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Grey tooth

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My daughter is an athlete with a gorgeous smile. A few months ago she had an accident on the court and fractured her tooth. Our dentist did a root canal treatment but, now the tooth has turned grey. She’s embarrassed about her smile. I want to get it fixed. Do we need to have all her teeth done, or just the grey one?

Allie H.- Babbitt, MN

Allie,

If there is just one tooth that has a problem and the rest of her smile is beautiful, then I wouldn’t change anything except the damaged tooth. Putting porcelain veneers on only one tooth is pretty tricky. The key will be finding an expert cosmetic dentist.

Unfortunately, I would not recommend going to your dentist for this procedure. He didn’t know how to do something as simple as a root canal treatement aesthetically. If you do it properly, the tooth will not turn grey.

Go to the mynewsmile.com website and see who they recommend for an area close to you. I wouldn’t go to anyone who wasn’t recommended by their site. They screen cosmetic dentists to make sure they have not only adequate post-graduate training, but that they are artistic with the smiles they create.

This blog is brought to you by Naperville Cosmetic Dentist Dr. David Newkirk.

Crowning a live tooth

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Is it normal to crown a live tooth? My dentist put a crown on a molar that didn’t have a root canal. I’ve just never heard of that before.

Nancy G.- Alabama

Nancy,

Yes, it is pretty common to put a dental crown over a tooth without a root canal treatment.  We do that whenever there is a significant risk that the tooth can break. This protects the tooth.

The reason most people associate it with a root canal is we always crown those teeth because they are now at a higher risk to break.

This blog is brought to you by Naperville Dentist Dr. David Newkirk.

My porcelain crowns keep cracking

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Hi I had porcelain caps for about 6 years now on just about all my teeth. Well since then I had to replace 8 of them from them cracking. I was eating chicken tonight and another one broke. The dentist that did the work said it happens. I paid over 40,000 plus constant root canals. I never had a problem with my teeth until I had my teeth done. Is there anything I can do to this dentist? I am going into debt.
– Robin from Pennsylvania

Robin,
To answer your question about your porcelain crowns cracking, I need to give a little background information.

There are two basic kinds of porcelain crowns, or caps as you call them, and then sub-categories. There are porcelain fused to metal crowns that practically never crack, and there are all-porcelain crowns which are strong enough for the front teeth but can crack sometimes when used on molars. But now, even with all porcelain, there are zirconia ceramics that are extremely strong.

And then there is a wide variety of patients, as far as the strength of their bites. There are some that I call “gorilla bites” that will break things in their mouth really easily. That happens with fewer than 1% of patients. Most practices will have a handful of those patients, and they can break a tooth clean off, but the porcelain fused to metal crown will stay intact.

What I want to say with all of this is that, even with good dentists, there is often a learning curve of dealing with real patients where they do what they were taught in dental school but the patient still breaks things. The way to tell if you have a good dentist or not is their attitude about this. If this makes them upset and they take extra pains to get it right and they fix things at their expense, then I would stay with the dentist. Maybe the dentist used all-porcelain and it really should have been porcelain fused to metal on this particular tooth. If I were the dentist, I would apologize for the mistake, and replace the crown, maybe waiving your portion of the cost if there is dental insurance involved, or even doing it completely for free. However, you seem to be saying that the dentist is trying to brush it off as normal, which makes it sound like this happens a lot with this dentist. If I were the patient, this would not be acceptable to me.

Now most dental insurance companies will not pay for a new crown if the old crown on the tooth is less than five years old. But a crown really should last considerably longer than that if it is done well – 10, maybe 20 years or even more.

And then, it isn’t that uncommon for a tooth that has a crown to also need a root canal treatment, either before the crown is done or afterward. But if this happened a lot to you and the crowns weren’t done for decay but as part of a bite reconstruction, then I would question the work.

This blog is sponsored by Naperville cosmetic dentist Dr. David Newkirk

My tooth feels like fire, even to tap water.

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What is a desensitizing agent? I had a large filling removed from a molar & re-filled & now it is so sensitive, even tap water feels like fire.

– Shirley from Texas

Shirley,
From the description you give of the intensity of your pain, it sounds like the tooth that was filled is infected and will need a root canal treatment and then later a dental crown.

Here are some guidelines to see if you need your dentist to help you with this pain:

If the tooth is getting more hypersensitive with each passing day, it is probably infected. If it is gradually getting better, it will probably recover.
If your tooth is momentarily sensitive from cold water, but it’s only for a couple of seconds, and as soon as the tooth warms up it feels fine, then it will probably recover. If the pain lingers more than a few seconds, it is infected and will need a root canal treatment.

If the tooth begins hurting spontaneously, where you get a sharp pain without any cold stimulus, it is infected, and will need a root canal treatment.

If the tooth gives you a sharp pain and then all of a sudden the pain goes away, cold doesn’t bother the tooth any more at all, the tooth is probably infected and needs a root canal treatment. What has probably happened is the tissue inside the tooth has died, which takes care of the pain, but now the infection begins spreading out the end of the root of the tooth and into your bone, causing an abscess. That needs to be fixed.

I hope this is helpful.

Naperville dentist.