Q: Recently, six old crowns and their posts came off the front upper teeth that they were attached to. My dentist wants to do all new posts and crowns. Why cant he just re-glue the old work back onto the teeth? Dan in West Boca
A: Well, Dan, you can consider yourself lucky that he can save the teeth. You know the expression: “I complained about not having a nice pair of shoes, until I met a man who had no feet”? There are many patients in your predicament who cannot save any of the teeth and must have them all extracted and replaced with dental implants and crowns, or, due to finances or lack of bone, where false teeth (dentures).
Let’s get to the “root” of the problem (sorry for that one.) Over time the cement often washes out from underneath crowns and posts, which were originally cemented to the inner walls of the root canal’s channels. Most patients who insist to just “glue” these failed restorations back in the mouth will eventually get massive decay below the gum line, which will make the teeth hopeless. You must have at least a two-millimeter circular band of healthy tooth structure left above the gum line in order save these teeth with new posts and crowns. If not, they must be removed and, ideally, replaced with dental implants: titanium anchors, which support new crowns.
EDITOR’S NOTE: Dr. Mitchell Josephs will be giving a FREE LECTURE on Hi-Tech dentistry: Incision-Free Dental Implant Surgery, Digital Crowns &Veneers and How to Choose a Dental Office at the Double Tree Hotel on PGA Blvd. in Palm Beach Gardens on Thursday October 13th at 4:30pm. All attendees will receive a FREE copy of his book: “Tooth Talk”. Seating is limited to 50. Call today to register at 561-832-2917
Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts the “Tooth Talk” radio show live on Fridays at 11am and Tuesdays at 8:30am on WBZT AM1230. (www.radiotoothtalk.com) On staff at Good Samaritan Medical Center, Dr. Mitchell Josephs is on the Faculty Advisory Board at McGill University’s Faculty of Dentistry. Send questions to drjosephs@palmbeachdentist.com or call 888-DRTOOTH (888-378-6684) or visit www.palmbeachdentist.com
Q: Dear Doctor Josephs: My brother has schizophrenia and has always had terrible dental problems. Now he needs implants, crowns and bridgework. I have already booked a consultation in your office, as you seem to be extremely well versed in these procedures. Is it common for schizophrenics to have extensive dental problems?
bone grafts and crown treatment. I already use NSAID pain medications for my arthritis pain, but I’m concerned that if I now use more of them during these weeks and months of dental surgery that I may increase my risk of heart attack or stroke. Is there a less risky drug for me? Stan in JupiterA: Firstly, let me wish you a comfortable and successful few months that is “tsoris” free. (For those who understand Mandarin.) Don’t worry about implants. Almost all of my patients tell me they take one Tylenol the day I place the implant, and that’s it for pain meds. A single dental implant can be placed in 5 min. with the newer flapless/incision less techniques, followed by the attachment of permanent teeth in as little as 12 weeks.A recent study suggests that naproxen (Aleve and Naprosyn) is the safest nonsteroidal anti-inflammatory drug (NSAID) in terms of heart attack risk. Ibuprofen (Advil, Motrin) was at an intermediate level in terms of heart attack risk. The riskiest drugs appear to be Cataflam, Volteren and Celebrex. One should also know that ibuprofen (Advil, Motrin) interferes with the ability of noncoated, low dose aspirin to prevent heart attack or stroke. If you take both, take the ibuprofen at least 30 minutes after or eight hours before taking aspirin.
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