Hi Slicker,
Welcome and thank you for the kind words! My knowledge is based on 35 yrs of being in the dental field... so wisdom a little... knowledge a lot
)
I'm going to re-post your questions and type my answers in bold print.
<<1) Fve years ago, I had a root canal on my left premolar tooth. Left first molar was extracted 6 years ago>>
WAS THE FIRST MOLAR A ROOT CANALED TOOTH? IF NOT, WHY WAS IT REMOVED?
<<2) Two years later - dentist advises me that the tooth is becoming dull and fits a crown?>>
THE PREMOLAR WAS BECOMING DULL BECAUSE IT WAS SICK WITH BACTERIA INSIDE OF THE TINY CANALS THAT CANNOT BE CLEANED OUT. THE TOOTH WAS ALSO FRAGILE BECAUSE IT HAD NO VITALITY. ANY LIVING THING THAT NO LONGER HAS VITALITY (LIFE) WILL BECOME DULL. THE CAP OR CROWN IS MADE TO COVER THE PORTION OF THE TOOTH SHOWING OUT OF THE GUM TO MAKE THE TOOTH LOOK BETTER. BUT IT DOES NOTHING TO HELP SUPPORT THIS DEAD TOOTH IN ANY WAY.
<<I am currently feeling a delayed vibration (no pain as there's no root) in this tooth area whilst jumping, running etc.>>
JUST TO CLARIFY THE ANATOMY OF YOUR PRE MOLAR.... A ROOT CANAL PROCEDURE DOES NOT REMOVE THE ROOTS OF THE TOOTH. THEY ARE STILL PRESENT IN THE JAW BONE JUST LIKE THEY WERE PRIOR TO THE RC PROCEDURE. THE ONLY DIFFERENCE IS THAT THE NERVE TISSUE THAT RESIDED INSIDE OF THE LARGE CANALS (TUNNELS) INSIDE THE ROOTS OF THE TOOTH HAS NOW BEEN SOMEWHAT REMOVED. THE RC ALSO CUTS OFF THE BLOOD SUPPLY FROM THE BLOOD VESSEL TO THE TOOTH MAKING THE TOOTH NON VITAL AND VERY SICK.
THE VIBRATION THAT YOU FEEL IS ALSO REFERRED TO AS A PULSE OR A THROBBING... DIFFERENT PEOPLE DESCRIBE IT DIFFERENTLY. IT IS CAUSED BY THE INFLAMMATION FROM THE BACTERIAL INFECTION THAT STARTED YEARS AGO INSIDE OF THE TOOTH WHICH HAS BEEN FESTERING THE ENTIRE TIME. ANOTHER "VISUAL" EXAMPLE OF THIS WOULD BE IF YOU HAD A SPLINTER IN YOUR FOOT AND IT BECAME INFECTED... EVERY TIME YOU STEPPED ON THAT FOOT YOU WOULD FEEL A VIBRATION OR A THROBBING IN THE AREA OF THE SPLINTER. EVENTUALLY AS THE INFECTION SPREADS, IT GOES FROM THE VIBRATION/THROB TO PAINFUL.
<<I saw my dentist a month ago who said this tooth is leaking and prescribed antibiotics. Plus, he told me to consider an implant (sounded really expensive!)>>
THE "LEAKING" (REALLY POOR DESCRIPTION) MEANS THE INFECTION HAS BROKEN THROUGH THE TOOTH AND IS (LEAKING) SPREADING INTO THE BONE.
ANTIBIOTICS CAN ONLY TEMPORARILY SUBSIDE THE SYMPTOMS... IT CANNOT AND WILL NOT CURE THE INFECTION INSIDE/OUTSIDE OF THE THIS TOOTH. THE BACTERIA CAUSING THE INFECTION IS TRAPPED INSIDE OF THE DENTIN TUBULES LOCATED THROUGHOUT THE INSIDE OF THE TOOTH. THERE IS NO ACCESS TO THESE TINY CANALS. THEREFORE THE ONLY WAY TO CURE THIS INFECTION AND PREVENT IT FROM SPREADING ANY FURTHER IS TO REMOVE THE SOURCE OF THE INFECTION.... WHICH IS THE TOOTH.
<<Conicindetally, my sinuses have been awful in the mornings recently and I suffered from tonsillitis a few weeks ago.>>
BINGO! THIS IS THE BACTERIA THAT IS "LEAKING" FROM THE TOOTH INTO THE BONE INTO THE SINUS AREA AND DOWN THE THROAT. ALL OF WHICH WOULD CAUSE THAT VIBRATION FEELING THAT YOU HAVE WHEN YOU RUN, ETC.
<<What are my options? Sounds vein, but extraction would look hideous!>>
THE VANITY ISSUE IS FAR LESS A CONCERN EVEN THOUGH THAT IS WHAT YOU ARE MOST WORRIED ABOUT. WITHOUT A DOUBT, YOU HAVE A SERIOUS INFECTION. YOUR DENTIST SHOULD HAVE BEEN MORE INFORMATIVE WITH YOU. TOOTH INFECTIONS THAT PROLIFERATE THE SINUS CAN SPREAD INTO THE BRAIN. THE BRAIN IS APPROXIMATELY 4 INCHES FROM THE ROOT OF THIS TOOTH. THE TRUTH AND HARD FACTS OF YOUR SITUATION ARE THAT THE LONGER YOU HANG ON TO THIS TOOTH, THE FURTHER THE INFECTION WILL SPREAD. THERE ARE NOT OPTIONS TO CURE THE INFECTION OTHER THAN REMOVING THIS TOOTH.
REPLACEMENT OPTIONS MAY BE A DENTAL IMPLANT BUT GIVEN THE HISTORY OF THIS TOOTH.... THAT MAY NOT BE THE WISEST SOLUTION AS THE BONE MAY BE TOO COMPROMISED FROM THE EXTENT OF THE INFECTION. IF YOU HAVE A FIRST PRE-MOLAR AND A SECOND MOLAR IN THAT QUADRANT, YOU MAY BE A CANDIDATE FOR A 4 UNIT PERMANENT BRIDGE.
The most important fact here is the infection and how it has spread and will continue to spread. Your wisest plan may be to remove this tooth asap and then decide how to replace it. I would also recommend that you see an oral surgeon for the removal of this tooth because the surgery may go into the sinus cavity and general dentists do not do that type of surgery.
I'm sorry to be tell you this bad news.... perhaps your dentist should have been more informative with you rather than making light of this and asking you to take an antibiotic which is just a band-ade.
Let us know your thoughts..........and your plans!
Bryanna