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Could Tooth Preparation for a Crown Break the Tooth?

Posted on by AllSmiles.

Almost 30 years ago, a dentist did a root canal on my right canine tooth. Although the tooth does not bother me, my dentist suggested placing a crown to prevent it from breaking. She said that if the tooth breaks while preparing it for the crown, I might lose it and need a dental implant. Should I be concerned about the tooth breaking? – Thanks. Jayson

Jayson,

We understand your concerns about getting dental work on a tooth that can risk its integrity.

Does a Root Canal Tooth Require a Crown?

Some dentists prefer to place a crown over every root canal tooth. However, whether a crown is necessary depends on the tooth’s condition and location. Some teeth are more susceptible to breaking.

  • Tooth condition – If a tooth is already fractured or its healthy structure is missing, your dentist may recommend protecting it with a crown.
  • Tooth location – Molar, premolar, and front teeth have different functions that naturally exert force and stress on teeth.
    • Molar teeth – Molar teeth chew and grind food, and the force causes stress that healthy teeth can handle. But the stress can push the four cusps, or peaks on the tooth, apart and lead to fracture. Premolars have similar risks.
    • Front teeth – Horizontal stresses affect the front teeth we use for biting. Front teeth absorb some of the stress for molar teeth. Canine teeth have long roots to help them absorb horizontal stress. When your teeth grind from side to side, the canine teeth force the back teeth apart to relieve horizontal stress.  Other front teeth absorb stress when you slide your lower jaw forward.

How to Protect a Root Canal Tooth from Fracture

A diagram with seven stages of root canal treatment from accessing the tooth to protecting it with a crown

Root canal treatment

Protecting a root canal tooth from fracture depends on whether a front or back tooth is affected.

  • Back tooth –  A crown or an onlay covers the chewing surface to help the tooth absorb stress and prevent it from splitting.
  • Front tooth – Although the traditional method is to place a crown over a front tooth, a crown can weaken the tooth. The neck of the tooth (near the gumline) is the weakest portion of the tooth. A porcelain crown requires your dentist to shave about one millimeter from every side of the tooth. Up to 30% of the tooth may be lost, and root canal treatment removes the tooth pulp. About 50% of the tooth’s original fracture resistance remains.

Many advanced cosmetic dentists avoid using a crown on front teeth unless they have a preexisting fracture, little remaining structure, or are dark in color, which can further weaken the tooth.

Fiberglass post

After root canal treatment, some advanced cosmetic dentists use a method like this to strengthen a front tooth against fracture and prevent the need for extraction and a dental implant:

  • Clean out the root canal filler material
  • Insert a white, flexible fiberglass post deep inside the tooth to strengthen it
  • Fill missing tooth structure with strong composite material

The post reduces the risk of horizontal fracture and prevents the need for a crown. If root canal treatment causes the tooth to darken over time, a dentist can use a porcelain veneer to conceal the discoloration.

Ask your dentist if your X-ray shows your tooth is weakening and requires a crown. You can also schedule a second-opinion appointment with an advanced cosmetic dentist to determine if your tooth is at risk of fracture.

David Finley, DDS, a Monroe, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.

 

Should I Still Have Post-Root Canal Pain?

Posted on by AllSmiles.

I had a traumatic root canal procedure in September. The pain was so intense that I asked the dentist if I could wait to get fitted for a crown. The pain lingered for a few days, so my dentist referred me to an endodontist. After taking X-rays, the endodontist said that my dentist missed a curved canal, and I would need a repeat root canal.

During the procedure from the endodontist, I felt discomfort near my jawbone. The endodontist said that she didn’t find any missed canals. Her findings surprised me because she previously said that my dentist missed a curved canal. Anyway, the endodontist told me that I would continue to experience discomfort for several days.

How long should the discomfort linger? It’s been four days, and the tooth still feels uncomfortable. How long will it take for the discomfort to decrease? I hope I won’t need a third root canal. – Thanks. Kylie

 

Kylie,

The endodontist estimated that you would feel discomfort for several days, so at day four, it is not alarming if you still have some discomfort. If the procedure fails, you will experience increased swelling. The key to evaluating your tooth is whether your discomfort gradually improves.

If the endodontist couldn’t find a missed canal, perhaps your dentist didn’t seal the tooth root properly.  If the discomfort in your root canal gradually decreases, you shouldn’t be overly concerned. Otherwise, call the endodontist’s office to report your symptoms and get the specialist’s opinion.

The Monroe, Louisiana, dentists at Bayou Dental Group sponsor this post. Please read how Dr. Finley and his team strive to offer some of the best dental care in Monroe.

I Still Have a Pus Sac on My Gums After Apicoectomy

Posted on by AllSmiles.

I had an apicoectomy in early May on an infected old root canal tooth. Yesterday, I had a follow-up appointment and an x-ray that confirmed the bone was rebuilding. However, my dentist thinks there is some minor infection because she noticed a small pus sac on my gum. I will take antibiotics for a week. Is there anything else I can do to eliminate the infection? Thanks. Teddi

 

Teddi,

With standard root canal treatment, an apicoectomy, or root canal surgery, if a dentist removes the dead tissue and seals the root tip well, the tooth will likely heal, and the infection will resolve.

What’s the Difference Between Root Canal Treatment and Apicoectomy?

Standard root canal treatment is not a surgical procedure, but an apicoectomy is surgery. Root canal treatment accesses the tooth from its crown or the biting surface of your tooth. However, a dentist opens your gum to access the root tip during an apicoectomy.

Will Antibiotics Cure a Tooth Infection?

Although antibiotics do not eliminate tooth infections, they can speed healing after root canal therapy. Successful treatment requires removing the source of the infection.

If the bone surrounding your tooth is healing, it suggests that your dentist removed the source of the infection and sealed the root tip well. A residual infection and pus sac will improve gradually. Your dentist prescribed antibiotics to accelerate healing. Ensure you finish the antibiotics and wait for healing. You will not need to do anything further.

If the infection lingers or worsens, contact your dentist. You may need an exam from a root canal specialist (endodontist).

David Finley, DDS, a Monroe, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.

How Risky Is It to Delay Seeing a Dentist for a Tooth Infection?

Posted on by AllSmiles.

My top right second molar broke in half ten days ago. The pain refers to my cheek, jaw, sinus, and nose. My temples began hurting today, traveling into my ear and neck. It was so bad that I called off work. I don’t have dental insurance yet, so I am taking antibiotics. My wife thinks I have a tooth infection, but I’m wondering if it’s a sinus infection unrelated to the broken tooth instead. How much time do I have to see a dentist? I get paid at the end of the month and will at least have a down payment for the dental work. Thank you. Kristoff from TX

Kristoff,

Your signs and symptoms are of a tooth infection.

How Risky Is It to Delay Seeing a Dentist for a Tooth Infection?

If you have a tooth infection, it is risky to delay seeing a dentist. Without dental care, the infection will continue to spread to other teeth, your jawbone, and possibly your bloodstream. Prompt root canal treatment can save the tooth and prevent long-term problems that develop after an extraction.

Diagram with five steps during root canal treatment, including, numbing the tooth, determining canal length, widening and cleaning canals, filling canals, and restoring the tooth.

Root canal treatment helps prevent future infection

What If You Don’t Have Money for a Root Canal?

If you don’t have money for root canal treatment, contact one of the organizations and ask if they offer free or discounted dental care:

  • Dental clinic – A free dental clinic can extract the tooth but may not offer root canal treatment.
  • Local dental society – A local dental society may do charitable work and treat or extract the tooth.
  • University dental school – Dental schools need patients as subjects to train students on specific procedures.

Although many people go to a hospital emergency room or urgent care facility for a toothache, the facility cannot treat your tooth. They may prescribe pain relievers or antibiotics, but you must see a dentist.

Can You Get Rid of a Tooth Infection with Antibiotics?

Root canal treatment is the only way to eliminate a tooth infection. Antibiotics help clear the infection from your system, but the root canal removes the infection from a tooth. According to the American Association of Endodontists, root canal treatment removes infection and bacteria, prevents reinfection, and saves the tooth.

See a dentist promptly, or call a clinic, dental society, or university dental school.

The Monroe, Louisiana, dentists at Bayou Dental Group sponsor this post. Please read how Dr. Finly and his team strive to offer some of the best dental care in Monroe.

My Dentist Had a Crown Made, But the Root Canal Failed

Posted on by AllSmiles.

My dentist prematurely ordered a crown without confirming that my root canal was successful. I had a tooth infection for two months.  The root canal failed, so I asked my dentist for an extraction and dental implant. My dentist referred me to an endodontist who recommends repeating the root canal. The endodontist said that my dentist should wait until ordering the final crown. My dentist had already ordered the crown. Can I get my money back for the crown if my dentist recommends a repeat root canal? I want an extraction. Thanks. Quince from MI

Quince,

You are correct. Although your dentist ordered the crown, you can refuse it because your tooth still seems infected.

When Should You Get a Crown on a Root Canal Tooth?

You should get a crown for a root canal tooth after your dentist ensures treatment is successful. Otherwise, the tooth can become further irritated, delaying healing. You would waste time and money if your dentist cemented a crown to your irritated tooth.

Nevertheless, root canal therapy can fail despite a dentist’s diligence. A dentist should not order a final crown, knowing that you still have a problem with your tooth.

Should You Refuse a Dental Crown?

You have the right to refuse a dental crown after root canal treatment if the infection remains. A dentist who makes a crown for an unhealed tooth is responsible for the risk. Your dentist should not ask you to accept or pay for the crown.

Should You Get a Repeat Root Canal or an Extraction?

The tooth’s condition depends on whether you should get a repeat root canal or an extraction. The endodontist evaluated your tooth and thinks it is savable. An endodontist is a root canal specialist who increases the chance of successful treatment. Keeping a savable tooth is better for oral health than an extraction and dental implant.

 

David Finley, DDS, a Monroe, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.

 

Why Do I Feel Shocks in My Tooth After Getting a Filling?

Posted on by AllSmiles.

Man holding the side of his face due to pain after a tooth fillingTwo weeks after getting composite fillings, one top and one bottom molar, I started feeling pressure shocks in the bottom tooth. I returned to the dentist, and he shaved down some of the fillings. Whatever he did didn’t help the pressure shocks. My dentist said that it sounded like the tooth might be cracked. He removed the filling and said the decay was deep and the tooth had a small crack. My dentist refilled the tooth and said I would need a root canal if it didn’t improve.

I still feel shocks in the tooth when I chew and sometimes when I touch it. Is a root canal the only solution, or should I get the tooth extracted? – Thanks. Bradley from NM

 

Bradley,

We are unsure whether your tooth is cracked or infected without an exam. Feeling no pain until two weeks after getting composite fillings suggests a crack or infection, which indicates the cavity was deeper than your dentist suspected. An X-ray would reveal the source of the shocks you feel in the tooth.

We are skeptical about your dentist’s ability to resolve the issue. An endodontist (root canal specialist) will give predictable results to prevent further damage and decrease the risks of root canal failure and tooth loss.

Do not ask a dentist to remove the tooth. Without replacing the tooth immediately, other teeth will drift into the space. You would experience several problems, possibly requiring orthodontics and a dental implant.

If your dentist says your tooth is cracked, we wonder why he didn’t recommend a crown. Without a crown, the tooth will break eventually.

We recommend getting a second opinion from an experienced dentist or an endodontist.

David Finley, DDS, a Monroe, Louisiana, dentist and Fellow of the Academy of General Dentistry, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.

Can I Take Leftover Antibiotics Instead of Getting a Root Canal?

Posted on by AllSmiles.

I had a huge filling on a decayed top left molar early last year. The dentist filled the tooth because I could not afford a crown. Since that time, I’ve only been to the dentist for cleanings because I did not have dental insurance. The tooth with the filling is starting to hurt, and my dentist said I would need a root canal soon. I still do not have dental insurance and cannot afford to pay for a root canal and crown out-of-pocket.  I have antibiotics from my primary care doctor that I took for a UTI. If it seems that my tooth is infected, is it okay to use the leftover antibiotics to take care of it until I can get the tooth pulled?  If the tooth hurts, how much longer do I have before I need it pulled? I want to save money from a few paychecks for the extractions. Thanks. – Eliana

Eliana,

Diagram with five steps during root canal treatment, including, numbing the tooth, determining canal length, widening and cleaning canals, filling canals, and restoring the tooth.

Only root canal treatment can clear a tooth infection

A dentist needs to examine your tooth to determine if it is infected. You should schedule the exam right away. Antibiotics will not make the infection go away. Root canal treatment removes a tooth infection. And after root canal treatment, antibiotics will keep the infection away. But your dentist will decide if you need antibiotics.

If you do not have dental insurance, look for an emergency dentist who accepts forms of payment other than dental insurance. Many dentists accept credit cards or offer payment plans or financing. Leaving the tooth untreated will lead to more expensive problems, like an infection that can spread to other teeth or your bone.

Even if you are considering a tooth extraction, please see a dentist promptly to discuss your options.

David Finley, DDS, a Monroe, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post.

Why Did Root Canals Fail on Three Teeth and Require Dental Implants?

Posted on by AllSmiles.

Since 2021, I’ve had three teeth that needed filling, root canals, and extractions. If my dentist continues this pace, I lose almost half my teeth in ten years. How is this possible? I brush and floss and keep dental cleaning appointments. Still, I’ve spent thousands of dollars on fillings, root canals, extractions, and dental implants. It’s been challenging to save money.

I’ve gone from my dentist monitoring two teeth to needing fillings. Then, the two fillings fell out after a few months, with the dentist saying that the cavity was too deep and I needed a root canal. The recurring issues concern me.

How do I know whether I’m experiencing poor care or if I have an underlying health issue that is leading to all these extractions? Should I insist on a refund, even if it takes an attorney to get it? Thank you. Ishmael

 

Ishamael,

Although one of our dentists would need to examine and x-ray your teeth, we will offer some suggestions. It is unusual for a patient with diligent oral hygiene, regular dental exams, and cleanings to need multiple root canal procedures. Regular checkups should detect early signs of decay so a dentist can treat it. However, you’re experiencing the opposite.

X-ray of an unrestorable tooth

X-ray of an unrestorable tooth with deteriorated pulp, courtesy of ToothIQ.com

If a dentist watches a tooth vulnerable to decay and declares it unrestorable on the next visit, they may be negligent. X-rays and a sharp explorer can detect problems with the tooth, and the dentist should intervene. Even if a dentist is watching a tooth with an old filling, the decay should not progress fast enough to damage the tooth pulp and root. That’s an issue that a dentist should catch.

When a dental filling falls out and leaves a tooth exposed, it is fair for you to be suspicious about the quality of your dentist’s work. Additionally, if the dentist’s solution is root canal therapy, which fails, and then a dental implant, you should consider getting a second opinion from a skilled dentist.

It will be challenging to get a refund from your dentist. We suggest switching dentists. Ask them to examine your history of X-rays and determine whether your previous dentist misdiagnosed your case or recommended treatment you didn’t need. If another dentist finds a blatant issue, you can tell your previous dentist that you will report the issue to the dental board. You can also leave negative online reviews.

Although your concerns may not be worth hiring an attorney to get a refund, they are finding a new dentist to preserve your teeth and oral health.

David Finley, DDS, a Metairie, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.

Why Do I Need Root Canals for Healthy Teeth?

Posted on by AllSmiles.

African American woman portraying concern over root canal treatment for a seemingly healthy tooth.Since 2018 I have used a sonic toothbrush and water flosser daily. Dental hygienists complement my oral hygiene habits, even the hygienists at my current dentist.

I switched to a new practice in late 2019, and since then, the dentist has found three “cavities” that he filled. Last spring (2022), one of the fillings fell out, and the dentist said I needed root canal treatment. Nothing about the tooth looked or felt unhealthy, but I trusted the dentist.

In November 2022, when I returned for a dental cleaning, the dentist said he needed to watch my upper left second bicuspid because it may need a root canal. I cannot read x-rays, so how do I know if the tooth is problematic? The dental hygienist was quiet when the dentist told me about a possible root canal, and she didn’t say much to me after the dentist left.

Now that the holidays are over, I will look for a new dentist. Is it possible that my teeth are decaying and getting infected despite my thorough brushing and flossing? I don’t know what to expect when I switch dentists. Thank you! Krystle

Krystle,

Thank you for contacting Bayou Dental Group. We understand and share your concerns about your dentist’s diagnosis.

Can Healthy Teeth Need Root Canal Treatment?

It is unusual to develop deep decay in a healthy tooth that leads to root canal treatment, especially when your oral hygiene habits are thorough. Your hygienist and dentist should detect signs of decay during your dental cleanings and exams. Still, a healthy tooth may develop decay and eventually require root canal treatment in these cases:

  • A tooth cracks
  • You experience trauma to your mouth or face that affects a tooth
  • You take a prescription medication that causes dry mouth and leads to decay

What Happens to a Tooth If a Filling Falls Out?

If a tooth filling falls out, it may be an old amalgam filling that recedes from the tooth and leaks in bacteria. The tooth beneath the filling can decay and need root canal treatment without prompt care. However, when a new filling falls out, faulty dental work is often the cause. Still, a dentist should be able to replace the filling without root canal therapy.

How to Switch to a New Dentist

Before you switch to a new dentist, take these precautions:

  • Ask your current dentist for a copy of your dental records and x-rays.
  • If you have dental insurance, check for plan providers first.
  • Look for cosmetic dentists with advanced training in procedures such as root canal therapy, dental implant surgery, and restoration. According to a study published by Regenstrief Institute, the lifespan of a root canal tooth that gets filling or crown afterward is about 11 years. A dentist who understands root canal therapy and implantology can help you assess your long-term oral health.
  • Schedule consultations before choosing a dentist. You can see the office, meet staff members, and discuss your concerns with the dentist.
  • Use your consultations, patient reviews, and recommendations from friends and family to help you choose a new dentist.

Monroe, Louisiana, dentist Dr. David Finley sponsors this post. Dr. Finley is an accredited Fellow of the American Academy of Cosmetic Dentistry and a Fellow of the Academy of General Dentistry. Please read about how he, Dr. Henderson, and Dr. Coughran strive to offer some of the best dental care in Monroe.

Will I Need Another Root Canal?

Posted on by AllSmiles.

Woman portraying the need for tooth removal for failed root canal treatmentMy 2018 root canal on my lower right molar went smoothly, but since June this year, the tooth has hurt daily. Within the past week, I have taken ibuprofen daily to concentrate on work. The timing of this toothache is in the middle of my plans to leave town next week. How urgent is this issue? I don’t want to say I don’t have time for another root canal, but please tell me if I should see a dentist this week. Thank you. Haley from NH

Haley,

Thank you for your question. One of our dentists would need to examine and x-ray your tooth to determine the issue, but we can explain what is probably happening.

What Can You Do About Pain in a Root Canal Tooth?

If you feel pain in a tooth that had root canal treatment years ago, we recommend promptly scheduling an appointment with a dentist. You have symptoms of root canal failure, but only an exam and x-rays can confirm that.

Is Root Canal Failure Common?

Root canal failure occurs if a dentist does not entirely remove the infection. Although a tooth may initially feel better, the infection will eventually recur. Sometimes, a dentist cannot see curvy tooth channels, and the disease will remain. Unless a dentist has advanced training in root canal therapy, they probably do not have instruments that access deep channels in the teeth. Your dentist may refer you to a root canal specialist (endodontist).

What Is the Treatment for Root Canal Failure?

Repeat root canal treatment or surgery is the treatment for root canal failure. After taking an x-ray of the infected tooth, an endodontist will use specialized tools to remove the infection and then sterilize the tooth. An apicoectomy or root canal surgery is sometimes required to access the root tip through your bone.

An endodontist will evaluate the condition of your tooth and determine whether it is savable or must be removed and replaced with a dental implant. Please do not delay treatment to prevent the situation from escalating.

 

David Finley, DDS, a Monroe, Louisiana, accredited cosmetic dentist and Academy of General Dentistry Fellow, sponsors this post. Read about what Dr. Finley and his team do to provide some of the best dental care in Monroe.

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