Hi. First I'd like to thank Bryanna for being so informative, I've lurked this subforum for a while and have learned so much from her.

I'm concerned about one of my teeth (top premolar, tooth #12) that had a root canal treatment more than 5 years ago. It was badly infected but ever since the root canal I had no problems with it. Now I know that root canals are never 100% and the infection can always come back. This tooth broke a couple of weeks ago as I was eating something hard, and the filling also got loose. I went to a dentist, she redid the filling with a post and recommended I get a crown. I agreed to it before having done thorough research. It was stupid on my part also because I've only ever gotten one crown before on another root canal, and it failed due to the infection coming back as an abscess under the root. I had that one extracted.

The crown isn't in yet, I have a temporary on at the moment. The procedure costs $800 and I keep feeling like it's a waste of money. But at the same time, I'm 23 and I would feel horrible if I also had this one extracted, I wouldn't be able to smile due to its location and I don't want an implant in me. I brush and floss daily but that can only do so much.

My question is, how likely is it that a root canal infection will come back? Can I request an x-ray of this new filling before cementing the crown? I don't know if I could do that at no cost. And also, do crowns make it more likely that an abscess forms again or does that depend on how well the dentist re-filled my tooth? I'm expecting the absolute worst.

Hi nomoreteeth,

Thank you for the kinds words

I am going to re post your question and answer you in bold type.

<<My question is, how likely is it that a root canal infection will come back?>>

THE INFECTION IS STILL PRESENT INSIDE THE TOOTH. IN SPITE OF HOW MANY TIMES A ROOT CANAL PROCEDURE IS DONE TO A TOOTH, THE TOOTH WILL REMAIN CHRONICALLY INFECTED. NOT JUST SOME ROOT CANALED TEETH, ALL OF THEM. THE ANATOMY OF A TOOTH DOES NOT ALLOW ACCESS TO THE HUNDREDS OF TINY CANALS CALLED DENTIN TUBULES. THESE CANALS CONTAIN NERVE TISSUE THAT HAS BECOME NECROTIC AND DISEASED BECAUSE THERE IS NO LONGER ANY BLOOD SUPPLYING THEM WITH VITALITY. SO THIS IS WHERE THE INFECTION CONTINUES TO BREW EVENTUALLY SPREADING BEYOND THE TOOTH. IT IS NOT A QUESTION OF HOW LIKELY WILL THE INFECTION RETURN, IT IS THE INFECTION HAS NOT LEFT THE TOOTH. ROOT CANAL THERAPY IS DONE IN THE ATTEMPT TO "RETAIN" AN UNHEALTHY TOOTH FOR AN UNCERTAIN AMOUNT OF TIME. IT CANNOT AND WILL NOT "CURE" THE INFECTION.

<< Can I request an x-ray of this new filling before cementing the crown?>>

ABSOLUTELY, BUT IT WON'T MAKE ANY DIFFERENCE BECAUSE THE INFECTION INSIDE OF THOSE TINY CANALS IS NOT ALWAYS VISIBLE ON DENTAL XRAYS,UNTIL IT HAS SPREAD BEYOND THEM.

<< I don't know if I could do that at no cost. And also, do crowns make it more likely that an abscess forms again or does that depend on how well the dentist re-filled my tooth?>>

HAVING A CROWN PUT ON A ROOT CANALED TOOTH DOES NOT ALTER THE INFECTION INSIDE OF THE TOOTH. THE TOOTH REMAINS DISEASED AND VERY FRAGILE/SUSCEPTIBLE TO BREAKING. A CROWN IS PUT ON TO PREVENT THE TOOTH FROM BREAKING. THE POST IS PUT IN A ROOT CANALED TOOTH WHEN THERE IS NOT ENOUGH TOOTH STRUCTURE TO HOLD THE CROWN ON. HOWEVER, A POST IS VERY INVASIVE, CAUSES FURTHER DAMAGE TO OCCUR TO THE TOOTH MAKING IT MORE SUSCEPTIBLE TO FRACTURE AND IT CAN BE A SOURCE OF ENTRY FOR BACTERIA TO GET IN AN CAUSE DECAY. BUT WITHOUT THE POST, THE CROWN WOULD KEEP FALLING OFF.

Many people are under the impression that the root canaled tooth got re infected once the crown was put on... or the crown didn't fit and that caused the tooth to become infected. None of that is actually what happens. The tooth is already diseased and the crown is irrelevant. What can occur is once the tooth is covered with a filling or crown, the bacteria is no longer able to drain from the open tooth, which means the bacteria has to find another path to drain to. So the area of drainage could be in the formation of a fistula.... or a swelling could occur... or pain could be felt elsewhere like the sinuses or the jawbone ... etc.... which makes the person think they developed a new infection.

I am sorry to deliver this news to you. I wish I could offer you something more positive.

Bryanna

Thanks for your reply. I get that the infection is always there, I should've asked instead how likely it is that it will get bad enough that it starts to hurt again after putting on a crown. But you pretty much answered that anyway. From what I understand, I'm just buying time and how long that is cannot be known. The post doesn't help either.

Oh well.

nomoreteeth,

Correct, the infection is always present in the rc tooth. It is irrelevant of how many times or how well the rc procedure is done... it cannot alter the bacteria inside of the tiny canals. Correct, the post truly adds insult to the whole issue.

Pain is not a real good indicator of a tooth problem as there is usually no pain until the problem has spread and become severe.

Buying time is one way to look at it... but keep in mind that the infection is progressive so as time goes on, so does the infection.

I'm sorry you are going through this... I wish I had better news for you.
Bryanna

Yeah, so I'll definitely have it removed in the future. One question about replacing missing teeth though, are resin-bonded bridges a good worth it/a good idea?

nomoreteeth,

By resin bonded bridges do you mean a maryland bridge?

Depending on your individual case, there will be certain replacement options that are available to you. I don't know your dental history, the health of your other teeth and gums or what other teeth you are missing. So I cannot comment on what your options might be.

Bryanna