Archive for the ‘Root Canal Treatment’ Category

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Problems with a root canal

Wednesday, January 30th, 2013

I had a root canal treatment done last year. Everything was fine until recently. Do you know what I should do for treatment? I really want to save the tooth.

David B.- Lousiana

David,

About 1 in 10 root canal treatments can fail. It is impossible to see into all the deep recesses of a tooth. Sometimes there is a branching root in a curve which can get missed and will later flare up. It is possible this has fallen into the root canal failure territory. If that is the case you can try a re-treatment of the tooth or get root canal surgery. You’ll want to get a root canal specialist to do this. They are called endodontists. There is still a chance it will fail, but if you want to save your tooth it is worth trying.

Another possibility is that your tooth is cracked. If that is the case, it will be very difficult to save the tooth.

This blog is brought to you by Boca Raton Dentist Dr. David Kagan.

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Treatment for a traumatic tooth injury

Tuesday, January 15th, 2013

I had an injury to my mouth. Now all my teeth are turning black. Is this an issue for a dentist or an MD?

Beau B.- Baltimore, MD

Beau,

This is a job for your dentist. When teeth turn black after an injury, it usually means the nerve tissue inside the teeth have been killed.  If that is the case, your teeth need root canal treatments. After that, it is possible to bleach the darkened teeth from the inside out so that you won’t necessarily need to get crowns.

This blog is brought to you by Boca Raton Dentist Dr. David Kagan.

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Sensitivity after a root canal

Wednesday, August 1st, 2012

i had a root canal a few weeks ago and am about to get the crown. i’m a little worried though cause the area is still sensitive. does this mean it didn’t work?

benny- from montana

Benny,

It is perfectly normal for your gums to remain sensitive after root canal treatment. In all likelihood your body will resolve the issue in just a few more weeks.

Your dentist did a root canal because the tooth was infected. It’s the removal of the infected tissue that has irritated the end of your tooth. Give it some time. Though, the pain should be getting better, not worse.

This blog is brought to you by Boca Raton Dentist Dr. David Kagan.

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All of a sudden my tooth is sensitive to cold. Do I need a root canal?

Tuesday, November 15th, 2011

Just recently, my back left molar became extremely sensitive to exposure to cold liquids and food, and if I suck in cold air. I’m not sure if I need a root canal or not. I feel like I take relatively good care of my teeth, but the tooth that is sensitive does have a filling that was done probably about a year ago. Warm food and drinks do not bother the tooth. All of my other teeth are not sensitive at all. When this molar does become painful from exposure to cold stimuli, it is only for about a few seconds. Does this sound like something is wrong with my filling…or does it sound like an infection? I’m very nervous about getting a root canal…procedure looks very painful! Are there any ways to kinda test for an infection at home? I have a dentist appointment next week, but I want an answer now, haha. Also, is there anything I should ask my dentist when i go?
- Chris from Connecticut

Chris,
There are a couple of possibilities that can cause a tooth to become suddenly sensitive to cold or air, if there has been no traumatic event.

One is that there could be decay that is approaching the pulp of your tooth, which would irritate the pulp. If you have an existing filling in a tooth, you can get recurrent decay around the filling which will then grow under the filling. Or, if you have a one-year-old filling, like you have, it could be a residual effect from the decay that was in your tooth at that time. Your inner tooth structure is filled with pores, and bacteria, if they get close to the pulp, can travel through these pores and get into the pulp. Yes, the tooth could be said to be infected. But if the pain is transitory and only occurs to cold stimuli or air, the situation is reversible. If there is decay and it is removed promptly and thoroughly and the tooth is sealed and restored with a non-irritating filling material like a composite, the tooth could fully recover without needing a root canal treatment.

Another possible cause could be an exposed root. Your gums can recede on your teeth, and this can cause the root surface of your tooth to be exposed to the air, which will make the tooth sensitive to air and cold. The treatment for this situation would be to have a desensitizer painted onto the root of the tooth to seal it from these stimuli.

There are other possible causes, such as microcracks in the tooth or traumatic occlusion.

So visit your dentist promptly and try to find out the cause, and get it taken care of promptly. It sounds like you’ve been doing that.

As far as being afraid of root canal treatment, it is generally a fairly easy appointment. There is little drilling involved. Sometimes the tissue inside the tooth is dead and you don’t even need any novocain, because it has no feeling. If you’re nervous about it, I would ask about having sedation dentistry, so you can sleep through the appointment, or nitrous oxide gas, which is a great relaxant.

This blog is sponsored by Boca Raton emergency dentist Dr. David Kagan.

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What to do about a root canal overfill?

Wednesday, August 17th, 2011

Five days ago my dentist completed a root canal treatment on my back molar. Dentist took last x-ray and saw that the sealed gutta percha was extending past the apex of the tooth. The pain was immediate upon closure of crown. Pain level is 7 on scale of 10, with a fullness in lower jaw area. Returning tomorrow for check-up and prophy and believe I need antibiotics. What can be done to recify this situation? Would like to keep the tooth if possible, as it is part of a dental bridge.
- Stephanie from an Army base in Europe

Stephanie,
Just because the gutta percha is extended past the end of the tooth doesn’t mean that the tooth won’t heal. This is called a root canal overfill, and it is possible that nothing needs to be done.

Let me explain.

In a root canal treatment the dentist removes the infected tissue from the inside of the tooth, cleans it out, and seals the tooth with gutta percha. It’s necessary to have the end of the tooth (the apex) sealed so that body substances and bacteria can’t get in. So the important question is whether or not the tooth is sealed. If the gutta percha doesn’t go far enough, then it isn’t sealed. If it squirts through the end of the tooth, it will hurt, but it may well be sealed just fine.

You want to see what happens over time. Take the antibiotics. You may need pain medication. If the tooth gradually starts to feel better, then I would leave well enough alone. You’ll want to have an x-ray taken after maybe six months or so to verify that there is good healing in the bone at the end of the tooth, and if that is the case, then this root canal treatment should serve you well for your lifetime.

If the tooth doesn’t heal properly, I’d wait until you are in the states and have a root canal specialist (endodontist) re-treat the tooth.

This blog is sponsored by Boca Raton sedation dentist Dr. David Kagan

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Is my first premolar worth saving?

Wednesday, January 5th, 2011

for a few yrs now i have a reoccuring bump on my gumline over tooth # 5 bicupsid right top side (sinus was affected some) but now better. main question: after tooth extracted i can’t decide to do bridge as it is alot more expensive and implant is even more… i am deciding towards tooth extraction (smile shows some) but i am more concerned if that’s okay medically speaking. over doing a bridge which is alot more expensive, i trust my dentist but feel like it is so costly and can i do okay with just a tooth extracted – i understand teeth shift and if i bite into a corn chip it could hurt? i am 58 female all my teeth – was told by orthodontist teeth can shift, i am puzzled what to do before i see my dentist. pls help.
- Edie from California

Edie,
The recurring bump on your gums above this tooth tends to indicate that the tooth may be infected and require root canal treatment.

Even though it may be expensive for you, I would strongly recommend doing the root canal and saving this tooth. For a couple of reasons.

You’re talking about tooth #5, which is your first premolar, which is right behind your canine tooth. When you look at yourself in the mirror, you may not be able to see much of this tooth, but it shows very prominently from the side. At some point you may have some innocent child ask you why your tooth is missing, and you may get self-conscious of this. And what I see happen all the time when people become even a little embarrassed about the appearance of their teeth is that they’re hesitant to smile.

And yes, if this tooth is extracted and nothing is put in its place, the teeth around it will drift. Often they tilt, and one missing back tooth can throw your whole bite out of alignment. One possible complication of that would be TMJ disorder. Not only do the teeth next to the empty space drift into it, but the lower tooth will tend to drift upward into the space. And besides affecting your bite, these teeth that drift and tilt tend to have more complications with gum disease .

This blog sponsored by Dr. David Kagan. Is Dr. Kagan the best dentist in Boca Raton?

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Three Root Canal Surgeries – what now?

Wednesday, September 29th, 2010

Ok, so I have had a root canal, and three (3) root canal surgeries afterwards due to pain. I’ve been offered a tooth implant, but my fear is that if I do get an implant, that the pain will still be there, and I no longer have my #9 tooth. And, I do not like to be vain, but I have a great smile and I’m scared that the implant will not look like my current tooth. I’ve been seen by an endodontist recently who said that he could do a 4th surgery but the chances of it being successful gets smaller with the amount of surgeries I have already had. Now, what makes this all questionable to me and I have no idea what’s been done right or not, is that the root canal and the three surgeries were done at an Air Force Base. What would you suggest I do? I would like to explore all other options before extracting my tooth and getting an implant. Is there a chance that the pain could continue after the tooth is exacted? Right now, I can not chew with the tooth and it’s extremely sensitive right under my nose (hurts to blow my nose, because of the pressure applied). I guard the tooth by pushing my tongue up against it in the back so that it does not hurt. Just by placing my finger on the tooth and not pushing on it causes pain. Any suggestions would be great, thank you!
- Jamie from Kansas

Jamie,
I can’t tell, from what you’re telling me, what is the right thing to do here. Sometimes these pain issues are tricky, and it can feel like your pain is coming from a tooth but it’s coming from somewhere else, so you have to take what I say with a grain of salt. But if the pain is coming from the tooth, and the tooth is taken out, that should end the pain. An implant will not have that infection around it.

I would agree that after a root canal treatment has failed, and you’ve had three root canal surgeries, the chances that another surgery would work are slim. Generally, we quit after one surgery. Though having them done at an Air Force base raises the question of whether or not they were done well. But your endodontist should be able to tell you that. Endodontists generally are a little on the pessimistic side. They tend to underestimate the chances of success.

If the tooth can’t be saved and you need a dental implant, it can be made to look very esthetic and matched to your other teeth, but you need an excellent dentist. Ask around to get a good referral – that would be my suggestion.

Good luck.

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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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