Retainer for 4 months...tooth is now grey!?

[Ace399]

Hello all,

I sincerely hope someone can give me some direction here. One of my front
teeth was out of alignment for the past 3 years. I had orthodontia as a teen
and now at 28 found this partucular tooth had come for far forward out of
alignment that it was really bothering me. I consulted my dentist and he
recommended an orthodontist. The orthodontist recommended treatment with a
retainer to be worn 24 hours. I was fitted and the orthodontist stated that it
was necessary to shave a bit off the side of each of my front teeth in order to
make room for the errant tooth to move back. I questioned him extensively on
the risks/drawbacks of this and was assured that this procedure would in no way
cause any damage to the tooth or make it sensitive. Now, after almost 4 months
of wearing the retainer the tooth is better aligned but has turned a horrible
grey and is so sensitive to heat and cold that I must use a straw to drink and
put all food to the back of my mouth. When this occurred I immediately went to
my orthodontist who took an x-ray and stated that the tooth was fine. He said
'a little sensitivity' was normal (this is not a 'little' anything) and that
the grey color was a coincidence, possibly from an old injury (that I do not
recall ever having!). I have an appointment with my dentist and with another
dentist who is a personal friend to get their opinions on this. Any
suggestions from all of you? I am just sick about this. I take very good care
of my teeth, have had only a couple of small cavities previously and cannot
stand the idea that I may now be losing a tooth...Please help!

Coleen

[Paul Harding]

Do you think that the grey is coming from the wire on the retainer or
is it the whole tooth turning grey?

Paul

[Orthodmd]

I pretty much agree, Coleen. The shaving of the tooth almost certainly did not
cause the any damage to the tooth in question.

Rarely, we do see a tooth turn dark during orthodontic treatment. This is a
rare event but I've seen it happen. I don't believe the orthodontist is in
anyway to blame. It is just an untoward and unexpected event. Discuss it with
you family dentist. He or she can vitality test it to see what
treatment is needed.

Charlie Ruff, DMD
Specialist in Orthodontics
Diplomate American Board of Orthodontics

[Ace399]

Thank you for your replies. Paul, my orthodontist put a small piece of
bonding? on the tooth to hold the retainer in place. The discoloration is
pretty much the entire tooth so I don't think it's the retainer wire causing
the problem. Dr. Ruff, thank you for your input. I understand that it's a
rare event but can you give me any idea why is does happen? And also, you
mentioned a vitality test...can you explain what that is?

Oh, one last question, my orthodontist says it's ok to continue to wear the
retainer. Since my gut tells me the current problem is somehow related to the
retainer (though I understand may not be the Dr.'s fault) should I continue to
wear it? Could I cause more damage?

Thanks again for all your help.

Coleen

[Orthodmd]

>Thank you for your replies. Paul, my orthodontist put a small piece of
>bonding? on the tooth to hold the retainer in place. The discoloration is
>pretty much the entire tooth so I don't think it's the retainer wire causing
>the problem. Dr. Ruff, thank you for your input. I understand that it's a
>rare event but can you give me any idea why is does happen?

I think this happens for several possible reasons:
1. the opening at the base of the tooth where the nerve and blood vessels enter
is extremely small. It is not necessarily in every case at the base of the
root tip. Sometimes it is a small distance up the root from the tip. If the
tooth is moved with braces or with a retainer there is pressure placed on the
sides of the tooth. I think (emphasize I think) in a situation like yours the
pressure on the side of the tooth catches the blood vessel just right and cuts
off the flow of blood to the tooth. Remember this is an idea.

2. in other cases, there was previous undetected damage to this tooth or damge
to the tooth during orthodontic treatment seperate from the braces. The best
example of this is a case of mine where the tooth became dark and the mother
was all upset, naturally. I asked the patient if anything had happenned while
he was wearing braces to his front teeth. "Well, my suster and I were
wrestling and her sweater caught on the braces as she pulled away. I thought
she was going to pull my tooth out." Thank God for honest kids.

Vitality testing is a way to find out if the nerve is dead or alive. A slight
electrical current is run through the tooth and compared to normal teeth. If
the tooth is nonvital, a root canal might be appropriate therapy. You need to
ask your family dentist that one.

>Oh, one last question, my orthodontist says it's ok to continue to wear the
>retainer. Since my gut tells me the current problem is somehow related to the
>retainer (though I understand may not be the Dr.'s fault) should I continue
>to
>wear it? Could I cause more damage?
>
>

My sense is that it is OK to wear the retainer. If the retainer did cause the
damage, it is unlikely to worsen. Also, it is unlikely to reverse itself if
you stop wearing the retainer.

Finally, if I had been your orthodontist, it would never have crossed my mind
that this type of thing could happen during retainer wear.

[Hans Lennros]

Hi Orthodmd,

Sorry for this tardy comments:

You wrote:
> the opening at the base of the tooth ... is not necessarily in every

>case at the base of the root tip. Sometimes it is a small distance
>up the root from the tip.

Actually it is not only sometimes, it is most times.

>Vitality testing is a way to find out if the nerve is dead or alive.

No it is not. The current just tells if the tooth has any senibility
(ok, this may in turn indicate vitality but the two should not be confused)

False positive and false negative response is a common thing.

Hans