Tooth and Gum Issues: When to Consider Dental Implants

Dental issues, swollen and painful gums?

There is a molar in the lower left quadrant that underwent root canal treatment and was capped over a decade ago, and it seems a pin was also placed.
In the past couple of years, the gums around the tooth have frequently swollen and even caused pain.
Some dentists have helped me with dental cleanings and prescribed pain relievers, antibiotics, or anti-inflammatory medications for home care.
However, recently the pain seems to have increased.
A dentist used 3D imaging and indicated that the bone around the tooth has been significantly resorbed and recommended extraction followed by dental implant placement.
I would like to ask: 1.
Is it necessary to have a dental implant? 2.
Is it possible to redo the crown instead? Given that my periodontal health is not very good, is there a risk of implant failure? 3.
Considering I have a crown and a pin in place, will extraction be very difficult? Thank you.

Chen, 50~59 year old female. Ask Date: 2016/11/22

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Chen,
Hello! As mentioned, the periodontal condition of this tooth appears to be severe.
If extraction is necessary, you may consider options such as removable dentures, fixed prosthetics, or dental implants.
Please communicate further with your dentist.
Thank you! Wishing you safety and health!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2016/11/22

More Info

When it comes to dental health, particularly regarding issues like tooth decay, gum disease, and the potential need for dental implants, it's crucial to understand the underlying conditions and treatment options available. Based on your description, it seems you are experiencing complications with a lower left molar that has undergone root canal treatment and has a crown placed on it. Let's address your questions one by one.

1. Is dental implant necessary?
The recommendation for a dental implant typically arises when a tooth is deemed non-restorable due to significant bone loss, infection, or structural failure. If a dental professional has indicated that the surrounding bone has deteriorated significantly, this could compromise the tooth's stability and health. In such cases, extraction followed by an implant may be the best long-term solution. However, it's essential to get a second opinion if you're uncertain about this recommendation. Sometimes, alternative treatments like bone grafting or periodontal therapy can help restore the health of the tooth and surrounding structures, potentially allowing you to keep your natural tooth.

2. Can a new crown be placed?
If the tooth is still viable and there is sufficient tooth structure remaining, it may be possible to place a new crown. However, if the tooth is severely compromised or if there is significant bone loss, the prognosis for a new crown may not be favorable. The health of your gums and the underlying bone is critical in determining whether a crown can be successfully placed. If your periodontal health is poor, it could lead to complications with a new crown, including further infection or failure of the restoration.

3. Is extraction difficult due to the crown and pin?
Extracting a tooth that has undergone root canal treatment and has a crown can be more complex than extracting a healthy tooth. The presence of a crown and any pins used for stabilization can make the extraction process more challenging. However, experienced dental professionals are equipped to handle these situations. They may need to remove the crown first and then carefully extract the tooth while minimizing damage to the surrounding bone and tissue.

Additional Considerations
- Gum Health: Your ongoing issues with gum swelling and pain suggest that there may be an underlying periodontal disease that needs to be addressed. Poor gum health can significantly affect the success of any dental procedure, including implants. It's essential to have a thorough periodontal evaluation and possibly undergo treatment to improve your gum health before considering implants.

- Risk of Implant Failure: The success of dental implants is influenced by several factors, including the quality of the bone, the health of the gums, and the patient's overall health. If your periodontal condition is not managed properly, there is a risk of implant failure. Therefore, addressing any existing gum disease before proceeding with an implant is crucial.

- Bone Grafting: If there is significant bone loss, your dentist may recommend a bone graft before placing an implant. This procedure can help restore the bone structure needed to support an implant.

In conclusion, while dental implants can be an excellent solution for missing teeth, the decision to proceed should be made after careful consideration of your overall dental health, the condition of your gums, and the viability of your existing tooth. Consulting with a periodontist or an oral surgeon may provide you with more specialized insights into your situation. Always seek a second opinion if you feel uncertain about the recommended treatment plan. Your dental health is paramount, and ensuring you have all the information will help you make the best decision for your needs.

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