Tag Archives: root canal treatment

In Pain After Dental Work in Mexico

I need some advice and am wondering if I have a dental emergency on my hands. I went to Mexico to save some money on my dental care. They gave the three crowns in all. One of the crowns fell off after a few days, so I made the trip back to have it fixed. Then, they told me it needed a root canal treatment in order to have the crown replaced. When I asked why they didn’t do that to begin with they said root canals only work sometimes so aren’t worth it unless there is a problem. It sounded like they were trying to save me money before so I agreed to the root canal treatment. Now I am in massive pain and the tooth is really sensitive. I called them back and they said I would need to come back in. Now they are saying the tooth is cracked and I will need to extract it and get a dental implant. If it wasn’t cracked before does that mean they cracked it when they did the root canal? Do I go ahead with this extraction and replacement? I’m starting to lose confidence in them.

Bryce

Dear Bryce,

Man in pain, grabbing his cheek in need of emergency dental care.

STARTING to lose confidence in them? I lost confidence back when the dental crown fell off. Properly bonding on a dental crown is a pretty basic dental procedure. Even the worst crowns should last a minimum of five years. Yours did not even last a few days. As for their root canal treatment, the excuse that they don’t always work does not wash with me. While root canal failure is a thing, if your tooth is infected you need a root canal treatment. Period. However, I don’t think you needed one. You gave no indication to me that you were in pain, which is one of the signs of an infected tooth.

I think you were given an unnecessary root canal. Not only that, they didn’t finish it. If they had, you would not be in pain. You can only have sensitivity in a tooth if there is still some viable tissue. A root canal treatment is supposed to remove all the inside tissue. Obviously, they didn’t. Now they are saying the tooth is cracked and you need to replace it. Even if it is true that the tooth is cracked, that does not make it unsavable.

I would not let these people anywhere near your teeth for even a second. I don’t know what the laws are in Mexico for patient recourse in these situations, but you may end up just having to cut your losses. If you are in pain, and it sounds like you are, I’d like you to schedule an urgent dental appointment with a dentist here in the United States. Get a true evaluation of this tooth and see where you stand. Then we’ll have a better idea of how you can get this healed.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Traumatic Tooth Injury and Dental Anxiety

I took a pretty bad fall and now two of my teeth are starting to turn black. Is there something that can be done to help this? I have to tell you I haven’t been to the dentist in two years because I have horrible dental anxiety. The last time I went the teeth were healthy.

Brooke

Dear Brooke,

woman asleep in the dental chair from dental sedation

When a tooth turns black after an injury, it means the nerve inside the tissue of your teeth has died. The treatment for this will be a root canal treatment. Then a dental crown can be placed over the tooth to both protect the tooth and to improve its appearance.

I do understand that you are not comfortable at the dentist and have some dental anxiety you are dealing with. I want to make sure you know there are dentists who work with anxious patients. By seeing a sedation dentist, you can have a completely anxiety-free and pain-free dental experience.

Most dentists offer two levels of dental sedation: nitrous oxide and oral conscious sedation. Nitrous is sometimes called laughing gas. It doesn’t actually make you silly as it does give you a relaxed, floaty feeling. This is often enough for some patients to have an easier dental experience. It has the additional benefit of allowing you to get on with your day immediately following your appointment.

If your anxiety is stronger, and for some it is debilitating, then I would suggest oral conscious sedation. This is so strong that some call it sleep dentistry because you are so relaxed you can sleep through your appointment. The only real downside is that, because of its strength, you will need someone to drive you to and from your appointment as well as stay with you for a few hours after your appointment until you are lucid and steady on your feet.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

CEREC Crown Hurts

I had a CEREC crown done on a tooth. This isn’t my first crown, but it is my first CEREC crown. For some reason, this one hurts when I bite down. Is that something peculiar to this type of crown? I’ve never had that happen before?

Jeff

Dear Jeff,

Man in pain, grabbing his cheek in need of emergency dental care.

I truly do not believe the pain you are experiencing is because it is a CEREC crown. Most of the time, CEREC crowns fit better because they are precisely milled by a computer. So, what COULD be causing your pain?

The first reason could be that the bite is too high. If it isn’t seated in the correct place, then when you bite down all your biting force is going to that one spot instead of being spread across all your teeth. This can cause some substantial pain. If this is the case, your dentist can adjust the crown and you should have no further problems.

You didn’t mention if you’d already been back to your dentist and this has been done. If the crown has been adjusted and you are still experiencing pain, the next step would be to check for a lingering infection. If you had this crown placed after a root canal treatment, there can be a canal that was missed. Though our teeth only have a limited number of canals, many times they have branches that shoot off into other parts of the tooth. A dentist can do everything right and still not be able to get everything the first go-round. In that case, a re-treatment can be tried. If you do need a re-treatment, I generally recommend you see a root canal specialist to increase your chances of success the second time around.

Even if you didn’t have a root canal treatment, there could still have been an infection there. Sometimes, the infections are small and hard to read, but get easier as the infection grows. A simple diagnostic x-ray should help determine if this is the cause of your pain.

I would start with these two avenues of inquiry as they are the most common.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Learn about our dental sedation options.

Can a Root Canal Infect a Salivary Gland?

My daughter has had two salivary gland infections and they are both on the same side where she had a root canal treatment done. Is it possible the root-canaled tooth is infecting her salivary gland?

Kerrie

Dear Kerrie,

A woman grabbing her jaw in need of an emergency dentist

I’m sorry about the ordeal your daughter has been facing. That must be painful. The first thing I would suggest is that you have some x-rays done for her tooth with the root canal treatment. In order for the salivary gland to get infected from the root canal, there would have to be an active infection in the tooth.

Root canal failure is fairly common so I wouldn’t be completely surprised if there was an active infection. You should be aware that the chances of a successful procedure go down with each root canal retreatment. If it turns out your daughter does have an active infection, you will have a better chance of success with the follow-up treatment if you go to an endodontist. It isn’t a guarantee, but they specialize in these treatments and will have more experience. Don’t put off the re-treatment. These type of infections are considered dental emergencies.

When a Tooth Cannot Be Saved

Sometimes, a tooth cannot be saved. When that happens, the tooth needs to be extracted and replaced. The best tooth replacement is a dental implant. You didn’t mention how old your daughter is. For her to get a dental implant, she would need to have a fully developed jaw. Until then, a temporary replacement (like a dental flipper) will keep the space open and will cost you less than other replacement options.

If the x-ray determines there is not an active infection, then whatever is going on with her salivary gland will have nothing to do with her dental health. I would suggest further investigation.

This blog is brought to you by Gilbert, AZ Dentist Dr. Matt Roper.

Antibiotics and a Tooth Infection

I went to see a dentist because of serious pain I was having along with swelling in my cheek that went all the way up to my eye. He said I have a massive infection and gave me some antibiotics. I have been taking them. The infection seemed to be getting better but then got worse again. Now I am out of antibiotics. Do I just call to get a refill or is something else going on?

Morgan

Dear Morgan,

Man in pain, grabbing his cheek in need of emergency dental care.

Are you certain the dentist you went to didn’t tell you to make a follow-up appointment? Antibiotics alone do not cure a tooth infection the way they do with other types of bacterial infections. Instead, they just keep the infection from spreading. The reason tooth infections are different is because, at some point, the pulp inside the tooth dies. This means there is no longer any blood flow to get the antibiotic to the infected tissue.

This means while the infection will seem to improve for a bit, without completing the treatment the infection will return. When that happens, it is dangerous and considered a dental emergency. This is where you are now.

The Solution to a Tooth Infection

The only way to truly solve a tooth infection is to remove the infected pulp. A dentist can do this two ways. The first is a root canal treatment. This is what you want because it will save your tooth. If that doesn’t work or it is too late to save the tooth, your next option is a tooth extraction.

If you end up having to extract the tooth, you’ll also want to replace it. Because you lose the root of your tooth when you have an extraction, you will want to replace that root. The only tooth replacement that does this is a dental implant. Without replacing the root, the minerals in the jawbone where the tooth was will begin to resorb and the bone in that area begins to disappear.

Bottom line, this is serious. Get to a dentist right away and get this treated.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Can’t Afford Tooth Care

I have had a decaying wisdom tooth for some time. I just don’t have money for the dentist. Lately, though the pain is going up my cheekbone toward my eye. Because it is not just in my tooth, do you think I could get antibiotics for a doctor for the infection? I have medical insurance, but not dental insurance.

Eric

Dear Eric,

Man in pain, grabbing his cheek in need of emergency dental care.

I don’t want you to mess around with this. Believe it or not, people still die from tooth infections. While you could go to your doctor and he might give you an antibiotic, all that will do is hold the infection back for a short time. As soon as the antibiotic finishes, the infection will flare back up.

Dental infections are different than other types because once the pulp of the tooth is infected and dies there is no blood flow in the tooth. The antibiotic cannot reach the root of the infection. The only way to “heal” a tooth infection is to physically remove the infected pulp.

Normally, if the tooth can be saved, the best treatment option will be a root canal treatment. However, with a wisdom tooth you would just extract it.

Affording Dental Care

I know that does not mean you have any more money. However, I want you to think about what will happen when this infection spreads. It is already moving up your cheek. It is not too far from there to your brain. An infection like that will be life-threatening.

One thing I would do is look for a dentist who advertises as an affordable dentist. This almost always means they are willing to work out payment options for patients. That will especially be likely in a situation such as yours where there is an urgent care situation.

Another option, if you can’t find a dentist willing to work with you is to work through Care Credit. This is a medical credit card that will pay for your care and allow you to pay it off. You have to have reasonable credit, but if you qualify their terms are remarkably good.

Please don’t put this off.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

When Does a Tooth with a Root Canal Treatment Need a Crown?

I have a root canal treatment that has never been crowned. Recently, I read that is a mistake. Should I get this crowned? I used to have dental insurance, but now I don’t so I don’t want to spend the money if I don’t have to. What are your thoughts on it?

Bruce

Dear Bruce,

I’m very glad this question came up because I have seen some people just crown every tooth that had a root canal. In some cases that can do more harm than good. Much of the answer to this question will depend on which tooth you are talking about. If it is a back tooth, such as a molar, then I would say to crown the tooth. It will protect it from the type of biting forces those teeth face. With other teeth, it gets more complicated.

illustration of a a front tooth

The biting stresses on a front tooth and their adjacent teeth are mostly horizontal because of the tearing stress. This means the neck of the tooth is the most vulnerable. By the time you prepare a tooth for a dental crown, it loses a minimum of 30% of its diameter, putting additional stress at the neck of the tooth. If that tooth also lost a significant amount of structure before the root canal treatment because of decay, there will be even less structure there.

If you place a dental crown on a front tooth that doesn’t have the necessary diameter to support the forces it is subjected to, it could end up breaking at the gumline. Some dentists try to overcome this by placing a post in the tooth, though that can increase the chances of the root fracturing, which will require an expensive repair.

The issue with front teeth after a root canal is that they tend to turn dark, which becomes an appearance issue. Our smiles are one of the first things people notice about us so we want them to look as nice as we can. Here is my advice on how to keep its white color longer and what to do when it does turn dark.

Helping a Tooth with a Root Canal Keep its Color

Your dentist needs to thoroughly clean out any root canal material and cement from the crown of the tooth, these are huge contributors to the dark appearance. Next, he or she should place a white fiberglass post into the tooth. Fiberglass is more flexible and will help with the stress. Finally, fill the remainder of the open area with white composite filling material. Doing this will extend your tooth’s color.

If it does eventually turn dark, instead of crowing it, I would suggest a porcelain veneer placed on that tooth. That removes far less structure, which will be better for the tooth viability in the long run.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
We treat dental emergencies.

This Dentist Doesn’t Understand Tooth Infections

I had a tooth infection and went to see a dentist. It’s my first time with this dentist. To be honest, I usually avoid dentists but this one couldn’t be helped I was in so much pain. He gave me and antibiotic and I started to get better, but now I’m worse again. Do I need a second round or did I have the wrong antibiotic?

Leslie

Dear Leslie,

A woman grabbing her jaw in need of an emergency dentist

Either there is some miscommunication between you and your dentist or he has a profound lack of understanding of how dental infections work. An antibiotic is only useful to hold off a dental infection. It won’t cure it. In order for a tooth infection to be completely treated, a dentist has to get in there and physically remove the infected pulp. This can be done by a root canal treatment or by extracting the tooth completely.

It is always better to try and save a tooth, so a root canal would be my first recommendation. If your dentist didn’t tell you this would be necessary and just prescribed you antibiotics and sent you on your way, I would consider this gross negligence on his part.

Yes, you would start to feel better after taking the antibiotics, because they were doing their job. Once they ran out, however, because the infected pulp is still there, it rears its ugly head again. This will continue to spread and what was a dental emergency can turn into a life-threatening emergency rather quickly. This is because your heart, lungs, and brain are all close to your jaw. This needs to be treated.

Dealing with Dental Anxiety

I noticed you said you usually avoid dentists. That is a common issue, especially with patients who suffer from some dental anxiety. If that is you., one step you can take that will help is to see a sedation dentist when you go in for your treatment. They can provide you with a pill that will completely relax you, allowing you to get the dental care you need in an anxiety-free and pain-free way.

Please don’t put this treatment off. It’s important. Sadly, people still die from tooth infections.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

What’s Wrong With My Root Canal?

Hi there,

I fractured my teeth playing sports a few months back, and was treated by an emergency dentist and released. A few weeks after the accident, my teeth became grey and discolored.  I was in severe pain and had swelling, so I had to go back to the dentist for an emergency root canal.

I was ok for a few days with antibiotics but now the pain is back. I don’t know what to do to get the pain to go away. My tooth is sensitive to cold food and even chilly air. I’m very uncomfortable and want the pain to stop.

Should I have gotten a root canal sooner? Do I need more antibiotics? What can I do about the pain?

Luca, from Quebec, Montreal

 

Hi Luca,

A discolored tooth means there is damage to the root, or an infection may be present. It needs a root canal treatment as soon as possible at the first sign of greying. Once the root is removed, the bacteria is cleared up and the tooth is sealed to prevent further problems. Leaving an infected tooth in your mouth longer than it needs to be there serves no purpose. Oral infections should be taken seriously, as they can spread to other parts of the body if left untreated too long.

It sounds like your root canal treatment was sealed before all the bacteria was removed, which is causing a flare up. Usually, the infection is allowed time and space to drain, but since it has been sealed, there is no where for it to go. Also, a few days of antibiotics is not enough time to be on the medication.

Your best bet is to find an endodontist specializing in root canals. They can fix what has been started, and will advise you on how to properly take your antibiotics for maximum effectiveness.

This blog post is brought to you by Gilbert emergency dentist, Dr. Matthew Roper, of Vista Dorada Dental.

 

 

Is My Pain Caused by my CEREC Crown?

Hello there,

I had three CEREC crowns done on my back teeth recently. I was pleased with how convenient getting the CEREC crowns was, but since then, I’ve had a lot of pain when chewing. Eating anything crunchy or chewy causing a bolt of pain, as though a nerve is exposed or something. My dentist has shaved down some of the crown. He says the pain I feel is from how I grind my food when I chew. Is that the case? I’ve tried being more careful when I eat, but the pain I feel makes me nervous during meals.

Richard from Amityville, New York

 

Dear Richard,

There are a few reasons that can cause a new crown to hurt. One reason may be that the crown is too high, so the rest of your teeth hit it first when you bite into something. The second reason is that the tooth under the crown may be infected. The infection can cause inflammation in the jaw, causing constant jolts of pain when biting or chewing.

Your pain is unlikely to be caused by how you chew your food, as you did not have this problem prior to the crown. Also, CEREC crowns are supposed to fit exactly to your mouth’s specifications, as they are milled to fit your teeth precisely.

Since your dentist has tried to grind down the crown, your pain is not likely to be caused by hitting too high on the crown. You will need to find out if you have an infection, and where it is in your mouth. An X-ray will be needed, and you may want to seek a second opinion if you do not trust your current dentist’s skills.

This blog post is brought to you by Gilbert CEREC crown provider, Dr. Matt Roper, of Vista Dorada Dental.