments for a tooth infection. The first is a root canal treatment. This is the preferred treatment because it will enable you to keep your tooth. You never want to lose a tooth if it can be helped. The second option is to have the tooth extracted. While it will get rid of the infection, it does mean you will need to replace the tooth. If you leave the open space there, the other teeth will drift or tip into the spot. This will throw off your bite which will lead to jaw pain, headaches, and possibly even TMJ Disorder.

I’m not sure you are being well looked after by this dentist. I would have thought there would be some follow-up on this so that they would schedule you for the necessary procedure to deal with your infection. Call their office and tell them you need to schedule an emergency dental appointment. Let them know you’ve already used the antibiotics they gave you and the infection has flared back up and is beginning to spread. If they say they want you to take more antibiotics first, that is fine, just make sure they schedule a date for your treatment at the same time.

One other note. Hopefully, it is not too late to save your tooth. If it is and you need to replace it, I would get a dental implant. It is by far the best tooth replacement option. If you don’t have the money for that right now, It would be worth it in the long run if you got a cheap-o temporary replacement, such as a dental flipper, as you saved up for the better permanent replacement.

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

Is a Tooth Infection Really Dangerous?

Posted on February 23, 2021 by writeradmin.

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,

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.

Broken Tooth

Posted on February 16, 2021 by writeradmin.

A few years ago, before I had a fully functioning adult brain, I broke a back tooth. I was too poor and too interested in having fun to do anything about it. Eventually, I decided I should at least check on it and found that half of it was missing. It didn’t hurt (and I was still poor) so I decided to leave well enough alone. Fast forward a year and the rest of the visible part broke off. There was still the underneath part (I think it’s called the root). Again, no pain so no worries. Recently, though, it has started hurting fiercly. When I look at it, I can see a hole. Is this something I should worry about or will it resolve itself.?

Casey

Dear Casey,

You have an infected tooth. Under normal circumstances, a dentist should try to save a tooth with a root canal treatment. Unfortunately, because of the state of this tooth, that will not be possible. Your only solution at this point is to have the remainder of the tooth extracted.

You won’t want to leave an empty place there, however. Even adult teeth are in motion and the adjacent teeth will begin to shift and tip into the empty space. This can throw off your bite, which can lead to a lifetime of pain and TMJ Disorder. In order to prevent the teeth from shifting, you will need to fill that spot in.

The best tooth replacement is a dental implant. You can see an example of one in the picture above. It surgically places a tooth root. Then, when the bone has integrated with the implant, a dental crown is placed. This is completely secure and the closest thing to having a healthy natural tooth in that space again.

Whatever you do, please don’t put off treatment. Your jaw is very close to your brain, heart, and lungs. If a tooth infection is not dealt with in a timely matter, and it continues to spread, it could infect one of those major organs.This is one of the reasons tooth infections are considered dental emergencies.

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

Options for an Infected Tooth

Posted on September 30, 2020 by writeradmin.

A month ago I had a filling placed on a lower second molar. It bothered me every day since and I was taking daily ibuprofen just to get past the pain. I told my dentist I felt like I needed to come back in. He did an x-ray and said the tooth now has an abscess and I need to have it extracted. Is there another option?

Brandon

Dear Brandon,

Whether you have options will depend on whether you are on government-funded insurance or not. If you are on something like Medicaid, then they don’t give you options. You do the cheapest solution or pay for it yourself. In your case, that would be an extraction. This may be why your dentist only told you about the extraction. However, a dentist is supposed to give you all your options, in my opinion, that would include the ones where your insurance doesn’t cover things.

The best solution for an infected tooth, especially a lower second molar is a root canal treatment. This will help save the tooth. Plus, the tissue inside the tooth is dead. This means it would be less traumatic to have a root canal treatment as well.

There are financial considerations with an extraction even if that is what your insurance wants. If you save the molar, you don’t have to replace it. If you extract the molar it will require a false tooth be placed there, such as a dental implant. That will cost even more money.

My suggestion is you get a second opinion on this tooth. I am actually a little suspicious that the original filling wasn’t done correctly and that is why he is anxious to pull the tooth.

If it does turn out the tooth cannot be saved and you replace it with a dental implant. I want you to be certain the dentist who does the implant has significant post-doctoral training in placing them. For instance, Dr. Thomas is a Fellow at the International Congress of Oral Implantologists (ICOI). This means he not only has advanced training but has recognized skills. Implant placement is an advanced skill that requires post-doctoral training. There are horror stories from patients who had them done by inexperienced dentists.

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

Two Problems With a Tooth Extraction

Posted on August 29, 2020 by writeradmin.

I had a tooth extracted. The first question I have is how normal is it for a tooth to require 12 shots of Novocain to get numb. Have you had this happen with a patient before? My second question is about what to expect post-operatively. I had a bone spur at the extraction site. It caused excruciating pain anytime my tongue hit it. He removed it but it took forever because it was hard to get to. Now there is this bony ridge. Is that a normal result of the bone spur or is something else going on?

Evan

Dear Evan,

While the difficulty getting numb can come from your dentist not hitting the right spot, twelve shots seem like an awful lot of times to miss. In all likelihood, it is a result of dental anxiety. Many dentists aren’t aware of this but when you have some anxiety, it burns off the numbing medication so quickly as to render it ineffective.

What your dentist could have done to help this situation would be to give you some nitrous oxide to relax you. This would enable your anxiety to calm down allowing the medication to do its thing. With some patients, their level of anxiety is so high that nitrous oxide will not be enough. Instead, they will need oral conscious sedation. This is much stronger but requires you to have someone drive you to and from your appointment.

If your dentist isn’t aware of this type of situation or doesn’t offer these services, then you will be better served to see a dentist who offers sedation options for people who experience dental anxiety.

As for the bony ridge, this is normal. Sharp edges can arise during the healing process. You don’t notice them as much at first because your swollen gum tissue is covering it. As the healing takes place, the gums shrink down and make it more prominent. Your dentist can smooth it over or clip it if it bothers you too much.

You haven’t mentioned anything about a tooth replacement. It will be important to replace any missing teeth. Otherwise, the nearby teeth will shift and tip into the open space, throwing off your bite. Aside from the aesthetic issues, this can lead to painful problems such as TMJ Disorder. I’m going to suggest you look at getting a dental implant. These are the best tooth replacement and are like having a healthy natural tooth in your mouth again.

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

She Needs a Second Opinion About this Tooth

Posted on August 2, 2020 by writeradmin.

I need some advice. I don’t know if I’m not trusting this dentist because of legitimate reasons or because of my fear of any dental work. I don’t want to put myself at risk, but I don’t want to put myself through any torture unnecessarily. I had a toothache starting last week and went to see a dentist today. I don’t have a regular dentist because of my anxiety and just tend to go when an issue comes up. He did an x-ray and said that a tooth which already had a filling would need to come out. He said only 10% of the tooth was still viable and the tooth would need to be extracted. This absolutely terrifies me. Is a second opinion worth it or should I just suck it up and get this tooth extracted? He also said I’d need a dental implant afterward to replace it.

Sandy

Dear Sandy,

I think this warrants a second opinion. Here’s why. First, a tooth that far gone would not require an x-ray. The decay would be massive and visible. Additionally, your filling would literally have fallen into the tooth. Thirdly, you said this tooth just started hurting last week. I believe this would have been hurting for longer than that. All of this is making me suspicious.

The only thing I agree with him on is a dental implant if the tooth needed to be extracted. They are the closest thing to having a healthy natural tooth again. Plus, it is always important to replace a missing tooth to avoid throwing off your bite and developing painful TMJ Disorder. However, I’m not convinced your tooth does. Something to consider when getting a second opinion is to make sure it is what is known as a blind second opinion.

Many dentists, especially in the same area, are friends with one another. They’re part of the same professional peer groups. It is always awkward for one dentist to say something negative or in disagreement with a friend. Because of that, it is easier for both of you if you just ask him to look at the tooth and give his opinion on how to deal with it without telling him who the dentist was and what his diagnosis was. He should completely understand you wanting a blind second opinion.

A Word About Dental Anxiety

It is very common for patients to have dental anxiety. One thing we want to do is get you to a place where you are not just seeing a dentist when you have a dental emergency. That both increases your anxiety and is much more expensive for you. To that end, I would highly recommend for you to see a sedation dentist for a while.

There are varying levels of sedation. For just your checkups and cleanings, you will likely only need nitrous oxide, which relaxes you. However, whenever you have a more extensive procedure, you may prefer oral conscious sedation. This is sometimes called sleep dentistry, because it is so strong you can actually just sleep through the procedure.

Many patients with anxiety find that using dental sedation as needed completely changes their lives. If you keep up with simple cleanings and checkups you are able to catch things much sooner. This not only will save you a TON of money for not needing the bigger more expensive fixes, but will also make your treatments much less invasive and scary.

I do understand how frightening dental work can be. You’ll find dentists who offer sedation are much more compassionate and understanding about those who struggle with dental anxiety.

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

Can I Just Take Antibiotics Until I can Extract the Tooth?

Posted on June 27, 2020 by writeradmin.

I have a tooth that I am sure is infected. I don’t have time to deal with it right now as we are about to leave for a family vacation. I do have some leftover antibiotics and am sure I can get my doctor to call in another prescription. Then, when we get back, I’ll have the tooth extracted. Is there a preferred antibiotic for this?

Douglas W.

Dear Douglas,

I want to make sure you understand that antibiotics will not “heal” an infected tooth. The infected tissue has to be physically removed. I think you’re planning on doing that with an extraction. You should know you do have an option that will save your tooth, called a root canal treatment. This is a procedure where the dentist goes into the tooth canals with a tiny instrument to take out the infected pulp. It is always better to save a tooth whenever possible. This is because of the danger of root resorption.

What an antibiotic can do is sort of hold off an infection until then. How long they hold it off varies on the infection. Bear in mind, tooth infections are considered a dental emergency for a reason. If the infection grows too rapidly, it can become life-threatening. Think about how close your jaw is to your heart, lungs, and brain, you can see that you don’t want to let the infection spread.

There is a danger that you take your antibiotic and in the middle of your family vacation the infection blows up and you end up in the office of a strange dentist you don’t know while your family flounders on without you.

The better plan is to go ahead and get a root canal treatment before you go. This is a much easier procedure than a tooth extraction.

If It Comes to an Extraction

if it does turn out that the tooth can’t be saved, there are other considerations. First and foremost is the tooth must be replaced. If you don’t, the nearby teeth will begin to shift or tip into the spot. This will throw off your bite. When this happens, you’ll begin to experience jaw pain and it can even lead to migraines and TMJ Disorder.

There are quite a few tooth replacement options. The best replacement is a dental implant. This has a prosthetic tooth root that is topped by a dental crown. Having a dental implant is the closest thing to having a healthy, natural tooth in your mouth again.

Another option is a dental bridge. This suspends a false tooth between dental crowns. The downside of this is it requires two healthy teeth to be crowned. You may not want to do that.

Finally, there is a removable partial denture or a dental flipper. Both are removable. The latter is generally used as a temporary replacement option while you’ are waiting on something better like a dental implant.

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