If dentists were to tell jokes one of them might be ‘when is a lift not a lift?’ ... Answer .. when it is an elevator. Blank looks all around? If you read on, things will become clearer.
In today’s blog we are going to take a look at a specific dental problem that might appear straightforward on the surface but comes with its own complexities. That is when a tooth crown breaks off and leaves no significant amount of crown above the gum line. Where the crown is above the gum line, and, presuming it can’t be saved, then extracting the tooth is usually relatively straightforward. When it is below though, this all changes.
Before we look at treatments, it is worth asking why this should happen. In many cases it is simply the case that decay has become quite extensive and this weakens the tooth structure causing significant breakage. There may still be a small part of the tooth showing above the gum line, but not enough for the usual dental tools used for extractions to be able to manoeuvre the tooth from its socket.
With the tooth being completely, or almost completely, beneath the gum line, we can’t see the full picture from a visual check. It is important then, that we take an x-ray before we take any action.
It may be that an extraction will be without any complications once an x-ray has been taken, but sometimes, a tooth root is located near a nerve and it is important that our Staines dentists are aware of this before the extraction takes place. For the purpose of this blog, we will assume that this is not a problem and take a look at what happens next.
In a standard tooth extraction, the dentist is able to take hold of the tooth and move it around until it loosens from the socket and can be extracted from it with relative ease. Where a crown is broken at the tooth, this eliminates this method and our Staines dentists will need to take a different approach altogether, without causing trauma to the bone and gum surrounding the ‘buried’ tooth root. In fairly rare instances, this might require some highly invasive dentistry, but for the large majority of patients, the solution is surprisingly straightforward.
One of the most important tools that we use for this purpose at the Clarence Dental Practice is the dental elevator (hence the poor joke earlier!) This is a simple but specialised tool that is used for this specific procedure.
As with any procedure such as this, the patient will be given a local anaesthetic to enable the treatment to be carried out without any pain. The elevator, which looks a little like a screwdriver, but is obviously more sophisticated, is carefully inserted between the tooth root and the surrounding bone tissue. It is then gently manoeuvred until the tooth root becomes loose and the tooth is then gently lifted from its socket. There is a slightly different method used in some cases and this uses a ‘cryer-style elevator’. This is very similar except that it is designed so that as the handle is turned and twisted, the tip lifts the tooth root from the socket as above. Both work in very similar ways but the option used will depend on specifics surrounding the issue.
By using a dental elevator, it is usually possible to extract the damaged tooth without causing trauma to the surrounding tissue, making healing more straightforward.
There may be rare situations where the above method does not work. In cases like this you may need to have the root surgically removed. This briefly involves making an incision into the gum in order to expose the tooth root. The root may then be cut into smaller pieces so that it can be removed. By and large though, this is likely not to be necessary.
As with any extraction, it will be necessary to allow the area to heal in the usual way. You will be given full advice at the time and, of course, we will always be available for any help or advice that you might need as it heals.
While you can simply leave a gap in your teeth, most people prefer to replace the missing tooth, especially if it is in a visible position. A gappy smile is not especially attractive. It can also cause teeth to shift, leaving you with a crooked smile.
We can discuss this with you at the time but the main options available are dentures, a bridge or dental implants which we've discussed in previous blogs. If you would like to talk to us about a dental issue or to book an appointment with us, you can call the Clarence Dental Practice on 01784 463 695.
Address: 21a Clarence Street, Staines upon Thames, Surrey, TW18 4SU
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