On this patient I noticed decay under two 20 year old crowns on teeth #30 and 31. Removal of the old crowns revealed tooth #30 with deep decay sub-gingival into the root furcation. This tooth was non-restorable. I recommended extraction and an implant. For tooth #31, I was able to clean out the decay and do a crown build-up and make her a new crown.
The first x-ray above shows my initial try-in with a gap between the implant crown and implant. The crown would not fully seat, so I re-did the implant crown. The second x-ray, after re-doing the implant crown, shows a perfect fit!!! Both the implant crowns #30 and #31 fit and look beautiful.
These two patients today had badly broken down teeth. One option would have been to extract the teeth and place implants. I wanted to try to save the teeth by building them up and placing crowns. Here are the before and after photos.
This first patient had a large deep cavity on the inside (lingual surface) of her upper lateral incisor. The decay extended under the gum-line and the pulp was necrotic. We discussed treatment options and could have extracted the tooth and placed an implant, but I felt we could save this tooth with a root canal and composite build-up.
The next patient had a cavity on his upper molar. I quickly and easily removed the decay and placed a composite restoration.
This is what happens when you don’t brush your teeth and do not see a dentist for 10 years. Most of this 64 year old patient’s teeth looked like these two that I uploaded here. Some are just too decayed and will need to be extracted, these two teeth I was able to restore with bonded ceramic composite restorations. Here’s are his before and after photos.
As Dean’s Faculty, Clinical Assistant Professor in The Advanced General Dentistry Department at The University of Maryland School of Dentistry, I am used to teaching and educating residents and senior dental students. I am always happy to answer questions and show patients exactly what I am doing and explain why.
This patient had been taking medications for depression and allergies causing dry mouth. As a result he developed decay under an old crown. I was able to save the tooth by removing the old crown, cleaning out the decay, and placing a new beautiful all porcelain crown.
This patient has decay on her molars caused by dry mouth from her medication Spironolactone, which she takes for acne. It clears up her face nicely, but with less saliva to clean off and protect her teeth, cavities form.
This patient hadn’t been to the dentist in 5 years. This upper molar tooth was not sensitive and he had no idea he had any cavities. Here’s the before and after cleaning out the decay and placing a ceramic composite restoration. The procedure took about 30 minutes.
This patient takes a medicine called atenolol, which is a beta blocker, used to treat high blood pressure. It’s great at lowering blood pressure, but also causes dry mouth. She also loves to eat Reese’s Peanut Butter Cups. The decreased saliva and frequent consumption of sugar caused these teeth to decay and the cavities to form. I was able to remove the decay and restore the teeth with ceramic cosmetic fillings. These before and after pictures were taken 15 minutes apart. Looks great!!!