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


We thank our advertisers who help fund this site.

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

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.

April 10, 2012

A dentist is ethically obligated to give you all your options

When I was a child I was hit in the mouth twice, once from falling out of a wooden school swing and the other time from throwing a croquet ball up in the air and catching it with my front tooth. Needless to say the older I’ve gotten the more yellow brown it has become. My dentist told me I would have to get an implant because there was no root but yet I still have the VERY UGLY BROWN TOOTH.

I also have several back teeth that need filings and at least 2 that need to be capped. I don’t have a lot of money to be putting into just one tooth when I have several others that need to be fixed, although the one that gives me an UGLY SMILE is the one everyone can see. PLEASE HELP ME.

Thank You so very much for your time.
Sincerely, THE GIRL WITH THE UGLY BROWN TOOTH
Danielle in Tennessee

Danielle,
I would switch dentists, and I will explain why.

One of these two traumatic incidents with your front tooth jarred it enough to sever the nerve and blood supply that go to the tooth. This would cause the tissue inside it to die, which would then cause it to become infected. It’s possible that if this tooth had received a root canal treatment at that time, it could have prevented the root of the tooth from being eaten away, but it’s also possible that would have happened anyway, as a side effect of the traumatic injury. The process is called root resorption, and it can happen because of an untreated infected tooth, or because of traumatic injury to the tooth.

But now that the tooth has no root left, you can’t save it.

There are three basic ways, however, to replace a missing tooth, and your dentist is negligent in only presenting one of them to you. He or she has an ethical obligation to give you all the options that would work. And while the implant option is probably the best choice for you, it is also the most expensive. Did you tell your dentist that this was too expensive for you? If you did, and you still didn’t get any options given to you, then it shows not only negligence but a lack of character on the part of your dentist.

A dental bridge is the traditional way to replace a single missing tooth. A bridge requires that the two adjacent teeth be covered with crowns (you may know them as caps), and then a false tooth is suspended between them. This is a little less expensive than an implant.

Another option is to use a removable partial denture that clips onto your other teeth and has a false tooth on it. While less comfortable than either a bridge or an implant, it is a fraction of the cost of a bridge. A flipper partial is the simplest way to do this, and it can cost as little as a couple of hundred dollars.

Find a dentist who is willing to give you all your options and who will work with you to keep the costs down. I don’t know everything that went on in your visit with your dentist, but just from the information that I have it doesn’t appear that you should trust this dentist.
– 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.

August 27, 2010

Does root resorption mean you can’t save the tooth?

Filed under: Extractions,Root canals — Tags: — mesasmiles @ 4:33 pm

Dr. Hall,
I hadn’t been to a dentist for treatment in 5 years – though I had x-rays and a treatment plan 2 years ago, I never went through with it due to cost and not trusting the dentist’s opinion. So I finally went to the dentist this month. I got a couple cavities filled by the general dentist, but while attempting a root canal on my upper molar, #14, the endodontist said I have root resorption, which he didn’t realize beforehand when looking at the x-ray – it had appeared I just had a cavity very close to the root. So he said unfortunately he can’t save the tooth and it would need to be pulled and I’d have to get an implant.

Was it necessary to pull the tooth in the first place because of the root resorption, or was the endodontist forced to pull it because he had already started the root canal and couldn’t finish it?
– Erin from California

Erin,
When root resorption is at the end of the root, it may be caused from the infection that started inside the tooth, and it may be possible to still save the tooth. But it sounds like your root resorption was on the side of the root. There is no way we know of to treat that type of root resorption, so yes, I believe the tooth was not saveable and needed to be extracted.

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.

Powered by WordPress

Follow this blog

Get every new post delivered right to your inbox.


Categories