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Dentistry/problem tooth


Hello,  My girlfriend has been seeing an orthodontist for about 3 years now.  During the first year she had a tooth that never came down surgecally pulled down.  When it was exposed the ortho put a chain on it to slowly pull it down over the next couple of years.  The issue that has come up is we think that the guy is scamming money for things that are a bit excessive.  First he started pushing for her to see a dentist for monthly cleanings and insisted she went to a guy he works closely with in the same building.  She goes every 3 months to the guy which is excessive i feel and he is increadably expensive.  Second the orthodontist will take xrays and a week later say she needs to have the dentist give a second opinion and the guy insists she pays for xrays that he takes instead of just looking at the ones taken the previous week.  Last over the last couple of years the ortho and dentist have been saying everything looks great and is going perfect.  The tooth is down and she is in the final stage obefore having them removed.  The problem that I am having a question about is all of a sudden the ortho told her that he worries the tooth needs to be extracted and she will need an implant.  I think thats crap and at the very least the dentist wants to make more money off of xrays.  The tooth looks fine, it doesnt hurt, it isnt loose and i dont think any credible doctor would suggest something like that if its not a problem or faling out.  I have puictures of xrays and i am attaching one from a week or so ago.  My question is do you see anything wrong with any teeth in the xray?

thank you


Yes.  I see that the upper right cuspid appears to have a defect at the distal side (looks like a triangular shadow pointing into the tooth) and there is a radiolucent area (dark circle around the end of the root).  This usually indicates an abscess.

If I am correct, there are two viable choices for this tooth.  Remove it and implant, which I do NOT recommend yet.  I would prefer that she have a root canal, then a crown lengthening to remove the gum to past the defect, then a post and crown.  The smartest thing to do would be to take all your information to a dentist who is independent from the ones you have seen, and get an independent opinion and recommendation.

By the way, the space between the lateral incisor and the cuspid tells me that she is about 6 months to 1 year from being ready to have braces removed.

Please let me know the results of the independent dentist's opinion.


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Howard Finnk, D.D.S., P.A., CEO


I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.


Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center ( On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (, I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.

American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)

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Bachelor of Arts and Sciences in Psychology from Wayne State University Doctor of Dental Surgery from University of Detroit College of Dentistry Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida

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