Hi Lori Bell,

Welcome to Neurotalk!

I am in the dental field for many years as a chairside assistant. Most of my posts are on the dental forum ... if you are interested in seeing some of the conversations there.

Just to clarify what your dentist was trying to inform you of and to also inform you of the risks of what has occured....

A build up on a tooth is made from a composite material that is put on in layers on top of the piece of tooth that is sticking out of the gum. When it's done, it resembles the shape of a small tooth. This material does not go into the roots at all. The material he was referring to has to do with the root canal procedure and it is one of two materials..... #1) It could be the cement that was injected into the large canals inside of the roots and/or.... #2)It could be the filling material called gutta percha that is used to fill the large canals inside of the roots.

Here's what happens...
During the root canal procedure, the instruments called files/reamers are repetitively pushed in/out of the inside of the roots in an attempt to crush and remove the nerves located there. Sometimes a rotary file is used which serves the same purpose. During aggressive use of the files, or when a tooth is infected, it is easy to perforate the end of the root. Then when the cement and/or the gutta percha is pushed into these canals it is often pushed through this perforation into the jawbone. It can easily be seen on an xray.

The surgery he is talking about to remove the material in the bone is called an Apicoectomy. This procedure is rarely done anymore because it has NO positive effect on the tooth and in fact it can compromise the bone even further leaving you with more infection and because this procedure can irritate bundles of nerves within the bone it can cause other areas of referred pain. During this procedure, a drill is used to cut a window into the bone below the root of the tooth. Files (similar to root canal ones) are used to scrap out that material that was overshot through the root into the bone. The hole is patched up with a mercury filling or some similar type of material and the tissue is sutured closed.

When he mentioned a surgery might be needed he was forewarning you that this tooth is now compromised in spite of putting on the crown which only covers the top portion of the tooth above the gumline. This means that eventually this tooth may show signs of abcess, pain, mobility, deep pocketing in between the teeth on either side, jaw pain....... etc. He probably mentioned it in a casual manner, but in reality, this is not a good scenerio and the life expectancy of this tooth is guarded.

A lot of information to be given.... but it's only fair that you are properly informed of what has occurred because you do have the option at this point to forgo the crown and have the tooth extracted. This would avoid a costly problem in the future.

Hope you can speak with your dentist about your options and make your decision based on what you feel is in your best interest.

Bryanna