The Tooth, the Whole Tooth and Nothing but the Tooth!

It's tooth talking time!   Let's talk about what happens when a tooth is broken,  missing, decayed, cracked or loses it's crown.


Ouch, your tooth broke!   Why? What caused it to break?  Years of clenching, or grinding, large fillings, or tooth decay are the likely culprits.  A perfect example is the photo on the right.   This molar tooth has a large silver filling with a hairline crack down the cusp. There's recurrent decay around the edges of this failing filling.  When I do my examination of teeth, I look for things like this so I can prevent that broken tooth in the future.  But what if that tooth  does break and it does not hurt?  Are you in the clear?  While this is not an "emergency," it should certainly be taken care of promptly- now, while it is relatively easy to repair.   It will eventually start hurting.  Once the nerve of the tooth is exposed to decay the tooth starts to die and will start hurting.  This infection goes down into the jawbone and infects you!  It does not stay just in your jaw either, it travels through your bloodstream to other parts of your body.  So then, besides the root canal, crown and infection you have in your mouth, you also have an infection within your body.  Aah, not a great thought, is it?  So, what would have been maybe a $300 filling,  will be either a $300.00 extraction and an  implant, or maybe a root canal and crown for another few thousand dollars. Not to mention the infection lurking elsewhere...   Pay me now or pay me much more later.  Waiting will not change the fact that your tooth is broken and needs to be fixed.

What about just having the tooth removed?  And, not replacing it?  Do you really need that tooth?  Teeth are always moving, they move down and in, slowly.  See the x-ray of the molar - it's tipping in, and as a result has bone loss.  Due to the improper bite, the tooth also has a hairline crack in the root.  This tooth is slated to be removed soon and replaced with a partial denture.   Had this person not lost the missing tooth, none of this would be an issue now, 30 years later.

Another scenario I saw this week, a crown in a baggie.  The crown had come off about two months ago. The tooth did not hurt so the patient waited until his recare appointment with me, thinking we could just recement it then.  Remember, teeth move ever so slightly.  Crowns do come uncemented occasionally, glue does not last forever.  That's one of the  many things I check for during your recare appointment with me.  When cement gives out, decay can get underneath the crown and cause havoc, or if you are lucky, the entire crown just comes off.  Lucky for this person, there was no decay under the crown.  Unfortunately, the crownless tooth did move and the tooth above it drifted down ever so slightly.  Again, this person was lucky in that the space still fit the crown.  But then, three days later, the tooth hurt.  Because the upper tooth had moved, doing what we call "super erupting", once the crown was back on, it hit the lower tooth and caused pain.  Frequent recare appointments will check your crown margins and be sure everything is nicely glued on. Don't wait if your crown comes off, get in to see your dentist toot suite!

Radiographes, or what you call x-rays, are an important tool for your dental team to see what's going on under the gumline and inside the tooth.  Our office takes cavity checking x-rays yearly. Sometimes, a patient prefers to wait another year or more.  Lots can happen in that time. See the pictures below-  There was no way to know this decay was occurring without taking that radiograph.

before

two years  later 

 And, last but not least, if we tell you there's tooth decay, please address it.  Decay does progress and while the tooth may not hurt, yet, as you can see, in this case it's getting close to this nerve and will eventually.   Decay is contagious from tooth to tooth, and person to person.

Here's the real scoop, you don't "need" teeth.   You survived fine the first year of your life without them.  Dentistry can of course replace them. (Not as well as your first or even second sets, trust me on that.)  So, teeth are a "want", in my book.  And, in my opinion, life is so much better with them!  Food tastes better, and life is more enjoyable with well functioning teeth.   I "want" my teeth to last me my life time.  Man-made stuff, while okay, is just not as good as what you were born with.

This was just part of what I saw in my office this week.  Interesting for me and totally avoidable for my patients.  Preventing tooth decay, preventing clenching and grinding, and replacing missing teeth will go a very long way to keeping you and your mouth trouble free!  The plus side is a lower dental bill any way you slice it!

Keep smiling,
Til next time,
Barbara