[Dawnrainbow]

Hi all I am new here, well story started back in May when I went for a check up at my dentist, who said I needed a filling, I went back for this filling, ten days after the tooth broke off leaving only a small part left, I went back, and he said I needed a root canal then I would have to have a crown. I went for root can treatment twice, had a temp put in last week, was in lots of pain after the temp, he shrugged this off as being just sore after the treatment :/ I know the difference between being just sore and in pain!!. Eventually he gave me antibiotics, I am still taking these, the pain did stop, but today I had the permanent crown, and in lots of pain again, also I dont think my bite is right, he took a few attempts to make it right , then he gave up and said it will right itself eventually

[Jomar]

I would go get it checked by another dentist, second opinion so to speak..

This dentist seems a bit lacking in quality care...

He did a filling & billed for it, and then got to bill for a RC & crown??? Same tooth??
seems questionable to me..
He never mentioned the filling might fail and need RC/crown before hand??

[Bryanna]

Hi Dawnrainbow,

It sounds like the tooth may have been fractured prior putting in the filling which often happens when a cavity is deep mainly because the tooth becomes weak from the infection caused by the cavity. After putting in the deep filling, the tooth was not only traumatized from the drilling (which occurs any time a tooth is drilled into) but the fractured portion of the tooth gave way from the pressure of the filling. That would account for a large portion of the tooth breaking off.

Based on your description, there is very little crown to root ratio left of this tooth. Meaning the upper portion of the tooth above the gum line is basically gone. The only thing above the gum line is the new crown which is basically cemented on to very little solid tooth structure. The roots of the tooth have been root canaled which causes further trauma, additional bacteria and inflammation to occur. Unfortunately, this tooth is very unhealthy and laden with bacteria. There is no restorative dental procedure to fix or repair the tooth structure that is missing or cure the infection that is brewing inside of this tooth. The pain you felt with the temp crown and now feel with the permanent crown is due to the fact that there is bacteria and inflammation building up in the tooth as well as the surrounding ligament and bone. Removing the crown may temporarily subside the symptoms as it would allow the bacteria to be exposed to the air which would reduce the amount of pressure on the inflammation. However, this tooth is going to continue to deteriorate irrelevant of being covered or not because not only is the tooth sick but the surrounding tissue and bone are also involved with the bacteria and inflammation.

Antibiotics may temporarily subside some of the pain but the meds cannot reach the infection inside of the hundreds of microscopic canals called dentin tubules or in the ligament or jaw bone where the bacteria is spreading to. The only way to attempt to remove the infection is to remove the source which is the tooth. The longer you retain this tooth, the more widespread the infection can become.

The cavity was the problem and the dentist attempted to conservatively restore it. Obviously that did not work because the cavity was too deep and the tooth was probably fractured. It can be hard to diagnose a fractured tooth as the fracture can be microscopic and not clinically or radio graphically visible. Because you just had the root canal and crown done, if you have the tooth removed soon, then you are entitled to a reimbursement of most of the $$ you spent on the root canal and the crown. If you wait, then you will be less likely to be reimbursed because you chose to live with the pain. I know that sounds a bit harsh but that's the way it is.....

Also, it is important for you to know that this tooth is very fragile and so is the surrounding bone. It is best to see an oral surgeon for the extraction because they are much more knowledgeable and experienced than general dentists in removing teeth in this condition.

I'm sorry to deliver this news to you.... I know it can be a bit scary especially when you are in pain and you have already been through so much. By any chance did either dentist give you the option of extracting this tooth or did they just tell you to have a root canal? The reason I ask is because you should have been offered both options.

Please check in with us when you can.
Bryanna

Originally Posted by Dawnrainbow

Hi all I am new here, well story started back in May when I went for a check up at my dentist, who said I needed a filling, I went back for this filling, ten days after the tooth broke off leaving only a small part left, I went back, and he said I needed a root canal then I would have to have a crown. I went for root can treatment twice, had a temp put in last week, was in lots of pain after the temp, he shrugged this off as being just sore after the treatment :/ I know the difference between being just sore and in pain!!. Eventually he gave me antibiotics, I am still taking these, the pain did stop, but today I had the permanent crown, and in lots of pain again, also I dont think my bite is right, he took a few attempts to make it right , then he gave up and said it will right itself eventually

[Bryanna]

Hi Jo*mar,

Both dentists that Dawnrainbow saw do seem to be lacking in compassion and chair side manner. She's been made to feel like her pain doesn't matter, which is just not cool.

It is typical for a dentist to do a filling on a tooth and within a short amount of time suggest a root canal and crown to be done on that same tooth. The filling may have been a patch up to buy some time to see if the tooth would calm down, or perhaps the patient wanted just the filling for financial reasons. One can argue the ethics of doing a filling on a tooth that required more but there are many circumstances as to why this is commonly done. Some dentists will reimburse or put a credit the patients account for the filling after the root canal or extraction..... others feel they did the initial work and want to be paid for their time. Ethics again I suppose.

Bryanna

Originally Posted by Jo*mar

I would go get it checked by another dentist, second opinion so to speak..

This dentist seems a bit lacking in quality care...

He did a filling & billed for it, and then got to bill for a RC & crown??? Same tooth??
seems questionable to me..
He never mentioned the filling might fail and need RC/crown before hand??

[Jomar]

I would think they would give options and explain "what ifs" and help their patient to decide what is the best route of treatment.

[Bryanna]

Jo*mar,

I agree with you, patients should be told the what ifs and be given the options to be able to make informed decisions. Typically, dentists do not offer options unless the patient states their uncertainty about the treatment plan or they specifically request to know the options. Dentists are not trained on chair side manner or how to discuss dentistry in detail with their patients. They are trained more specifically on how to perform dental procedures. That is the main focus of the majority of their education. Dentists who do not want to take the time to discuss options but feel the patient has the right to be informed of the options will hire someone to do the communicating for them and give them the role of the liaison between the dentist and the patient. But not all dentists feel it's necessary for the patient to become more informed so they hire staff who is basically uninformed and they typically will offer options if pressed to do so by the patient.

Due to the antiquated curriculum being taught in most dental schools, dentists need to seek additional education if they want to even remotely think outside of the box. But I think the public is becoming self informed on many dental issues which forces the profession to become better communicators. Which is a good thing!

Bryanna

Originally Posted by Jo*mar

I would think they would give options and explain "what ifs" and help their patient to decide what is the best route of treatment.