The Random Questions thread

Agree you need to ask what to do if the temp crown comes loose when you’re traveling. My relative (who is a dentist) had to help a person on our tour when their temp crown came loose/fell out. Fortunately they kept the part and had an adhesive from the home dentist so the fix wasn’t too arduous.

Can you have the crown done when you return? Two reasons:

  1. Temp crown comes off. You can reglue with denture adhesive or a product called temp it. Less is more. The farther back in your mouth, the harder for you to get it on right. Plus, it will most likely continue to loosen. Chew on the other side, keep to a softer diet. Only floss if you have to—chances are great you’ll pull it off even if you do the pull-through.
  2. If a problem arises , like pain in the tooth, you’ll already be gone. This could be due to now needing a root canal or the bite in the temp is high. Even same-day crowns can have these problems. Problems are less likely to occur in front teeth.

I always preferred my patients did not travel by plane from tooth prep to crown cement, especially overseas.

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H had a “permanent” crown come out when we were in Greece. (This is an old one from his former dentist.) We were on a higher-end small group tour, and the guide took him to a local dentist that night in walking distance. H said the place was busy at 8pm. Got it done and wasn’t expensive.

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Yes, I could change my appointment to accommodate this TBD-dates family visit (though I was hoping to get it done as early in the year as possible to keep open other TBD travels). I just wanted to have some feedback from CC pals before approaching the dentist office and perhaps screwing up their scheduling. Of course this is all conjecture, since I am not sure yet what dates make sense for the family visit due to variables on their end.

@dentmom4 : I’m glad you showed up here. I have some questions about periodontal disease.(I"m so glad you’re on this forum!)

So I have been seeing my regular dentist for cleanings twice a year and, for maybe 8 or 10 years, a periodontist twice a year for periodontal cleanings. I understand that periodontal disease is caused by bacteria. (Obviously, correct me if I’m wrong!) So why can’t periodontal disease be “cured” with the deep cleanings and some antibiotics? My periodontist tells me it can’t be cured but it can be “managed,” with the twice-a-year cleanings. Seems to me it’s a periodontist’s cash cow – the disease that keeps on giving. Can you explain this to me??

If you are going where I think you are going, let me ask my Mom who she uses.

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Periodontal disease can’t be cured. That’s because it’s diagnosed by bone loss and gingival inflammation, and even with the best home care and routine 3 month recall visits, you aren’t going to get those bone levels back. I want to maintain patients where they are and not see bone loss progression. The bacteria is in your mouth and antibiotics won’t get rid of them. Your best bet is meticulous home care using a manual or spin brush, floss, water pik and a diet low in carbs, sugar, and acid. Many medications for heart, BP, psychiatric diagnoses dry your mouth, and your teeth and tissues act like fly paper, building plaque and calculus. Unfortunately you can do all this and still experience bone loss. A program called Perio Protect might be available through your dentist that can help reduce gingivitis/periodontal inflammation. It’s had moderate success, but is 100% patient compliance dependent (and it’s not cheap).

There are current clinical studies ongoing to try and arrest periodontal disease in the early stages, before measurable bone loss occurs, using medications to keep the bacterial counts low. Right now there is research using cloned mice that’s fairly reproducible, but I’m not sure when they will start clinical trials for humans.

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Thanks, @dentmom4 . I’m absurdly obsessive about my oral hygiene. [Flossing with with woven, not waxed, floss; brushing three minutes twice a day w an electric toothbrush; proxy brush between each tooth; fluoride mouthwash twice a day for one minute each time.] I get compliments from the hygienist whenever I go! And I just learned that I will not need a bone graft when I have my two implants early next year so, I guess, yay me? :face_with_diagonal_mouth:

It’s just annoying to consider that I will never, ever be free of having to get four, not two, cleanings a year.

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Where can one get WOVEN dental floss? I’ve not been able to find it.

You can get woven floss at Amazon, Target, CVS, most pharmacies. If you use it and it shreds between your teeth, go back to waxed.

Have the teeth been extracted yet?

Most sockets are grafted at the time of extraction. I describe it as fake bone particles mixed with saline to create a paste and placed in the space where the roots were. Often a solid, but dissolvable material is placed on top of the paste and your gums are stitched together. This helps your own bone fill in the socket while you are healing and maintain the dimensions of the space. Otherwise, the tissue just heals and you may not have enough space cheek to tongue sides (of the extraction site) to place the implant (like it’s shrink-wrapped) and then you’ll end up with a major bone grafting procedure to create the space.

Sounds like you are doing all the right things. The 3 month maintenance appointments are the price you pay to keep your own teeth in your mouth for as long as possible.

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Not yet. My periodontist, who will be doing the extractions and the implants, had a 36-degree radiologic thingie of my jaw, radiologically “placed” the implant screw in the bone, and was able to see that the bone was sufficiently big that the screw will fit easily.

I will probably start all this is mid-February. I’m also working with my endocrinologist to determine the best time, considering the timing my Prolia injections – which really make the dentists nervous!

@HImom : I use GUM Pro-Weave Woven Dental Floss, Shred-Resistant Waxed Floss, Mint Flavored from Amazon. Sorry; it is waxed. I was mistaken.

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Got it. The X-ray is a CBCT scan that has 3-D software that can tell the dentist the dimensions of the space and help choose and guide the placement of the implants. I suspect you will have some graft material placed in the socket for added stability because the implants are not identical to the shape of the extracted tooth. You
won’t notice because you’ll leave with the implant buried or with a healing cap, then stitched.

I just saw the Prolia injection part. I think my surgeons prefer to extract teeth 4 or 5 months after the injection, then delay the next injection 2 months after surgery to be sure integration of the implant has occurred, usually by the 8 week mark.

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That’s exactly the plan.

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Thanks for all the good feedback on temp crowns / travel. So what about after I get the permanent crown… should I expect that to be more trouble free once installed? (Still waiting to learn other TBD travel variables but figured I should ponder my own constraints.)

You should be good to (literally) go!

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Nope. You should be fine.

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