Question: Dear Dr XXXXXXX

Thanks for your earlier reply to my earlier questions re the threadhttps://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=387230

I have now uploaded my X-ray photos for your reference and advice.

It has been over three weeks after I hurt my teeth. Now I feel my displaced lower front tooth (tilted forward a little bit) still a little bit pain but improving slowly. But when eating or talking, the displaced tooth sometimes touches upper teeth during occlusion, and I feel unnatural. My first dentist said he could polish a bit the tilted tooth to make it a bit lower so that it would not touch the upper teeth so directly during occlusion. But another dentist did not recommend because it will likely make my tooth sensitive and is irreversible. Is this true? What is the chance of making my tooth sensitive if I go for my first dentist’s suggestion?

My displaced lower tooth and upper front teeth are a bit painful when eating. However the pain is improving slowly. Is it a sign of my tooth healing slowly and will eventually consolidate in its position?

My dentists both said the teeth are not hurt seriously and ask me to give some time for them to heal and if conditions persist, I may need treatment. I want know how long will it usually take for the healing process? How long should I wait and observe before I revert to dentist for further examination?

Appreciate much your expert advice

Dear Dr XXXXXXX

Thanks for your earlier reply to my earlier questions re the threadhttps://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=387230

I have now uploaded my X-ray photos for your reference and advice.

It has been over three weeks after I hurt my teeth. Now I feel my displaced lower front tooth (tilted forward a little bit) still a little bit pain but improving slowly. But when eating or talking, the displaced tooth sometimes touches upper teeth during occlusion, and I feel unnatural. My first dentist said he could polish a bit the tilted tooth to make it a bit lower so that it would not touch the upper teeth so directly during occlusion. But another dentist did not recommend because it will likely make my tooth sensitive and is irreversible. Is this true? What is the chance of making my tooth sensitive if I go for my first dentist’s suggestion?

My displaced lower tooth and upper front teeth are a bit painful when eating. However the pain is improving slowly. Is it a sign of my tooth healing slowly and will eventually consolidate in its position?

My dentists both said the teeth are not hurt seriously and ask me to give some time for them to heal and if conditions persist, I may need treatment. I want know how long will it usually take for the healing process? How long should I wait and observe before I revert to dentist for further examination?

Appreciate much your expert advice

Thanks Dr XXXXXXX for your advice. Some further questions and points to clarify.

You said you can see the injured area below the root tips... Do you mean the root of the tooth is injured or the surrounding bone and tissues that is injured?

1.     You said “Well if the tooth is not hurt, try to avoid touching the upper teeth”. Not sure what you exactly mean. Can you explain a bit?

2.     In eating, even if I try to use inner teeth, my lower front teeth will inevitably touch the upper teeth sometimes during occlusion. What are the consequences if this touching continues over a long time? Is my dentist’s earlier suggestion to grind the tooth a bit a good option to avoid these consequences?

3.     Apart from the lower front tooth (the one hurt and tilted forward), do you see any injured areas for the other teeth especially the upper ones? I ask because I feel the upper left front tooth and the one next to it on the left side (see picture uploaded) a little bit painful when eating.

4.     You said “the injured tooth can heal but if it continues to hit upper teeth then healing will delay due to continuous trauma.” and “You can watch for another 2 weeks and if there is no improvement or pain continue to persist then Root canal treatment can be done. “

I want to know how to tell whether the tooth has healed or the tooth has stopped healing and it is time to do root canal treatment? Can another x-ray help in the assessment? What I mean is that if the injury has healed or worsened, will it be reflected in the x-ray?

5.     A dentist has told me that when doing root canal treatment for the front tooth, there is a risk of cracking and will then need to have the tooth removed. How likely is this risk?


Appreciate your expert advice. Thanks a lot.

Thanks Dr XXXXXXX for your advice. Some further questions and points to clarify.

You said you can see the injured area below the root tips... Do you mean the root of the tooth is injured or the surrounding bone and tissues that is injured?

1.     You said “Well if the tooth is not hurt, try to avoid touching the upper teeth”. Not sure what you exactly mean. Can you explain a bit?

2.     In eating, even if I try to use inner teeth, my lower front teeth will inevitably touch the upper teeth sometimes during occlusion. What are the consequences if this touching continues over a long time? Is my dentist’s earlier suggestion to grind the tooth a bit a good option to avoid these consequences?

3.     Apart from the lower front tooth (the one hurt and tilted forward), do you see any injured areas for the other teeth especially the upper ones? I ask because I feel the upper left front tooth and the one next to it on the left side (see picture uploaded) a little bit painful when eating.

4.     You said “the injured tooth can heal but if it continues to hit upper teeth then healing will delay due to continuous trauma.” and “You can watch for another 2 weeks and if there is no improvement or pain continue to persist then Root canal treatment can be done. “

I want to know how to tell whether the tooth has healed or the tooth has stopped healing and it is time to do root canal treatment? Can another x-ray help in the assessment? What I mean is that if the injury has healed or worsened, will it be reflected in the x-ray?

5.     A dentist has told me that when doing root canal treatment for the front tooth, there is a risk of cracking and will then need to have the tooth removed. How likely is this risk?


Appreciate your expert advice. Thanks a lot.

Thanks Dr XXXXXXX for your advice.

I have now uploaded two pictures for your reference and advice, one taken on the day right after the accident for the lower teeth, and the other one on the tenth day after accident for the upper teeth. Not sure whether they are IOPAR.

I feel that the pain of my lower displaced tooth decreasing. If after two weeks, the pain persist but keeps decreasing, should I wait and allow more time for healing before proceeding to treatment?

Besides, could you tell from my earlier OPG x-ray whether I have periodontal disease? I asked because a dentist told me I have mild periodontal disease, saying that the “black triangle” between the teeth seen from the x-ray indicate periodontal disease. He said the gum has swelled and so covered the “black triangle” which therefore cannot be seen visually. If deep cleaning is to be done, the “black triangles” can then be seen visually because the gum will longer swell.

I am puzzled because no dentist has ever told me before I have periodontal discease.

May I have your expert views? Thank a lot

Thanks Dr XXXXXXX for your advice.

I have now uploaded two pictures for your reference and advice, one taken on the day right after the accident for the lower teeth, and the other one on the tenth day after accident for the upper teeth. Not sure whether they are IOPAR.

I feel that the pain of my lower displaced tooth decreasing. If after two weeks, the pain persist but keeps decreasing, should I wait and allow more time for healing before proceeding to treatment?

Besides, could you tell from my earlier OPG x-ray whether I have periodontal disease? I asked because a dentist told me I have mild periodontal disease, saying that the “black triangle” between the teeth seen from the x-ray indicate periodontal disease. He said the gum has swelled and so covered the “black triangle” which therefore cannot be seen visually. If deep cleaning is to be done, the “black triangles” can then be seen visually because the gum will longer swell.

I am puzzled because no dentist has ever told me before I have periodontal discease.

May I have your expert views? Thank a lot

THanks Dr XXXXXXX

Can you tell the extent of my periodontal disease? mild, moderate or severe?

My dentist said many people have periodontal disease to some extent. He said if I go for deep cleaning, he reminded that I must be prepared to accept the results, e.g. seeing the black triangles visually, and there is possibility that some teeth will become sensitive after deep cleaning and will then need to do root canal treatment, possibility that some teeth may become a bit loosened. Is what the dentist told me true?

I do not have gum bleeding during teeth brushing, so I am surprised to know that I have periodontal disease. Is the bone loss a must as an ageing process?

Is it that periodontal disease must progress? What can be done to prevent further progression? What is the consequence if I do not do deep cleaning for the time being?

Also, want to clarify whether my upper front teeth are fine based on the few x ray images uploaded earlier ?

Thanks again for your expert advice.

THanks Dr XXXXXXX

Can you tell the extent of my periodontal disease? mild, moderate or severe?

My dentist said many people have periodontal disease to some extent. He said if I go for deep cleaning, he reminded that I must be prepared to accept the results, e.g. seeing the black triangles visually, and there is possibility that some teeth will become sensitive after deep cleaning and will then need to do root canal treatment, possibility that some teeth may become a bit loosened. Is what the dentist told me true?

I do not have gum bleeding during teeth brushing, so I am surprised to know that I have periodontal disease. Is the bone loss a must as an ageing process?

Is it that periodontal disease must progress? What can be done to prevent further progression? What is the consequence if I do not do deep cleaning for the time being?

Also, want to clarify whether my upper front teeth are fine based on the few x ray images uploaded earlier ?

Thanks again for your expert advice.