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Old 12-01-2011, 05:37 PM   #1
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dentaldilemma HB User
Unhappy Root Canal and Crown for a tooth with slight inflammation??

Hi,, anyone know if a tooth w a slight inflammation is capable of healing by itself? So a month ago, had an old silver filling replaced w/ white (in three areas on tooth), all was well until 2 wks ago bit down on something (not very hard) and felt a sharp pain/dull ache. Was finally referred to an endodontist today (that charged $150 just for the consult) who said that my lower back molar may have a crack (not visible on x-ray) and is slightly inflamed at root tips which may be the cause of my dull aching. Was told to wait 2 wks to see if it gets worse at which point I would then need a root canal (over $1300 for the root canal and over $1000 for the crown?!). Is this dull ache capable of healing or is it the feeling of my root slowly dying?! Help!

 
Old 12-04-2011, 08:27 AM   #2
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Re: Root Canal and Crown for a tooth with slight inflammation??

The pain may subside in a few days. That does not mean it has healed itself. Did the specialist not prescribe an antibiotic? I would suggest a second opinion from a dentist. Most General Dentist offices will only charge 40-100 to do an xray and looks see. Just dont ignore it.

 
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Old 12-04-2011, 09:14 AM   #3
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Re: Root Canal and Crown for a tooth with slight inflammation??

Hi,
If the tooth has a crack in it (which is what it sounds like from the symptoms you described - sorry), it won't heal without treatment, and an xray may not show a small crack. Even with the a small crack the periodontal ligament will pull on the tooth every time you use it, eventually making the crack wider.

The only treatment for a small crack is RCT and a crown in the hopes of holding the tooth together. Many times this fails, esp if the crack continues below the gumline, or is below the gumline, and an implant or a bridge to replace the missing tooth is necessary.

IMO your dentist is being conservative and trying to give the tooth a chance to heal on the off chance it just suffered trauma from a filling close to the nerve. If there is no infection present antibiotics would be contraindicated.

As tmfuller said, the pain may subside in a few days. If not, your dentist's treatment plan is indicated.
Try not to chew on that side and if you can take OTC ibuprofen, that will help reduce any inflammation that is not infection. If it becomes more painful, or gets infected, you will need that root canal to try and save it as that would indicate that it is cracked.

A back molar is difficult to save once it's cracked. If that's the case, and hoping it's not, you may want to consider an implant.

My best to you and I hope your tooth just had some trauma and is not cracked.
GOOD LUCK!

Gellia

 
Old 12-04-2011, 06:45 PM   #4
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Re: Root Canal and Crown for a tooth with slight inflammation??

Thanks for the replies. I don't understand how, at 32 years of age, chewing on a thick, soft piece of bacon has led to 4 different dentist office visits this week. My dentist said it was probably TMJ, or caused from grinding..1st endodontist (who didn't even take his own pic but looked at the week-old one I provided from my dentist said to "call him in 2wks if it doesnt get better" but then he also said that it would probably not heal by itself (great). 2nd endodontist took x-ray and said the tooth/root is not dead (yet?) and to give it a week. And what's the point of charging all that money if x-rays cant even show a crack?! Honestly, I was so mortified sitting in all the different dentist chairs, I dont even remember half of what was said. Any chance Sensodyne would help (with what I don't even know at this point)? And why cant a tooth root or inflamed root heal itself and/or why cant they find a way to do it?! They can replace a human heart valve with animal parts but the only options for dental problems are still root canals and/or pulling the tooth? Very frustrated...

 
Old 12-05-2011, 05:00 AM   #5
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Re: Root Canal and Crown for a tooth with slight inflammation??

Hi again,
I'm really sorry you are going through all this. A cracked tooth is very hard to diagnose. Because of that alone, most dentists would rather give it a chance to heal in the off chance the tooth is just inflamed along the ligament. It's the ligament that gets inflamed, not the tooth itself. If there is a crack, the ligament holding the tooth will exert forces on it each time you use it. If the crack is very small root canal and crown "may" hold it together.

Once a tooth is RCT, it can become brittle and crack further leaving you again in the position of extraction, with resulting bridge or implant.

Your position is between the devil and the deep blue sea, as they say. You can only wait and see if it heals by itself on the off chance it is just an inflamed ligament. But, if it's a crack, you have to decide on what you want to do. If the crack is too big, extraction is the remedy. An implant is a good choice here. If the crack is small and doesn't extend down below the gumline there is a chance the tooth can be saved with a RCT and crown.

I wish you good luck and good vibes that it will heal itself. If not, you can only go from there one step at a time. Some people just go right to the implant.

My very best to you and do let us know how you are doing.
Gellia

 
Old 12-07-2011, 04:14 PM   #6
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Re: Root Canal and Crown for a tooth with slight inflammation??

Thanks again for your reply. Not sure where to go from here, the tooth seems to be better (hasn't been doing that non-stop pulsating thing, then again I've been taking lots of advil so maybe I'm just masking the problem) but just when I relax and start getting into the holiday spirit, it'll give me a zing(!) to remind me that all is not well. I've had 3 different dentists (my own, plus 2 endodontist) look at the tooth and their is no crack visible, but when they say a "tooth is cracked", are we talking about some invisible to the eye, mini-crack that no one including an x-ray can see in the middle of a tooth? All I did was change a silver filling to white for goodness sake and I've been living in terror the last two weeks Also, is it odd that the 1 endodondist seems to be very "gung-ho" and said that if i'm still taking advil, then I should make an appt to come in for the root canal?! I had a root canal at 15, and it was the most horrific experience..then it failed/got infected and I had to get a bridge at 19 (implants were not that advanced at the time). If the pain is not excruciating, should I just wait it out? I thought root canals were only done when one was in excruciating pain or infected but apparently that is not the case either...it feels like I'm living in the dental Twilight Zone

 
Old 12-07-2011, 04:58 PM   #7
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Re: Root Canal and Crown for a tooth with slight inflammation??

Hi,
I'm sorry. It IS a dilemma. If the tooth has even the smallest crack the ligament will pull on the crack whenever you use that side of your mouth. Cracks that small are impossible to see, even with xray. But, they still cause pain to you.
I think your dentist is hoping that the white filling may have just been close to the nerve when the tooth was refilled. White fillings transport hot and cold sensations to the nerve easier and it may be doing that. If that is the case it should settle down.

I think your dentist is trying to see if that is so. The nerve may settle down and all will be well. If there is a crack, you will continue to get that "zing". A root canal "may" be the answer, with a crown to take care or holding the tooth together better.
How long that would last depends on where and how wide any crack would be. If there is a crack below the gumline, saving the tooth isn't impossible, but a heck of alot more difficult and usually you wind up going to the next step anyway.

So, if I understand the problem you are on a wait and see. If the zing continues and you want to try and save the tooth, a root canal and crown would be the next step, IMO. If the crack is too wide and the tooth not salvageable, an implant would be a great choice. If the crack is below the gumline, some people would go right to the implant as they have found it is eventually necessary.

You didn't do anything wrong to cause this. A tooth can crack on anything. I broke mine on a donut and felt the same way. Good grief! It was just a donut! A cream filled one!! But, it broke the tooth in half. If there was a small crack already starting and you chewed that bacon strip just right. Well, there is a good possibility you did just that.

I think if you have given the filling time to settle and you're still getting zinged you need to go to the next step. If there is a crack, it sounds as though it is a small one. That's where the expense can come in. A root canal will eventually weaken the structure of a tooth by making it brittle. A crown will help strengthen it but it will only help in an above the gum crack, IMO. Below the gum and that ligament will constantly stress and pull on the crack causing you pain.

So I guess it's timing for you. If your still zinging after a couple of weeks you may think about what you would like your next step to be.

Good luck. I hope the tooth settles down and all will be well.
Good vibes for just that!
My best to you,
Gellia
P.S. Just a thought. Has your dentist checked your bite after the filling? If it is a bit high you can also get zinged. You may want to ask him to check it and file it down a teeny bit.
Again, good luck and do let us know how your are doing.
G

 
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