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Dr. Frank Vascimini, Sound Bites, 6/17/14

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Reader asks about options for a broken front tooth

By Dr. Frank Vascimini

Q: I hope you can help me with my decision.  I am 34 and recently fell, breaking one of my front teeth in half. My dentist did a very temporary patch filling that looks OK. He stressed that it was only for appearance and can not stay this way. 

The options he gave me were to have it removed and have an implant placed followed by a crown. Another option was to do a root canal in the tooth and place a crown. He warned me that the tooth broke below the gums, which may cause gum irritation. The last choice was have the tooth removed, shave down the teeth next to it and make a bridge. 

I am not comfortable with any of the removable options he discussed, so I won’t mention those. My dilemma is which one should I go with. 

He really didn’t lean one way or another on any of this. I kinda wish he did. Please help, thanks.

A: I will try and comment on this but, as always, I cannot make any suggestions without seeing you. I will give you my thoughts on this in general terms.

I would have to say that if there were a way to save your own tooth, I would prefer things be done that way. I have seen many cases like you described where saving the tooth turned out to be a great long term solution. 

I must say that the health of the gums is imperative for this to be successful. Take this seriously if your dentist discusses it. Don’t be afraid of the root canal if you haven’t had one yet. If a root canal is done properly, it can help save a tooth. The days of a root canal being a painful experience are gone.

The implant is another great option, but only if saving your tooth is not possible. The most critical concern for an implant on a front tooth is the condition of the gum tissue when it is done. It takes a lot of skill and a great surgeon to do this properly. 

I cannot stress this enough. 

I have seen many implants be a success in terms of replacing a missing tooth; however, the cosmetic result, as it relates to the gum tissue, can be frustrating. Please make sure you discuss this with your dentist up front.

The bridge is usually the last choice, unless the teeth adjacent to the space are also in need of restoration. I am assuming that this is not the situation from what you wrote. The other time a bridge makes sense is when the patient either wants to avoid the surgery necessary for an implant or their medical history dictates the need to avoid it.

I hope I have given you some more information in order to make a good decision. I would suggest you think about what I mentioned and schedule a consultation with your dentist. Be sure to be clear on the plan and have all your questions addressed. Best of luck.

Dr. Frank Vascimini is a dentist practicing in Homosassa. Send your questions to 4805 S. Suncoast Blvd., Homosassa, FL 34446 or email them to him at info@MasterpieceDentalStudio.com.