Hi sadie,
I am going to re-post some of your statements and answer them in bold type.
<<<Instead, the periodontist said that he thought there was some violation of the biologic width of the first root canaled tooth. This tooth had a Cerec crown on it that had universally criticized by every dentist and endo who subsequently saw it. It never felt like it fit in my mouth, and in fact always seemed like it was cutting into my gum. Eventually (it was less than a year old at the time of the root canal) I sort of got used to the discomfort, though never completley. Last year right before Xmas, however, the pain welled up and instead of going to my regular dentist (not the same one who made the cerec crown), I asked for a endodontist, thinking I needed to take care of it before the holidays.>>>
THERE PROBABLY IS SOME VIOLATION DUE TO THE ILL FITTING CEREC CROWN.... WHICH PROBABLY SHOULD HAVE BEEN REDONE SOON AFTER IT FIRST BECAME A PROBLEM. FOR DENTISTS TO CRITICIZE THE WORKMANSHIP BUT NOT INFORM YOU THAT IT NEEDED TO BE REDONE.... HAS MOST LIKELY COST YOU THE MISFORTUNE OF HAVING HAD TWO ROOT CANALS UNNECESSARILY.
THE PERIODONTIST DEEPLY SCALED THE POCKET BETWEEN THE GUM LINE DOWN TO THE CREST OF BONE ALONG THE ROOT OF YOUR TOOTH. THIS IS DONE IN AN ATTEMPT TO REMOVE ANY GRANULATION TISSUE THAT HAD FORMED IN THAT INFLAMED SPACE DUE TO THE ILL FITTING CROWN. THE GOAL OF DOING THAT IS TO HOPE THAT THE GUM TISSUE RECEDES AWAY FROM THE MARGIN OF THE CROWN. IF THIS FAILS, YOU WILL MOST LIKELY BE TOLD TO HAVE A CROWN LENGTHENING SURGERY TO PHYSICALLY REMOVE THE INFLAMED TISSUE DOWN TO THE CREST OF BONE.
IF THIS TOOTH HAD NOT BEEN ROOT CANALED, THIS PROCEDURE WOULD HAVE MADE THIS TOOTH <PERMANENTLY> SENSITIVE TO COLD.
<<<After the root canal, however, the gum swelled and wouldn't calm down. Even after they fixed the pain and pressure of the tooth itself, the gum never felt right. It is this feeling that there is always something stuck under the tooth (or that I need to floss constantly because of some invisible pressure) that has been the most troubling part of this last year. He performed some minor work scraping the gum away from the tooth (here I'm slightly fuzzy on the the details) to see if the gum can start to repair itself. >>>
I HAVE A SUSPICION THAT THE PAIN WAS NOT TOOTH RELATED... IT WAS GUM RELATED DUE TO THE ILL FITTING CROWN. HAVING HAD THE ROOT CANAL WAS LIKE PUTTING GASOLINE ON AN ALREADY BURNING FIRE AS IT DID NOTHING TO ALTER THE PROBLEM AND JUST ADDED MORE INFLAMMATION.
<<<More important (at least in my mind) is that he said that thought both of my root canals may have been unnecessary. He thought it was possible that my original pain may have come from the awkward placement of the cerec crown, and that the additional pain might have originated with that as well: my bite has shifted to one side, possibly from the crown and some other dental work I had done at the same time. He suspects I also now have a TMJ issue, which makes sense to me as I have been having headaches and some numbness on that side of my face.>>>
WELL THERE YOU GO! THAT IS EXACTLY WHAT I AM SAYING... IT IS THE ILL FITTING CROWN THAT WAS YOUR ORIGINAL PROBLEM. SO AT THIS POINT THE CROWN STILL FITS POORLY, THE GUM IS BEING CHOKED BY THE POOR FITTING MARGIN ON THE CROWN AND THE TOOTH HAS BEEN ROOT CANALED. I KNOW YOU ARE FOCUSED ON THE GUM ISSUE, BUT THAT IS TRULY ONLY ONE ASPECT OF WHAT WILL LIKELY TURN INTO A CHRONIC TOOTH PROBLEM. I'M TELLING YOU THIS SO THAT YOU ARE MINDFUL OF THE SHORT COMINGS OF ANY OTHER TREATMENT RECOMMENDATIONS TO DEAL WITH THE "GUM PROBLEM".
IF YOUR OTHER DENTAL WORK IS NOT FITTING PROPERLY AND IS CREATING A TMJ PROBLEM.... THAT MAY MEAN THAT YOU HAVE TO REDO YOUR DENTAL RESTORATIONS BEFORE THE BITE BECOMES SO BAD THAT YOU START HAVING ADDITIONAL TOOTH PROBLEMS DUE TO THE POOR BITE.
You can only make one decision at a time. I am hoping that your gum irritation subsides..... but in the long run I think you realize that it would just be a temporary thing due to the bacteria contained in root canaled teeth.
I have seen your exact situatuon countless times...... it always breaks my heart to see people go through unnecessary dental work and pain because of crappy dentistry. One of the dentists that you had seen along the way (the endodontist especially) should have been more truthful with you and said hey..... go back to the guy who did the cerec and get him to redo it.
I am just so sorry you are going through this. Just try to stay positive and please be mindful that spending more money to treat the gum issue is not going to solve the overall situation.
Bryanna
Quote:
Originally Posted by sadie682
Thanks Bryanna. Of course, I realize that you are not available 24/7 to answer my questions; I'm just very appreciative to get your input, and I thought (or was hopeful) that I might get a chance to do at least one extraction today, so I was worried that I had to make an immediate decision.
Instead, the periodontist said that he thought there was some violation of the biologic width of the first root canaled tooth. This tooth had a Cerec crown on it that had universally criticized by every dentist and endo who subsequently saw it. It never felt like it fit in my mouth, and in fact always seemed like it was cutting into my gum. Eventually (it was less than a year old at the time of the root canal) I sort of got used to the discomfort, though never completley. Last year right before Xmas, however, the pain welled up and instead of going to my regular dentist (not the same one who made the cerec crown), I asked for a endodontist, thinking I needed to take care of it before the holidays.
After the root canal, however, the gum swelled and wouldn't calm down. Even after they fixed the pain and pressure of the tooth itself, the gum never felt right. It is this feeling that there is always something stuck under the tooth (or that I need to floss constantly because of some invisible pressure) that has been the most troubling part of this last year. He performed some minor work scraping the gum away from the tooth (here I'm slightly fuzzy on the the details) to see if the gum can start to repair itself.
More important (at least in my mind) is that he said that thought both of my root canals may have been unnecessary. He thought it was possible that my original pain may have come from the awkward placement of the cerec crown, and that the additional pain might have originated with that as well: my bite has shifted to one side, possibly from the crown and some other dental work I had done at the same time. He suspects I also now have a TMJ issue, which makes sense to me as I have been having headaches and some numbness on that side of my face.
He wants me to wait before any further procedures (i.e, extraction) to see if his gum treatment yields any benefit and also if I get any relief from some simple TMJ exercises and treatment. I can't tell you how awful it was to learn that I quite possibly had TWO root canals for no good reason, not even as you say to "retain" the teeth. It's horrible to think I spent all this time and money AND compromised my present and future health just because I thought I needed a root canal, and I found an endodontist who agreed.
I like this periodontist and despite the pain I have been in, he did manage to persuade me to wait another couple of weeks to see if the treatment he did (and the other stuff he wants me to do) will make a difference. I realize I probably still need to have the extraction, but I am so angry at having two teeth root-canaled for no reason that it is hard to make another drastic decision at the moment. It's bad enough to have a root canal when you are facing a major abscess; in my case, the endo told me only after the fact that there was no infection, just "inflammation" of the nerve. I guess that means I killed two perfectly good (or at least, not BAD) teeth.
At least I hope I know enough now not to be talked into another root canal, ever.
I know you're going to say I still need to extract the tooth (teeth). And I'm sure you're probably right, but I am going to wait until after Labor Day, since everyone on vacation until then anyway. In the meantime, I would love to get your input on this gum issue, the biologic width thing. From what little I have read online, it does seem to match up with my pain and the sensation in my gum. Also the TMJ: I kept feeling like my bite was off, and it just kept getting worse after the root canal (especially since I couldn't chew at all on that side for the last 9 months.)
And thanks again so much for getting back to me. I feel like I spent 9 months wandering in the wilderness until I found this site. THANK YOU again! I'm very grateful for your help.
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