Broken Teeth to the Gum Line?

Question

I have quite a few teeth broken down to the gum line and I know they have to come out. I know that they all have to be extracted. After extraction what do I need to do?

Dan Hagi, DDS · Answer

Then teeth break at the gum-line its either because there was little tooth structure to begin with after multiple restorations or very bad decay.There are a number of options, really depends on whether the roots and bone is strong enough to maintain the teeth.  If so then root canal treatment, post and core insertion as well as crown lengthening procedures may be necessary to try to rebuild the teeth.  The final outcome is not ideal in these cases.The other option if the teeth are not worth saving is to extract and replace with implant retained crowns and bridges.  This involves extractions, bone grafting and implant placement as well as crowns and bridges on the implants.  You need to evaluate all these options with a qulified doctor that is invovled with both the restoration of teeth and the surgical and restorative aspects of dental implants.Best of luck.

Herbert Veisman, DDS · Answer

Teeth broken to the gum line can, sometimes, be saved by pushing the gums lower to make room for a new crown. You would have to see a periodontist for a procedure called a "crown lengthening" and then wait about 8 weeks for the crown to be placed by your dentist. If, however, the teeth are hopeless and cannot be treated, then these broken down teeth can be extracted an immediately replaced with implants at the same time. This may not ALWAYS be possible because there are anatomical and physiological reasons which may preclude this from happening. However, a qualified surgeon ('Board Certified Periodontist or Oral surgeon) should be able to discuss the best options with you in this regards.

Eric Linden, DMD, MSD · Answer

As a Periodontist, we evaluate all teeth to see if they are worth saving.  We evaluate the  following:

	1- Crown/Root ratio 

	2- health of the patient

	3- amount of bone support and the extent of the surgery..worth the effort?

	4- overall treatment plan and prognosis

	5- restorative treatment plan

	6- finances and patient feedback

	7- implant options

	In summary:  You should have a full set of quality digital x rays and  have a comprehensive treatment plan with a highly trained Laser Periodontist to go over all your options including the latest laser techniques in extractions, implants and bone regeneration.

Joseph W. Worthington, DDS · Answer

The best way to restore these teeth will be with dental implants. The important thing will be to graft the extraction sockets at the time of extraction in order to preserve as much of the bone as possible.

H. Ryan Kazemi, DMD · Answer

Dental implants are the ideal option for teeth replacement. They may be placed immediately at time of extraction if appropriate (determined by surgeon) or placed in delayed fashion once the sites heal (typically 2-3 months). A transitional prosthesis can be made by the restorative dentist while the sites or implants are healing. In some circumstances, implants may be immediately restored so a patient can have a fixed set of teeth on same day. This is only done, again, if appropriate as determined by the surgeon and the restorative dentist team.

Kevin Coughlin, DMD · Answer

You can immediately insert a partial denture or full denture if your appearance will be compromised. You could consider immediately inserting dental implant if bone quality and quantity is present, or you could place a bone graft in the extraction sites and in 6-8 weeks consider the removable prosthesis, fixed bridge or dental implants good luck

	 

	Kevin Coughlin DMD, MBA, MAGD      CEO Baystate Dental PC

Jean D. Morency, DMD · Answer

It depends on how cosmetically conscious you are. If it doesnt bother you, from a look point of view, you don't have to do anything. You can just go around with no teeth. In reality, we (human beings) do not need our teeth to do anything except to look good. With the advances in cooking and appliance technology, we don't really need our teeth to eat anymore. But if the look of you being toothless bothers you, you should consult a dentist who can give you a wide array of choices before and after the extractions. Depending on your finances and your social status in life, these choices can range from a " one tooth removable bridge" to a full mouth "implant supported dentures, caps and / or bridges". Search for a dentist with advanced traning who can recommend these options.

Nick M. Mobilia, DDS · Answer

If quite a number of teeth have broken down to the gumline and if all of you teeth have to be extracted, we need to first restore your dentition to proper function. After radiographs including a panoramic study are taken, a proper diagnosis and treatment plan can made with you and your dentist. Accurate occlusal or bite records that follow facial proportions need to be taken along with pre-operative photographs. An immediate denture might be a good idea to start with. If you have adequate bone, adequate support structures and if your health history is non-contributory, implants might be the best option. If these conditions are met, implants can be placed at the same time your broken teeth are extracted. This will reduce the overall treatment time of you case. When dental implants are placed, you may have a choice of either a fixed or removable prosthesis. If implants are not an option, a final removable denture can be fabricated once all the hard and soft tissues heal. Good luck and keep us posted.

Lilya Horowitz, DDS · Answer

Prior to even having the extractions, your dentist can make you an immediate denture to wear so you do not have to walk around without teeth after the extractions are completed. Further down the road, you can explore more options such as dentures that are implant supported, or implant crowns to replace the missing teeth. Not everyone is a good candidate for an implant, it depends on the amount of bone present, and factors in your medical history. No matter what, your dentist will be able to provide a restorative option for you so that you will have replacement teeth.

Jay Neuhaus, DDS · Answer

You should discuss your specific options with a good restorative dentist. Your options can range from Full Dentures, partial dentures, implant supported teeth, permanent bridgework & on and on.

Broken Teeth to the Gum Line?

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