Patient's Query
Hello doctor,
I had my teeth cleaned two weeks ago, and they said I need two fillings for my back teeth. But I noticed new pain in some of my front and side teeth. I think she damaged my tooth while cleaning. I just took a picture of the canine and noticed a chipped area, which I had never remembered. And I have pain now, and it is affecting my whole chewing, which I never had. Please take a look at the picture and let me know what treatment you think you would recommend and its approximate costs. I am planning to travel back to my native this year for some dental work, as I do not trust the dentists here. I also included pictures of a side tooth with a hole or chip, a front tooth with gum recession, and another with the erosion of the tooth. I brush my teeth at least twice a day and floss. But I wake up with a bad, sour, dry taste in my mouth, and sometimes I get up in the middle of the night to brush again to reduce the bad taste in my mouth. I tried Chlorhexidine, salt rinses, and Nexium for reflux, but nothing has helped. Eliminating alcohol and minimizing coffee and caffeine helped a bit, but it is still an issue.
Please suggest.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
I will update you after the clinical evaluation of the attached pictures (attachment removed to protect the patient’s identity). After clinical evaluation of the attached pictures, I noticed that there is cervical abrasion along with recession. The recession, as per the clinical picture, is in grade 3, and it requires a free gingival graft for partial coverage or an increase in the width of the attached gingiva. I suggest you please get an X-ray to confirm the interproximal bone loss. However, for cervical abrasion, simple restoration of GIC (glass ionomer cement) or light cure composite can be done. However, for fractured teeth, RCT (root canal treatment) is recommended, followed by splinting. As per my clinical experience, the overall expenditure will be a maximum of eight to ten thousand. However, there can be slight variations if you get it treated in government hospitals or dental colleges. So I can summarise the treatment options. Graft surgery for recession, restoration for cervical abrasion, RCT for fractures followed by splinting after clinical evaluation, and lastly, if required, coronoplasty can be done if occlusal adjustment is needed. The last procedure will be required if there is some discrepancy in occlusion.
I hope this helps.
Thank you, and take care.
Patient's Query
Hello doctor,
Thanks for your reply.
In the case of the canine tooth with the chipped area, does that look like it was the result of overly aggressive cleaning by the dental hygienist or damage to the tooth by hitting it with one of her instruments? I had no pain in that area before. The cleaning was done about three weeks ago. Do you think that it could remineralize naturally, or would some kind of sealant or filling work?
They did x-rays, but it is a hassle getting them to share them. I will have to get them done elsewhere. Anyway, how urgent would I have to get treatment? Could I leave it for a few months? The recession has been there for several years, but the canine issue is almost definitely new. They also told me that I need two fillings, but I need to find a new dentist. I am attaching another picture of a molar that is discolored and painful. Please let me know what you think about that. Also, is there any treatment for waking up with a sour, bitter, dry taste in the mouth? Almost feels like the teeth are slightly coated. Maybe acid reflux is contributing to the problem, but it has not improved with antacids or Esomeprazole.
Kindly help.
Hello,
Welcome back to icliniq.com.
Yes, due to instrumentation trauma, the associated tooth can be chipped. However, it can be easily restored. Regarding remineralization, it is not possible, so restoration is a must. For waking up history, it seems like dental erosion, and you can get GIT (gastrointestinal) tests done for confirmation. For a discolored molar, please share a picture.
I hope this helps.
Thank you, and take care.
Patient's Query
Hello doctor,
How soon is it necessary to treat the chipped tooth? Is it possible to wait a few months? I will try to upload some pictures later. I uploaded some more pictures of teeth with some black marks and the surface of my tongue, as well as a picture of the biting surface of the two upper front teeth. If you notice anything else that needs treatment, please let me know. How soon do I have to repair the crack on the top of the canine?
Thanks in advance.
Hello,
Welcome back to icliniq.com.
Chipped teeth can be treated within 6 to 12 months, considering that there is no further trauma to the tooth involved. I will review the attached pictures. After the evaluation, I could see incipient caries that caught on the molars and some teeth. For molars, you can wait for some time since caries are not so deep, and it takes three to six months for further progression, but for the rest, you will require restoration in an emergency. The tongue seems normal; just do the scraping, and the rest is fine.
I hope this helps.
Thank you, and take care.
Patient's Query
Hello doctor,
I will try to get treatment for those issues as soon as possible. I will do another consultation soon. Thanks again.
Hello,
Welcome back to icliniq.com.
Most welcome.
I hope this helps.
Thank you, and take care.
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Answered byDr. Bharat Joshi
Medically reviewed byDr. K. Shobana
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