Hello everyone,

I am new to this site and was hoping to get some answers for a dental problem that is currently causing me a lot of stress!! Please bear with me, it is a long story!!!

8 years ago (April 2008) I had a root canal and a crown put on my bottom left, second-to-last molar (apologies for the non-technical description!). Three years ago (2009), I experienced quite a bit of pain and swelling of the gum around that tooth. My NHS dentist said that I had a gum infection, gave me some antibiotics and sent me on my way. The same problem occured again about two years after (2011). I saw the same dentist and he gave me the exact same treatment.

About two months ago, I went to a BBQ, ate some meat and a piece got stuck between the crowned tooth and the one at the front. It felt rather painful at the time but I could not do anything as I was not at home. I flossed as soon as I got back, but I felt like I was pushing the meat further in rather than taking it out. My gum went puffy and red and by the middle of the night I was in so much pain that I had to take four painkillers! I did some rinses with baking soda water and that also seemed to help. I got an emergency appointment and as my regular dentist was on leave, I had to see another NHS dentist at the same practice. He also prescribed antibiotics and told me that the problem was caused by food getting trapped in a 'pocket' formed in the gum close to the crown. He suggested that I saw a hygienist to treat it.

Unfortunately, the amount of antibiotics he prescribed me was too big and caused me so much stomach pain that I had to go back yet again to have the dose adjusted! By that point, my regular dentist was back and he said there was no pocket in the gum, the problem was an imperfect root canal that would cause me gum infections from time to time and there was nothing I could do about it apart from take antibiotics!

I went away disheartened as I don't really think that taking antibiotics for gum infections once a year is very good. I decided to see the hygienist anyway to check if the problem was indeed a gum pocket. She said that my gums were in perfect health (all between 0 and 1 for those in the trade) and there was no pocket next to the crown so apart from flossing and using interdental brushes, she could only recommend treating the area with Corsodyl gel on a daily basis. At this point let me add that I brush twice a day with a medium, flat toothbrush and Sensodyne, use blue, pink and red interdental brushes, dental tape and alcohol-free mouthwash.

About two weeks I went for my 6-month check-up. My regular dentist had left the practice and as is the NHS policy I saw a locom dentist who was filling in at the time. He said that on the small, local xray that my old dentist had taken a year ago (2011), he could see that the root canal was infected and that he would recommend that I had the crown removed and the root canal re-performed. He said that there was a risk that the infection would spread along the jawbone to the other teeth if I left it and that I could only get treatment privately for about £700 ($1130).

By this point, I was very confused and panicked so I told my mum who lives in Greece to show the panoramic xray that I had taken in April 2011 in Greece to an endodontist. He said that he could not see an infection and that he thought my problems might be caused by the crown having moved and food getting trapped under it. However, this was his opinion based on a fairly old xray and given over the phone...

Can someone please please tell me if they think the problem is my root canal or a gum pocket or a moving crown? I am at my wits' end! At the moment my gum seems ok (healthy pink, same colour as the rest of my gums, no pain, no bleeding when I floss and use the interdental brush) but there seems to be a line on the lower part of the gum underneath both the crowned tooth and the one at the front. It is a bit hard to describe, kind of like I pushed my teeth down into the gum and the gum was so soft that it ever so slightly folded. I also need to add that I have recently developed the unfortunate habit of grinding my teeth at night due to stress

Please please please help me! Any advice is welcome

Thank you in advance

Welcome to Neuro Talk. There will be others that come by to help you with this too. Bryanna is the most knowledgable. It is my understanding, that once you have a root canal, the tooth is basically being retained just for a period of time. They can't get rid of the infection, even with a re-do of the root canal, and another crown. The tooth deep in the crevices retains some of the infection no matter what they do. The dentists don't tell you that. Eventually, the tooth will cause more problems and more infections, and more money. There is alot of money to be made with this process, and yet the tooth is still not healthy. I decided along time ago, knowing this to remove the tooth that was infected for me, rather than to spend the money and re-do on a situation that really doesn't have a resolution. If this infection you have, has been going on this long, I would consider having it removed. Your infection will go away, and gums will heal, and you won't have a risk of further infections. Nobody wants to loose a tooth, but it is better than the infections that seems to repeat. I do wish you all the best, and hope you go to a different practice for another opinion. I hope they tell you the truth. ginnie

Hi Busybee,

I am in the dental profession and I can answer your question...

Your ongoing dental problem with this root canaled tooth is very common simply because the root canal procedure cannot eliminate all of the necrotic bacteria inside of the tooth. Which means the tooth will eventually, then repetitively show signs and symptoms of infection. Treating it with antibiotics may temporarily subside the inflammation, but they can not cure the infection. Re treating it with another root canal procedure will not change the outcome because the necrotic infected nerve tissue resides inside of the microscopic canals which are not accessible. The only sure way to rid yourself of an ongoing infection and prevent further deterioration of the surrounding bone is to remove this tooth.

Frequently tooth infections do not show up radio-graphically until they are very severe and have spread beyond the tooth. Also, some dentists do not offer the option of extraction unless the infection is very severe..... which is truly an injustice to the patient. It is not wise to rely solely on a radiograph as the diagnosis for an infected tooth... especially one that is root canaled because all of these treated teeth are chronically infected.

I'm sorry you have been going through such difficulties. I hope you are able to find a dentist who is more concerned about your health than he is about re treating this tooth with yet another root canal.

Please keep us informed on how you're doing.

Bryanna

Hi
I have done root canal about 7 years back. Got it capped about 5 years back. Got it recapped about 3 years back. Not it suddenly started paining. So i took an X-Ray. Doctor says that there is an infection & tooth has to be removed as the cap cannot be removed.
But I feel that it is easy to remove the cap as I have done it before. What should I do? Is it necessary to extract this root canalled tooth? Or is there any other option.
Please help.

I know you hate to loose a tooth that you invested so much money in. That is the crime about RC teeth. The infection has been there since you had the RC. They can't get all of it deep inside the tooth. Because of that years later, these teeth go bad. Your dentist is telling you the truth, to remove the tooth. It is not because of the crown, but because the infection cannot be resolved, even if you had another RC done on that tooth.
From the beginning you should have been told, that RC teeth, only retain the tooth for a period of time. It is not a cure for the tooth. Dentists who specialize in RC, make a huge amount of money, off the uneducated public who don't know the truth. It is a money making side of dentistry that is very unfair to the patients. I invested thousands on a single tooth, only to loose it last year for the same thing you are describing. My dentist did tell me the truth. You will be better off without the infection. I wish you all the best. ginnie

Hi sagarpatil,

The cap is not the problem. The tooth is infected and has been for 7 years. Most dental infections have little to no symptoms and are frequently found by xray only. When an xray shows an infection this means that the infection has spread from the tooth into the jawbone.

It is best to remove infected teeth before the infection spreads to the adjacent teeth or further.

Hope this info helps...
Bryanna

All by teeth are caps/crowns. Also had surgery for gum disease some years ago so all my roots are exposed as well. Have been getting decay/fillings just below crowns. There have been a couple of times decay went under crown and the crown had to be removed/replaced.

I had cleaning/checkup end of January. The dentist found one of my molars has decay at the root and up to crown (he is not sure it is under crown as well) The soonest one hour appointment I could get to have this work done
is next Thursday, March 21st.

Lately, off and on, I have been having some ache and throbbing to the ear. I called and was put on a waiting list. This was a few weeks ago. Evidentially difficult to squeeze in an hour appointment. If decay is under crown; time needed will be even longer.

Hope this tooth is not infected. Many years ago, the tooth in front of this molar was removed so there would be quite a space should it need to be removed.

Hopefully, both of us can just have the crown replaced.


Gerry