Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

September 28, 2017

I want to avoid getting a crown on my front tooth, after a root canal


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Hello Dr. Hall,
Back in May 21st I had my front upper tooth knocked out. It was put back in, bonded and set back into place. I had a root canal done on it as well. I’m noting that the color is slightly off (more yellow) than the rest of my teeth. My dentist said that I would probably have to get a crown after my last visit, but looking online I see that a crown for a front tooth may not be a good idea. How can I preserve the whiteness of this tooth without needing a crown? Thank you for your time.
– Joseph from Staten Island, NY

Joseph,
You’re right. A crown on a front tooth, while it strengthens it against chipping, actually weakens the tooth against lateral stresses. So if you have a heavy bite at all, it is at greater risk of breaking off.

After a root canal treatment, a tooth tends to discolor. But that discoloration can be greatly lessened by cleaning out the inside of the crown from any root canal filling materials such as gutta percha or cement. If it is starting to discolor already (four months after treatment), the dentist has left some of those materials inside the visible part of the tooth.

Here’s what I would do.

Go to one of our recommended cosmetic dentists in Manhattan, Queens, or New Jersey, and have them clean out the inside of the crown. Since the tooth has begun to discolor already, it would be a good idea to have them do internal bleaching. Then you could have them fit the tooth with a fiberglass post inside and seal the opening, and you should be good for several years before it starts to discolor.

Then, when it discolors, I would just have them do a single porcelain veneer to correct that. This would require a fair amount of expertise in appearance-related dentistry to match the color of the adjacent tooth, but I’m confident that any dentist we list would be able to get that to look great for you.

Oh, one other thing. Since this is a replanted front tooth, you want to have it x-rayed again to make sure you don’t have any external resorption. It’s possible that your body could be eating away at the root. That happens sometimes with these replanted teeth. Be sure to find that out before you invest much money into this tooth.

And just a comment about your dentist. It looks like he or she did a nice job of saving your tooth—did all the right things, and is probably an excellent dentist. But these demanding aesthetic problems are over the head of the vast majority of general dentists.

I hope this is helpful.

Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

August 22, 2016

Do you recommend Save-A-Tooth?


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Dr. Hall,
What do you think of this product, Save-A-Tooth? Is it worthwhile?
– Annmarie from Arkansas

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Annmarie,
I’ve looked it over, and it looks legitimate–based on sound dental principles.

Save-A-Tooth for saving avulsed teeth

What they have here is a kit that is designed to help keep a tooth alive after it has been knocked out (avulsed). If you have an accident that causes a tooth to be knocked out, if that tooth is replanted within half an hour, the chances are good that it will survive. When this would happen and a patient would call our office, we would tell them to not touch the root but keep the tooth moist and come in immediately and we would put it back for them. Sometimes we were fast enough and we got the replanted tooth to survive just fine. Other times we weren’t and the tooth would heal initially but then become a victim to external resorption and eventually fall out.

What they have done with Save-A-Tooth is provide first, a solution that is specifically designed to help keep the tooth ligament alive. It contains a balanced salt solution that is especially gentle to the tissue. It is the condition of this ligament that determines whether or not the tooth will reattach successfully to the jawbone. For example, if the patient were to try to clean off the tooth, that would guarantee failure. They say that the tooth can be kept alive for up to 24 hours. That seems like a stretch to me, but I wouldn’t be surprised to learn that it worked for a couple of hours at least–plenty of time to get to a dentist and get the tooth replanted. Second, the container is designed to carry the tooth gently without any damage to the delicate ligament tissue.

All in all, the product seems based on sound dental principles.

It can be bought as a stand-alone product for about $20, or as part of a general first-aid kit, either directly from the company or through Amazon. The company gives it a three-year shelf life. Is it worth it to buy it? You’ll have to make that decision on your own–weigh the risks that someone in your family will knock out a tooth and you will have this kit handy at the time, weigh that against the cost. Most of these accidents happen to young men ages 8 to 18. If the accident happens and it takes you half an hour to find and retrieve the kit, you may as well spend the time getting to the dentist’s office. But if you have the kit handy, it could be a tooth-saver. (For ages 6 and under, an avulsed front tooth is going to be a baby tooth and I wouldn’t recommend trying to replant it.)
– Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

August 8, 2012

How long can you put off a root canal treatment?

Filed under: Root canals — Tags: , , — mesasmiles @ 10:57 am

Dr. Hall,
How long can a tooth with no pain that needs a root canal go for without getting the procedure done?
– Maria from New Jersey

Maria,
How long should you go with a tooth that needs a root canal treatment and you haven’t done it yet? That is hard to say and without seeing your tooth I’d hesitate to guess. If it’s hurting, of course, you want to do it right away. Even if it’s hurting just a little bit or if it has been hurting recently but the pain has gone away. All of these situations indicate an active infection that is growing.

Also, if you have drainage in your mouth or a pimple in your gums right where the  tip of the root of this tooth is, the same applies. This is an active infection, and the tooth should be treated promptly. It’s not an emergency that has to be done immediately, but schedule it at your convenience and to fit into the dentist’s schedule, and get it done.

But if it’s not hurting and hasn’t for a long time, it may or may not cause problems to delay. I had a patient who had an infected tooth that needed a root canal treatment for over ten years and he didn’t know it. It was an arrested infection, and while it affected his system, the effect was so subtle he didn’t notice it. We did the root canal treatment, he noticed that he felt a little better, and everything turned out fine. But you run the risk of what is called external resorption – where the infection slowly eats away at the root of the tooth to where the tooth becomes not saveable. And then if the infection is from active decay, the decay will keep growing until the tooth is destroyed. But if the infection is latent and the tooth is intact with no active decay, you may be able to safely wait.
– Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

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