Common Dental Issues: Pain, Treatment Options, and Orthodontic Concerns

Teeth

I would like to ask the following questions.
Thank you!
1.
The three dental crowns (bridge) on the left side have been in place for 8 years.
Recently, one of them has been causing pain when biting, even though the nerve has already been treated.
Why is there still pain?
2.
If treatment is necessary, can the crown be removed and then reattached, or once it is removed, does it need to be completely remade?
3.
Currently, I have two major issues: misaligned teeth and missing teeth.
If I decide to undergo full orthodontic treatment, how will the areas that already have crowns be handled?
4.
Regarding the two major issues of misaligned teeth and missing teeth, if left unaddressed, will they lead to facial deformities, asymmetry, or even sagging over time? Thank you, doctor!

Zhenzhen, 30~39 year old female. Ask Date: 2007/08/20

Dr. Cao Guoqing reply Dentistry

Dear Miss Zhenzhen,
The source of tooth pain is not solely due to nerve inflammation; periodontal tissues can also cause pain.
To treat this, it is necessary to remove the dental braces, which will be covered by insurance, and they will need to be redone.
Regarding orthodontics, if it is a single brace, normal procedures do not require removal.
However, if multiple braces are involved, it may be necessary to remove them to facilitate the orthodontic process.
If malocclusion and tooth loss are ignored, over time, facial deformities may occur.
Sincerely,
Cao Guoqing
Dental Department, Hualien Hospital, Ministry of Health and Welfare

Reply Date: 2007/08/20

More Info

When it comes to common dental issues, particularly those involving pain, treatment options, and orthodontic concerns, there are several factors to consider based on your specific situation. Let's address your questions one by one.

1. Pain in a Tooth with a Crown: The fact that you are experiencing pain in a tooth that has had a root canal and is capped with a crown can be concerning. Even after a root canal, pain can arise due to several reasons. One possibility is that there may be residual inflammation in the surrounding tissues, or there could be an issue with the crown itself, such as improper fit or occlusion (bite alignment). Additionally, the underlying tooth structure may still be sensitive or have developed secondary issues, such as a fracture or decay beneath the crown. It’s important to have this evaluated by a dentist to determine the exact cause of the pain.

2. Removing and Replacing a Crown: If treatment is necessary, it is generally possible to remove a crown for evaluation and treatment. However, whether the crown can be reused depends on its condition upon removal. If the crown is intact and undamaged, it may be possible to re-cement it. However, if there is any damage or if the crown does not fit properly after removal, a new crown may need to be fabricated. Your dentist will be able to provide guidance based on the specific circumstances.

3. Orthodontic Treatment with Existing Crowns: If you are considering full orthodontic treatment, it’s essential to discuss how existing crowns and bridges will be managed. In many cases, orthodontic treatment can be performed without needing to remove crowns, especially if they are stable and well-fitted. However, if significant movement of the teeth is required, it may be necessary to remove or adjust some restorations. Your orthodontist will create a treatment plan that considers your existing dental work.

4. Consequences of Neglecting Dental Issues: Ignoring issues like misaligned teeth and missing teeth can lead to more significant problems over time. Misalignment can cause uneven wear on teeth, jaw pain, and even changes in facial structure. Missing teeth can lead to shifting of adjacent teeth, which may exacerbate alignment issues and lead to further tooth loss. Over time, these problems can contribute to facial asymmetry and other complications. It is advisable to address these concerns proactively to maintain both oral health and overall facial aesthetics.

In summary, it is crucial to consult with a dental professional who can provide a thorough examination and tailored treatment plan based on your specific needs. Regular dental check-ups and addressing issues as they arise can help prevent more severe complications in the future. If you are experiencing persistent pain or discomfort, do not hesitate to seek immediate dental care. Your oral health is vital not only for your teeth but also for your overall well-being.

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