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Hello,
More likely than not, it would be possible to give you a more permanent solution with dental implants. The main considerations would be whether or not you have sufficient bone to support the implants and&nbsp;if the &nbsp;implant can be placed to avoid the metal plate. If your jaw does not have enough bone, you can have a&nbsp;bone&nbsp;graft procedure&nbsp;done to increase the volume and density of support available. In order to properly diagnose and treat, however, some 3D&nbsp;imaging, such as a CT scan, would be beneficial. This would help in avoiding the plate during placement of the implant.&nbsp;

I have a metal plate in my bottom jaw. Would I be a candidate for implants?

I'm sorry to hear about your situation! I would recommend seeing your dentist as soon as possible. If it was just the crown/ that fell off, the fix may be as simple as re-cementing it. However, if it truly was the abutment that broke off, there may have been a defect in it. Hopefully the dentist/lab honors their work and replaces it for you. If the implant body is still integrated into your bone and remains stable, there should be no need to replace the implant itself- just the abutment. The process of replacing the abutment (and crown) should take no longer than 2 weeks, but it could likely be rush delivered (by the lab) in a week's time.  In the meantime, save the piece(s) that fell off and bring them with you when you see your dentist. Best of luck!

What am I gonna have to do to get it fixed? Am I gonna need a new implant altogether? How long is that gonna take?

My dental implant fell off the abutment today and actually broke off a chunk of it. I haven't even had it a year!

I cab see what you mean with your temporary crowns- they are most definitely not even. However, hopefully they do not reflect the size and shape of your permanent crowns. Although it may be frustrating to have temporary crowns that don't match your natural teeth, they will be coming off soon and hopefully be replaced with an aesthetic result. As far as the PFM crowns go, I, personally, don't recommend them for the anterior. Zirconia (a ceramic material) is quite strong, even used for heavy bruxers/grinders. It is metal-free, so it won't produce a dark halo near the gumline. The only downside is that sometimes these can look a bit opaque compared to natural teeth... but in the end I still think it looks more natural than PFM. Although the most aesthetic option is Emax, sometimes a practitioner may choose against it if a stronger material is needed. If you are not happy with the look of the crowns, do not go ahead with the cementation. These are your front teeth- it doesn't matter if your doctor says they're "good enough"... if it really doesn't look or feel right, say something. Your color may be difficult to match, but if that is the case, you can go to the lab for a custom color match. Only go through with it when you are happy with the look and feel. I hope you end up with a nice result!

I'm getting two porcelain fused to metal crowns on teeth #8and#9 the dentist said I have to get pfm crowns because I have a deep bite today I went to get my permanent crowns fitted they were too dark The doctor put the teeth in my mouth they didn't fit properly I seen a space between my teeth and my gum line but she said that it was normal and the teeth looked bulky and uneven the doctor said my teeth color is hard to match because they are two toned my temporary teeth look dark yellow and uneven

Do you have to get porcelain fused to metal crowns because of a deep bite, are your crowns supposed to look bulky? (photo)

Hi Amanda, I agree with Dr. Mahooti's recommendation of using sensodyne. I, myself, have very sensitive teeth- the sensodyne helps quite a bit. Use it as your everyday toothpaste (2x a day) when you're bleaching, and don't rinse out your mouth- just spit the toothpaste out. This will increase its effectiveness, as the potassium nitrate in the toothpaste will have more time to penetrate into the teeth. For immediate help, you can also take ibuprofen (advil/motrin) if you have no allergies or contraindications. Additionally, for the future, make sure you note the duration of time the strip should be left in the mouth (some are only recommended for 15 minutes, whereas others are recommended for up to 6-8 hours depending on the bleaching agent used)... If you know you have severe sensitivity when using whitening products, only use them for half of the recommended time and see if that helps. Over-the-counter white strips can be quite harsh, as they usually do not have any desensitizing agents in them. If you are looking for great results with minimal sensitivity, I would suggest asking your dentist about in-office whitening options, as they more often than not have desensitizing agents in them and give much better results in much less time. Lastly, if you are doing at-home whitening, make sure you don't get any of the bleaching solution on your gums, as this can cause bleach burns, gum sensitivity, and gum discoloration.

I put the strip at 9:30pm took them off at 10:30pm started hurting me slowly and now they hurt bad I used this morning Colgate total advanced whitening

I used the 3D whiten strip last night and left it on for an hour. They hurt bad. What should I do?

I am sorry to hear you're having some pain. Although the nerve has been removed from the tooth, and you should no longer be feeling sensitivity or pain directly associated with the tooth/nerve, it is not uncommon to have the kind of pain you're describing. After a root canal procedure, it is best to take the tooth out of occlusion, meaning that it should be ground down by your dentist so that you're not biting on it. The reason for this is that the root canal therapy often causes swelling or inflammation of the tissues and ligament surrounding the tooth due to the manipulation of the tissues during the procedure. When you chew or clench or bite, any forces applied on the affected tooth will only aggravate the area. I would suggest going back to your dentist and having him/her check to see if you're applying too much pressure on the tooth when you bite. Another possibility is that you may have something lodged in the gum space. Either way, I would have your dentist check it out. The crown should be fine to put on the tooth if it is properly adjusted so that you're not biting with too much force on it. Good luck!

I had a root canal done about 3 and a half weeks ago. I have not had my crown put on yet. My tooth recently started hurting when biting on it and the gum is tender when touched. I am having my crown done in 2 weeks. Once I have the crown put on will the pain go away?

Is it possible to hurt the tooth after having a root canal done?

Hello Zappalal, I am sorry to hear about your situation. It sounds like you may have an infection in the area of the implant that may be reaching the inferior alveolar nerve. This nerve runs down your jaw, essentially starting just in front of the ear and travelling down the jaw line to the lower lip. It is important to take care of this issue before the potential infection causes irreversible nerve damage. Without seeing the xray, it is difficult to give an opinion on definitive treatment options, but from the sound if it, you may have to have the implant removed. Have you been put on antibiotics? If you do, in fact, have an infection, that may be a smart choice.  I would suggest getting a second opinion from an experienced dentist or specialist as soon as possible.

The implant abutment placement was very painful both during the measuring appointment and the actual abutment placement appointment. Took lots of numbing and knuckle clenching to get through it. Two years later I am getting sensitivity when biting down on the implanted crown with tingling in the jaw bone below the tooth. Today Xray shows darkened area below tooth. CT review is next week. Will I need to have another surgery? Will I have to pay all over again? What is the status quo?

Abutment placement was painful; two years later I am getting sensitivity when biting down on crown. Any suggestions?

Hi, I would say it depends on the kind of whitening system you are using and what your habits are. If you are looking to whiten dramatically, or if you have sensitive teeth, I would suggest consulting your dentist and looking into an in-office whitening option. Often times, these options (like Zoom, or Kor), have desensitizing agents that will help with some of the post-bleaching sensitivity you may experience, whereas over-the counter whitening strips are not as effective and are known to cause more severe sensitivity. Regarding if it is better to do it in the morning or at night- if you are in the habit of drinking coffee or tea in the morning, whitening right before that can actually make your teeth darker instead of whiter. This is because your enamel rods open up during the bleaching process and your teeth are much more susceptible to staining if you drink or eat darkly colored items. Same goes for if you like drinking wine at night. I would actually suggest staying away from any food or drinks that are harshly colored (dark chocolate, coffee, tea, sodas, wine, etc) while you whiten. This will ensure the best results, as you won't have any forces working against the bleaching. Outside of taking this into consideration, it is important to note the recommended duration for the whitening, as each system differs. Some systems recommend times as short as 15 minutes, while others (such as carbamide peroxide-using systems), recommend keeping the trays/strips in for as long as 6-8 hours. This may also be a deciding factor, as you may want to wear the longer-wear system to bed, depending on your sleep schedule.

I was curious if there's a certain time that's better to whiten teeth like in the morning or at night?

Is there a good and bad time for at home whitening systems?

From these pictures, it looks like you have a couple of factors coming into play that contribute to the appearance of your teeth and smile. The canines ("fangs") are flared outward and slightly rotated, creating a large triangular black triangle, or embrasure space, between those teeth and your lateral incisors, which are also on the smaller side. The smaller trapezoidal shape of your lateral incisors only makes this embrasure space appear larger. I think Invisalign would likely be a good first step in correcting the positioning of the canines and straightening out the levels of your teeth. After your course of Invisalign, if you still deem that your canines look too sharp, some light reshaping may help. Beyond that, some gingival recontouring will help to even out your smile line. As of now, the gums/ gingival margins on your central incisors are pretty much even with those of your lateral incisors, and several mm shorter than the canine gingival margins. Ideally, the central incisors and the canines have about even gum levels, and the lateral incisors margin is about 1mm below that. These treatment options are fairly conservative will do a lot for your smile. The other suggestion I could make is taking veneers into consideration for your laterals. After the gingival recontouring, a fuller lateral incisor will also help close the embrasure space between it and the canine, therefore helping soften the currently sharp look. Hope that helps!

Would I be a good candidate for teeth reshaping and dental bonding? Overall, I am fine with all of my teeth except the obvious vampire fangs I have.. I do have a significant overbite, but since my bottom teeth get little exposure due to my bite, my major concerns are my fangs. I am not sure if they are considered a major cosmetic repair. Are they workable without braces or veneers, would they be pretty much straight across or stick out but squared off?

I have vampire fangs. In your experience could I be a candidate for teeth reshaping and dental bonding? (Photo)

Hi arky0012, With trauma that severe, root canal therapy is often recommended because the nerves of the teeth affected are often also compromised. There is, of course, a possibility you may not need root canal therapy (it is difficult to say whether or not you need it without seeing your case in person), in which case, the most conservative treatment option would be placing large fillings to correct the fractures on the remaining teeth and replacing the missing tooth with an implant. However, I would be inclined to recommend crowns as opposed to fillings for the other two teeth, as they will last you longer and look more natural next to the implant crown. And I would definitely recommend the crowns is it is deemed necessary for you to have the root canals done- this will reinforce the structure and support for your front teeth. I would agree with the recommendation of the individual root canals with post core and crowns, and the replacement of your missing tooth with an implant. This option will provide your teeth with the most support and give you the most longevity. A bridge can also replace the missing tooth, but having individual crowns will allow for better upkeep/ easier home care, and will give you a more natural look- especially important since these are your front teeth. Although it may seem like a lot of work, the proposed treatment option will be best for you in the long run. Good luck!

I was in an accident and fell on my face. One of my central incisor was knocked out, while my other central and lateral incisor were chipped. I went to two dentists. One recommended 1) RCT for the remaining central and lateral incisors 2) Post 3) Implant and crown for all 3 Another dentist said that RCT were not needed and I could either do an implant or a bridge. Are there any alternatives that is more conservative? I would really not like to get a crown or RCT. Thanks for the help.

Are root canal treatment and dental crowns really needed? (photos)

There could be a few reasons your dentist may not suggest an implant. The first being opposing occlusion; if you don't have a second molar in your lower jaw opposing where your upper second molar used to be, then placing an implant would serve you no real function, as you would not be chewing against anything. The other reason is that maybe you have very little bone to support the implant, as its possible the floor of your sinus may be very low. If that is the case, however, you could have a grafting procedure done to lift the floor of the sinus and create space for implant placement. If you have an opposing tooth to bite on, I would be inclined to suggest replacement with an implant so that you could regain your function. In any case, I would seek another opinion from a different office/practitioner. Hope that helps!

About a year ago, I had my upper 2nd molar extracted. Before the procedure, I asked my dentist about getting an implant. He seemed to dismiss it as it was not necessary. I later talked to the Endodontist who worked at the same practice. He too told me that the missing tooth did not affect my smile and that I would need a bone graft. When the procedures were done, I would be paying around $4000. I can afford the procedures without too much hassle. I seem eligible, but my dentist says I shouldn't.

Is getting an implant on my upper 2nd molar possible and/or worth it?

Paola Annoni Patel, DDS

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