Root Canal Alternatives
Last week we talked about root canals, but what are your options if that’s not possible or desirable? Actually, the only alternative if the nerve has died or become infected, would be to remove the tooth. So the real choice is what to do with the space once the tooth is gone.
This is probably one of the most difficult dental choices people face. It’s difficult to lose the tooth in the first place, but then what do you do? There is the Zen choice of course, called the no choice. You wake up five years later and that space is still there.
Unfortunately, it is usually not that simple. The other teeth gradually collapse into that space from the sides and from the opposite arch, causing an increase in the tendency for decay and gum disease because of their unnatural relationships. There is a loss of function and comfort in the affected area, and a general malocclusion from the change in the way the teeth bite together. This in turn increases the muscular tension around the temporomandibular joints, causing premature arthritis, headaches, and cervical spine misalignment. It’s a cascading effect that seems very far reaching and maybe a little far fetched.
But these are very real consequences. The sneaky part is that it happens so gradually, like the old boiling frog adage. It’s like after three or four years you wonder why you hear a crunching noise when you open your jaw, or why you get those tension headaches.
There are some priorities, however, when considering whether to replace a tooth. A wisdom tooth of course is virtually disposable, and although it’s recommendable to replace any lost second molars, I must admit the loss in function and the shifting in the other teeth is minimal. But the first molars bear more stress than any other tooth, so replacing those or anything forward is an absolute must. And there is also the obvious cosmetic concern if the space is visible.
You usually have three basic ways to replace a missing tooth. The first is a removable partial denture. Although it’s the least expensive and it will maintain the correct relationship between the teeth, it’s not very functional or comfortable, or natural looking. It’s also a little overkill for one or two missing teeth, and is more useful when there are more spaces than teeth.
The second choice is a fixed bridge. This typically consists of two crowns that have the replacement tooth fused between them. The one piece ceramic construction can be computer generated for unparalleled accuracy. It is permanently cemented in place for a completely natural appearance and function.
The third choice is a dental implant. It is a titanium post coated with calcium that is very biocompatible. It functions like a root, and then a crown is attached at its surface. It is as close as you can come to a natural tooth.
The cost and appearance are similar for the bridge or the implant, but there are other pros and cons that may influence your choice. Although the success rate is better for the implant, it can take up to eight months after the extraction to finish, whereas the fixed bridge can be done much sooner. Whatever the choice though, it is much better for you in the long run to replace a missing tooth.
Dr. Moulton’s article was published in the Desert Valley Times on November 10th, 2009
This entry was posted on Wednesday, November 11th, 2009 at 10:51 am and is filed under Root Canal Therapy. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.