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Dr. Thomas

Broken Tooth

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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,

A diagram of a dental implant between two teeth

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.

Two Problems With a Tooth Extraction

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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,

Man grabbing his tooth in pain.

 

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.