Best way to repair teeth?

[Gilbo]

Hi. I broke a tooth between Christmas and New Year. I went to the dentist and she put on what she called a 'strong, yet temporary' filling. This repair lasted until yesterday. I had been eating on the left (undamaged) side of my mouth and that was fine. Then my tooth gap/extraction site started hurting yesterday, as food had kept getting stuck in the gap, so I started eating in my whole mouth. That lasted for about an hour, until a 'normal' piece of food like potato or something, broke the temp repair and I was back to having a sharp point on the right side! Now I wonder, my previous dentist, who I left, used to use a material for repairs, that lasted for years and some teeth are still good because of that. This latest 'temporary' stuff was hard, but very rough and grainy and obviously didn't last. So could you please tell me what you think the more permanent fixing stuff is? As I think when I next see her, that she will probably use the same temporary stuff again, could I maybe ask her (if she won't use a more permanent type repair, as this is on the outside edge of my tooth, and not a filling) if she could just drill/file down the sharp edge of my tooth, so that it is no longer a problem? My previous dentist always refused to smooth anything down, as he said that it would be 'illegal' for him to do that! I can eat just fine with this broken tooth, so with the sharp edge taken off, I think it would be OK. I just want this problem to be over! (I also used this Den Temp repair stuff, but that only lasted for a couple of hours before falling off!) Thank you.

 

[Gilbo]

Hello? Any dentists available please? I'm hoping to see my dentist either tomorrow (Monday) or Tuesday even and would like to be forewarned, so I know then how to ask/answer questions related to my treatment. Thank you very much.

 

[MountainMama]

Not a dentist, but why can’t they do a composite filling? I chipped my front tooth as a kid and the dentist just did a regular composite filling which lasted 30 years.

 

[Gordon]

^^ That. Or just smooth off the rough edge

My previous dentist always refused to smooth anything down, as he said that it would be 'illegal' for him to do that!

Bollocks

 

[Gilbo]

Well that's what I thought Gordon! But he was adamant, which seems just stupid to me.
And thank you MountainMama. A composite filling, right, well I'll ask her if/when I get to see her. Yes I would be happy if she could just smooth it down, as I can eat just fine on what's left of it, there's just a small bit of the edge of the tooth been chipped off. Anyway, thank you both for that, makes me feel happier to face her now, with my new knowledge!

 

[Hazel527]

@Gilbo I'm no dentist but from my understanding as you have used the dema repair stuff you have to be seen by a dentist as that stuff only lasts a couple of weeks & it actually damages the tooth further, that is what I got told by my own dentist.

I had a filling fall out & a tooth snap in June 2020 I used that stuff, I have only just been seen by my dentist 20/01/2022 where I ended up with a 1 hour appointment for treatment.

 

[Gilbo]

@Hazel527 thanks for that. But in my case, the DenTemp filling stuff only stayed on the tooth for about a couple of hours! I don't know why, but having the first attempt fall out almost immediately, I stood holding my mouth open for an hour, waiting for it to harden (while I breathed through my nose) and having done that, tried to eat on the left side (opposite the broken tooth) and it just slowly fell to bits! I heard of one chap who made a whole 'tooth' out of the stuff and glued it in place! He could eat on it, but mine was totally useless. So thanks for your concern, but I will be seen by a dentist soon at my six-monthly checkup anyway, when hopefully she will fix it a bit better than me! My checkup is on 10th. Feb, whereas their next available 'emergency' appointment was only 2 days before, on the 8th! So much for emergency dentistry! In the meantime, waiting this long is doing untold damage to what remains of this tooth.

 

[Gilbo]

* Update * I see the dentist tomorrow, but last Saturday I had another bit break off that same tooth. So with the two missing bits, I now have a 'V' shaped pointy bit digging right into my tongue, which has made it impossible to ignore now! So I don't know what she will do about that? Could she maybe fit a crown over it? Though I would be happy for a more permanent filling type fixture, as my anxiety about tomorrow is now going through the roof! (This is due to having waited nearly 4 weeks for an emergency appointment!) But as it's also my checkup, I just hope she will actually do something. As my previous dentist wouldn't take any action on a six-monthly checkup, but would always have you make another appointment for a week or more away. Whatever happens and whether she does anything or not, I'm sure that I will run away from there as fast as I can!

 

[Gordon]

Crown or inlay would be possible, but it might not need anything so drastic. Just wait and see what they say tomorrow, it won't be that bad.

 

[Gilbo]

Thanks for that reassurance Gordon. It helped me get through today's appointment and I even managed to not gag once, during my 4 X-rays! Whereas last year she only managed to take one, as I couldn't stop gagging. I think that's probably because I laid on the couch? bed? (while she was doing paperwork), for 25 minutes before even looking at me. Which gave me time to relax at least. (I also heard, while in the waiting room, that she was going on a course tomorrow, for root canal treatments, I hope she already knows how to do these and that this is just an update or refresher!)

However, I now think it may become that bad again, as she said the only way to repair this tooth is with a crown and having researched it, it seems that she will once again, have to take impressions! I really hope not, as I had two sets of impressions taken last year, so she could have one false tooth made for me! I read that there is more than one way to make a crown, but that one of those ways is to take impressions, although I'm really hoping that she somehow does it another way? As I was gagging non-stop for about ten minutes while she did the lower set. Could I maybe just refuse to go through that again? Although, putting up with it like this for too much longer, could result in the tooth splitting and falling out of my mouth I suppose, which happened to another one, leading to my molar extraction in 2020.

I just want to run for the hills screaming, but I'm sure I'm just going to have to 'man up' and put up with this impression torture again, unless you (hopefully), know of a better way?

 

[Gordon]

There is another way but I don't know if your dentist can do it... it's called 3d imaging, the tooth is scanned by a special camera thing which sends an 3d map to a CAD/CAM machine that makes a crown. If she has the kit then she can do that or I suppose refer you on to somebody else. It's going to cost you though.
Of course you can refuse to go through anything, but the dentist would be within their rights to remove you from their list. Hopefully though you can come to some kind of accommodation with each other since it seems you have a good relationship going!

 

[Gordon]

Actually, just remembered, there's a 2nd and much more old fashioned way to do a crown without impressions.
The dentist can make the crown out of wax directly on your tooth. (We all had to do this in the late 70s when I was an undergraduate). It's really fiddly, takes blooming ages and you're stuck with only a gold crown, no white porcelain I'm afraid.

I wouldn't expect the resulting crown to win any beauty contests but it will fit extremely well (you're not introducing any minor errors during the impression/casting processes).

Given how much we all hated doing this, you'd probably need to dangle a major incentive under your dentist's nose to get her to do it

 

[Gilbo]

Thanks again Gordon. I've just had a panic attack over all this and felt terrible about it all. I've just rung my dentist (last Friday) and cancelled that appointment until I feel better about it. Hopefully I will be back to normal soon (the receptionist said I've got up to one year to come back to them!) But I'm sure I won't need that long. I just can't handle it at the moment.

I was really proud of myself for not gagging once during the X-rays too! I was reading though, that I could maybe get through the impressions by either spraying my throat with numbing throat spray, or by having the dentist numb me up, with injections, as if they were going to do a root canal or something similar. What do you think of that? Could it possibly work?

 

[Gordon]

There are a few well proven ways to help with gagging. Numbing throat spray isn't effective and can be a bit dangerous, I'd avoid that one. Not sure how injections would help either.

What does work very well is all or some of the following:

1) The salt trick. Sprinkle some table salt granules on the very back of your tongue before the impression. A salty mouthwash can work but actual salt is better. No idea why it works but it works very well. (It isn't a placebo, I used it several times on a patient with such severe brain damage that she couldn't possibly have reacted to a placebo).
2) Acupuncture. There's a couple of points that work quite well.
3) Inhalation Sedation can be very effective

 

[Gilbo]

Oh dear, that's a shame, as I'd been 'promised' by various websites that the throat spray would DEFINITELY work and if not, then the usual way of numbing up by injection would instead! I expected a few problems though, as always. I'd heard about 'the salt trick', but where I'd read it, said it must be on the very TIP of the tongue! I can't imagine not gagging with it on the back. Acupuncture seems to be touch and go, with some people swearing by it and others swearing at it! And I think inhalation sedation would only be available at dentists who do that wouldn't it? I know that neither of my dentists (previous and current) wouldn't/don't do it. So I'm scuppered by the sound of it! But once again, thank you for this. I will try the salt thing and see if I can bear salt on the back of my tongue.

Another thing I read, said to brush your tongue as far back as you can stand, going a little farther back each time that you get used to it. Could that possibly work?

 

[Gilbo]

Just to add that, as I am at the moment, there is a very good chance that I will probably refuse any kind of treatment, as my palms are sweating and my heart is racing, just reading your reply Gordon. So I need to find something 'guaranteed' to work, by the time my next appointment comes around, whenever that may be!

 

[Gordon]

Since the salt stuff works with a rinse of salty water then I don't think it's particularly crucial where it goes!
There is a technique involving marking up a toothbrush, mark off even increments with tape or whatever, the sizes of the increments is not important. In front of a mirror advance the bristle part of the brush on your tongue very slowly and carefully.
If you feel any urge to gag then stop. Do NOT proceed until you actually gag, this is important.

Note how many increments you can manage. Keep on doing it as often as you can be bothered to, trying to gain an increment every now and then, but the trick is to control your breathing and relax to overcome the urge to gag.

Keeping your mouth wide open and concentrating on breathing through the nose is the way forward, you're essentially training yourself to do it.

 

[Gilbo]

That's great Thanks Gordon! I will practice with that a bit each day. I've tried cleaning my tongue with a brush before now, but always found it hard, but got a bit more used to it eventually, so I suppose that's the trick, a bit at a time.

 

[Gordon]

I think that having the increment marks is to give you a target to aim for, to get some positive reinforcement or something
Like I said, the important thing is not to provoke a gagging event, which will set you back a bit.