Archive for the ‘Root Canal Treatment’ Category

Toothaches after new fillings

Wednesday, August 18th, 2010

I hadn’t been to the dentist in a while and I finally went and had 6 cavities. I’ll admit I wasn’t flossing like I should and most of the cavities were in between teeth. Anyway I had 2 on the upper left, 3 on the lower bottom, and one on the upper right. I had the ones on the top left filled and those are good-no problems. I then went back and had the 3 done on the bottom left. That was sore the first night but then was fine, for 2 days. Then one of them in the back started hurting, everyday all day long to where I couldn’t sleep through the night without waking up, for a week and a half. So a few days later I went back and had the upper right one filled and told my dentist about this pain. He then referred me to a root canal specialist. I went there and ended up having a root canal ( she said because that tooth had been worked on so much over the years that eventually they just don’t get better. Fine. So I now have to pay for a filling that was useless. On top of the root canal and all of the other fillings. Well that same day (8-13-10) one of my molars on the right bottom started hurting, nonstop unless I take medicine every couple hours. Right now it is killing me, this is without eating/drinking, anything to where I cannot stand it, it’s making me! cry. Co uld this be related to all this work I have had done in about a month? I really don’t want to do anything else and I can’t really afford it. When I had went the first time he took x-rays and examined my teeth and this tooth was never mentioned and it was fine, until last Friday. I don’t know what to do. The dentist did use white filling on all these cavities, some that used to have the silver filling. I just can’t take it anymore. I have ibuprofen but when I take it it makes me feel sick so I can’t stand taking it anymore either. I’ve never been one to complain about pain and usually don’t take anything for anything and I’m fine but this is just driving me crazy. Help? Thank you.
- Sarah from Kentucky

Sarah,
Your problems with the teeth hurting wouldn’t be from the number of fillings you had but from how big the cavities were. When you don’t go for a long period of time, the cavities keep growing. And what happens is that the dentist gets the decay out and fills the tooth. But if the decay was deep enough so that it is close to the pulp of your tooth, there will always be some bacteria that get into your pulp. The dentin on the inside of the tooth is porous and this is what happens. So you have these bacteria in the pulp, and the tooth is a little irritated from having been worked on, and it starts an infection in your tooth that results in this toothache pain that you’re having. Unfortunately, once the inside of the tooth gets infected, the only way to treat that is with a root canal treatment.

Nothing you have said gives me any indication that your dentist did anything wrong.

I hope this is helpful to you.

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Follow-up to Question about Pulpotomy and Root Canal

Tuesday, August 3rd, 2010

Last week we posted an answer to a question from Emily from Texas. She wanted to know if she should follow her dentist’s advice and get a root canal, and questioned the earlier need for a pulpotomy. We reassured her and told her about the importance of being able to trust her dentist. Find a dentist you can trust and then trust him or her – it’s a good rule.

Here’s her response:
Thank you very much for your response. I had it done today with less fear and more confidence in my dentist. It still hurts but I guess I’ll be ok in a couple of days.
- Emily from Texas

Links: see the original posting: My tooth doesn’t hurt – why did it need a pulpotomy?
Read more about root canal treatments.

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My tooth doesn’t hurt – why did it need a pulpotomy?

Wednesday, July 28th, 2010

Several months ago I had an abcess at one of my premolars. After taking antibiotics it went away. I was pregnant at the time and did not want any work done. It never hurt. A few weeks ago, the abcess came back, so I finally went to see a dentist (within two weeks from the recurence). The tooth did not hurt this time either. The dentist performed a “pulpotomy” (I am not sure I nedeed that procedure).

I went home and the tooth start hurting. He could see me only two days later and at that time he “cleaned up” some more. This time he gave me some antibiotics – for 7 days. 7 days later still hurts. More antibiotics for another 7. I am now 5 days later and still have pain – I don’t know if the infecton cleared up yet. Tomorrow I am scheduled to get a root canal. Should I get it while my tooth still hurts? Did I needed the “pulpotomy” in the first place? Thank you.
- Emily from Texas

Emily,
With dental work, it’s especially important to be able to trust your dentist. The reason is that often you cannot tell when anything is wrong, and then problems that are put off are always more expensive to fix later, and can result in irreversible damage to your teeth. So far, from what you’ve told me, your dentist is treating you right. So hopefully you feel you can trust him. If not, find a dentist you feel you can trust.

Let me explain what is happening in your mouth. If a tooth is abscessed, antibiotics alone will not clear up the problem, they only help put off the symptoms. You see, infections are caused by dead or infected tissue inside the tooth. Antibiotics don’t get to the inside of your tooth when it is filled with dead tissue, because there is no blood circulation there. The abscess is caused by the tooth spewing bacteria out the end of the root. So the antibiotics will fight those bacteria but can’t ever eliminate the source because it’s protected inside the tooth.

And to answer your questions, yes, you did need the pulpotomy and yes you need the root canal treatment. Your tooth may continue to hurt until you get this done. The root canal treatment is to solve the pain, the abscess, by getting rid of the source of the infection. The tooth is carefully and thoroughly cleaned out and then is sealed.

I would have actually strongly recommended that you have the root canal treatment when you first discovered the abscess. While you want to avoid dental work during the first and third trimesters of a pregnancy, it’s worse for the baby if you have an infection in your body when you are pregnant. Now, after having waited this long, you are more likely to have complications from the deeply entrenched infection as your dentist tries to remove its source by doing a root canal. That’s probably why the infection seems now to be so resistant to the antibiotics. But get it done – the sooner, the better.

Follow-up: Read Emily’s response a week later.

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Long-term sensitivity in a tooth with a crown

Sunday, June 20th, 2010

I had two crowns put in (I believe #19 and 31) approximately 1.5 years ago. One was a replacement porcelain crown. The other was for one of my molars (#19) that was extrememly sensitive to bite pressure.

After the new crowns were installed, I began to notice sensitivity to cold and bite pressure. I asked my dentist and he said that this was normal after this type of procedure. I asked if I may need a root canal and he said that the X-rays did not show anything and that he didn’t think it was warranted. After a short while, the pain associated with the bite pressure went away. I never felt any discomfort with hot foods. After 1.5 years, I still feel pain when eating cold things and recently started to experience pain with bite pressure. I have contacted my dentist on two separate occasions over the 1.5 years and each time, he stated that this will either eventually go away or will be permanent. Can you provide me with your thoughts on what might be causing this pain and recommend my next course of action to get rid of this pain? Any input would be greatly appreciated. Thanks.
Gene from California

Gene,
I can’t really tell what is wrong with your tooth without an x-ray and testing it, but it sounds as if it may need root canal treatment.

Pain to cold indicates that the pulp of the tooth is irritated. When the pain to cold lingers, it indicates that the irritation will not get better on its own, and the tooth needs root canal treatment.

Pain to biting could mean that the bite is off, or that the tooth has a traumatic injury, or that the tissue around the end of the tooth is infected from the beginnings of a tooth abscess. When the pain to biting just appeared seemingly out of nowhere with a tooth that has had long-term cold sensitivity, my first suspicion is that there has been a long-standing slight infection in that tooth, and that infection has spread to the end of the root. An infected tooth will not get better on its own – it will need a root canal treatment.

Have your dentist look this tooth over very carefully and test it. If  he is unsure, ask for a referral to a specialist.

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Should I have the root canal or an extraction?

Tuesday, January 12th, 2010

I had a cracked lower second molar, which, when the broken piece was removed I was directed to go to an Endodontic specialist. I have now started a root canal for that tooth. It has been brought to my attention that the broken segment of the tooth is partially below the gumline and there is some concern about whether I should go ahead with the root canal and then getting post and crown to attempt to save the tooth or to just extract the tooth and have a dental implant and permanent tooth put in place. Besides the spiraling costs to be considered, I have no way to determine what to do. Please advise.

Thank you,
-Stan from New York

Stan,
There is no way we can tell from this distance if your tooth will hold up or not. But let me try to be helpful.

If a tooth is broken below the gumline, yes, it does cause some concerns about whether the tooth will hold up. But often a dentist can do a crown lengthening procedure and the result will hold up just fine.

And then another thing that may be going on is defensive dentistry. The dentist wants to be sure you are fully warned about every possible thing that could go wrong, in order to protect himself or herself legally, and sometimes this causes more worry than is necessary.

I would just go back to your family dentist who sent you to the endodontist and ask the question: what are the long-term prospects for this tooth, and what would you recommend? Then make a decision based on what you’re told.

In general, it is better to try to save your own natural tooth when you can.

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Has my root canal treatment failed?

Monday, November 16th, 2009

I have had root canals on 2 molars. The first one was done twice and failed twice and was extracted. The 2nd was done two weeks ago and like the first one is sore to touch and unable to eat on that side. Any suggestions? Should I get this repeated? And what are the chances of saving the tooth? – Kathleen from Ireland

Kathleen,
Whether a root canal treatment is successful or not depends a lot on the techniques used and the skill of the dentist. It doesn’t sound like your dentist has a strong track record with root canal treatments.

But even when the treatment is done skillfully, sometimes they don’t work. But the chance that it will work should be a good 90 percent. But if that tooth never healed and is still sore to the touch and it hurts to where you can’t eat on it, and it is two weeks later – that isn’t a good sign. I’d go somewhere else and get a second opinion. If something is wrong, yes, I would have it re-treated if that can be done, preferably by a root canal specialist, but at least by a different dentist.

Root canal treatments can be done by general dentists with excellent success. But your dentist should refer you to a specialist when the difficulty of the case is beyond their ability. For a re-treatment, I would recommend going directly to the specialist.

I hope your dentist has at least reduced that tooth so that you don’t touch it when you clench your teeth. That’s a simple procedure that can make it a lot more comfortable right now.

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Teeth broken off at the gum. Can they be saved?

Wednesday, October 28th, 2009

I have two teeth that had root canals done several years ago and couldn’t afford the crown and now the teeth are broken off to the gum. Do I have any alternative other than surgery to extract what is left of the broken teeth and the post, or what other choices do I have?
- Gail from Texas

Gail,
You very well may not be able to save these teeth. Sometimes you can save teeth that are broken off at the gumline and sometimes you can’t. Depending on how much tooth is actually left, and whether posts can be placed, and if crown lengthening can be done.

But don’t go from bad to worse. Find a dentist who will try to save them if they can. If they indeed can’t be saved, have the missing teeth replaced within the next few weeks, especially if they are in the back of your mouth. When you have a missing tooth in the back of your mouth, the teeth on either side tip into the space and the opposing tooth hyper-erupts, and it can create a real mess of your bite leading to TMJ disorder. If you can’t afford a dental bridge or a dental implant, then get a temporary flipper partial or something to put into that space.

The lesson is – when you have a root canal treatment, especially on a back tooth, you may not think you can afford the crown, but what you really can’t afford are the consequences of breaking the tooth. It can triple the cost if you wait until the tooth breaks. If paying for a crown is a real problem, talk with your dentist about some interim measures to protect the tooth. Sometimes a bonded core can be placed that will work in the interim. Then make a definite commitment for an appointment for the crown – even if it is two years down the road. Put it on your schedule and save up for it. It will be much less costly in the long run.

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Root Canal Treatment Still Hurts

Friday, October 16th, 2009

I recently had a filling in a tooth. A week later the tooth was so sensitive to cold and hurting so bad they did a root canal. It has been over a month and the tooth still hurts (not bad) and it seems to be slightly loose. It is not sensitive to cold like it was before. The reason I am asking you instead of my dentist, I won’t go back to him. I didn’t like him and the way he treated me. Besides, he had 2 strikes on this tooth already.
- Wanda from England

Wanda,
If the pain is only mild and you can ignore it for now, I’d wait until it has been three to six months since you had this tooth done and go to another dentist and have them x-ray the tooth root to see if it has healed.

It isn’t unusual for a tooth to be sensitive after a root canal treatment. That can come from the irritation of getting the infection cleaned out of the tooth. That post-operative irritation should only last a week or so, but it can last longer. It’s also possible that you have a failed root canal treatment and that it will need to be re-done or to have root canal surgery. Infection around the end of the tooth could also cause it to feel slightly loose. But give it time to heal and see what it looks like.

Even if the pain goes completely away, you still want this x-rayed, given what you have told me. A tooth can be infected and still not hurt, but the infection will spread and may slowly eat away at the root of the tooth.

Related information: Read more about failed root canal treatment on mynewsmile.com.

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Should I have root canal retreatment or root canal surgery?

Wednesday, September 16th, 2009

Should I have a root canal re-done by a root canal specialist, or have apex surgery? I am not in any pain however the x ray shows an area of infection in my gum, this has been there for about 12 months now.
- Rachel

Rachel,
Something doesn’t seem right about what you’re telling me. I’m not sure why a dentist would give you a choice between root canal re-treatment and apical surgery on your tooth.

You apparently have a long-standing infection around the root apex of a tooth that has had a root canal treatment. This happens sometimes, and it should be fixed, even if it isn’t causing any pain. Left for long enough, these infections will sometimes just spread, or sometimes they will eat away at the root of your tooth which will eventually come loose if there is nothing done.

But if re-treatment is possible, in my opinion, that should be attempted first. Usually when apical surgery is recommended it is because re-treatment isn’t practical, isn’t expected to succeed for some reason, or it has been attempted and failed.

Other links:
Dr. Kagan is a mercury-free dentist. He can also be considered a holistic dentist.

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