Dear Bradley,

It is common for most patients going through orthodontic treatment to incur some root resorption during the treatment process. The root resorption most likely will stop now that your braces are off, no further treatment should be necessary, and the possibility of you losing the tooth in the future is highly unlikely. Now if your resorption is severe and you have bone loss around the tooth then the probability of losing the tooth in greatly increased. Only if your tooth is infected will you need to have a root canal. Our advice to you is to see an endodontist for an evaluation of the tooth. Endodontist specialize in root canal treatments. If they say the tooth is not infected then you will not need any treatment even if root resorption is present. We advise you to have your tooth x-rayed at least once a year during your dental check-ups to make sure your tooth is not losing any bone and that the resorption is stabilized.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

Thanks, Rebecca

Dear Rebecca,

Hearing that you have had teeth extracted with no signs of infection and are having another toothache may be an indicator that something else is going on. There is a condition known as Trigeminal Neuralgia (TN), which is a constant pain that affects the trigeminal nerve. This nerve carries sensation from your face to your brain. The pain is like an electric shock that can last a few seconds up to several minutes. These episodes can last days, weeks, and even months and then can subside for months or even years. Pain can be triggered just from brushing your teeth, putting on makeup, eating, and even talking. Nobody knows the exact cause of TN but it’s assumed that a blood vessel is pressing on the trigeminal nerve as it leaves the brainstem which causes a deterioration of the nerve sending abnormal signals to the brain. Many people with TN develop toothaches with no signs of infection and have teeth extracted over the years before they are even diagnosed with this condition. The only way to determine if you actually have TN is to have a neurological examination completed by a physician. If you are diagnosed with this condition medicine is the most common treatment to subside the pain, however in severe cases surgery is needed.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

Thanks, Terrance

Dear Terrance,

It is highly possible that you dislocated or even fractured your jaw. A fractured or dislocated jaw can cause difficulty when eating or talking, pain, bleeding, and even airway blockage. Some symptoms of a dislocation are difficulty speaking, teeth feel out of alignment, difficulty closing the mouth, lower jaw may protrude forward, and pain in the face or jaw and gets worse with movement. Signs that your jaw may be fractured are difficulty opening your mouth widely, facial swelling and or bruising, hurts to bite or chew, numbness of the face especially the lower lip, and an abnormal appearance of the cheek or jaw where you hurt yourself. We recommend you seek medical attention immediately to prevent the possibility of breathing problems or bleeding. A physician or oral surgeon can restore your jaw by using his hands to press your jaw back into place, however do not attempt to do this yourself. If your jaw is fractured the only way to repair it is to have your jaw wired shut and if the fracture is unstable surgery will be required.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

Thanks, Tim

Dear Tim,

It sounds like your wisdom teeth may be the reasoning for your front tooth to shift. Most people nowadays get their wisdom teeth removed from the ages of 16 into their early 20’s. Over the years dentist have come to realize that wisdom teeth left in can cause gum disease issues with the back molars due to the fact that they are hard to keep clean. Another reason to extract wisdom teeth is that most people don’t have enough room in their mouth for them which can cause the teeth to shift. We recommend you visit your dentist for an evaluation to see if your wisdom teeth are the reason for your shifting tooth. If that’s the case it may be wise to have them extracted to prevent further shifting. After your wisdom teeth are removed you have the option to get clear braces like Invisalign to straighten out your bottom tooth and make you feel comfortable again.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

Thanks, Ashley

Dear Ashley,

We are glad to know that you have been doing some of your own research on TMJ Dysfunction. The cause of temporomandibular dysfunction is unclear and can be difficult to treat at times however some things that can contribute to this disorder are grinding and clenching of the teeth, stress, a bad bite, and arthritis. Wearing a splint can relieve a lot of symptoms like a popping and clicking jaw, headaches and earaches, as well as in the prevention of grinding and clenching of ones teeth. This disorder can last for a short time and go away on its own or last for years. At times orthodontics is recommended especially if your bite if off. Having braces may eliminate your TMJ dysfunction but not a guarantee. If patients experience severe symptoms and a split is not working for them surgery is recommended however this is very rare. Making some lifestyle changes is not a bad idea and may help relieve some pain therefore reducing stress, eating soft foods, exercise, and not chewing gum to name a few. Placing ice or heat packs on the side of your face may also help in relieving some discomfort.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

Thanks, Tony

Dear Tony,

There are instances when a dental implant is connected to a dental bridge, however this is not necessary in your case. You have one  missing tooth so your dental options would be either a dental implant or a dental bridge, but not both. However if your space is too small for an implant or a bridge you might be a good candidate for Invisalign, depending on the space location. Invisalign is clear braces and if your teeth are not quite perfect this might be your best option to close the space and have straight teeth. Without insurance a dental bridge can cost up to several thousand dollars and usually takes two appointments completed over a three week period of time. A dental implant from start to finish cost anywhere from $4000 on up and takes approximately six months from the initial placement of the implant to having the crown put on the implant. Invisiline treatment is anywhere from 18 to 24 months and can cost roughly $5000. We recommend you consult a dentist about what treatment options would be best for you, your budget, and your time.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

Thanks, Gary

Dear Gary,

Yes, it is necessary to floss under a dental bridge daily, even more so if you were previously treated for gum disease. Flossing daily will help in the prevention of further bone loss around the teeth. There could be two reasons why your gums are swollen and bleeding around your bridge. Due to the fact that you have not been flossing under it, there is a big possibility that your teeth anchoring your bridge are reinfected with gum disease and may need to be retreated. Another problem could be that your dental bridge was placed right after the teeth were extracted therefore the extraction site may have not had the proper time to heal which can cause a similar affect on the tissue under the bridge.

There are different types of bridge floss threaders available in the toothpaste isle at your local store to help you clean under your bridge. Ask your dental hygienist at your next cleaning appointment to show you how to floss properly around your bridge. We recommend you discuss this matter with your dentist to find the root of the problem with your bleeding gums.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

Thanks Derek

Dear Derek,

It sounds like your grinding your teeth at night while you’re sleeping. It is common for this to happen especially if you have some stress or anxiety, an improper alignment of the teeth, or even some missing teeth. Grinding over time can chip and break your teeth, cause them to become worn down, and even cause bone loss around your teeth. If you notice that you are continually doing this in your sleep we recommend you let your dentist know about your grinding and have them do an exam to see if there are signs of grinding. If so, a custom made mouth appliance will probably be recommended for you to wear at night while you are sleeping to prevent you from causing damage to your teeth and help in the prevention of future grinding. Try to avoid caffeine and alcohol and relax your jaw muscles at night by putting a warm washcloth on your jaw by your earlobe.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

Thanks, Jim

Dear Jim,

There are different types of temporary cement used in dentistry however most temporary cements can last several weeks. Due to the fact that these crowns are on your front teeth your dentist may have used a type of cement that has more retention to hold your temporary crowns in place better, however call your dental office and ask them.

We recommend that you take some precautions to help prevent you from having a problem with your temporary crowns. Keep away from hard foods like carrots or apples because these types of foods could cause your temporaries to break or shift and try to avoid sticky foods like gum which could pull the crowns off. When you floss around your temporary crowns do not lift the floss out like you normally would. Instead slide the floss out otherwise you could pull the crowns off.

If one of your temporaries comes off, all is not loss. There are several types of temporary cements found in local stores in either the toothpaste isle or pharmacy area that you could purchase if needed. It’s important that you clean out your temporary crown so no old cement is in there. Afterwards try it in and make sure it fits well and that you can seat it all the way. Before you add cement to your temporary it’s very important to dry your crown as well as your tooth otherwise the cement with not adhere. Follow the instructions thoroughly on the printed package and you should not have a problem. If you have difficulty with this you always have the option to see a dentist on your vacation and they can recement it for you.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist

Thanks, Steve

Dear Steve,

It’s great that you were able to quit such an addicting habit that affects the entire mouth as well as your general health. Studies have shown that 10% to 30% of regular chew tobacco users have gum recession and develop some bone loss around the teeth. Besides gum recession other risk factors for tobacco use are sores in the mouth, oral cancer, tooth decay and sensitivity.

Unfortunately our gums do not grow back. Gum recession is usually permanent and difficult to repair. Stopping your tobacco use will prevent further gum recession; however you also have to make sure you have good dental hygiene by brushing and flossing daily as well as visiting your dentist every six months for your dental cleanings.

We advise you to address your gum recession concerns with your dentist who may recommend surgery of a more cosmetic or restorative nature to make your smile look more aesthetically pleasing.

Post courtesy of Dr. Malone, Lafayette Louisiana Cosmetic Dentist