Root Canal Issue Is Delaying My Invisalign Treatment

I am concerned about a root canal issue that is delaying my Invisalign treatment. Last November, my dentist filled a small cavity. But the tooth became sensitive to cold on and off. My dentist said I needed a root canal and a crown. He completed treatment, but my dentist had problems getting the bite correct. I was beginning to get jaw pain and earaches. The tooth settled down a bit but was still a little sensitive. Within the past two weeks, the sensitivity increased. When I went to the dentist last week, he said he might need to repeat the root canal. But I am six months pregnant now. And I am a little frustrated because this ordeal is delaying when I can start Invisalign. How do I know if I need repeat root canal treatment? – Lashelle from Kansas


Thank you for contacting our office.

Although Dr. Burba would need to examine your tooth and crown, we are concerned about your dentist. It is unusual for a small cavity to end up with an infection and root canal treatment. And your dentist has been unable to resolve tooth sensitivity completely.

From Small Cavity to Root Canal Treatment?

When a dentist tells you that they filled a small cavity, but the tooth soon needs root canal treatment, the dentist’s diagnosis was incorrect. The cavity must have been large, or your dentist missed signs of infection.

Tooth Sensitivity After a Filling and Crown

A tooth infection may be causing the sensitivity. But your dentist may have made a mistake while placing the filling or during your root canal treatment.

Dental X-rays During Pregnancy

We understand your concerns about exposing your baby to x-ray radiation or chemicals during pregnancy. But dental x-rays emit low radiation. So, you can review the American Dental Association’s recommendations about dental care during pregnancy. But if you have a tooth infection, it can potentially spread into your bloodstream and become more serious.

If you are skeptical about your dentist’s care, we recommend finding an advanced cosmetic dentist. The dentist will examine your tooth to identify the cause of sensitivity and your jaw pain and earaches. The dentist will also determine if you have a tooth infection and need repeat root canal treatment. Although the process is delaying your Invisalign treatment, it is best to resolve it now than have the issue recur or worsen during orthodontic care.

Best wishes for a quick resolution.

The Salem, Massachusetts, dentists at Burba Dental Partners sponsor this post.

Do I Need to Switch Dentists to Get My Implant Crown Color Right?

Although my dentist replaced the first mismatched implant crown he gave me, the second crown is no better. Twice I went to the lab my dentist uses for color assessment. But my dentist attached the crown without assessing the color. He did not even ask my opinion. I thought he was putting the crown on for me to check—not cementing it on. On top of that, I felt like my jawbone would break because my dentist had trouble attaching the crown to the implant. Well, now the crown is the wrong color, and it hurts. Should I ask for a refund and find a better dentist? Am I wrong for thinking this is ridiculous? Thank you. Scott from Kansas


Your frustration is understandable. Unfortunately, you are the victim, but your case shows the difference between dentists who understand aesthetics—creating beautiful dental work—versus those who want to fix it and get it done.

It seems that your dentist has little or no interest in aesthetics, so your crown does not match. And your description makes it seem that your dentist is not interested in your satisfaction with the work either. A cosmetic dentist would ensure the color is right before cementing it. And if the color is off, they would return your crown to the lab to correct it.

When a dentist sends you to the lab for a color check, it is a clue that the dentist is not skilled in matching restorations (e.g., a crown) to your tooth color. Your dentist should be more qualified than the technician and instruct the technician with notes on what to do to color match the implant crown to your natural teeth. A cosmetic dentist also sends a shade guide and pictures of your smile to help the lab tech craft an accurate match.

We think that you realize that you cannot rely on your dentist. If you want your implant crown to match your natural teeth, you need to find a dentist trained in aesthetics and having artistic inclination. A skilled cosmetic dentist is your best option for getting predictable results.

How to Find a Reliable Cosmetic Dentist

We recommend that you look for a dentist with advanced cosmetic dentistry training. How can you find a trustworthy cosmetic dentist?

  • Look for a dentist with accreditation from the American Academy of Cosmetic Dentistry or extensive post-graduate training in cosmetic dentistry.
  • Look at a few dentists’ websites and their smile galleries to see the quality of their work.
  • Then, schedule consultations with two of them, discuss your concerns, and decide who you can trust to finish the work.

Best wishes for a beautiful new implant crown.

Salem Massachusetts dentist Dr. Randy Burba sponsors this post.

Will I Need Bone Grafting for Dental Implants?

I think I will need bone grafting for dental implants. I lost most of my teeth to disease and injury and probably need extractions. I’m guessing, though, because I’ve only seen my family dentist about this. Although my dentist says he can do the implants, I am not confident that he has enough experience. I am not comfortable. How will a dentist determine if I am a candidate for bone grafting? Thank you. Rochelle from Denver


Thank you for your inquiry. Your decision to get dental implants will improve your oral health. And you are wised to be cautious when choosing an implant dentist.

Will You Need Bone Grafting for Dental Implants?

You will need bone grafting for dental implants if your teeth have been missing for years and do not have enough bone volume to support implants. Your dentist must take a CT scan to measure your bone volume.

What Is Dental Implant Bone Grafting?

Dental implant bone grafting is a procedure that builds up jawbone volume. When your teeth are missing, your body takes minerals from your jawbone in those areas and uses them elsewhere. As your jawbone shrinks, it will become challenging to support dental implants.

Snap on Dentures
Snap-on denture

Whether you need implants to replace individual teeth or to support a snap-on denture, it may require bone grafting to give implants enough support. The bone grafts need to heal before your dentist places implants.

Bone sources for dental implant grafting

Bone grafting for dental implants can come from your bone—perhaps your hip or below your knee. Other bone sources included a tissue bank or artificial bone.

Are You a Candidate for Dental Implant Bone Grafting?

An implant dentist will need to take x-rays and a CT scan to reveal your oral anatomy, bone volume, and bone health. But you are probably a candidate for implant bone grafting if the following is true:

  • Good oral health
  • Good overall health, including free of gum disease
  • A non-smoker

How to Find a Dentist for Implants

Look at dentists’ websites and review each doctor’s biography for post-graduate training in implant dentistry or partnership with a specialist in implant surgery.

After identifying two or three dentists who meet the qualifications, schedule consultations to discuss details about your case. You can prepare questions and take notes to compare dentists’ qualifications and whether you liked their interaction with you.

Best wishes.

The Salem, Massachusetts, dentists at Burba Dental Partners sponsor this post.