Dr. Robert T. Cadalso

We cannot see everything that is necessarily wrong with a tooth by merely looking at the tooth in your mouth. An analogy I often use is if there is something wrong with your engine in your car your mechanic must raise the hood and look inside. An x-ray is like “looking under the hood” of your tooth. If a tooth is abscessed (infected) it is visible inside the bone which can only be seen in an x-ray. Cracks are difficult to diagnose we sometimes request a CBCT a dental CT scan of the tooth to help evaluate a cracked tooth. In summation to properly diagnose tooth problems we need:
1. X-ray
2. Clinical Exam
3, Patient history of symptoms
Then we can properly determine a diagnosis of the problem and a plan of action to correct the issues

3 year olds have only deciduous or baby teeth we can only do root canals on permanent teeth. What your dentist was referring to is what is called a pulpotomy as the name implies we remove the pulp which is the nerve and blood vessels from the baby tooth because of deep decay that has reached the pulp. The best sppace maintainer for the underlying permanent teeth is to maintain the baby tooth in place as long as possible until the permanent teeth can erupt at the proper time. My greater concern is why is a 3 year old in need of a "root canal" dietary concerns are a must to prevent cavities and regular checkups are needed as well so that cavities do not get to the state that more aggresive treatment is needed.

This is "normal" for her. Most patients consider a gap between the upper two front teeth referred to as a "diastema" to be cosmetically undesireable evryone is different and if it doesn't bother her then leave it! As far as it being normal in an ideal sense there should not be a gap sometimes it is caused and/or made worse by the muscle attachment to her upper lip called a frenum. To close the gap we either bond the teeth to close the gap or orthodontically move the teeth to close the gap if the frenum is contributing to the gap the orthodontist would refer the patient for the frenum to be trimmed. The famous actress/model Lauren Hutton has a diastema and for years she wore a device to hide her gap. After many years she decided to embrace her diastema and is seen in photos with her God-given gap!

Pain a week after wisdom teeth extractions is NOT unusual the question is difficult to answer in that I have no idea how difficult the extraction was. In the case of a fully impacted lower molar pain can last a week or more. Additional factors besides the difficulty of the extraction that can make pain worse is the presence of infection, a dry socket (improper healing of the wound) food packed into the extraction area and your own pain tolerance level. Avoid eating hard crunchy foods that break up into hard nuggets such as peanuts taco chips etc., rinse your mouth several times a day with warm salt water and return to the dentist who did the extraction for an evaluation to detrmine the extent of the problem.

The most likely diagnosis is that this is lichen planus it is a lesion that is relatively common it is not malignant and has low conversion to a malignant lesion. We are NOT certain what causes lichen planus there are many theories such as it is linked to auto-immune disorders, contact dermatitis from adjacent silver fillings, stress induced, and even dietary nutritional deficiencies such as iron/folate deficiency and vitamin B12. A definitive diagnosis can ONLY be determined by doing a biopsy of the lesion. There are several different classifications of lichen planus and one type often appearss as a white filmy almost spider web appearance on the oral tissues most commonly on the cheeks, these are known as "Wickam's striae". Often patients complain of discomfort when eating acidic or spicy foods so a bland diet is recommended. It is not uncommon for the lichen planus to disappear spontaneously. As far as medications sometimes oral topical steroids are prescribed or steroid rinses as a palliative treatment.

You can begin transitioning towards more solid foods, however, avoid hard crunchy things tat break up into hard little nuggets such as nuts, taco chips, etc., that will certainly get lodged into the sockets. Once the sockjets ("holes") are closed, then you can pretty much eat anything.

On average, 5 years, give or take; it all depends on 1. how well it was done, 2. how well you take care of your mouth, frequent brushing/flossing, and visits to your dentist 3. are you a clencher/grinder, this habit reduces the life span of a filling, and lastly, any bad habits? Chewing ice, hard nuts/candies can potentially damage a filling/teeth and reduce the lifespan of restorations.

Yes, that's a possibility. You may have a dry socket and that is usually quite painful and is associated with a bad taste/odor in your mouth. You need to return to the dentist that did the extractions and have him evaluate it, or see an oral surgeon. Warm salt water rinses, 3-6 times a day will help keep the area clean and is soothing to the teeth/gums.

Yes, you can certainly request that you be anesthetized when having your teeth cleaned, however, to have your entire mouth anesthetized is rather uncomfortable. Discuss with your dentist having nitrous oxide (laughing gas) to have your teeth cleaned. If you hate the sound, wearing headphones with your favorite music can also help.

Get to a dentist ASAP!!! Nothing good is on the horizon if you wait IF it is savable the sooner that is dtermined the better

Diabetics have a higher incidence of periodontal disease. We diabetics don't heal well/quickly. Make sure your diabetes is under control working with your MD and have teeth cleanings more often 3-4 times per year. Lastly, use good home care and at all costs avoid smoking.

Systemic infections known as "bacteremia" can definitely originate in the mouth. Individuals with periodontal disease can exacerbate heart issues. That is why often physicians request that a dentist treat you "prophylactically" with antibiotics to reduce the likelihood of a heart infection known as "subacute bacterial endocarditis" or SBE. Some bacteria can also cause bronchitis and pneumonia, and make conditions such as emphysema and chronic obstructive pulmonary disease worse.

A porcelain veneer or even an all porcelain crown would be a longer lasting restoration, however, that may be a drastic decision based on the size of the filling if the filling is relatively small try lessening the chances of discoloration avoiding really abrasive toothpastes along with highly intensely colored foods such as red wine boysenberries, blueberries etc. will stain the filling quicker

When we are young all of our teeth are relatively "sharp", however, as we age we wear down the cusps (the sharp points on teeth). If you are a heavy/habitual grinder this process happens quicker. Our bite also determines the amount of wear our teeth suffer.

Depends on the issue with your TMJ arthritic changes for xample happen as we age and affect all joints including your TMJ. If the TMJ issue was caused by heavy grinding during a particular time in your life those changes can reverse to a certain extent. A bad bite can contribute to TMJ issues check with an orthodontist to see if braces are indicated also wearing a bite plate often called a night can take the stress of the joint

Brusing too hard is definitely a common problem. Amazingly enough grinding your teeth is often the cause of those ditched out areas at the gumline which if we brush too hard or with too hard a brush can make them worse/deeper. Google the term "abfraction" for an explanation. Although an electric toothbrush is more efficient a t cleaning teeth if used INCORRECTLY such as applying too much pressure while brushing can be very harmful. Unfortunately MOST electric toothbrushes have too hard of nylon bristles which are not kind to teeth

This is called "tongue thrust", it is an abnormal swallowing pattern that can cause your front teeth to be thrust forward by the force of your tongue which is a very strong muscle. A speech therapist can train you to develop a proper swallowing pattern to reduce/eradicate this problem!

Have your sensitivity evaluated mor ethoroughly by your dentist or seek another opinion. Are you grinding/clenching your teeth? What is your diet like? A "medicament stent" can be made and you can apply topical flouride or a desensitizing toothpaste in them to give yourself "desensitizing treatments

Have possible allergies evaluated such as for latex gloves that were used by the hygienist/doctor or to the anesthetic used such as the topical.