Question: Once a denture is broken, then repaired, can it ever be the same?

I dropped mine, since the dentist repaired it I now have a space between my two front teeth I've never had. The dentist said if you don't get too close you don't notice it so much. What!! The inside of the plate is rough. I have a toxic taste of what acrylic smells like. And when I talk I have a lisp. He took an impression so it would be right and it does clip on as it should, that aside .....it doesn't fit. Do I have to live with this as he said? I feel like I was written off and I don't know where to turn. Do you have any advice?

Answer: Sounds like the dentist attempted to perform a lab repair and the broken pieces were not reapproximated correctly. Depending on how bad the denture fractured, it can be a very difficult to repair and sometimes impossible. If there is a space between the teeth that was not there, it means the broken pieces are not bonded back together correctly. The rough surface is due to newly formed acrylic and may possibly not be 100% compatible with the acrylic in your exisitng denture.

If you are having issues with phonetics, esthetics and fit issues, I would go back to your dentist and voice your concerns over the repair. I, often times, will not do repairs as they can be very difficult and very unpredictable. As a result I often advise having a new one made based on the extent of the fractures as well as the age of the denture.

Hope this helps!

Dr.Glasmeier

I don't understand..if my child has a cavity on a baby teeth and they are going to get a permanent replacement anyways, why fix the baby tooth?

I get this question a lot as one would think if there is replacement what is the big deal? The big deal is that the baby teeth need to be thought of as "space holders" for the permanent teeth. If a baby tooth is lost prematurely, a permanent tooth can come in a different position which can further alter the development of the rest of the adult teeth. An adult teeth can also be affected if an infected baby tooth left untreated can cause disturbances of a permanent tooth's growth and development. In some cases I have seen an abscessed baby tooth that caused an adult tooth to become infected before it had a chance to even erupt!

Once again, an ounce of prevention can prevent a ton of problems...it is much more conservative(and cheaper) to have a cavity fixed on a baby tooth rather than "letting it go" only to find out then that the child could lose a permanent tooth or have major crowding issues with the permanent teeth(much more expensive!!). Having said this, if the baby teeth has a cavity but is within 3-6 months of coming out anyways, then a filling may not be necessary. Please consult the dentist before you try to make that determination as we are knowledgeable when a child will lose a particular baby tooth. Don't let your child miss out on school and other activities due to a toothache!

Dr.G

Question: Hi Dr.Glasmeier,

My son is 9 years old and has a big space between his front teeth and it seems bigger than his siblings' spaces. I want to know if this will resolve on his own or he is going to need dental work to correct this space?

Answer: Spacing between the two front teeth (known as a "diastema") is a very common finding not only in children but adults as well. Children who have baby teeth with type of spacing is actually a good situation however if this occurs with the eruption of the permanent teeth, this is quite different.

There are many different factors that can contribute to abnormal spacing between the two front teeth. The one I most commonly see is what is called a "low frenum attachment". The frenum is the soft tissue that attaches the inside of your lip to the gums above or below your teeth. Normally the frenum attaches high up above the tooth but it can also much lower on the gums between the teeth. When the gum attaches between the teeth, it can result in a diastema(space between the teeth).

When this occurs, typically two things must happen to close the space:

1. Patient needs to be evaluated to determine whether or not

orthodontics(braces) will be necessary to close the space or if they can be

closed by other means (e.g. veneers).

2. Patient will likely require a frenulectomy, where the soft tissue attachment

between the teeth is removed or reduced. There are multiple ways this is

accomplished but the most common is with a laser. With a little local

anesthesia and a laser, this procedure can be accomplished in several

minutes pain free and with little, if any postop pain. Most children have no

pain or discomfort the next day!

So back to your question, yes it can be treated but he needs to be evaluated the best way to accomplish this. Consult your dentist for the course of treatment necessary!

Best of luck!

Dr.G

Question: Dr.Glasmeier,

If there is no plaque, what are the chances of getting only gum diseases. Also, how does floride toothpastes help,if any, to avoid gum swelling or minor gum problems like gum bleeding?

Answer: Great question! That is complicated question because plaque is only

factor that can contribute to gum disease. There are many other things that can contribute to gum disease such as:

1. Poorly fitting dental restorations

2. Medical History (Smoking, diabetes, autoimmune diseases)

3. Genetics

4. Grinding and clenching teeth, etc.

These are only a few of factors that can promote gum disease. The big misconception is that your hygiene is the only thing that determines gum disease and this is simply not true! Regarding fluoride toothpaste and its effects on gums--the fluoride is more geared for preventing cavities and minimizing thermal sensitivity that can develop on the teeth. The abrasive additives in the toothpaste in combination with brushing is what helps reduce plaque/tartar from forming on the teeth than can setup problems with gum disease. So to answer your question, the fluoride is more for the teeth than the gums. There are prescription mouthrinses that made to help prevent and/or control gum disease but most of them are prescription.

Hope this helps!

Dr.G

Question: Dr. Glasmeier,

I had composite fillings done 2 weeks ago. Soon after, I was put on amoxicillin for an infection on the top tooth that was filled. Now that I have finished the medication, I still have aching in not only the top but also the bottom teeth that were filled. Is this normal? I've never even had to take OTC pain meds after a filling in the past, and now that I no longer need Vicodin for the terrible infection pain, I am still taking ibuprofen for the aching. Is this normal? Should I go back to see my doctor? Thank you!

Answer: Hi there, yes if it has been two weeks then you should return to your dentist for further evaluation. Typically composite fillings, aka "tooth colored fillings" can present with some localized soreness to biting along with some brief cold/sweet sensitivity. However, this type of sensitivity should resolve typically within 7-10 days. I am a little confused why an antibiotic was given for a tooth that received a filling unless that tooth has become infected. If this is the case, then you will need additional treatment beyond an antibiotic, such as a root canal.

Re: pain on top and bottom teeth..is it possible your bite could be "off" or "high" from the new filling. Sometimes if the bite is changed by a "high" filling, it can cause biting sensitivity that can progress to thermal sensitivity. I would go back to the dentist and have them evaluate the bite but also rule out that you are developing an infection around that tooth.

Good luck!

Dr.Glasmeier