Possible Fractured tooth which dentist to believe?
 

Sorry for long post.

Had a root canal and crown put on the first molar on the left hand side about 4-6 years ago (cannot remember the exact time). I have since moved cities had a long travel, jet-lag and general stress. The dentist at home has previously told me that I do grind my teeth quiet bad.

Two days later, after my first good night of sleep since moving, I had a small intermittent pain on this tooth when biting down - no sensitivity to hot/cold, pain didn't last long, no throbbing, no aching. Even when clenching as hard as I could there was no pain, I didn't think too much of it. Next day I woke up and around lunch time noticed the pain had come back when I was eating, so I decided to make a dental appointment for the next day to a dentist I had never been too.

The next day I go to the dentist, she was nice and listened to me when i talked, took an xray and saw nothing. Tapped around on the tooth and poked around, when she tapped it hurt briefly, again the pain did not last and went away instantly. She said it's best I go to the endodontist as something might be wrong, and I could have an infection etc. She did notice i needed some cavities filled on other teeth.

Since then there has been absolutely no pain. Like I've eaten carrots on that tooth etc and have had zero pain.

Went to the endo he came in listened very briefly, took an xray (was like a 360 xray machine), came back and simply said the tooth was fractured, there was no infection, and I needed an extraction and sorry for the bad news. So I left thinking damn.

Given I was in a new city, girlfriend suggested I go to her uncle who was 45min plane ride away to get it extracted and have the cavities filled. Saw him this morning, again he took his own xrays he poked around did substantial more testing then the original dentist. He said that the xrays showed nothing, the root canal looked really well done and healthy. He said that if it was his tooth he would not get it extracted.

He tried to contact the endo, but couldn't however the endo's office faxed him over the report which he read to me and it said "Fractured tooth , if it hurts AGAIN should call for extraction". They were both confused/perplexed by the word AGAIN, given that a fracture should be removed the tooth should be removed ASAP. So he and his colleague (who he called in to look at the xrays too) agreed that it seemed like the endo is not 100%.

He did however think that could be because of my grinding and it seemed like I might have a slightly high bite. He fixed the high bite slightly, and to be honest I can kind of already notice a slight difference, but that could just be mental. He prescribed me amoxicillin and said if I have the pain again just take that ( to prevent infection I suppose?) and come see him again.

Given I had already paid $2k+ for the RCT and crown I don't really want to get it extracted. At the same time I am **** scared of tooth ache's, not so much going to the dentist itself, but getting a toothache/abscess etc scares the crap out of me. The whole reason I had the RCT was because I waited way to long on a cavity when I was young and I just remember it got infected and the pain was real bad.

I'm just at a loss as for who to believe. I don't have insurance but I'm not overly concerned about the cost, like I said I am more concerned about the pain that could occur with the wait/see approach. I'm a pretty paranoid person and I really can't stop thinking about what IF. I have ANOTHER appointment with an endodontist tomorrow so hopefully they can shed some more light on the issue.

Again, sorry for the long post but thanks for reading (if you do read it!)

Hi Ab23,

I am in the dental field and can offer you some information here. What I am going to tell you will be different than what you have been told by your "conventional" dentists as they see nothing wrong with root canaled teeth in spite of the fact that all rc teeth are chronically inflamed and infected.

With that said..... it is typical for an rc tooth to fracture as these teeth are unhealthy, fragile and void of vitality. The likelihood of a fracture is increased in people who have a bruxism habit because the amount of force that is put on your teeth when you clench or grind them is unmeasurable. So eventually the teeth that get the brunt end of the force and/or the weakest teeth will suffer the most.

Irrelevant of how many times this tooth is root canaled, the tooth will never be healthy. Inside of every tooth there are many hundreds of microscopic canals that contain nerve tissue but these canals are inaccessible. So these canals will always contain this nerve tissue no matter what. When a tooth is root canaled, the blood supply is cut off to the tooth, voiding all nourishment and rendering the tooth non vital. So these tiny canals, called dentin tubules, with the nerve tissue inside of them become inflamed and the nerve tissue becomes necrotic and infected. There is no procedure or magic potion that can alter this from happening.

Not all teeth will give symptoms of a problem until the problem has progressed. Radio graphically most rc teeth will eventually have areas of pathology around them which is often considered "typical" because it is seen so frequently. It is often undiagnosed or misdiagnosed as scar tissue or "just a normal" occurrence. It is also "typical" to see a fracture in an rc tooth and generally if the patient is not complaining too fiercely about it, the dentist will adjust the bite and wait for additional symptoms to occur. Again, this stuff is routinely seen with rc teeth... even though it indicates an unhealthy state, it is expected to be seen... if that makes sense to you.

From a healthy perspective, keeping a chronically infected tooth in your mouth is not a real good idea. Eventually the bacteria migrates beyond the tooth, into the bone and into the blood stream. This too is a common occurrence but not one that is readily acknowledged by conventional dentists. All dentists are in the business to be tooth carpenters and many focus on the restorative aspect of teeth, not the oral-systemic connection. Biological dentists are also trained the same way but have furthered their education to become better informed about this important connection.

If you are concerned from a health perspective about the systemic consequences of keeping this rc tooth..... here is a recent article that goes into an easy to understand explanation about the subject.

http://articles.mercola.com/sites/ar...ternative.aspx

I hope you find this information helpful. Let me know if you have other questions. Feel free to give your feedback on this subject.

Bryanna