Redoing root canal
 

Hi,

I got RCT for teeth 24 and 25, that was 10 years before and just few days back I got a crown for 24 but not 25. And last two day the pain is off and on.

At the time the dentist told the RCT to 25 was not done properly, I used to get pain occasionally for that tooth. But previous visits to different dentists didn't say anything about that.

Now should I get RCT redone for 25? if yes how much time it may take to do it?
Could it be done is 1-2 days?
Is there a chance of breaking the tooth in the process?
Please suggest.
Regards,
Kanna

Hi Kanna: I have no answer for you since I know very little, but I think it's a great question! I'll be interested to know the responses from people who know more.

Stacy

Hi Kanna,

Teeth number 24 and 25 are the two lower front anterior teeth. They generally have a small, fragile root structure compared to the other teeth. Many things can be happening with these teeth especially since they were root canaled 10 yrs ago. Any chance you could post an xray??

Re treating any tooth a second time with a root canal does nothing to alter the condition of the tooth because the tiny canals that are infected will remain infected after the retreatment because they are not accessible. It is a waste of time and money.

Telling a patient that the root canal was not done properly is a lame excuse for doing a retreatment that will not change the condition of the tooth. It is irrelevant of how the root canal procedure is done, the tooth will always remain infected for the reasons that I've stated above.

Bryanna

Hi Bryanna,

I don't have a xray with me, and could not get them.
I visited two dentists and they both said that the root end was not touched.
I'm going on travel, so I went ahead and had RC redone. It was done in one sitting.
Now I started have pain and I feel there is some kind of pressure, and now the tooth touching upper tooth and unable to chew properly. Also sometimes when I speak the RCd tooth hits upper tooth gives me sharp pain.
Pain is relieved for a brief period of time when I have some hot beverages

I called the dentist and he said its common to have pain and f
Now I think I'm going to lose both 24 and 25.
am I paranoid???
Cheers,
Kanna
I cannot upload images and post links as I'm new to this forum.
**

Kanna,

The teeth are infected. The infection is progressing to the jawbone adding to the already present inflammation, that's why they hurt. Is this pain typical after a root canal, yes because the teeth are infected and the bacteria is building up pressure inside/outside of the tooth. Does that mean it's ok to have this happening, absolutely not.

There is not much more information that I can offer you other than to say root canals can not cure the infection and unfortunately yes you will lose those teeth. The worst part about this whole thing is that your dentist has not properly informed you by telling you that the longer those teeth are present the more deteriorated the bone will become and that when this occurs replacing them will be difficult.

I am sorry to be so blunt... I am sick and tired of people being mislead and misinformed by their dentist. It is not only financially costly to you, but your overall health is at risk also.

Bryanna

Thanks for the reply.

I want to get rid of those teeth but the problem is they are front ones.
What are the options if I go for extraction?

I would not like having something removed daily so for me implants would be good but again as you mentioned in your posts it may not be suitable for everyone.

Once I get permission to post images I'd like to get opinion based on my xrays.

Thanks again.

Cheers,
Kanna

Kanna,

You are correct, the bone may not be adequate or healthy enough to hold implants in that area mainly because the teeth were root canaled. If the teeth had been removed at the onset of the infection, you would have had an excellent chance at having the implants. But because of the chronic infection in those teeth and bone, the width, height and health of the bone will be compromised from the disease process.

A removable partial denture is one option, but you'd rather not have that... understandable. Another option may be a 4 unit fixed bridge that would replace both of those teeth and it would be permanently cemented. If the anchor teeth (one tooth on each side of the missing ones) stay healthy and you clean the area well every day, these bridges generally last about 10 years before the cement wears out, sometimes longer. When the cement wears out, sometimes the bridge can be removed and re-cemented.... other times the bridge needs to be redone.

Yes, when you get the xrays please post them. They may be helpful in seeing the degree of bone loss as well as the health of the adjacent teeth if you are considering a fixed bridge. As for the issue with infection irrelevant of what is on the xray.... root canaled teeth are always infected.

Look forward to seeing your xrays....
Bryanna

Re Hi Bryanna
 

I am coming to understand my own tooth that I had a RC done on. It has been sensitive for the entire 8 years. If the origional infection really hasn't gone away, why don't the dentists tell you up front? None of what you said was ever told to me. I only know the proceedure cost a bit of money, and that my future with this tooth isn't so good. Is it all about money? I am dumbfounded that dentists are not up front with information, and this make me leary of my current dentist, when I don't care for them to begin with. I also was told I need a crown on a tooth. How do I know this is true? this will cost $900 and I am on medicare/medicaid, and would have to charge the proceedure. Now I am not so sure I actually need one. He did not say that there was further damage to the tooth, or that the filling was coming loose. My money situation is critical, and I hate to invest without knowing for sure that this is a necessary thing to do. I appreciate your responce, ginnie

Hi ginnie,

Dentists are legally obligated to inform patients about the health risks associated with all dental procedures. In 35 years.... I've known about 3 dentists who actually do that and they "select" what they say and to whom they say it. My position in the dental field has always been to disclose the risks so the patient would be at least somewhat informed before making their decision about what they feel to be in their best interest.

With that said.... there are many things that can go wrong with any dental procedure and complications can arise for any number of reasons. A patients systemic health as well as their oral health has alot to do with the outcome of their dental work. So it is difficult to go over ALL of the pros and cons. However, it is unethical to tell a patient that a root canal or an apicoectomy will "cure" the problem with the tooth knowing full well that the tooth will remain infected and with that will come an assortment of concerns sometime in the future.

Most dentists and physicians that I personally know who have become informed through various articles published in dental/medical journals about the correlation between oral infections and systemic disease, have opted to either not have root canals on their own teeth.... or they've had their root canaled teeth removed and replaced with implants or a bridge. Hmmmm, I wonder why??

The BIG dilemma amongst the "concerned" dental community with informing the public about this issue and others such as mercury toxicity is simply this.... how do we inform the public that these procedures (as well as some others) put your health at risk when we've been advocating them for 150 years? There is a concern about causing pandemonium and not having any means of controlling it.

If that weren't complicated enough.... Endodontics (root canal therapy) is the most lucrative form of dentistry and for that stupid reason, these dentists are looked upon by their colleagues (not me of course!!) as the elite group. So greed and status plays a huge part in how and when a patient becomes informed about the reality of dentistry.

With regard to the crown that your dentist suggested.... ask your dentist specifically why he is recommending this and post his reason here. An xray would also be helpful. You could send it to me through the PM if you want.

Some reasons for doing crowns are.... a large filling in the tooth that is either breaking down or weakening the tooth.... a minor fracture or craze lines in a portion of the tooth that can be mended and then crowned.... root exposure due to periodontal disease will cause the tooth to die if the exposed part is not protected/covered.... worn down teeth from a bruxing habit that need to be protected from further wear.... etc.

Ginnie.... you're becoming a well informed dental patient!! Your dentist will be taken aback by your questions.... you go girl!!!!

Bryanna

Re: will be informed
 

Well, you presented me with the right questions now to ask my dentist about. I feel that you have provided what a patient needs to know when doing these kinds of expensive proceedures. I am a bit sickened to know that none of the dentists, nor the specialist for the root canal, were up front with me. I have four auto immune diseases. I do not want to put my health at risk with proceedures that may have no benefit to me. I will ask the dentist all about this crown he wants me to do with written questions for him. Thanks
Bryanna, not just for my responce, but for the information you give to all of us, so we can be better informed patients. ginnie:hug:

Ginnie,

You are very welcome. I wish I could reassure you that your dentist will be forthright with the information, but unfortunately the dental profession has a huge flaw when it comes to informing patients about the "down" side of dentistry. I'm a part of the few that are determined to change that..... one baby step at a time.

Keep us posted on how your consult goes!
Bryanna

Hi Bryanna,

Finally I have permissions to post my images.
I'm attaching the images.

Please provide your views.

Regards,
Kanna

Hi Kanna,

Thanks for posting the xrays... very good shots!

You have minimum dentistry in your mouth and lots of spacing making it easy to clean everything. It looks to me like you would be a good candidate for a 4 unit permanently cemented bridge. This would require cutting down both laterals (#23 and 26) but it could be done conservatively. You may also be a candidate for a maryland bridge which would not involve cutting down either lateral. This is when 2 fake teeth are held in place by 2 metal wings that get cemented into small grooves made in the back of each lateral.

Dental implants in this area would be risky since you have had the teeth root canaled because the bone in this area is thin to begin with and the chronic bacteria from the teeth compromises the integrity of the bone. So it is a very vulnerable situation and not ideal for implants. There is already some bone deterioration associated with both of these teeth evident on your xrays.

Also, did you know that you have 2 additional (small) wisdom teeth on the upper right and left? Has your dentist talked to you about having those teeth as well as your other 3 wisdom teeth removed? They are all way back in the jaw making it difficult to keep clean and therefore they trap bacteria. On the right side you have no lower wisdom tooth for the upper to bite against so it will drift down into that open space which usually results in a periodontal infection with that wisdom tooth and the molar in front of it. Has your dentist addressed any of that with you?

Hope this helps..... looking forward to your feedback..!
Bryanna

Hi Bryanna,

Thanks for the inputs.
The dentist told about right side upper wisdom tooth but not others. He said because there is no bottom one its moving sideways so better remove that.

Also mentioned that I have bone loss for upper front teeth and recommended deep cleaning.

So in total the recommended work by dentist is remove right side wisdom tooth, deep cleaning, and crowns from bottom front teeth as they might break, but he didn't notice any infection.

The crown on molar is new, it was done because tha cavity was caused by the removed wisdom tooth and molar was half broken and could not support filling but RC was done before crown.

Apart from this I would like to get the upper gaps closed, I do have frenum attached.

All in looks like lot of dental work :(

Regards,
Kanna