This patient broke off her front teeth and delayed treatment due to fear of contracting COVID. I cleaned up the decay and made her a PMMA temporary bridge so she could smile for the holidays.



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 30 year old patient drinks lemon water all day long. She also grinds her teeth. The grinding causes her teeth to crack and the acid from the lemon juice erodes the tooth causing demineralization of enamel allowing tooth decay.
Next, his 23 year old patient had a crack in his back upper molar. The tooth had a 10 year old amalgam restoration in it. The crack allowed decay to spread deep under the old amalgam filling. The tooth was not sensitive and the patient was unaware that he had a cavity. I removed the old filling and cleaned up the decay, placed a fluoride base to protect the pulp and restored the tooth with a beautiful ceramic composite.
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.