Hello everyone,
I am in some need of help. About 7 years ago i had root canals done in my 4 front teeth. Posts were placed in there and that was that. I didn't have to many problems. I lost dental coverage for a long time and just regained it about a year ago.
In one of my teeth(Tooth right next to two major front teeth) where I have the crown I started to kinda feel a tingle and some sensitivity in the tooth itself and in the gum. I brought this up to the dentist I started going to and he just referred me to a specialist. I had a couple procedures done with him and unfortunately decided to go elsewhere.
Last week seeing a wonderful new dentist I brought this up to him. He did some kind of x-ray and said he had bad new. The post that is in my tooth is to close to the bone??? or something to that extent. The post has shifted and is causing a lesion in the gum. He stated the dentist that did the root canal went to close to something and doesn't look good. He suggested I see a specialist to see if it could be saved, but he doubtful that it can be. He stated that it needs to be pulled out and an implant needs to be placed in there.I am so devastated because he said the tooth can fall out if I am not careful. I asked him if this could have progressed over the years and me not feeling anything till recently. He said yes. What I am wondering is where do I start with this? It has been years and I don't have $3500.00 dollars for an implant as well as the other cost to have this thing pulled. Please help. I am beside myself on this. Thank you for taking the time to read this.

Welcome to Neuro Talk. There is one very knowledgeable person on this site with dental issues. If you post your questions to Bryanna even in the private message, she will get back to you. She has been an assistant for 35 years, and helped me through several of my own issues. Get in contact with her if you can. She may spot this post and respond to you soon anyway. I do wish you all the best. don't do anything until you talk to her. You have many issues involving your case from what I read. There are complications that need to be addressed. I do wish you all the best. I hope you get a response from her very soon. take care, ginnie

I had my front tooth, which previously had a post, root removed. The two teeth on either side are crowned holding supporting a tooth in the middle. This is a permanent bridge. I do not have an implant since the two crowned teeth, along with a tooth in the middle hold up very well. I have had the bridge for many years. Unfortunately, this is expensive as well.

(Ger)

Hi Kriss,

I'm a dental assistant for over 30 yrs and I will offer you information to hopefully help you to discuss your treatment options with your dentist. You may be a bit alarmed at some of the things that I am going to share with you, but my intention is to help you become better informed so you can make decisions that you feel are in your best interest.

It is common knowledge amongst the dental profession that all teeth that have been root canaled are in a compromised state right from the beginning. This is due to the actual root canal procedure itself which removes the nerves within the tooth leaving the tooth vulnerable to infection due to the lack of nutrients or vitality. Like any organ in the body, teeth included, vitality is necessary for it to be healthy because without it, infection and "proliferation" of bacteria are inevitable. Loss of vitality also creates a continual breakdown of the structure of the tooth as well as the surrounding bone making the tooth vulnerable to fracture and the bone susceptible to necrosis.

Just so you are aware.... it is common to see the post that was put into a root canaled tooth actually perforate through the tooth into the jaw bone and/or cause a fracture in the tooth because of the continual deterioration of the tooth. Sometimes the perforation occurs while putting the post in... other times the post wears a hole through the side or end of the tooth.

With regard to symptoms of something going on........ Our immune system works very hard to deal with this chronic condition and in doing so we usually don't notice visible or obvious symptoms until the problem has progressed beyond the tooth. In any case involving root canaled teeth, the most effective way to treat the ongoing problem is to remove the source of the problem which is the tooth. Any other expensive and painful efforts to "retain" the deteriorating tooth will only further compromise the health of the surrounding bone, gum and other teeth. Another big issue in "retaining" a non vital tooth is the growing concern that the bacteria will cause a systemic infection elsewhere in the body and once again, symptoms of that may not appear at the onset.

Dental implants are a wise option for the replacement of some teeth. However, you should be informed that implants have a sketchy prognosis or lower success rate when they are replacing root canaled teeth and/or are placed in the bone next to an existing root canaled tooth. This all stems back to what I explained above about the chronic deterioration of the root canaled tooth and how the bacteria from the tooth proliferates into the bone causing it too to become unhealthy. Depending on the individual case, caution is also used when placing bone grafts in areas that had root canaled teeth for the same reasons.

This is one of those situations that unfortunately has a tragic history and will continually need to be readdressed so long as the teeth are present. The other option would be to remove the 4 root canaled teeth and replace them with a permanent bridge. Depending on the health of the teeth adjacent to the root canaled ones, the bridge would expand as far as one or two teeth over on both sides.... meaning a 6-8 unit bridge to include 1-2 anchor teeth on both sides. The other option would be a removable partial denture to replace the 4 root canaled teeth and any other teeth that you might be missing in the arch.

I'm sorry to be the one to tell you all of this..... but perhaps you can consult with your new dentist again and express your long term goals with him and then go over the different options. Anything you do is going to be expensive. However, keep in mind that it will be most expensive if you have to keep readdressing the same issues.

Please let us know if you have any other questions...... or thoughts about this.

Bryanna

Thank you everyone for sharing your thoughts and giving me some direction.

Bryanna,
Thank you as well. Thank you for taking the time to express how serious this is.
Like I said I am deeply saddened by this. Do you think it is rational to go back to the office that did this and have them look at it? I contacted them and they are asking that I come in to be see by them. I called requesting my x rays after the crowns were put in, but it has been almost 8 years since I have been there. The girl said they use different x rays now and would have to see about getting my old ones. I explained to her what has happen the best that I could. I don't really know the dental terminology to well. She said something about a possible retreat on the tooth. I told her that the root canal looks to have been done incorrectly and now is not saveable. She suggested to see an endodontist to have that ruled instead of a general dentist.
I stressed to her that I am going to see a specialist and would like the previous X Rays to take along with me plus the current X Ray I had last week. I am mainly going off what my general dentist stated to me and don't really want to see the specialist to hear the same thing again.
I almost feel like going to the Board of Dentistry for such a thing happening, but I am trying to give everyone a chance to explain to me what has happen. The dentist that did the procedure is no longer there. I am questioning if I should even schedule the appointment with them or not. Again Bryanna that you so much for taking the time to explain things and give me some very helpful advise.

Hi Kriss,

The problem in a nutshell is that all teeth require vitality to remain healthy. Once a root canal is done, there is no turning back, the vitality is gone. There is no way to "save", as in cure or bring back to life, a tooth that has already been root canaled or one that is infected and/or fractured in a way that would cause the tooth to die on it's own. To re treat the tooth with another root canal does not alter the condition of the tooth other than to weaken it even further. To perform a surgical apicoectomy is a barbaric procedure that causes additional bacteria and inflammation and it does not alter the death state of that tooth.

The term "save" when used in dentistry means to "retain" the tooth that is non vital and compromised. The only other option you would have had at the time of your accident other than root canal therapy was removal of those teeth. If you weren't offered that option at that time, then that is where the fault lies with the attending dentist at that time. If you were told that root canaling the teeth was going to cure them from future problems.....and you were not informed of the long term risks of root canal therapy, then you were misinformed and that is where the fault lies with the dentists who treated you without discussing all of the information.

Your dental problems have nothing to do with who did or does the root canal or the root canal being done wrong or the root canal failing or the post moving or not being put in correctly. Those statements are routinely told to the "uninformed" patient because again, most patients have no clue and the dentists assume you want to "retain" your tooth so they will sell you another root canal re treatment and/or an apicoectomy. The problem is strictly an issue of having a dead tooth that cannot be rejuvenated and the only remedy is to remove the source of the problem which is the tooth/teeth. I know this is very hard to read..... I am so sorry :/

The dental board will be of no use to you because unfortunately, root canal therapy is acceptable "standard of care" dentistry even when no other options are given to the patient. Dentists generally assume the patient wants to "retain" their tooth so that is what they sell the patient on doing. The dentist is not doing this in a malicious manner, it's just become a way of doing business and many people wouldn't know to blink an eye at it. Many dental personal, assistants, hygienists, receptionists.... are not properly informed either because they weren't taught this in any depth in school and they just go along with the usual day in and day out routine. I personally learned about all of this, as did some others, by working with dentists who were open minded and concerned about the level of bacteria in root canaled teeth and after biopsying many thousands of these teeth, the pathology was too great to overlook.

You may get the run around from your previous dentist with xrays and so forth simply because your situation is commonly seen in all dental offices and they know that the history of the teeth is irrelevant at this point because the endo is done and the teeth are compromised.

The bottom line is to know that you have choices. One is to re treat with root canal therapy or do an apicoectomy, both of which are very costly and will not change your dental problem at all. Two is to discuss replacement options for this tooth (and the other three) which would be long term solutions to your dental problem. It's important to stress to your dentist that you are seeking a healthy, long term solution... this will make him more likely too be more open with you.

Again, I sincerely apologize for all of this heavy information. I wish there was a third option that was more to your liking and less costly and invasive.

Please keep in touch here...
Bryanna

Bryanna,
I cannot thank you enough for all this helpful information. I will take your advise and get with my current dentist on this issue. I truly respect your words and am so thankful to come across this forum and find you. I will keep you posted on the follow up. Thanks again. Also there is no need to apologize about what your saying. I am glad to hear it from someone rather than get the run around. I never understood root canals. I always thought this would help. I knew the nerve was killed, but never explained how it all worked etc. At the time I just wanted something done.
As a young child I fell and hit my baby teeth on the bath tub. As the adult teeth came in they started to decay as well as "V" shape in the front two.
I felt I had no choice, but to do the Root Canal. It saddens me, but I will just have to move forward.
Question:
Is it painful having the crowns removed and so on?
I have the biggest fear of dentist and I have finally found one I trust. He is the one who brought the Post to my attention. Thanks again Bryanna.

Hi kriss,

It is of no fault of your own with regard to having the root canal therapy. This dental procedure is sold to patients without any warnings of the long term consequences. Hopefully one day that "oversight" will be changed.

I am not sure I understand your question...
<<<Is it painful having the crowns removed and so on?>>
Please elaborate on your concerns and I will try to answer them with clarity.

Bryanna