Tag Archives: tooth trauma

what is essential treatment?

I know during this time of quarantine that we all have to do our part. I’ve been doing very well and not going anywhere. Unfortunately, I took a spill down our stairs and ended up chipping a tooth. Would this be considered an essential treatment? I feel silly. I know it is just a chip but it is bugging me.

Camille

Dear Camille,

a before and after picture of dental bonding for a chipped tooth.

The CDC hasn’t listed what procedures and treatments are considered essential and what isn’t. For the most part, they expect us to avoid routine procedures. If it were just a cosmetic issue alone, I would say you would need to wait until the quarantine is over.

However, based on what you said, there is more to this than just cosmetics. You took a fall which caused the damage. There could be underlying trauma to the tooth which needs immediate treatment. Sometimes the ligament can be stretched and if you don’t splint the tooth you can end up with a tooth that comes loose. Other times, the trauma is so severe, the pulp of the tooth dies and you need a root canal treatment.

Under normal circumstances, I’d suggest you call your dentist and ask him to squeeze you in for an emergency dental appointment. In this case, the only appointments are for situations like yours.

If you’re going to need an emergency appointment. This is the perfect time!

Getting the Chipped Fixed

If it turns out there is not damage from the trauma that requires immediate treatment, then your dentist can likely go ahead and fix the chipped tooth. I mean…you’re already there.

The ideal solution for this is to have dental bonding done. You can see an example of that in the image above. I will warn you. It does take an expert cosmetic dentist. If your dentist isn’t one, my suggestion is you see him for the trauma. Then, once the virus calms down, see an AACD accredited dentist to do the bonding to repair the chip to your tooth.

This blog is brought to you by Louisiana Cosmetic Dentist Dr. Mike Malone.

Should I Have Gone to a Cosmetic Dentist for a Root Canal?

Both my sister and I received root canals within the last year. My dentist put a crown on mine, which meant filing down the tooth to a nub. It’s not that attractive either. It’s toward the back so isn’t completely visible but it still bothers me. My sister sees a cosmetic dentist. When he did her root canal, he put a porcelain veneer on hers. It looks so much nicer than mine and she hardly had any of her tooth structure removed. Did I make a mistake not going to a cosmetic dentist?

Betty

Dear Betty,

Porcelain crown on left and porcelain veneer on right

You should know there isn’t a recognized specialty in cosmetic dentistry, which means every cosmetic dentist is just a general dentist who prefers to also do cosmetic work. However, before we get into choosing a dentist to do cosmetic work, let’s talk about a root canal restoration.

Whether or not you get a dental crown or a porcelain veneer restoration depends on a few things. First, the location. If it’s a back tooth, a crown is more important. After a root canal, a tooth becomes more brittle. The crown will protect it from the biting forces which affect your back teeth.

If it’s on the front teeth, you may have a choice. Most of the time crowns are done because there was so much decay on the tooth there is not enough structure left for anything but a crown. However, if the tooth needed treatment because of trauma and is still fully intact, then you could get a porcelain veneer. This is more effective because of the type of forces your front teeth undergo.

However, you’re talking about getting a porcelain veneer on a single front tooth. This requires a cosmetic dentist with superior aesthetic skills.

When You Need a Skilled Cosmetic Dentist

Most of the skills required to do a beautiful smile makeover are not taught in dental school. The dentist has to invest post-doctoral time in learning the skills required. However, there is an aspect that can’t be taught— an artistic eye.

Like any art form, there are different skill levels. So, how do you find the right dentist? The American Academy of Cosmetic Dentistry realized the quandary patients found themselves in. To remedy that, they began an accreditation program.

To become accredited, dentists have to pass stringent oral and written exams. Additionally, they have to provide evidence of a list of cases they’ve done showing they can give beautiful results. Any AACD accredited dentist can give you a gorgeous smile makeover. They can also match a single porcelain veneer to the rest of your teeth.

If you’re ever in the need or porcelain veneers, make sure you go to aacd.com and find an accredited dentist in your area.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

Help! My Front Tooth is Loose

I am terrified. I discovered my front tooth is loose. I don’t remember hitting it and I don’t think the other teeth are loose. Can a dentist fix this? What if it can’t be fixed? Do they make dentures for one tooth? Help me!

Samantha

Dear Samantha,

A woman with a gorgeous smile created by cosmetic dentist Dr. Mike Malone
A gorgeous smile created by cosmetic dentist Dr. Mike Malone

First, I want you to take a deep breath. You will not end up with a space where a front tooth should be for the rest of your life. The first thing you need to do is schedule an emergency appointment with your dentist. If the tooth is loose, regardless of the cause, it needs to be splinted to keep it secure.

Next, your dentist will need to determine why it’s loose. Do you have gum disease? Was there trauma? He’ll want to do some x-rays to see if the pulp was damaged. If so, you’ll need a root canal treatment.

Dental Solutions for a Missing Tooth

If you do end up losing this tooth, which would surprise me if this is the first sign of a problem and you don’t remember any trauma, there are solutions. We’ll go over each of them, from the least desirable (and least expensive) to the highest quality replacement, which is also more pricey.

Removable Partial DentureYes, there are “dentures” for a single tooth. It’s called a removable partial denture. It connects onto your other, healthy teeth, with a false tooth attached. It does put pressure on the teeth it hooks to so it’s not the ideal solution, but depending on your budget, you might use it as a temporary solution while you save up for one of the more preferable treatments.

Illustration of a dental bridgeThe next best solution is a dental bridge. This suspends a false tooth between two dental crowns. In reality, this makes more sense if your adjacent teeth (which will receive the crowns) need work anyway. In that case, it’s like knocking out two problems with one. However, if they don’t need work, I wouldn’t want to remove any healthy tooth structure.

Dental Implant DiagramThe top of the line replacement is to get a dental implant. It’s like having a healthy, natural tooth back. If your budget allows, this would be the treatment I’d choose. A prosthetic root is implanted where the natural root was, then a porcelain crown is placed on top. You can eat, brush, and floss just like you normally would. They’re very strong and last for many years.

Getting a Beautiful, Natural-Looking Tooth

You’re talking about replacing a front tooth, so you want to be certain the dentist is also a skilled cosmetic dentist. Whatever crown he creates for your front tooth needs to look just like the adjacent tooth. Above all else, make sure they give you an all-porcelain crown and not a porcelain-fused-to-metal crown.

This blog is brought to you by Dr. Mike Malone.

Dentist Refuses to Fix Son’s Tooth with Veneers or Crowns

I’m really frustrated. My 9-year-old took a bad fall. When he did, he lost half his front tooth. I want his repair to be stable. My first thought was a porcelain veneer but my dentist said no. Then I suggested a crown. The dentist said no. I don’t know what to do. Why won’t they treat him?

Laura K.

Dear Laura,

Porcelain Veneer being placed on a tooth

I know you’re frustrated. You want the absolute best for your son and it seems like your pediatric dentist isn’t cooperating. He may not be explaining things well, but he’s not wrong. Though, he should have told you what solutions would work.

With a child, their jaws and bite are in an almost constant state of flux. He will outgrow both the porcelain veneers and dental crowns so fast it could mess up a lot of things about his bite. Not to mention the fact that it would cost you a fortune to constantly replace them.

Alternative to Porcelain Veneers for a Child

The best solution at this point would be to have dental bonding done to make the tooth look completely natural. It’s much less expensive than veneers or crowns anyway. Then, when his jaw has fully developed you can look for a more permanent solution.

I’m assuming at this point the dentist checked for trauma to his nerves and such and that the tooth is safe. If he hadn’t, I’d go see an emergency dentist just to have his teeth looked at and make sure no permanent damage is done where he’ll need a root canal treatment.

This blog is brought to you by Dr. Mike Malone.