Hello, I am 31 years old, I am missing two first molars, and the third one, which after an apicoectomy abroad I had retreated by an endodontic specialist, has started hurting again after three years. It has been hurting for about two days and I cannot sleep because of the pain. I had an X-ray taken and I will return to the endodontist to see what to do next; I am afraid I will lose a third tooth as well. Is it possible that this is only some temporary inflammation that could be treated with antibiotics and that it is due merely to a weakened immune system and is a “weather-related” issue? I know I should get implants. I hesitated for some time because I smoked and heard that the combination of these procedures and smoking is not good. I now smoke one cigarette a day. How should I prepare so that the implant procedure will be as effective as possible? Thank you for your answer, Meta

Dear Sir/Madam! If a tooth that has already undergone root canal treatment hurts, it is best to take an X-ray. Based on the image, it may be possible to decide whether repeat root canal treatment is necessary. In any case, a non-vital tooth (whether root-treated or not) represents a certain chronic focus where bacteria can occasionally multiply more intensely than usual, which can also cause certain symptoms (pain, swelling). Whether this is related to a weakened immune system or not could be the subject of a longer discussion. Smoking is a relative contraindication for the placement of dental implants, although, for example, the classical German school considers a smoker to be someone who smokes more than ten cigarettes a day. Much more important is good hygiene. The combination of poor hygiene and smoking can of course cause inflammation of tissues around an implant much more quickly, although there are major exceptions here too. There is no sharp boundary or rule in this regard; ultimately this is a matter of decision between the operator and the patient, as they will jointly bear responsibility for the success of the treatment.

Dear Sir/Madam, I discovered that I have 9 conventionally treated non-vital teeth (which have been in my mouth for many years, with no visible problems). In addition, since last year I have had one treated according to newer root canal cleaning guidelines (and filling, gutta-percha, etc.), and two more teeth are planned to be treated with these endodontic fillings. I still have all 4 wisdom teeth, which have never caused noticeable problems. I also have numerous amalgam fillings in addition to all this. Is it even permissible for someone to have 10 or 12 non-vital teeth, and how over the years are possible intoxications of the body with mercaptan and thioether and other toxins from anaerobic bacteria tested? Many years ago I had an autoimmune disease (myositis), and for many years I have also had a heart murmur. The autoimmune disease has long been cured, but since learning that I have so many non-vital teeth I fear they may be harming me by spreading infections through the body. My immune system has already been severely tested (I also had to take corticosteroids for 18 years). Occasionally I have minor episodes of chronic fatigue and mood swings. I also have persistent minor urological inflammations. Otherwise I am fine and live a very healthy and active life. I am definitely interested in your opinion because, as far as I know, the burden of bacterial toxins increases with the number of non-vital teeth in the mouth. Bioresonance or the Orotox test are supposed to show the toxin burden—what is your view on this? Before perhaps having all non-vital teeth extracted (which is a “horror story” scenario), I would like to measure precisely the burden from individual teeth—I know dental X-rays do not show this. Thank you and best regards, Dušan Jež

Dear Sir/Madam! Dentistry relies on established clinical guidelines. Root canal fillings are checked with X-rays, which primarily show the quality of the filling and, of course, any changes in the periodontal tissues around the root apex. If these images show no abnormalities, we consider the tooth properly treated and, according to our knowledge, it does not cause other pathology. As a dentist, unfortunately I cannot take a position on other alternative diagnostic procedures, which in my opinion certainly cannot be relevant when making decisions such as whether to remove teeth. In clinical practice I am aware of cases in which people had one or more non-vital teeth removed and then noticed changes in systemic health (patchy hair loss, changes in vision), but we can never confirm that this action itself caused the positive change. Most often it is merely a placebo effect (positive thinking), which nevertheless should not be disregarded. Have a nice day!

Dentist - Your questions

Visitor asks:

Please tell me after how much time I am entitled to a complete denture. I last received one on 27.6.2006. Because it has started moving around and it is difficult for me to eat. Thank you! Best regards, Martin

Dentist Tomaž Rotar answers:

Dear Sir/Madam! If the denture was made at the expense of the insurance company, its durability period is five years. For at least that long the insurance company will not cover the cost of a new denture. When you can receive a new one depends on the waiting time for prosthetic s

Visitor asks:

Hello, I am 31 years old, I am missing two first molars, and the third one, which after an apicoectomy abroad I had retreated by an endodontic specialist, has started hurting again after three years. It has been hurting for about two days and I cannot sleep because of the pain. I had an X-ray taken and I will return to

Dentist Tomaž Rotar answers:

Dear Sir/Madam! If a tooth that has already undergone root canal treatment hurts, it is best to take an X-ray. Based on the image, it may be possible to decide whether repeat root canal treatment is necessary. In any case, a non-vital tooth (whether root-treated or not) represent

Visitor asks:

Hello, The price for a dental veneer is 350 eur. Is there any discount for cash payment? I would need two veneers on the upper front teeth. The teeth are healthy, just darker in color and smaller.- Thank you for your answer. Irena

Dentist Tomaž Rotar answers:

Dear Sir/Madam! For two veneers we can offer you a 5% discount, regardless of whether you pay in cash. Have a nice day!

Visitor asks:

Hello. I have quite a few problems with my teeth. During my last vacation I developed a large abscess next to a bridge extending from the canine and first premolar to the second and third molars. Since there will probably be no other solution than removing the prosthetic work and placing a new one, probably with implan

Dentist Tomaž Rotar answers:

Dear Sir/Madam! To arrange an appointment for an examination, it is best to call me at 040 294488. At the examination we will make an exact treatment plan and corresponding quotations. Throughout the entire treatment you will have a temporary restoration, so I see no reason why y

Visitor asks:

Dear Sir/Madam, my dentist gave me a referral for extraction of most of my upper teeth and fabrication of a denture. Based on recommendations, I decided that I would like to have the procedure performed at your practice. I would like to know the waiting time and whether a consultation and examination for further treatm

Dentist Tomaž Rotar answers:

Dear Sir/Madam! We certainly begin every treatment with an examination and X-ray and preparation of exact quotations. If you would like to schedule the first examination, please call me at 040 294488 so that we can coordinate appointments. We will perform the examination as soon

Visitor asks:

The bridge that replaced teeth 14, 16 and 17 and was attached to tooth 15 and tooth 18 was removed because tooth 18 hurt on pressure. Tooth 15 is non-vital. A metal post is inserted in it. Tooth 18 is vital with a fairly large filling. Endodontic treatment may be necessary. The X-ray shows that the root portions of bot

Dentist Tomaž Rotar answers:

Dear Sir/Madam! Based on the X-ray (as you describe it), it is possible to make another bridge on the two abutment teeth. If necessary, root canal treatment of tooth 18 is certainly recommended before making the bridge. Price: -210 Eur (metal-ceramic crown) X 5 = 1050 Eur. We try

Visitor asks:

Hello, in November 2015 I developed caries on the upper left first premolar, at the edge of that tooth (right next to the second premolar). My dentist drilled quite deeply into the first premolar and then placed a white filling. Since then I have had the feeling that there is a large “gap” between the first and second

Dentist Tomaž Rotar answers:

Dear Sir/Madam! The phenomenon you describe is common when treating extensive caries, when tight contacts between neighboring teeth have to be removed during preparation for a filling. In addition, the filling probably extends below the gum level, which means that the gum is no l

Visitor asks:

Hello. I have an extremely low pain threshold, which makes visits to doctors very difficult for me, especially to the dentist. It is unpleasant for the doctor himself (and can also interfere with the procedure) that when I feel pain I involuntarily jerk or move—unfortunately I cannot control this... I do not know wheth

Dentist Tomaž Rotar answers:

Dear Sir/Madam! The sensation of the needle prick can be reduced with topical anesthesia (spray or gel). The injection of the anesthetic itself can also be somewhat painful, at least in some areas (upper incisors), which is difficult to avoid completely. The cost of anesthesia is

Visitor asks:

Dear Sir/Madam, I discovered that I have 9 conventionally treated non-vital teeth (which have been in my mouth for many years, with no visible problems). In addition, since last year I have had one treated according to newer root canal cleaning guidelines (and filling, gutta-percha, etc.), and two more teeth are planne

Dentist Tomaž Rotar answers:

Dear Sir/Madam! Dentistry relies on established clinical guidelines. Root canal fillings are checked with X-rays, which primarily show the quality of the filling and, of course, any changes in the periodontal tissues around the root apex. If these images show no abnormalities, we

Visitor asks:

Hello, today the filling fell out of my upper second premolar. My dentist is currently on vacation. She will return from vacation in one week. I would like to know whether I urgently need to go to the emergency dentist tomorrow or whether I can wait for my own dentist. Thank you for your answer.

Dentist Tomaž Rotar answers:

Dear Sir/Madam! If the tooth does not hurt or is not excessively sensitive to stimuli, you can wait for your dentist. Have a nice day!

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