I had a second opinion today with an endodontist about two lower front teeth that had root canals over 20 years ago. They have become infected again and I don't know what to do. My lower front teeth have always been weak due an injury when I was a toddler. I fell on top of a TV set and lost my lower teeth and went through a series of penicillin shots daily for one month. I am now 51 and don't want to keep treating these two teeth that are so weak. I have a lot of bone loss and from reading other posts it seems like the infection will never completely go away. The endodontist thinks she can re-treat the root canals but was hesitant because of my bite. She feels that braces will help that and put less stress on the teeth ( she thinks I grind my teeth). If my teeth are already weak, won't braces put more stress on them? I had braces when I was a teenager and don't want to go there again. The endodontist also thought that crowns would be needed if I decide to have the root canals re-treated. Implants were also suggested as another option but again I question whether my bone loss and overall weakness will support implants. At what point should I consider a partial for my lower front teeth??? Please help with any suggestions/ info. before I go back to my general dentist for a 3rd consultation and another $150.00 on top of the $300.00 I spent already. Thanks.

Hi Tensailswin,

I am in dentistry (35 yrs) and can offer you some help.

First of all your intuition is speaking volumes here! So please listen to it
You are correct these teeth are infected but what you may not have been told is that they have been infected for 20 years! Irrelevant of whether you've had symptoms of infection or not throughout the years, the teeth themselves carry infectious bacteria inside the microscopic canals which can never be removed via a root canal or an apicoectomy. The bacteria also proliferates from the teeth into the bone. Thus the bone loss. There are also systemic risks to long term oral infections which you may or may not be aware of or experiencing.

In all honesty, the endodontist is just taking your money if he convinces you to re treat these teeth because irrelevant of what he does to them, the status of the infection will not improve. Any procedure that is done to these teeth or to the bone around these teeth in an effort to "retain" them will cause considerable inflammation and irreversible trauma to the jaw bone.

I too would question replacing these teeth with dental implants simply because of the longevity of the infection. The bone may be too compromised to hold implants. To undergo orthodontia (and you've been there and done that) to attempt to retain two infected teeth that will sooner than later need to be removed due to infection ..... makes no sense what so ever. Why go through all of that?

I think you know you have managed to retain these teeth far longer than perhaps you should have. It is inevitable that these teeth will be removed. So you are wise to think about doing that and replacing them with a partial denture. If you are missing any other teeth in your lower arch, they too could be replaced with the same partial denture. The other possible option for replacement may be a 4 unit permanent bridge. This would mean that the adjacent teeth, the laterals, would need to be cut down and crowned as they would be the anchor teeth to the 4 unit bridge.
Perhaps you could discuss both options with your general dentist and way the pros and cons of both.

I hope this information has been helpful to you. Please keep us posted!

Bryanna

Bryanna,

Thank you so much for your advice and information. I also wondered about a bridge. The two lower teeth that need to go are the middle/front ones. The ones adjacent to them seem to be ok. You have helped me to narrow down my best options to a bridge or as a last resort, a partial denture for the lower front teeth. I never imagined even considering dentures at 51, but I am thinking long-term. I don't want to sit in the dental chair over and over for these two teeth for the rest of my life. And, I DON'T want to go through braces again!

Thanks again for your help!

Tensailswin,

Just a side note..... at the "young" age of 51 it is truly wise to always take in to consideration your overall health anytime you are dealing with a situation in which you have the choice of staying "status quo for who knows how long" or "being pro active to avoid an inevitable problem".
Looking down the road.... loosing a couple of teeth to infection is sure better than loosing several teeth to that same infection.

Removing teeth is never an easy decision.... just one that concerns your overall well being.

You are welcome for the information .... come back any time!

Bryanna




QUOTE=Tensailswim;1001488]Bryanna,

Thank you so much for your advice and information. I also wondered about a bridge. The two lower teeth that need to go are the middle/front ones. The ones adjacent to them seem to be ok. You have helped me to narrow down my best options to a bridge or as a last resort, a partial denture for the lower front teeth. I never imagined even considering dentures at 51, but I am thinking long-term. I don't want to sit in the dental chair over and over for these two teeth for the rest of my life. And, I DON'T want to go through braces again!

Thanks again for your help![/QUOTE]

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Having had a partial permanent bridge with my three upper front teeth since my 20's; was not much of a choice. I was ten years old when my tooth came in decayed; eventually drilled off and root canal, screw into root and a tooth added. As I say; at the tender age of ten. By my early 20's the root and all needed to be removed thereby causing a permanent three teeth bridge (the two on either side holding a tooth in the missing space.

Unfortuantely, during the years all my teeth eventually becamed crowned. As of last week, the dentist had to remove one of the crowns because of decay under it. The decay goes to the pulp as well. My dentist put in a temporary but will have to make a decision in the next few weeks. The dentist gave me a few options; but didn't think it a good idea to replace the crown because bone loss and also would need a root canal. This tooth is two teeth from upper left canine tooth. One of the suggestions is removing the tooth and replacing with a three teeth permanent bridge, which would mean repalcing new crowns on either side of missing (removed) tooth.

Tensail , having a permanent lower front bottom bridge would not really be of much discomfort; of course, once the work is finished.


Gerry

Hi Gerry,

Thanks for sharing your experience. Hope all goes well for you also in your next treatment.

Hi Bryanna,

It's me again! I have my third consultation with my general dentist next week.
After reading other posts about bridges, I am thinking that this might be my best option. However, I don't know how many teeth can be "bridged". Since I have the two front lowers that I want taken out, can the teeth on either side support the bridge? I've heard of a bridge for three teeth, but not four. And, can a bridge be done if there is already bone loss???

I appreciate any information you can provide so I can go into this appointment with the knowledge I need to make the best decision. I am grateful that I have a great dentist who has offered a third consultation free of charge.

Thanks!
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Hi Tensailswim,

Permanent bridges can include several teeth if necessary. The number of teeth that would be needed to support the two lower ones depends on the amount of bone loss and the condition of the adjacent laterals (the teeth next to the two front ones). Sometimes a 4 unit bridge is adequate and sometimes the bridge has to be extended to the canines which would make it a 6 unit bridge.

Another option may be to just have a removable partial denture to replace the two lower teeth and any other lower teeth that may be missing. With this option you would not have to have any other teeth cut down to hold a bridge. But this appliance can be a bit tricky to wear while eating. Some people do real well with these, others not so much.

Bryanna





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