Dental Education Lecture: Fallen Front Tooth

Mr. Zhao is in his early forties and has pretty severe gum disease.  Almost half of the bone has been lost in the bottom front teeth (between single and double white arrowheads in Fig.1).  One of the front teeth with * has severe root tip infection (a large shadow surrounded by black arrowheads).  The tooth is loose, but he is postponing proper treatment (root canal and splinting).

One year later, the tooth is so loose that it comes out by itself (Fig.2).  The root is short, below the black arrowhead.  Additionally, there is a lot of tartar over the root (white arrowheads), the cause of gum disease.  We take X-ray for the fallen tooth (Fig.3) to show the short root; the arrowhead points to the junction between the crown and the root.

After falling out, we make a temporary fake tooth, but it keeps coming out (Fig.4).  The tooth bed is shrinking (between two arrowheads) two months later.  The best solution is to place an implant as soon as possible.  

Xin Wei, DDS, PhD, MS 1st edition 01/01/2010, last revision 04/09/2010