Franklin,

Any chance you can obtain and post x-rays of this area of our mouth both pre and post op root canal?

I have a feeling that the root canaled tooth is not in good shape and may be one contributing problem and the other may be that the bridge is ill fitting.

Bryanna

Hi Bryanna
Thanks once again
I just came back home from both dentist.
Went to see a new dentist today and he did a new xray
If I had read your response before going to see the new dentist today would have collected the crazy results

Well the new dentist said from the xray, there's no infection in the tooth.
He said the likely cause of the pain is because my lower front teeth keep jamming the bridge from time to time putting pressure on the tooth carrying the bridge.

He said the tooth carrying the bridge is supposed to be healing but the jamming would not make it heal hence the pain as soon as I wake up in the morning and the jamming starts

So he did the carbon paper test and had to scrape some parts of the bridge off to reduce the jamming

The first dentist also scraped the bridge previously but she stopped after scraping little saying that the bridge may break

But this new dentist scraped as much as he could and the jamming has reduced alot. No pain so far. He then recommended I go see the old dentist for the completion of the root canal

So I went to see the old dentist.... Didn't tell her I saw a different dentist though. Only told her I've been in pains and then she recommended this drug.. That it would reduce the tooth pain


The name of the drug she wrote down is Tegretol
Do you have any idea of the drug related to dental pain?

I'll buy it on Monday hopefully

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Hi Franklin,

To help make you aware of what actually occurs with root canaled teeth I will inform you of things that your dentist and many other dentists do not inform their patients of prior to recommending a root canal treatment. This may explain why you are having the ongoing problems with this bridge and how medicating it with pain meds is not going to solve the problem.

Teeth have one to four large canals that are visible and large enough to access during the rc treatment. Teeth also have many hundreds of tiny microscopic canals that are not accessible. All of the canals contain live nerve tissue. The only areas of the tooth that are treated during the root canal procedure are the large canals leaving the hundreds of tiny canals with nerve tissue in them. The rc procedure severs the blood vessel that supplies the tooth with oxygen and nutrition leaving the remaining nerve tissue inside those tiny canals left to die. Dead nerve tissue becomes inflamed, bacteria sets in and then infection. Not sometimes, all the time. Just as it would if it were someplace else in the body. The tiny canals are microscopic, so they do not show on dental radio graphs. The inflammation and infection inside of these canals does not show on radio graphs until it spreads and becomes large enough to be visible. So to be clear, although the inflammation and infection is not clearly apparent on the xrays now, the inflammation and bacteria is very present in the tooth.

It is typical for an inflamed tooth to be painful upon pressure. The dentist will reduce the occlusion (bite) on that tooth so that it is not hitting against the opposing tooth too hard. This can make the tooth feel better and in teeth that are NOT root canaled or infected, the inflammation can subside. However when the tooth is infected or becoming infected the relief of the pain does not mean that the problem is solved because as I have explained, there is still bacteria that is building up inside of the tooth.

During a root canal procedure a harsh disinfectant chemical is used to kill off the nerve tissue that remains in the large canals after they are scraped. This chemical does not penetrate the tiny canals but it does remain in the tooth. So as the bacteria from dead nerve tissue in the tiny canals spreads beyond those areas, it drags the chemical with it. The interior of the large canals are filled with rubberized latex material which off gasses a toxic substance that is also carried in the bacteria that moves through the tooth has it becomes infected.

The infection process that I have explained occurs in every root canaled tooth. Depending on the individual case and patients health, the symptoms of the infection, which could be vague or severe, may appear right away or may not appear for weeks, months or even years. Irrelevant of the onset of oral symptoms, the process still occurs and the bacteria and complications can become widespread.

So with all that said, whatever pain meds or antibiotics you are given may work to temporarily subside the inflammation thus reduce the current pain. But they cannot resolve the ongoing process that occurs in root canaled teeth. Tegretol is actually a seizure medication and it blocks nerve pain. It is typically used in dentistry only for severe pain associated with complicated oral surgery or cases of trigeminal neuralgia. There are case studies that show this drug may contribute to bone loss of the jaw especially if taken long term. I would suggest that you read up on this medication before taking it.

A side note... your original dentist may not have said anything to you but she was able to tell that you had been to another dentist because the evidence was apparent in the reduction of the bite and because the drilling away of the porcelain on the crown to reduce it also reshapes the crown. So she knew what she had done previously now looked different. Just letting you know that.

Bryanna

Hi Bryanna
So short of words. Funny these dentists are so quick to offer root canal as the best way out.
My hope is that the bridge stays for a year plus without pain and infection as I'll be extracting that tooth soon and going for two implants. With the implants all these issues of infections and pains would be no more.... Right?


Franklin

Franklin,

You are correct that dentists are very quick to offer a root canal and without much information about it.

Because the root canaled tooth is infected, within a years time the infection can spread to the bone causing enough bone loss to compromise the integrity of the bone and a dental implant may not be possible. These are also things that your dentist should be informing you about.

I'm sorry to be the one delivering this to you..........
Bryanna

So short of words. I was doing perfectly OK with the denture. Still wondering what pushed me to get a bridge

What do you think is the best thing for me to do at the moment?


Thanks

Franklin,

Given the fact that the rc tooth is infected and it is an anchor tooth for the bridge, you need to discuss your options with your dentist. Extracting the rc tooth compromises the bridge so that could mean that you end up back in the removable denture. The other anchor tooth is crowned also and that may be able to remain crowned if the bridge is able to be cut between that tooth and the pontic. That would leave you with one crowned tooth and 2 missing teeth which would be replaced by the removable denture. Within a year or less perhaps implants can be placed in those two areas of missing teeth.

Bryanna

Hi Bryanna
It's only one tooth she used as anchor for the Bridge. Feeling way better since the other dentist trimmed down the Bridge.
I have a plan and need you to kindly tell me if it's OK.

Since I'm getting better, I'm thinking of holding on for some time to see how it goes. If it gets worse in anyway I'll get the tooth extracted asap. In the main time I'll be going for dental check up and also do an xray every three month if it's permitted . Whenever the xray reveals any form of infection even if I'm not in pains I'll get the tooth extracted asap.

I'm hoping the bridge is going to last for a year without any complications when I relocate to the United States I'll get the implants done

Kindly let me know if it's okay this way

Thanks alot
Franklin

Franklin,

So you have a 2 unit bridge, a pontic and the rc tooth? Correct? That is called a cantilever bridge and they are rarely done anymore because the anchor tooth is carrying a lot of tension on it. I have not seen one of these bridges done in at least 15 or so years. The anchor tooth has to bear the burden of pressure that is applied to the pontic when you chew. This causes unnatural stress on the anchor tooth. Why did she make this type of bridge?

Of course it is your choice to wait and see what progresses. But keep in mind that the rc tooth, irrelevant of symptoms or radio graphic findings, is inflamed and infected. Just to be sure that I am being clear here, in a years time do not be surprised if that area of bone is not able to hold an implant.

I understand your predicament and I hope you get a year out of it and the bone is still healthy. Fingers crossed!!

Bryanna