Monthly Archives: January 2021

Sedation Dentistry

Is it too late to save my fractured tooth?

I split my left incisor tooth, and after seeing three dentists, none of them want to save it. They all recommend extraction, but I want a dentist who will try to save it first. How can I find a dentist without schedule one consultation after another? I sweat when I think about what it will take to repair the tooth, but I can’t worry about the pain. I want to save it. – Thank you. Clarke

Clarke,

You have two challenges in finding a dentist who will try to save your fractured tooth.

Timing – It is essential to get treatment within a day or two. Although you didn’t mention when your tooth split, more than two days may have passed if you have seen three dentists.

Technique – Few dentists try to save a fractured tooth. But some have found success with this method:

  • Fit the tooth pieces perfectly back together
  • Hold the pieces with a dental crown
  • Follow-up on the tooth for the life of the patient

Documentation on this technique is limited, and there is insufficient research to declare it an acceptable method.

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Ask your dentist about sedation options

If a dentist is willing to save your tooth, perhaps an endodontist (root canal specialist) might be willing to do it. Visit the American Association of Endodontists website for information about traumatic tooth injuries, the risks associated with them, and where an endodontist can save a tooth or need to extract it. Regardless of which treatment you receive, an endodontist will numb the tooth. If you are anxious, you can request sedation.

But you must get an appointment right away. Look for a board-certified endodontist and schedule an appointment for an exam. You do not have any more time to schedule a consultation. The longer you wait, the higher the risk of requiring tooth extraction and a dental implant.

Plano, TX female dentist Dr. Miranda Lacy sponsors this post.

Teeth whitening

Is an extraction instead of a root canal necessary?

I scheduled an appointment for a dental exam and teeth whitening consultation. The exam included an x-ray, and the dentist said he isn’t comfortable doing teeth whitening yet because one of my top left molars that already has a crown on it no longer has a canal. The tooth has been uncomfortable for a few months, but I didn’t think it was that serious. My dentist prescribed antibiotics and said that since the tooth doesn’t have a canal, he can’t do root canal treatment. If the tooth doesn’t improve from antibiotics, he recommends extraction. I’ve read many times that it is always better to keep your natural teeth. My dentist didn’t give me any options. Are there alternatives to an extraction? – Thank you. Latha

Latha,

Although Dr. Lacy would need to examine your tooth and x-rays for an accurate diagnosis, we are not comfortable with your dentist’s evaluation.

Antibiotics for tooth discomfort

Your tooth cannot be treated with antibiotics alone. A dentist might use antibiotics as a diagnostic tool.

  • Tooth pain that improves with antibiotics – If tooth pain goes away with antibiotic treatment, you have a tooth infection. Treatment options can include root canal treatment or extraction. But if your dentist does not treat the tooth and remove the infection, after you stop taking the medication, the symptoms will return.
  • Tooth pain that does not improve with antibiotics – When antibiotics do not resolve tooth pain, it is an indication that a tooth infection is not the source. Your dentist would need to find the cause before recommending treatment.

A tooth without a canal?

If a dentist tells you that your tooth does not have a canal, two possible factors include:

  • Upper molar teeth have a lot of bone around them, making it difficult to see the root canal, so your dentist’s assessment might not be correct.
  • Tooth irritation causes a buildup of dentin (layer beneath tooth enamel) inside the tooth pulp and canals. The buildup narrows the canals and can make them more challenging to see on an x-ray.

Saving your natural tooth

If you want to save your tooth, we recommend getting a second opinion. Look for an endodontist (root canal specialist) or ask your dentist for a referral to an endodontist. Be aware that your dentist might refer you to a friend who will agree with your dentist’s assessment. You may want an independent opinion.

Photo of upper and lower teeth whitening trays in a blue case; for information on free teeth whitening from the office Plano dentist Dr. Miranda Lacy.
Only begin teeth whitening treatment if your teeth are healthy

After an examination and x-ray, an endodontist will explain if it’s possible to save your tooth and the results you can expect with root canal treatment. It is wise to postpone your plans for teeth whitening until your tooth is healthy. Otherwise, it may become further irritated.

Miranda Lacy, DDS, a Plano, TX, female dentist sponsors this post.