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Pain in tooth, gum disease, gapped teeth. What is the solution?

Hi. I have some pain in my left front tooth and has become loose. Went to my dentist which he told me that the tooth is loose because of gum disease and the tooth cannot be saved. The other front tooth is solid and doesn t seem to have any gum disease. Also want to mention that I have a gap between the front teeth . My dentist wants to replace the loose tooth with a bridge which means he ll need to pull the good tooth along with the loose tooth. I object to this because I don t want to lose a good tooth for the sake of making my front teeth look even and ridding me of the gap. Couldn t he just replace the loose tooth with an implant and even up or get rid of the gap by capping the good tooth? Isn t there another alternative?
Asked On : Fri, 29 Mar 2013
Answers:  4 Views:  116
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Dentist 's  Response

Thanks for asking the query,

Lower front tooth became loose due to some localised peridontal infection ,
Suggest you to take an x-ray before extraction of the tooth if not taken.
As you have a gap it is better to go for a bridge .
Implant can also be placed , it depends upon the condition of the supporting structures, it requires visual and radiological examination of the tooth , discuss with your dentist.

Get complete mouth scaling and polishing done .
Use antiseptic mouthwash gargles like chlorhexidine twice daily.
Maintain a good oral hygiene .

Hope this helps out.

Answered: Sat, 30 Mar 2013
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Dentist Dr. Bindiya Bhaskar's  Response
Hello and welcome to hcm forum,

As you mentioned,your front tooth is mobile due to periodontitis.
Depending on the supporting bone structure of adjacent teeth,the mobile teeth can be replaced with a implant or bridge.
An x-ray will help to rule out the condition of tooth.
Deep scaling and root planning has to be done.
Maintain good oral hygiene.
Since your teeth are periodontally compromised,extreme care is required.
The dentist prefer bridge after removing the mobile tooth due to the spacing or gap between the adjacent teeth.
Take care.
Answered: Fri, 29 Mar 2013
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Dentist Dr. Farah Hussain's  Response
hello there ,

As you ave mentioned your front tooth is mobile it indicates your tooth has lost the underlying bone support due to a inflammatory condition called periodontitis.

Such mobile teeth with poor prognosis cannot be saved and should be extracted and replaced in position by an implant tooth or a prosthetic bridge replacement.

since you have spaced dentition , gaps in between the front teeth can be better managed with a bridge rather then a single implant tooth.

you have get a implant tooth done to replace the missing but gap in beteen the two teeth cannot be managed.

i hope this information helps ,

take care.
Answered: Sat, 30 Mar 2013
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Dentist Dr. Sushant Benjamin's  Response
Hello, thanks for contacting Healthcare Magic. On the point of your problem, first of all, i would first or all like to call your attention to your loose tooth... As you imply, your tooth is quite loose (mobile), that itself implies that the supporting structures to the tooth have become eroded, and hence probably cannot be saved (your dentist can explain better), also, you reported of experiencing pain in the same tooth, which implies inflammation (probably due to infection) in the periodontium of the tooth. The infective inflammatory infiltrate destroys the periodontium, and if more than half of the supporting structures of the root of the tooth are destroyed, then it is always better to extract the tooth, than try to save it (the status of the periodontium will be clear on an IOPA X-ray).
Now, addressing your query about an implant, yes it may be the best option, if your alveolar bone is strong enough, if your blood reports show adequate levels of Calcium and Phosphate compounds, and if you are not allergic to the bone graft material (which usually people are not). But, it may not cover the gap (also known as a "mid-line diastema").
Now, comming to the "capping", in-case your adjacent (unaffected/normal) tooth is rotated, or mal-aligned in any way, then trying to cap it may be disastrous, as the "bridge" (or the "multi-toothed" cap) may not remain stable, and can anyway then result in a periodontal disease of the healthy tooth itself, and then it will need to be extracted anyway.
All in all, you do have valid objections, but you need to clarify them with your treating dentist, as he/she is better versed with your condition.
Hope that this is helpful to you.
Answered: Fri, 29 Mar 2013
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