This page has been created as a question and answer page for anyone with dental questions. Dagon H.C. Jones, DDS will check this page periodically and answer general questions about dentistry that anyone may have. Other Dentists are encouraged to answer questions as well.

The advice and information given here are strictly for entertainment purposes only. Please understand it is impossible for any health care provider to diagnose or treat any condition via a wiki or any other online source or other media. For the most accurate information please visit your family health care provider whether dental or otherwise. That said, it is an entertaining note that questions are usually answered by dentists within the community. But legally, it's entertainment, got it?

This page is intended for questions about dental procedures, dental science, and dental materials, but not for questions about billing and insurance. Questions about billing and insurance should be addressed to your dentist's office or insurance company.

Questions about fluoride? See Water Fluoridation Information about Xylitol can be found on the Xylitol page.

Other dentists in the community are welcome to respond to questions as well.

Please be sure to read through the archive before asking a question, as your question may have already been asked and answered. There is a ton of information there that is organized pretty well.


2014-01-08 22:54:30   Hi Dr Jones.long history with tooth 15. Good place to start..2 years ago I had to have root canal done on it.still been in pain since then. They said probably because of it being part of a bridge..I would lose bridge and show missing teeth. So I just dealt with the wasn't real bad mist the time. About December 13 the wwhole kept side of face got a burning rash feeling and same time terrible headache usually just on left side but eventually became whole head most the time and the tooth or that jaw aara started to hurt whole lot. So I got it pulled about Dec was cracked in center of roots. Anyway she had to cut all the way up to where cheek meets gums to get out and the stitched it all up.Took pain meds seemed not to bad headache felt some better and the face burning was slowly diminishing. About the 4th day the area seemed to be hurting more and headache back full force. Did a nasal rinse and it felt like about 4 drops of the solution came out the hole. I could be crazy, I am not sure. Went to see a different dentist cause the one who pulled it was out. He said it was possible could be small hole. Gave me climatic in 300 my 4 a day and per pain by couple days before end of antibiotics I was getting better seemed headache was diminished and tooth area bone was better..oh when I went back and got antibiotics I was having what felt like lot of pain in a day or so after then the headache was slowly coming back so went and saw the original dentist she said it looked ok but seemed a bit concerned there was still some swelling going on.gave me a lighter pain med and off I went.saw her 3 days ago for some other work and she looked at it and said nothing..but I told her I was getting better I guess just cause if I said that I would be..haha. today the bone just started hurting pretty bad and I felt where the pain was which I hadn't before and there was and big bump wear she had made the incision up to the cheek area. It's hard.and the headache has come back full force.i always have some crazy problem whenever I have dental work done and the dentist thinks I am crazy but they always find out there was a problem. Like root canals one time I went through 5 months of terrible pain finally went and seen a 3rd endo with this special camera and he saw the problem there was an extra tiny root or something that most people don't have but I seem to have them on all text I have had root canals on and my old dentist should have known I was with him like 15 years. Amyway. I just don't want to be a problem to my new dentist. But the headaches are so bad. Any suggestions of why this could be happening. I also have bad to on that side just sayin.please help.thanks and sorry for the long explanation but I wanted you to know all the details. Thanks again. —VondaHack

It is possible that there is a sinus communication, which means that either due to the extraction or the infection that was there, a hole is now present between your sinus and your mouth through the tooth socket. If these are small they often heal on their own but may require surgery. Ask your dentist about this. The bump near the incision is probably scar tissue. —DagonJones

2014-01-08 21:43:19 Is it true that an inner molar has to extracted if the Dental drill cannot fit into the area to remove decay? Do hope for a quick reply soon! Thanks! —AaronGan212

depending upon how far you can open your mouth, and how the access is to the area, it may not be possible to put in a filling, the decay will eventually spread to the nerve and cause an infection so extraction would be the only option. —DagonJones

2014-02-05 08:31:58   I need a root canal and I'll be paying cash from my Health Savings Account. Is there any way to find out if the dentist will be charging me the same amount as an insurance company would pay him? —JimStewart

2014-02-10 08:18:12   Call the dental office and ask directly, they should be able to tell you. —DagonJones

Transferring question from Who, What, When, Where, Why, HowJT:

2014-02-10 06:41:50   We noticed at the fluoride varnish toddler program my 2 yr old has a small cavity between his two upper front teeth. The dental assistant there suggested I see a pediatric dentist and have two fillings done. So I went and it took a month to complete there process of apts to lead up to having something actually done. The pediatric dentist suggested crowns. Now my son is only 2 and the rest of his teeth are very well kept and felt that was too excessive. Had a second opinion and she thought the same, to just have fillings. So I went back and told him I felt uncomfortable that I'd prefer the fillings for now. He agreed to do it. But instead of doing that he went against my wishes and simply shaved each tooth from the gumline straight down to the biting surface on each tooth. Now the dentin is exposed. He hadn't filled it. My heart is broke. I feel he did this to simply be spiteful to get my money for the crowns. Which is probably what is needed now since what had happend. I don't know what to do, I've been crying all weekend I feel I am to blame since I was there while it happend. —Katelynn113

2014-02-25 14:40:14   sorry for not writing sooner, have not been to check this page in a while. It sounds like a pretty frustrating situation. I would take your child to the other pediatric office (the one that recommended only fillings) and have the teeth evaluated and get their advice on what to do next. Don't worry too much, those primary front teeth are very common to get decay or trauma. Even if they have to be extracted early it does not cause any long term problems other than being toothless until about age 7. —DagonJones

2014-03-12 07:31:20   I am allergic to glycerin and need to find dental floss and toothpaste that doesn't contain glycerin. please help me!!! —maryleclair

2014-03-12 11:53:28   I am sorry I don't know of any toothpastes that are glycerin free. If you do a detailed internet search you will probably find some. —DagonJones

2014-03-12 15:18:08   Recently, while on vacation, I had a crown placed over the last bottom right molar, (#31 I believe); my regular dentist has told me that it is ill-fitting in that it does not contact the adjacent tooth. My original tooth had good contact. I have noticed that food gets packed in between the two teeth. My dentist advises a re-do on the crown and tells me the food packing between the teeth can/will cause decay and subsequent bone loss. My regular dentist would do the re-work, which would probably require a root canal, or he could (on my behalf) send a letter to the other dentist that created the poor fit. The crown work was done out of state and I will not be in that area again for several months. How bad an issue is the gap? What action would you advise?


an open contact between the adjacent tooth is a significant problem. food will constantly get pushed in there and can create very significant bone loss and/ or decay. This does not always happen but given the location I would recommend having the crown redone. You could probably wait a few months if you need to just be sure to floss regularly after meals. I think you should probably just have your regular dentist do it, going back to the other dentist is often a big hassle and it may not save you money when you factor in travel expenses etc. —DagonJones

Hello Dental Questions page, I have a query for you: Recently my #8 which is a full ceramic replacement set into the bone (that I got when I was 10, thanks Public skate park!) chipped on the bottom right exterior... It's not that massive of a chip, & it isn't deep. How do I proceed? Will I have to get the whole shebang redone, can the tooth be touched up? Can it be capped? Daubert

Yes it can be touched up, it can either be polished or a small ammount of composite bonded to it. The bond between composite (resin filling material) and porcelain is not very strong so these repairs have a tendency to chip off every year or two. It is probably possible to replace the whole crown as well. I am not sure by what you mean "set into the bone" that seems to imply an implant but an implant would not be possible on a 10 year old so it is probably a porcelain crown that is deep below gum line, maybe with a root canal. Either way there are plenty of options to address your issue. —DagonJones

IIRC it was crowned with a root canal (something to do with nerve exposure to air?) if you look at the xray you can see the porcelain tooth & the wire that runs from 1/2 way up the tooth to the bone. I busted the whole big tooth in half horizontally on that fun box... Permanent tooth fought baby tooth & baby tooth won.

This question is about dental enamel that seems to be growing faster on one tooth in particular, while no other teeth are showing such activity. The tooth I'm asking about is the second one from the back of my mouth, on my right, on the tongue-side of the tooth (wisdom teeth all removed at age 23 or so; I'm now 61), and this weird activity is actually annoying, in that it is coming in contact with my tongue (as well as my tongue seeking it on its own, as happens).

I noticed this a couple of years ago, where I realized there was almost a needle-sharp point on one "corner" of that tooth, and it seemed sharper every time I touched it with my tongue. I felt it with my fingertip, and realized it was not how that tooth had been previously. In an emergency measure (admittedly probably not wise) I took a "diamond" metal nail file and smoothed out the tip of the point with a couple of soft strokes, which seemed to take care of the immediate problem. I was surprised several weeks later, that the sharp point had returned! I put up with it until I couldn't stand it any more, and GENTLY filed it a bit more.

Flash forward to recent dental work on that tooth (I deny that there was any breakage on the tooth; nothing changed except for that one strange "stalagmite" seemingly growing faster than surrounding enamel on it). The dentist thought it was due to a broken area she noticed when replacing the filling, but it is worth noting, when I first encountered the situation, it was shortly after she'd worked on it a couple years prior. Here's the interesting part: after she replaced the filling recently, no more than a month ago, I now am encountering that same rapid growth of the same "corner" of that tooth, again into a rather sharp point! I'm tempted to make a mold of the area, every few weeks to prove my point (no pun intended!), because while I love my Dentist, she doesn't seem to have an answer as to WHY this would happen, and frankly, the possibilities rather concern me.

Your thoughts?

I have never heard of such a thing before, it is really hard to say without taking a look at the area. It is most likely not growth of enamel because enamel does not grow on a tooth once the tooth is fully formed. It might be growth of calculus (tartar) or possibly the cusp tip is getting sharper from grinding on the tooth, which can create a sharper point. —DagonJones

2014-03-26 14:36:12   What rights does a patient have wrt excessive dental appts for one procedure. I have been trying to get my bridge replaced (now has been almost two years for the process). This upcoming bridge will be the fifth bridge my dentist will be inserting. This all started because my dentist's assistant temporary cement she mixed with my original temp bridge would not come off to put in my permanent bridge. I have had at least four appts with him hammering my temp bridge top try and break the seal. I think I have had 15 appts in total. The last appt I had to replace the third bridge, the lab didn't put enough material on my bridge so when he was grinding it down to check my bite level, he hit the metal screws or nails they put in to make the bridge. So...he was checking the height and I was grinding on my metal filling and the nail from my bridge...ughh. Today he called he called me and said the lab screwed up yet again, and now the bridge he got made again isn't going to work. The fourth bridge I will have put in. You must know he has already written off $1200 of my $4300 cost of the bridge, and the bridge is paid in full. The last appt I went to last week was four and half hours long, he didn't offer me a break or a bathroom break. I have severe arthritis in my back, three herniated disks, and severe pain. I was processing the freezing every 45 mins so had four needles up the front of my nose jaw was so sore I had a headache for a week after and can not chew on that side as a shooting pain goes up my front top tooth. All in all, when he called today to say I have to get another new bridge made, I almost went into a panic attack. I have a severe fear of dentists as it is, so I would rather deliver a baby then go back. Should I demand all my money back I have paid out of my pocket for this minus what my dental plan has covered of course. I realize the lab screwups aren't not directly his fault, but it is his practice, and he is ultimately accountable. Please Please someone who has some idea of my rights please give me some advice. I am beyond upset at this. —PennyEffler

I am sorry Penny but I want to keep the forum about specific dental issues and not legal/ billing questions, so I cant really help you because I am not a lawyer. Your dentist may be an excellent practitioner with a streak of bad luck, your teeth may be a very difficult case, or it is possible that your dentist has made some oversights. There is just no way for me to know so I don't want to speculate. My advice first would be to call the office, voice your concern, and try to come to a resolution you are happy with. —DagonJones

2014-03-27 11:24:47   My 6 year old son has an infection (abcess?) on the upper front gum. It is just smaller than a pencil eraser and it does not hurt. It is directly above a baby tooth that has a filling. It appears to be draining. He was taken to the dentist and the dentist said that it would go away on its own? My question is is that true? I thought abscesses for more serious than that, He said to bring him back if it starts to hurt or doesn't go away. But I'm still concerned, Could an infection like that even if it's smaller than a pencil eraser but like a big pimple affect the adult tooth in the gum? —jessicalyon

It is unlikely to effect the adult tooth, however generally in these situations an extraction of the baby tooth is the best solution. I would recommend getting a second opinion, if the abcess is coming from an infected baby tooth it should be extracted. However sometimes minor irritations in the gums can present like what you are describing so it is possible no treatment is needed. I would have to see an xray to be sure. —DagonJones

2014-03-27 17:37:21   Do misaligned teeth have anything to do with TMJ? In high school, I had braces to correct my malocclusion. My teeth were straightened for a while, but then one day, two years after I got my braces taken off, I lost my retainers and never got them replaced. Now most of my teeth have shifted back to their original position before I got braces. My jaw first started to "lock" 4-5 years ago when I was eating bread. At first I thought it was caused by my wisdom teeth growing in, but even after I got them removed, I would still experience clicking and locking jaws. Because of that, I am no longer able to open my mouth as wide anymore like I used to —MichelleNguyen

Occlusion refers to how the teeth meet together, this can have an effect on TMJ symptoms. However, your TMJ symptoms may not be related to the history of your braces at all (Many TMJ disorders manifest in late adolescence ). Unfortunately TMJ disorders are a complicated issue with many factors, even with some very advanced examinations there are a lot of unknown factors. The clicking noises by themselves are not a significant problem (these sounds are quite common and do not always represent significant pathology). As long as you are not experiencing any chronic pain I would not be too concerned. Even a normal functioning Jaw can lock open at times, given all your symptoms I would say that you likely do not have any significant jaw disorder now but you are at a higher risk for developing chronic pain symptoms. My recommendation would be to get a dentist to make you a hard night guard or "bite plate". This is a device that will help stabilize your jaw at night while you are sleeping, it is likely to help prevent any possible further exacerbation of your jaw symptoms. —DagonJones

2014-03-30 13:11:59   Hello. 4 days ago I went in to get my teeth prepared for a temporary bridge. The dentist decided that my front left tooth, which was to be one of the anchors for the bridge, was not suitable due to decay. He showed me the x-ray and there was some, not a lot, but he said, ultimately, it could become worse, so better to just take it out (it had had a 30 yr old crown on it, still strong) and then shave down the other front tooth to use as anchor. I was mortified to be losing my two front teeth (I am 51 and work with public). This means a 5 tooth bridge at the cost of $4000 (I am also a single parent with a disabled 22 year old)

By the time he got to this point, he had already prepped the other teeth, so it seemed there was no choice but to agree to it. So he shaved my right front tooth down to a stub then he yanked, tugged, pulled and finally got my left front tooth out. I heard his assistant ask "Suture?" and he said "No, No". I had been in the chair for almost 3 hours, I was the last patient and it was closing time. One of the other assistants was coming in and grabbing tools to sanitize off the tray and cleaning office already. He made the temporary and cemented it in. I was still bleeding from the pulled tooth and there was a gap above the temp. bridge and the area of the pulled tooth, so they gave me gauze and told me to hold it there. Gave me a whole bag of gauze and the receptionsist told me if it was still bleeding after all the gauze was used up, to switch to tea bags. For the next 6 hours later...I could stop it for a few minutes, then it was like a dam would bust and bright red blood would gush fill my mouth. I couldn't talk, I had to keep a towel to my mouth and let the blood pour out and blood tinged saliva in between.

After 6 hours of this, my other son came home from work and immediately took me to ER where they had to stitch thru my gums (since the temp bridge was in the way) 3 stitches to compress the area and it finally stopped bleeding. I called the dentist a couple days later (was too angry to speak to him) and left voicemail to let him know I had to go to ER to stop the bleeding. He called back and unfortunately I missed his call but in his voicemail, he apologized and minimized (called it a "little trip to the ER") and then said he had put "a compression splint against the socket". THIS I do not recall. He had been very good about explaining everything else, I was awake the entire time, I don't recall any action inside the socket besides blotting and air blowing and more blotting with gauze as temporary bridge was being shaped. I did question about the bleeding and why wasn't a clot forming while still in his chair and he said, well, it's normal and he is still kinda disturbing the area, but it should be ok.

Sorry to go so long...MY MAIN QUESTIONS ARE:

1) WHAT IS A Compression Splint and is it normal practice to put one in a freshly extracted tooth before a temporary bridge is cemented on over it (all within an hour time frame).

2) Is a Compression Splint something you can see on an X-ray?

3) Was this negligence to not ensure the bleeding was stopped? The assistant herself obviously felt a suture was needed. Also, the temp bridge is a little sloppy, there is cement around the outside of it as if he didn't take the time to clean it up. I saw him leave the office before I had finished paying up front. Normal closing time is 5 and it was 5:30 by the time I I feel like this "unexpected" extra procedure came up (tooth extraction and one extra tooth to shave down, additional paperwork to charge the additional $800 and sign new consent) doubled the time frame they had set aside for me and in the end, everyone was just wanting to get out of there (me included) so the quality of work went down and became rushed and sloppy. AT MY EXPENSE.

My son was horrified when he came home and saw all the blood. I do not know if I can trust him to finish the job he started. —JoanneStreeter

1) I am not certain, but I think what he means by a compression splint is a part of the temporary bridge that puts pressure on the extraction socket. So a compression splint is part of the temporary bridge, it is a false tooth that extends very slightly into the socket area to put pressure there and help hold a blood clot in place. 2) It does not involve any treatment to the extraction socket itself, so it will not show up on the xray other than being part of the temporary bridge, and you would not notice any different activity in your mouth other than the dentist making the temporary bridge. 3) Regarding possible negligence, I won't comment because that is a legal question. However, it is common for an extraction site to bleed for about 24 hours after, this bleeding can sometimes increase after the patient leaves the office. Sutures can sometimes help retain a blood clot but don't always make a difference, the main purpose of a suture is to hold tissue in place where it should be for proper healing. If the tissue is sitting in a good position for healing then a suture is not needed. I do a lot of surgical extractions in my office and my assistant often will ask about a suture when one is not needed, this may have been just a routine question the assistant asked. Your description of the extraction (yanking, tugging, whole bag of gauze, mention of teabags) all sounds very routine. I or my assistant always check and make sure bleeding has stopped before the patient leaves. Many times I call the patient that night and they say that it is bleeding a lot and I am certain they left with very minimal bleeding, sometimes it is patient perception and sometimes the bleeding increases after the patient leaves. Regarding excess cement: It is often hard to get all of the cement off of a temporary, ideally all the cement should be removed but sometimes some gets left behind (we are all only human) and this excess cement is rarely a problem, (it may cause a slight increase in temporary irritation on the adjacent gum tissue). I hope this information is helpful to you and I am sorry to hear you had such a negative experience, I understand your frustration. —DagonJones

2014-03-31 11:15:42   I recently went for a check up, and the dentist said I had an impacted wisdom tooth that grew in sideways. I've had it like this for almost 15 years. He wants to have it extracted, but he also wants to extract the perfectly straight upper wisdom tooth on the same side as well. Why? Should I allow them to extract both or tell them to just extract the impacted one? —TonyRomano

yes get both of those teeth out. Even though the impacted tooth has not caused any problems for the last 12 years, it will most likely cause an issue as some point in your life. Extraction of a wisdom tooth when you are young is routine and heals much quicker than when you are older (the bone becomes more dense). Also if the impacted tooth causes a problem you may have to have the tooth in front of it extracted as well. I recommend removing the straight tooth above it for many of the same reasons, if that upper tooth does not chew against a tooth on the bottom it is only going to cause problems for the tooth in front of it by trapping plaque and bacteria. Wisdom teeth are notoriously hard to keep clean and often suffer from much worse gum disease than any other teeth in the mouth. —DagonJones

2014-04-15 06:38:05   Hello there, I had a root canal performed due to infection last year with no problems. Recently a 1/4 of that tooth cracked off as I ate a boiled sweet. I went to the dentist 2 weeks ago who said it looked clean and fine with the option of having a filling, crown or leaving it for now. So I decided to leave it for now being a student and saving. However over the past week whilst brushing my teeth I have noticed grey/black on my toothbrush and saliva. It's not blood. I wonder if I am disrupting the material used for the root canal whilst brushing against it? Is this harmful or not? I have made another dentist appointment for 2 weeks time. Any advice for the meantime? Kind Regards. —Jadewootton

I would guess that that black stuff is just food that got caught in the area, it is probably not root canal material, that is often pink or white. Black could be debri or stained tooth structure. You probably will be fine to wait another 2 weeks but I recommend you definitely get a crown on the tooth if it has had a root canal and a fracture. A crown will protect the tooth from further fracture, a filling will not. —DagonJones

2014-04-19 09:12:49   Hello,

My dentist said that I need my upper incisor tooth extracted because my body is rejecting the tooth. I want to do an implant. Would it be better to have the implant done at the same time the tooth is extracted, assuming no bone grafting is required? Also, if bone grafting is require would be better to add the graft at the time of extraction?



Bone grafting is best done at the time of extraction. In general it is more predicatable to have the implant placed about 4-6 months after an extraction. However, sometimes the implant can be predictably placed at the time of extraction. Talk to your dentist/ surgeon, it depends upon the density of bone in the area and the length of the root of your tooth. —DagonJones

2014-04-23 18:22:12   Hello. I am 23 years old and have had excessive erosion on my teeth due to excessive grinding for the last 20 years or so. I've noticed my jaw line slipping and was wondering what solutions there would be in order to get my jaw line to its original state. Would I have to get veneers or is there a simpler solution to simply have my jaw expanx? —JeremyNau Veneers would not be a solution, it may be possible to correct the situation with full crowns on almost all of your teeth but veneers would be a poor choice because they would likely fracture from your excessive grinding. You are describing a complex situation that often does not have any "simple" solutions. It is also difficult for me to know exactly what your concerns are without a detailed exam. Above all else I would recommend you get a custom hard night guard made by a dentist to prevent further damage from grinding. —DagonJones

2014-04-30 19:32:06   I had my tooth extracted 4 weeks ago and then my dentist suggested fixed bridge since the tooth that was extracted is a front tooth. Three days ago i had my fixed bridge, i have tooth ache but its not from the teeth that has the dental crown. I was wondering is it normal to have toothache to the other tooth that doesn't have any treatment. (Not really that tooth was filled maybe 10 years ago) (yeah i know i really hate visiting the dentist-and i learned the hard way.) im in so much pain. —Cessypat

2014-05-01 01:57:43   One more question. It seems like whenever i ate hot or cold drinks or foods the pain goes away. What seems to be the reason why i am having toothache. And i went to my dentist and he said that the said tooth just have bruise and it doesn't need any treatment other than taking some antibiotics and pain killer. And about the permanent crown he said that it was just about something about the bones that is why its kinda aching. I wanted to have xray and see whats wrong with my teeth. —Cessypat

I am sorry but it is hard for me to know exactly what you are talking about, I need more details about what your symptoms are and which teeth are hurting. Normally after a bridge (or any dental work) the teeth involved can be very sensitive and perhaps ache a bit. If it is not the tooth involved on the bridge it may be the teeth that the bridge chews against, If it is the opposing teeth that are sensitive then the bridge may be too high and need to be adjusted. If it is the teeth next to the bridge then the bridge may be putting pressure on those teeth, causing pain. Call your dentist with specific concerns, if you still don't understand, ask more specific questions. —DagonJones

2014-05-01 22:49:27   Sorry Dr.Jones i dont have more information. My gums is kinda swollen around the crown, is it normal? I only have it for 4days. And it is painful. Dentist prescribe amoxcicillin for 3 days to be taken 3xday. —Cessypat

2014-05-02 06:48:22   Dr. Jones, the gums around my dental crown has pus pocket and it is very painful. Im going to the dentist tomorrow hope its just gum infection. I dont want to loose my tooth. I already lost one. —Cessypat

Definitely go see your dentist, there are a variety of issues this could be and they all require careful examination. I hope it goes well for you, let me know if you need anything else —DagonJones

2014-05-03 03:25:34   Hi again Dr.Jones. Well i went to my dentist and he said that i just need to continue my antibiotics for 7 days and if that doesn't work, he'll put me on a higher dosage of antibiotics. And after that he will re-evaluate. And he also said that, there is a possibility for root canal or tooth extraction. If this is the case im going for rooth canal. Thanks again for entertaining my question Dr.Jones. —Cessypat

2014-05-08 11:46:06   i had a impacted wisdom tooth extracted may 1st,along with with the tooth in front of it,the tooth in front is healing fine i had a lot of pain where wisdom was taken i could feel something was still there ,so i went back to dentist 7 days later the dentist told me it was bone he told me he thought i should let my gums heal over the bone. the tooth was very bad im fifty years of age its still very painful is this correct? thankyou —marywheeler

In a situation such as you describe the gum tissue may heal over the bone or the bone may become necrotic and slough off on its own. Both situations are rather uncomfortable but usually heal fine. In some situations surgical intervention is needed to remove the additional bone. —DagonJones

2014-05-11 21:26:58   About 3 years ago, I had intermittent pain & sensitivity to hot/cold on #30 tooth. X-rays showed nothing, but dentist determined it could be a cracked tooth, even though a crack could not be seen, and suggested a crown. The crown was placed, and I have still always had had the intermittent pain, more like an ache since then. The only thing it alleviated was the hot/cold sensitivity. So I have just lived with the occasional ache/pain which would happen when chewing on that side, and taking ibuprofen when needed. About six weeks ago, during a routine cleaning, I happened to mention it since it had just been acting up, (this is not the same dentist who did the original crown) and an x-ray was taken of the gum area, and there was an abscess. The dentist suggested I see an endodontist who would determine whether a root canal could be done or, if the crack was too deep, if extraction was necessary. One week later, the endodontist did a root canal, so I assumed he had determined the tooth was savable. About 7 to 10 days after that, the tooth was "achy" and I had the funny taste in my mouth and my jaw was still a bit swollen. "Just to be safe", he prescribed 500mg of Amoxcil for 9 days. It's been 10 days since I finished. Three days ago, the tooth again became sensitive when I brush my teeth. I shouldn't be feeling anything on that tooth, right? Also, these last couple days, I have that funny taste in my mouth, and I'm quite sure the infection is still there and getting worse. I'm scheduled to go back to my dentist on Thursday to have the permanent crown/filling done, but I am going to see if I can get in tomorrow due to the suspected infection. I'm afraid he's going to suggest a re-do on the root canal, or an apecitomy (sp?). Would another round of antibiotics fix the problem? If not, I'd rather have the tooth pulled, since the more I read about cracked teeth and root canals, there are no guarantees. If I do get the tooth pulled, that should cure the infection, right? After 3 years of constantly be aware of this tooth, I'd like to just get rid of it. I'm 62 and have had the "same" tooth missing on the other side for 30+ years and have not missed it. And as others have said, thank you so much for the information you share with everyone. I have learned so much from reading all the posts here this evening. —SueDen —SueDen

If you extract the tooth it will eliminate the infection. But I encourage you to give the root canal some time, even though you have a root canal and the nerve is removed the ligament around the tooth is still alive and can be sensitive to biting and pressure so some discomfort is expected after a root canal. It may be a good idea to see the endodontist before the final restoration is done just to evaluate all your symptoms. —DagonJones

2014-06-17 22:25:43   I recently on March 24th had a tooth removed and a artificial bone graft put in the socket and sutured up. Pain went away and everything has been great and now past couple days my extraction point is hurting and I feel a burning pain down that side of my neck. I'm very worried what could that be and what's causing it? I know I have a bone sliver working it's way out and the doctor told me it may be normal to have a few work theirselves out?? But what could be causing burning into my neck? The extraction point does not look infected, it's healed up nicely and kind of whitish not red or swollen looking at all. Id appreciate any help and thanks —Tobygooch

Sorry it took so long, I just got back from a dental mission trip in Honduras. I am not sure what is causing the pain down the side of your neck. The nerves of the head and neck are rather complicated and sometimes unexpected pain can result from a situation as you describe. It may be pain from infection, in which case you should start a course of antibiotics, see the practitioner who did the graft as soon as you can. —DagonJones

2014-07-25 22:08:05   I happen to think this stuff is way cool, too!! Thanks for creating this page and taking the time to respond so thoughtfully and thoroughly :) I am a woman in my mid-thirties, relatively healthy teeth all things considered. Well, okay, maybe not *great*—I've had both bottom second molars extracted, after my first and second pregnancies, 9 and 5 years ago. Three days ago, I had my top second molar extracted as well, but this time I have no new baby to blame for it (I know, old wives' tale ;). This last extraction was not considered by my dentist to be problematic, although I do know that the tooth came out in more than one piece. (I don't remember much about my prior extractions—one was done by an oral surgeon while I was on nitrous, the other done by a medieval barber-butcher despite my protests that I wasn't fully numbed, so any attempts to recall details are impeded by a dark cloud of rage ;) Yesterday I began suspecting that I'd developed a dry socket, as I had with the most recent previous extraction. Problem is, I put down a *lot* of whiskey in the weeks after that one, so my memories of the dry socket are also pretty hazy. But this didn't feel *quite* the same—-it's intermittent, for one, I'll go for maybe an hour or two several times a day when it isn't the only thing I can think about. And while the pain is diffuse in the same way I remember from the prior dry socket, it also has a burning sensation to it along with the throbbing ache and sharp agony. I returned to my dentist today, who said that there was a small area of exposed bone, but not a complete dry socket. I haven't run across anything in my reading that has mentioned a "partial" dry socket, so that was interesting. He packed some gunk back there (far more gently than I expected and remembered), prescribed me four more vicodin, and sent me on my way. Tonight I was poking my tongue around the area like I know I'm not supposed to, and felt a sharp bit. The previous extractions also resulted in sequestrae working their way out, but not until weeks and months after the gums had healed, and those were also accompanied by a milder version of the burning pain I'm feeling now, minus the aching, throbbing, and wanting to lay down on the railroad tracks. I took a look as best I could, and I can see white bone/tooth/not-gum, but it is further back, on the edge of the socket/extraction pit, rather than down in it. It's on the buccal side, and I can also see that the gum on that side . . . well, to be honest, it looks kind of like the darn thing came out sideways. There seems to be a LOT of tissue missing (of course, this being my mouth, I may have an exaggerated idea of what is normal and acceptable ;) I can't feel anything that feels like bone actually *in* the socket, although I haven't done that much exploration because OW. So my question (finally!!)—rather than a dry socket from a loss of the blood clot in the usual place, in the socket, is it possible that there was enough soft tissue damage done that there is exposed alveolar bone posterior to the location of the extracted tooth? Because this really doesn't appear to be a place that a blood clot could feasibly form and/or adhere! And if so, do you think I can expect a somewhat shorter recovery period for *that* than I could were this a traditional "dry socket"? It would be terribly reassuring to think that not only is this not my fault, but that it won't be agonizing for another 10-15 days like the last one was—I mean, two of those four vicodin are gone already, and the other two are looking really, really good right about now . . . —MistyNuckolls

It is difficult to predict what your symptoms will be like but what you are describing is a common situation. With an upper molar bone to buccal and distal (back) can often be fractured and/ or exposed during the extraction. This bone will usually slough off or eventually be covered by tissue, however, it may need to be removed. "Dry socket" is pretty much a catch all term to describe any delayed healing with increased pain of an extraction site, it is often caused by loss of a blood clot but any area of exposed bone can have these symptoms, sometimes you can get it without any obvious exposed bone, so lets just say you have a "dry socket". Narcotic pain medication is often helpful for these types of situations but of course we always want to be very cautious with this type of medication because it can lead to addiction much easier than most people expect. The gunk your dentist put in there is a pain relieving dressing and they often need to be replaced every few days. You can probably expect a total of 10-14 days of discomfort, try Ibuprofen 600 mg for the pain, you may need a refill of the vicodin, talk to your dentist. —DagonJones

2014-09-08 07:06:19   Hello Dr. Jones. I'd appreciate it if you'd tell me if dental explantation and re-implantation by the aim of doing some operations on it is common or even done ever. Also is it common for all teeth or is it done to some teeth only? Thanks beforehand. —alirezaTaravati

It is certainly not common. I have heard talk of a tooth transplant from one portion of the mouth to another (this would require a root canal to be performed on the tooth). However I have never spoke to anyone who has done this. I don't know how predictable it is and I would not recommend it. In theory it can work and if you do some research you can find some people who do this but it is not common place. It certainly would not be indicated for the aim of doing some operations on it but it might be used to transplant a wisdom tooth to a location that had another molar that needs extraction. Essentially it would only ever be done using a donor tooth taken from an area that it needs to be extracted from and transplanted to a location that needs a tooth. Here is a link to a 2001 article about this subject and another case study article:

2014-09-13 09:27:13   Hello. So about 1 or 2 months ago I was getting a root canal done. My dentist said she was done and only had to do the crown. She said she would call to make an appointment but never did. Then yesterday I was brushing my teeth and realized my tooth is turning black. What does it mean? Is my tooth dead or can it still be saved? —Jenniferbenitez

It is very common for a tooth to discolor after a root canal, the tooth can become gray or blackish in color. This discoloration can be due to coagulated blood within the dentin of the tooth. There is nothing to worry about in this situation, the crown will cover the discolored area and should give the tooth a much more natural appearance. —DagonJones

2014-09-18 03:21:23   Here's a question that might help many folks: what do you often see people living with that they are surprised to discover is easily and/or inexpensively fixed? Anything: pain, cosmetic, embarrassment, gum, teeth, breath... anything people often think they have to just deal with that they can easily get help for? —JabberWokky

This question depends upon the population you are asking, for patients that I see in my private practice the most common problem that I see is decay or inflammation between the teeth from people not flossing enough. This problem could easily be fixed by a diligent pattern of proper daily flossing. In populations I work with during volunteer efforts (both in the US and abroad) I most commonly see chronic abscesses that could easily be taken care of with an extraction. Some times these infections are very low grade and draining fluid so there is often more chronic (mild to moderate) pain. Sometimes there is no pain. —DagonJones

2014-09-21 15:57:54   I bumped my front tooth with my wedding band VERY SLIGHTLY when covering my mouth and have health anxiety. Checked it with a flash light and when shinning the light from the bottom, can see a horizontal line about halfway up but only middle of the front tooth. I am 64 and am concerned because this is horizontal. No pain and it cannot be felt with my fingernail. ONLY seen with the light and light seems to go right thru tooth. The line is in the area where the tooth gets very thick toward the top of the tooth and sort of curves like that part of the tooth. —dianetavegia

What you are describing is most likely a "craze line" which is a very superficial fracture of the enamel rods. No need to worry they are quite common, it may have already been there and you did not notice it or it may have been caused by the recent blow to the tooth you describe. These minor fractures do not significantly weaken the tooth and cause no long term problems. —DagonJones

2014-09-26 18:18:22   just had my l1 molar extracted due to periodontal deseise and am experiencing nasal drainage that can best be described as smelling and tasting like the smell of a bloated corpse and tastes like rotten meatis this cause for concern?what could this be? —heatherbilyeu This sounds like an infection and it is a cause of concern. The smell is likely caused by aerobic bacteria. see your dentist ASAP. —DagonJones

2014-09-28 07:43:57   why do the cementum part of my teeth were exposed that causes an excessive tooth ache? what should I need to do regarding it? what would dentist do regarding it? —JulivaBatuna Recession can cause exposed areas of cementum or root surface. These areas are often very sensitive to cold and touch, but rarely ache on their own. First I would try using a sensitivity protection toothpaste like sensodyne. If that does not work (which it usually does not) then you can use a desensitizing paste dispensed by your dentist called MI paste. MI paste helps to deposit layers of calcium and phosphate to provide a protective layer over the exposed root surface. MI paste is often more effective than a sensitivity protection toothpaste, both of these products take a few weeks to work. If neither of these options is effective then you can talk to your dentist and the areas can be covered with a small, tooth colored, filling. The filling option often works very well. —DagonJones

2014-10-04 22:52:43   I am a 58 yr old female, not great health but doing ok. Recently several of my teeth have started coming loose. I saw the dentist about a week ago to get my right back molar pulled cause it was abscesses and extremely loose. She gave me a prescription for an antibiotic and to come back in two weeks. Since then my right eye tooth has started coming loose and is becoming very painful. I have Central Sleep Apnea and use a CPAP with an oxygen feed of 3 liters. I brush and floss after I eat. Even if it's just a snack.I also brush and floss before I go to bed. I have lost eight teeth and all four wisdoms. Two of the lost teeth were due to failed root canals and two were from breaks sustained in an accident. Why might this be happening and what if anything can I do to stop or at least slow down the loss of my other teeth. Thank you very any information, help and/or advice. MeliciaGonzalez —MeliciaGonzalez

The most common cause of tooth loss for people in your age range is periodontal disease (gum disease). You should see your dentist regularly for professional cleanings, you will likely need 3-4 cleanings a year with a "deep cleaning" (aka Scaling and Root planning) every two years. You also may need to see a gum disease specialist. There are other possible reasons for tooth loss, such as decay and root fractures but periodontal disease is the most common and it typically affects all the teeth. —DagonJones

2014-10-20 06:19:51   Dr. D, I just had the last one of top teeth extracted ( Poss. #16?) on My left side back, and not wisdom but the one that the root runs up the nasal and ear area, it was newly abscessing and it was extracted. The one in front of that one the Dr. said possible root remained, I told him that a part/piece of possible tooth had just come out a day or so prior to my visit. When I went home and slept and drooled some I woke up to a bumpy pinky nail sized sore on the outside of my mouth below my lip. I'm treating it with what i have for now, until i can call the Dentist, as a bacterial infection. Sulfamethozole/tri 800mg/160mg and Nystatin oint. Just would like your opinion. Thank-You Doctor. Appreciatively, KElly Nelson —KellyNelson

It is hard to say exactly what it is but it sounds like a "cold sore". Cold sores are caused by the herepes virus and they are often on the lower lip on one side and preceded by stress or trauma. It should resolve in 1-2 weeks, a prescription medication called acyclovir can help but it only seems to reduce the duration of the lesion by 1-2 days. Sorry for the late reply. —DagonJones

2014-11-04 12:18:48   If, after 40 years I have some decay under an otherwise perfectly good crown, is replacement of that crown my only option? I'm 80 years old. Fixed income. —MaryOstrander It really depends upon the extent of the decay, it is sometimes possible to place a "patch" or a filling on the edge of a crown if the decay is very small. Ask your dentist if you think this is possible, many times it is difficult to tell until we clean out the decay. —DagonJones

2014-11-21 07:33:45   My husband is convinced there is something terribly wrong, & death will follow due to jaw bone, gum & palate loss. He thinks something drastic is being over looked!! We've been to a dentist, an ENT, a periodontist & have had deep cleanings. Even been to a disease ctr to be checked!! He is still convinced there is a major problem being overlooked! He feels the loss of his jaw bone, gums & palate... there must be something you can suggest!! Please help!!


I am sorry to say that I can not really give any advice to you here. It sounds like your husband is actually in very good hands, if he has seen an ENT and a periodontist then I would be surprised if there was anything significant that was overlooked. Death is very very unlikely from any type of periodontal bone loss, especially if he is under the care of multiple specialists so I would say he should not worry about death from his condition.

2014-12-06 13:06:34   Hi. I am really stressed over what is happening with my teeth and have sought two dentist opinions in person — and got two radically different answers. I was having pain in my front right tooth (#8 I am told, one of the two front teeth), and there was no injury. I just woke up one day with the pain. The pain could be described as that sensation after accidentally biting down on a fork. The tooth has also moved slightly inward and it now hits on my bottom teeth when I fully bite down. I'm having trouble chewing because I can't grind the food properly because of this hitting. There is pressure in the root and sometimes pain in the tooth. I went to dentist #1 (my regular dentist) who took xrays, which showed nothing, and used that special light to look for cracks. He then said I have a crack in my tooth (can't see it) that goes about 2/3-3/4 of the way up the tooth. He told me I need to get a cap, where he would grind down the tooth and put a cap on it. I was very scared about this cap and losing my precious front tooth that I sought out a second opinion. Dentist #1 said he "would not" put a cap on it, and that the crack is a small fracture and is possibly superficial, not affecting the pulp of the tooth but just a surface crack like old china dishes. Dentist #2 also said I must grind my teeth at night and he showed me all the grind marks. I have long suspected that I grind, but dentist #1 never seemed to think it was a problem. Dentist #2 wants to make a retainer and try to move the tooth forward so it doesn't hit the bottom teeth. I cancelled my capping appointment with dentist #1 because of course if dentist #2 is right then dentist #1's treatment plan is pretty extreme and permanent. However, dentist #1 had warned me that if I continue to use the tooth and no have it capped, I run the risk of cracking it further and then I will lose the tooth. Dentist #2 does not think this is the case. Then, dentist #2 suggested a mouth guard and said I should get a sports mouth guard in the interim. I've been using the sports mouth guard for 3 nights now and my jaw is killing me. The guard is uncomfortable at night, but oh my goodness my jaw is in such pain during the day (the pain is in the jaw joint and radiates upward into my temples and back into my neck). Advice appreciated. These two dentists have such radically different opinions, I'm currently in a lot of pain, and dentist #1 really scared me saying I can break the tooth further. Help! Thanks. —SadieT

Stop using the over the counter guard ASAP. Most over the counter guards (especially sport guards) are not designed to position your jaw properly. So if you are experiencing pain you should discontinue and probably get a custom made hard night guard. Most custom made hard guards will help reduce and prevent jaw pain. Both dentists may be correct in their treatment plans but are choosing different options to achieve the same result, the tooth needs to be changed so it is no longer hitting the bottom teeth, this can be accomplished by either moving the tooth with orthodontics or changing its shape with a crown. Fractures on the front teeth are rarely very deep, but sometimes they can be quite significant. I really cant say without taking a look at it. The most conservative option would be moving the tooth with orthodontics and then making a hard custom night guard, however a crown will likely provide quicker results. I would discuss both options with whichever dentist you feel most comfortable with. —DagonJones

2014-12-08 14:30:50   I am very confused as to which direction to take with the issues I am having with my teeth/mouth. For the past 7 years (at least), I have been trying to find a way to get my teeth fixed. I have had the misfortune of having bad dental problems my whole life. I don't know if having celiac disease contributed to this, but having problems absorbing nutrients would sure seem to play a major role. I am a single-mom on a very fixed income. I returned to school and have worked part-time and attended school for the past 4 years, and before that, I was just struggling as a welfare recipient. My current job offers no dental insurance, and while I am covered by Medi-Cal, it is common knowledge that the only thing adults can have performed with Medi-Cal is tooth extraction in an emergency. So, essentially-no dental insurance.

Please bear with me, because my question is not about insurance, but I feel I need to explain my situation. After waiting so long to get my teeth fixed, and more problems occurring each year, I was going to resort to going to Mexico to have my teeth fixed because it seemed to be my only alternative to all my teeth falling out and being toothless. I finally decided to get individual dental insurance, thinking that I might have one last chance before crossing the border, and all the risks that go with that. I should mention that I had an emergency root canal about 8 months ago which forced me to pay out-of-pocket with my student loans and grant money because it was an emergency.

The dentist that performed the root canal also gave me an estimate for work that totaled almost $10,000. I currently claimed bankruptcy, and no finance company will help me with a payment plan. The aforementioned dentist made recommendations for at least 4 crowns, and these crowns must be the most expensive ones available because lava crowns are priced at $1400 each. He also recommended a Man Partial Denture Resin Base at the cost of $2400. At that time, I had no insurance. The most recent visit I made last week was with a wonderful dentist who has many awards for cosmetic dentistry, etc. He did not agree with the previous dental recommendations, and he recommended porcelain inlays instead of the crowns. I absolutely loved that idea, until he told me they were $1200 each, and that we could break it all down into a long-range project so I could afford it. At this point, I can no longer deal with "long-range" dental projects. My teeth need to be taken care of now, and I want them to look decent, as well as to stop maiming my cheek with a jagged broken molar that needs to be fixed.

What I would like to know is this:

What can I do that is (1) affordable for a person on an EXTREMELY limited income, though I do have dental insurance that covers a good number of crowns and fillings with a co-pay of about $200-$300 per tooth. I can handle something like that, but not $1200 per tooth. (2) Anything would look better than the tatooed, deteriorating amalgam fillings that are falling apart and making my molars look black, as well as the prefabricated temporary stainless steel crown on one molar. (3) Something that won't break in one year and bring me back for a complete do-over. There has to be something in between that is better than what I have, and the top of the line porcelain inlays that are being suggested as well as the lava crowns. I would love nothing more than taking that route, but I am being realistic, knowing that I will be a senior citizen by the time everything is said and done. I am only 50 now, and I would like to be able to smile before I am in an old-folks home.

It is really embarrassing talking about my limited income with the dentist, even if I was ever given enough time to have that conversation. Can you recommend something based on what I have told you here? I would really appreciate, because I don't want to have to go to Mexico, but it is my last option. Thank you?

One last question! I am also missing two molars, one on each side on the bottom. This means I have a choice over implants (Not a choice, I know the costs!) I also know about the bridgework as an option, and if you could also steer me in the right direction based on what I have said previously about my limited income. Thank you! —CarrieShearman

Answers: 1) Ask for composite build ups on the teeth that need crowns/inlays, these are basically large fillings that should be good mid term restorations until you can afford crowns on these teeth. However these build ups will not protect the teeth from further fractures as good as crowns will. 2) Composite is a white material that is quite strong, however I would not recommend replacing any of your amalgams unless there is decay or fractures, they may look bad but they are a very strong long term restoration. Your main concern with your limited budget should be function and amalgam is a very functional material. 3) composite build ups will likely last several years but should eventually be replaced by a crown to prevent further fractures on the teeth. I would only recommend bridges on the lower missing teeth if the two teeth adjacent to them would benefit from crowns. In order to do a bridge the two adjacent teeth have to be prepared for crowns and this is very unfortunate thing to do if they are virgin teeth with no other problems. Implants really are your best option for those. Leaving the space empty is also an option. Please don't go to mexico for your dental work, I doubt you will get good quality care. Most border dental practices that cater to Americans do not do quality work, you may end up creating more problems. There might be some very good dental practices in Mexico but I don't think it is worth the risk.

2014-12-09 23:38:16   Is it possible to get a false #9 silver or stainless steel tooth in place of the #9 missing?


Yes, you could probably get a purple tooth if you want, just ask your dentist —DagonJones

2014-12-19 00:30:22   What happens if your tooth or teeth decays all the way ? —brettchonis severe dental decay

Good question, most of the time decay will reach the nerve (pulp chamber) inside the tooth and cause pain. This decay often results in an infection and the tooth will form an abscess requiring emergency treatment. Sometimes the abscess/infection can be very small and if the pus can drain into the mouth the situation may not be painful. When this happens the decay can continue until there is nothing left but the root of the tooth, most of the time parts of the tooth break off due to being undermined by decay. The decay can slowly continue down the root, often the bone around the root will begin to resorb away. I have seen several situations where there is just a decayed little nub of a root left behind with little or no bone support. Sometimes the decay stops just below the level of the gumline and a root is left behind, this situation is seen frequently in severe meth abuse. —DagonJones

2014-12-19 13:58:50   what should i do if one of my teeth is decaying very badly but dont have to money to fix it?


If the decay is not into the pulp chamber then it would be best to get a filling, even a temporary fill would be fine but you want to get the decay removed so it does not continue to get worse. If the decay is already into the nerve then you should have the tooth extracted. Of course you will have to go to a dentist to have it evaluated, I suggest the Davis Community Clinic if you are low on finances.

2014-12-26 22:07:03   In a few weeks I'm finally getting the stains of my front teeth fixed through a bonding procedure (instead of veneers). I'm fairly confident that this is a good call for me since it's something that has been troubling me for years. However, my dentist also mentioned that he'd also push up my gum line a bit during the same visit. I've never been concerned about it, but my teeth do look rather small because my gums cover quite a bit. I also have a fairly mild case of gum disease. I've searched around the Internet and everyone seems to be concerned about receding gum lines. Should I forgo this portion of the procedure and what are possible future risks/concerns? —mwoodacre

Recession on the upper front teeth is rarely a significant problem.  Also if your dentist is sugesting removing some of this tissue it is very likely that you have excess tissue there.  During procedures like this, gum tissue is very rarely removed beyond the level of enamel, so there should be no recession afterwards.- Dagon Jones

2014-12-30 18:57:53   I just got braces and there is this hard orange stuff on both of my upper second molars. What is it for? -Sfryew7 —sfryew7

I am not sure but it is likely material placed on the occlusal (chewing surface) to slightly open up your bite so the other teeth can be moved without interferance.- Dagon Jones

2015-01-12 08:00:35   I am 71 with multiple crowns(some20 yrs old) that are asymptomatic. Although my gums have been consistently said to be very healthy my dentist has recommended wholesale replacement of all my crowns because of age related gum recession and root exposure. Is this a reasonable approach generally speaking? —cummings105

It is really hard to say without knowing the whole story of your crowns.  Sometimes it is worthwhile to replace crowns to cover areas of recession but I will usually only recommend this if the patient is unhappy with the appearance of the crowns or there is pronounced sensitivity on the exposed root surfaces.  If you are skeptical about the treatment plan, ask your dentist to give you a very detailed explanation what you could expect if you decide not to have them replaced.  Typically I would not replace a crown unless it was damaged or had decay under it, but there are some other indications where crown replacement could be a benefit.- Dagon Jones

2015-01-24 22:24:23   I recently fell earlier this afternoon, and chipped a part of my front tooth. Where can I get an x-ray at a reasonable cost (below $150) to determine whether I would need a root canal or not? —MichelleNguyen

Ok, after a fall the first thing to do is have the chip repaired, this can often be done the same day with some composite (white filling material).  If the fracture exposed the pulp chamber (blood seen in the core of the tooth), then the tooth will definitely need a root canal.  If the pulp chamber was not exposed then an x ray will not tell you much until several months after the incident, even then it may not show the need for a root canal.  The most predictable way is to test the nerve of the tooth  3-4 weeks after the accident, your dentist can often tell you at that point if the tooth will need a root canal by testing the tooth response to cold and mild electrical stimulus.  However, in some situations the tooth will be fine for years and then spontaneously die and need a root canal because of this traumatic event.  Any dental office will be able to do this for you, unfortunately many offices have different fee schedules and I can't give you a price quote but $150 is about right for a limited exam and x ray.- Dagon Jones

2015-02-12 01:25:34   Okay, I have a lot of bad teeth, I needed a total of 2 crowns, 11 fillings and my question is this, okay I have five teeth, numbers 6,7,8,9,and 11, so I scheduled to.have all.these fillings. Done at once. I also have a temporary crown on number 10, so I went today, and now I have no spaces between my teeth. The procedure.took maybe 10mins....and he worry about flossing, that the fillings, (they were mostly on the sides of my teeth an at the very top) we're "pretty packed in there. So do not floss them. Ever. ", my two front teeth, one feels fine the had a huge.lump on it. , as I was done,the assistant told me he did it wrong an I am suppose to be floss my front teeth. I'm so confused about what to do....and my 6 looks like the piece of filling at the and number 7, hurts really bad. I have insurance. Please help with some kind of advice. —judithhanvy


It sounds like  you have some concerns about the quaility of your current dentist's work, In these situations I recommend people seek a second opinion before getting any further work done. Flossing is an important step of oral hygeine, It is very rare to design fillings in such a way that they cannot be flossed, but there are situations where it may be indicated. -Dagon Jones

2015-02-12 01:29:14   Also, he said my guns bleed a lot...but didn't offer advice. I still need a bottom filling, about 3 more. Please answer my other questions, asap. —judithhanvy


2015-02-12 04:01:53   Hi, I have for the past year been getting a build up of a white sticky substance on my gums and teeth. the substance grows rapidly and I spend approx. 4 hours a day scrapping it off. It evens grows into the shape of a tooth and polishes up like hard enamel. When I scrape it off it breaks off in bits but then dissolves once its out of my mouth. The build up is so bad it makes my mouth stick together and stops my saliva flowing therefore my mouth is dry and sticks together. I have seen various dentist's but have had no joy. One dentist said I was depressed, which I agree with but only because this problem is driving me mad. I had two implants last year and the problem seems to have started since then. However the substance seems to grow from the crown which is located next to the implant. It usually grows on one side of my mouth but if I leave it then it does migrate behind the front teeth over to the other side. When I try and talk I feel it cracking and bits come off into my mouth. Please can anyone help diagnose the problem. Am at my wits end —Chez1

I have to say this is a very strange description, I simply have never heard of anything like this.  I do not think I can help you in this situation. - Dagon Jones

2015-03-02 22:24:58   Hello, I went in to get a cavity filled and afterwards my dentist said I had a cracked tooth and I needed a crown. He said that was probably the reason I got the cavity. If this is true why didn't he notice before he filled it? And why does it hurt now after the filling, and it didn't before. Did he crack it, and he's trying to make me pay for it? —Jmarler11

This is a really good question.  Often cracks in teeth cannot be seen because they are hidden by an existing filling or sound tooth structure.  You may be able to see a small portion of the crack at the edges of the filling or tooth but you cant see the full extent of the crack until you visualize the tooth structure under that filling.  The discomfort you are feeling is probably normal post operative sensitivity, it is normal for a filling to hurt a bit for 1-2 weeks after a filling, sometimes even a little longer, sometimes not at all.  Your situation is actually quite common.  Many dentists will see a large filling and say it needs a crown right from the get go, so it sounds like your dentist is actually being conservative by starting off with a filling.  It would probably take a purposeful effort to crack the tooth while working on it, it is not something that happens easily by accident.  -Dagon Jones

2015-03-06 01:25:54   Hi Dr Jones, I have a bridge on the top right rear of my mouth. I have never had any problems with it but, last week after a routine appointment for cleaning I developed a persistant pain in the area of the bridge. I dont think it is loose however it has not felt correct since my cleaning. It just feels off. I suspect that it may need adjustment. I have a high pain threshold but I have been taking Advil regularly since my appointment last week. —mikeb0319

I would have your dentist take a look, it is most likely just some transient sensitivity following a cleaning (which is common) but it could also be that the bridge is loose.  -Dagon Jones

2015-03-09 19:23:30   hi im 12 year old girl and i got an over retained baby tooth pulled out what can i eat and what cant i eat............. —crazykitty14

You should avoid spicy foods and anything very crunchy like tortilla chips, everything else is ok.  Wait until you are no longer numb to eat.  Areas like you are describing heal very quickly and there is very little special care you need to take. -Dagon Jones

2015-03-12 21:12:29   Dear Dr. Jones, I'm writing on behalf of an adult male who recently suffered facial trauma that resulted in a broken front tooth. It is not broken by the gum, but near the bottom, leaving the end of the tooth jagged. He does not have access to good dental care. Is there a white filling material that could be used to repair the tooth? Are there pros to pulling the tooth? Thank you for your help. —beeanne

Bonding with composite is probably the best option for him here.  Composite is a long lasting white filling material that is very good at restoring these jagged edges.  I would not recommend pulling the tooth, the only reason to pull it would be if an infection develops and he cannot afford a root canal.  Bonding with composite also gives very nice results.bonding.jpg

March 25, 2015 Hi, I have a gold crown that just fell out from my front right bottom molar. Can my dentist use my same gold crown to place back where it came out? What is the cost when something like this happens? I am a single educator and finances are limited.I have had the crown for approximately 18 years. Thank you very much in advance! 

At times the crown can simply be cleaned and re cemented, this can only be done in situations where the crown still has a good fit on the tooth and there is no decay on the tooth.  with an 18 year old crown it is likely that the long term prognosis for this tooth would be greatly improved by having a new crown made.  If there are perforations in the crown or poor adaptation to the tooth at the margins then I would definitely recommend a new crown.  However even in situations such as perforations and poor margins the crown can be re cemented and may be serviceable for a while so long as there is no decay on the tooth.  The fee for re cementation of a crown is often $150-$200.  You should see a dentist to find out if there is decay.  -Dagon Jones

(Moved from Questions, 4/28/2015) The crown of my bottom back tooth has broken off.  It was a. tooth that I once had a filling in.  Do i need surgery to remove the root?

You should definitely have the root removed, otherwise this situation could result in an infection.  Any type of dental extraction is considered surgery, however, the removal of roots is often straightforward and does not require stitches. -Dagon Jones


(Moved from Questions, 5/7/2015)   2015-05-07 04:34:07   I am having a problem finding where to ask a dental question on the Dental page. I am 58 yrs old and have had severe anxiety of dentists and the shots they give since my traumatic, childhood, dental work experiences. I avoided dentists for over 30 years and is one reason why I am now in the process of getting dentures. I had two consultations before choosing a Dental School in order to afford it . . . no insurance. For 8 months now (takes a long time dealing with students which started mid Oct. and is now May) I have had 7 surgeries - two torus removals and 5 Alveoplasty (LL was a do-over) and interim dentures that look like horses teeth, which I refuse to wear. My question is - after all teeth are extracted, will bone remodel if dentures are not worn for a few months? Do dentures keep the bones from splintering all over and sticking out of my gums after extractions? In case you need details, I have included a short record of the work I have had done: Because of a friend's bad experience, at the first appt. I had with my student and teacher, I told them horse teeth were unacceptable. I also explained my deathly fear of needles and Dentists. In December my back few teeth were extracted first and two surgeries . . . removal of torus mandibular LL and LR (Student said they were preforming 4 but billing says only 2) a couple weeks later. The end of January, when impressions were made, I had one very loose front tooth that would stick out when I bit down, so I reminded my student again to make sure the Lab was aware that my teeth do not normally stick out. He said, "No problem". Same thing at 2nd and 3rd impression appts. The end of February the remaining teeth were pulled, Alveoloplasty LL done and interim dentures put in. The dentures stuck out so much I could not even close my mouth and were so big I could hardly breath. I refused to wear them. After a couple more appts trying to fit these huge dentures into my mouth, that the student kept insisting I wear, the Head of the Dept. checked them out and agreed I could not wear them because I had bone sticking out that needed to be addressed. I was told then that they could fix the dentures or replace them if I wasn't happy. After my student graduated and Spring break came and went, in April I met my new student and a different Dr. (Head of the Dept.) who, after relining my plates that I still refused to wear, informed me I needed 4 more Alveoplasty. The head Dr. promised to push the teeth back next appt. I asked him if the remodeling of my bones (as he called it) was because I had no interim teeth to wear for 3 months and he said, "No". "Bone remodels itself all the time". 2 days ago, May 5th, I had 4 hrs of very traumatic and painful surgery done on all 4 sides of my mouth and now, since I can't take pain medication, I am again in tremendous pain and very traumatized. I was told the end of May they would try to push the teeth on the interim dentures back to look more normal. Will probably be next year before I get my permanents and a few months from now I will get my 2 bottom implants. Well, that will give me time to come up with the extra costs that have incurred, (I paid up front for the original treatment plan). Is this drama normal for getting dentures? Is all the bone remodeling in a few short months normal? Should I stick with them or come up with more cash and go elsewhere? I appreciate any advice you can give me. —Badaddidudeslady

Unfortunately the process that you are describing for dentures is fairly standard.  The bone will do a lot of remodeling in several months, this should be unaffected by whether or not you wear the immediate dentures. Given the fact that you had to have Tori (extra bone in the jaw) removed there is going to be a considerable amount of remodeling and healing (and unfortunately discomfort). I am glad to hear you will be having 2 lower implants, that should make the eventual lower denture stay in place much better.  Adjusting to dentures is a very rough process, dentures are not teeth and they feel very bulky when first worn.  Just hang in there, the eventual result should be good, but expect to have many more visits and time because you are at a dental school.  -Dagon Jones

Hi there. I have been going through a lot of questions in this page and found that your answers are absolutely wonderful. I am preparing to get root canal done for a couple of my teeth and just as I was curious about how it is done, got online to read a couple of experiences from people who have already had one. Most of them have stated that I should expect an uncomfortable niggling pain after four or five months from the treatment which has left me worried. Although I knew that it would be a task to go through the process, I did not expect the pain to be there. Can you tell me exactly how it would be? I am getting it done from Sierra Dental in Calgary who assured me that it would be painless. Can you elaborate on the process. Your feedback will be much appreciated. - ThomasCrowson 

A root canal involves cleaning and shaping the root canal space inside a tooth.  First a hole is drilled to access the pulp chamber (root canal space)  then small files are used to gradually enlarge and clean the canal space, an irrigating solution of bleach is used to rinse out debris and bacteria.  The canal space is then dried with absorbent paper points and  filled with thermoplastic material called gutta percha.  The gutta percha is heated and packed into the canal, it simply fills the space and seals the canal to discourage bacterial growth.  Once the root canal is finished the access hole is filled and a crown is often recommended for the tooth (unless it is a front tooth, then a crown is often not needed).  Root canal treated teeth often have a higher risk of catastrophic fracture and a crown protects the tooth from fracture.  The niggling pain you mention is pretty uncommon and only happens in about 10% of cases.  When it does occur it is often only during chewing pressure.  The root canal process can irritate the ligament just at the tip of the tooth which can result in some slight pain to chewing that lasts for several months after the root canal.  Let me know if you have any other questions, and thank you for your kind words.  - Dagon Jones