DENTAL CARE

Q: Can You Save My

A: Tooth? When I was asked this question yesterday, another patient came to mind. The other patient I had treated the day before encountered a similar situation. The question is fundamental and one I deal with multiple times during the week. I felt that the topic of preserving a tooth in the mouth would be a good

discussion for this week’s column. As all of you know, I am an ardent

advocate of keeping teeth forever. Teeth are vital to our health for a variety of reasons. The most

obvious one is nutrition. A good and healthy dentition allows us to chew various foods vital to our overall health. We see today in America the extent of disease that develops because of poor eating choices. Some of those choices arise because of a desire, and others arise because

we don’t have a healthy set of teeth whose job is to chew our food well.

All that being said, there are times when I recommend removing a tooth instead of keeping it in the mouth. The rationale behind those decisions can be from a multitude

of factors. Today, I want to focus on the amount of decay of the tooth in question. When I tell a patient a tooth has a cavity or when a patient

comes to me with a hole in their tooth, my mind immediately goes into an assessment mode. What do I have to do to stop the cavity process most simply and straightforwardly?

The level of decay guides my thinking. Teeth with a small or

medium cavity or hole in the tooth can easily be put back into service and a state of health with a simple filling. Whether the filling is an older style silver amalgam or a newer, white-colored filling does not make a difference. I remove the decay and then “patch,” if you will, the area with some hard material that will let the patient chew.

Both patients that I saw had decay under old crowns. The crowns were in good shape, but the tooth underneath, due to cement leakage and breakdown over time, allowed

bacteria to enter the tooth. In these two patients, the decay went down under the gum area. A routine matter of decay can become very complicated whenever decay goes under the gum. A dentist cannot fill a tooth or create a proper seal

when we work under the gum. The difficulty stems from gum tissue

having fluid, and the tiniest amount will leak into the tooth area. Our materials do not attach well to a wet surface.

My goal involves creating an area where I can control this wetness and proceed to fix the tooth. Whether that fix is as simple as a filling or more involved, like a crown or even

a root canal procedure, dryness is key. If I cannot achieve this goal, then, unfortunately, the tooth will

come out, and I will replace it with a bridge or an implant to maintain function, health, and balance in the mouth.

Every situation is different, and every dentist has their comfort level and skill set. The more years we practice, the more we expand our skills to handle a wider variety of situations. If you recently received a message that a tooth is hopeless, I encourage you to get a second opinion. Maybe we can come

up with a positive solution for you. Please call me at 440.951.7856 and make an appointment with Nicole.

I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD, is an Ohio licensed general dentist and is a staff member at Case School of Dental Medicine in the Department of

Comprehensive Care.

The Healthy Smile

34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095 440-951-7856 Severance Medical Arts, Suite 603 5 Severance Center Cleveland Heights, OH 44118 216-371-2333 www.jeffreygrossdds.com