Last month, my dentist said I need a root canal on a tooth for decay beneath the crown. I was surprised because neither the tooth nor my gums around it hurt. Last week my dentist attempted a root canal, and after almost two hours, he stopped. He said the canal is calcified, so he could not locate it. After putting a temporary filling in the crown, he referred me to an endodontist. My crown and part of the tooth broke, and I have two weeks before my appointment with the endodontist. Should I just skip the endodontist and get an implant? I think the tooth is too broken down for a crown anyway. I want to know the best way to handle this because I am scheduled to begin Invisalign treatment in mid-September. Thank you. John T. from TN
Thank you for contacting our office. We are sorry to hear about your experience. No doubt, your dentist’s two-hour hunt for the canals in your tooth weakened it and caused it to break. And unfortunately, he did not do anything to strengthen the tooth. A temporary filling is not enough. Although your dentist may not know who to preserve your tooth, he should take responsibility for it.
Decay Beneath a Dental Crown
When decay is beneath a dental crown, and a dentist must perform root canal treatment, removing the crown increases visibility and access to the tooth. These steps are often successful:
- Remove the crown
- Remove the decay and disinfect the tooth
- Find the canal
Save or Extract the Tooth
If a tooth has little structure left, it may be challenging for a dentist to attach a crown. You could lose the tooth and need a dental implant. However, if your bite is not stressful or intense, a dentist may be able to insert a dental post into the tooth, build some composite around it, and attach a crown to it. But based on your experience, it does not seem that your family dentist has the skill to complete the work.
Schedule a Second Opinion
We recommend that you schedule a second opinion with an advanced cosmetic dentist trained in orthodontic treatment with Invisalign. A cosmetic dentist with experience in both areas can examine your tooth and determine if they can save your tooth or if you need a dental implant. A trained cosmetic dentist will create a treatment plan that includes Invisalign.
David Finley, DDS, of Monroe, LA—a Fellow of the Academy of General Dentistry—sponsors this post.