Restorative Dentistry is described as the basics in dental treatment. Most dentists know it can sometimes be just the beginning of your dental journey.
Dental Journey for Ms. S
Ms. S journaled her medical and dental care which provided an excellent history of her dental treatment. Tooth #19 had received restorative dentistry multiple times over forty years. The first was a filling for a cavity. Then in 2018 she began to have sensitivity in that area and her dentist recommended a crown. Within a few weeks, a lab custom made crown was bonded.
A crown is recommended when a filling is very large, a tooth is fractured, after a root canal, or to restore function when occlusal attrition or wear is significant.
According to her journal, the tooth remained sensitive even after adjustments were made to her bite. Ms. S had a root canal to alleviate the pain. A new crown was placed. A few more years went by and Ms. S stated the discomfort in that area never actually went away. While seeing another dental practice for an unrelated issue, Ms. S asked for an evaluation for tooth #19. A cavity was discovered requiring a fourth restorative treatment and a new crown.
Successful Resolution
It is now 2023, and Ms. S presented to Fox Dentistry for consultation regarding unresolved pain in her left TMJ and discomfort with tooth #19. Dr. Fox took time at her first visit to review her medical history and listen to her concerns. Her primary concern was her left TMJ.
Based on her history and an examination, she presented signs and symptoms of Sleep Disordered Breathing. Dr. Fox referred her to Sleep Medicine for a consultation. In most cases of TMD/Jaw Pain there is typically an underlying airway issue. Based on that final diagnosis, her treatment may include an oral appliance.
Regarding tooth #19, Dr. Fox completed an exam with X-rays, but a more sophisticated radiograph was needed, a CBCT (cone beam computed tomography). The CBCT revealed a cracked tooth. Ms. S would loose her tooth, and she chose to proceed with an implant procedure.
The fracture had probably been the underlying cause of her discomfort for several years, but tooth fractures are difficult to discover at an early stage. Every dentist who treated Ms. S followed the steps of restorative dentistry that Dr. Fox would have. Restorative dentistry can be straightforward, but often times it can be complex, particularly when multiple issues must be diagnosed. In this case; TMJ, Sleep Disordered Breathing, a fractured tooth, an extraction, and an implant.
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