New Patients Call: 866-869-2595
Existing Patients Call: 717-757-3214
Beautiful Smiles and
Comprehensive
General Dentistry

Archives for July 2011

Do I need to have this tooth pulled by an oral surgeon?

Posted on

I broke a tooth almost four years ago. It had a filling in it, which fell out, and shortly after that it broke. After a year or so, the pain got to be more than I could bear, so I went and had a root canal treatment. I’m pretty sure it didn’t really take care of the problem, but I hate going to the dentist so much that I couldn’t make myself go to the follow-up appointments, and eventually he stopped calling.

The temporary filling fell out a while ago, and now the tooth is infected. I saw a dentist (not the same one who did the root canal) and he said that the tooth needs to be pulled. He also said that he thinks I should talk to an oral surgeon to have this done, and that he isn’t really comfortable with performing this extraction.

Does this sound right? Or should I just ask my dentist to take care of it? He didn’t say he wouldn’t, just that he thought I should consider an oral surgeon.

Lisa in Seattle

Dear Lisa,

The most important rule to keep in mind with dentists is that you should never push a dentist out of his or her comfort zone. If you don’t want to find the services of an oral surgeon, you’ll want to look for a dentist who is comfortable with the procedure.

You may also want to consider locating a dentist who does dental implants. That would be the optimal method for replacing your lost tooth, though a talented dentist can do a great job with a dental bridge for a single missing tooth.

Dr. Currie is a York PA cosmetic dentist, and his office sponsors this blog.

Grooves in my teeth along the gumline

Posted on

I have really noticeable grooves in my teeth, right next to where they meets my gums, on both my upper and lower teeth. My dentist said this is from brushing too aggressively. The grooves look really bad, and I want to do something both to make my teeth look better, but also to protect them from eroding any further. To that end, I have some questions about porcelain veneers.

I’ve read about Lumineers, but a lot of people mention them being bulky, so I am not sure that is a very good choice for me. If get porcelain veneers, would the teeth underneath them be more vulnerable to decay? Would the porcelain veneers erode just like my natural teeth did if I can’t figure out how to ease up on my brushing? I use a soft brush and try to be as gentle as I can, but the grooves just seem to get worse. Will porcelain veneers stain quickly? My natural teeth are quite discolored, from years of drinking coffee and smoking. I’ve quit the smoking, but coffee is here to stay, and I just want to know what to expect in terms of staining.

That’s it for now, I guess. I appreciate your input.

Ron from Salem, MA

Dear Ron,

The first order of business is to address what is probably causing that notch or groove in your teeth along the gumline. For many years, dentists thought that it was from brushing too vigorously. Aggressive brushing can wear away your teeth, but the pattern of wear you describe is very likely from biting stress, which is also called bruxism. When you clench or grind your teeth, it causes them to flex right where the teeth meet the gums, creating a weakness in that spot, which results in the notches or grooves that you describe. If you have a grinding issue, which may or may not also result in TMJ problems, that will need to be addressed before considering whether or not to go with porcelain veneers.

When the time does come to look at porcelain veneers, make sure you chose the dentist you want to work with very carefully, and let them make recommendations about what type of veneers would suit you best. Lumineers have been criticized for being bulky, but an experienced dentist should make that decision. You want to find an experienced, talented cosmetic dentist.

To address your other questions, no, porcelain veneers will not stain quickly. Given proper care, they will remain white and bright longer than natural teeth will. They will not erode in the same way as your natural teeth, either, but if you have a clenching or grinding issue that caused the notches in your natural teeth, it will weaken the porcelain veneers, possibly causing them to snap off after time has passed.

Posted courtesy of York PA cosmetic dentist Dr. Currie.