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Posted by Frank on July 13, 2000 at 09:55:02:

In Reply to: Re: Another lost tooth? Why? posted by David on July 13, 2000 at 00:33:11:

: : I'm 35 and having the same trouble as Desparate. I had a root canal about 10 years ago and in May I got a massive abcess and lost that tooth. I went back last week to start work on the bridge to replace the tooth and 3 days later, the tooth next to the one I lost started to hurt. The doc was great because he came in at 8:45pm to check it out and saw the beginnings of another abcess, so he did a root canal (that was last night). Today, I'm in tons of pain much like the first abcess. Much like Desparate, I don't know what's going on either. My Dentist said he has no explanation for this. I'm afraid now I'm going to lose another tooth and go through the same nightmare I went through on the first tooth. If anyone can let me know what the problem I have is, PLEASE HELP!!!!

: Hey Frank (and Desperate):
: Here's my two cents worth. There are basically one of several
: possibilities with regards to your problems. Here are some things to
: consider:
: 1. The most probable explanation is that you are either clenching
: and grinding your teeth, or your dietary habits are causing problems
: to your teeth. These problems are known as CRACKS in the teeth.
: 2. You are actually suffering from sinus or other problems that are
: being misdiagnosed, or mistreated (although this is a lower probability).
: Sinus problems can mimic dental pain, but I cannot believe that your
: case fits into this category.
: 3. You may fit into a category of individual whose teeth will not accept
: root canal therapy. Once again, a low percentage chance for this.

: Let's look at Frank's symptoms:
: 1. He had RCT done 10 years ago. Was the tooth crowned after that
: procedure? If not, then the chance of cracking the tooth is very high,
: perhaps 75%+. However, even with a crown, the tooth can still crack.
: 2. The tooth is removed, so a bridge (preparation) is started. Three
: days later, a second tooth flares up. The dentist says he sees an abscess,
: but the chance of an abscess starting in three days is fairly low. Bacteria
: would take 2-4 weeks to start causing an abscess. So, the abscess must
: have been present prior to the bridge work. Therefore, something must have
: irritated the nerve previously, like a........CRACK (perhaps)
: 3. Well, if the tooth is cracked, get your checkbook out, as you'll pay for
: the RCT, crown or bridge, then the extraction of the tooth you just paid
: for. The trick is to nail down the diagnosis. Cracks can be detected in
: many ways: 1)with a stain 2)with pain 3)or visualization after extraction.
: 4. Was the tooth that was removed carefully checked for cracks by an
: expert in crack detection?

: Some solutions:
: 1. Cracks and fractures are at epidemic proportions in the US. Daily life
: stresses, kids, spouses, etc cause us to grind our teeth. Cracks are like
: potato chips, you can never have just one. Afterall, to crack one tooth
: you must be chewing against another tooth.
: 2. Stop your grinding and clenching, and get a bite guard.
: 3. You must soften your diet. Gum chewing, raw carrot stick eating,
: bagels, pretzels, ice, etc, etc, etc, cause cracks in teeth. Why don't
: you ever see these reports on TV? The manufacturers would lose
: money and pull ads from the television stations.
: 4. Don't alternate from hot to cold foods. Drastic temperature changes
: cause expansion and contraction of fillings and teeth, and cause

: Just a few ideas, but I could be wrong about your case(s).
: Good Luck to both of you (and others)
: David

Thank you so much for your response! I appreciate the advice. I am feeling better today but the tooth is still hurting; however, only when I bite down on it. It isn't a constant pain like I had yesterday. I guess that's good news huh? I'm taking Amoxicillin for the infection.

Responding to your issues:

1. I have been known to clench my teeth (especially while sleeping)

As far as dietary habits, I don't really eat any hard candies or the food you mention.
2. It is my lower teeth (Could that still be sinus problems)?
3. I have had a root canal and it did work before. I don't know if things have changed

1/2. I did have a crown put on the RCT done 10 years ago. My dentist speculated I had a crack but could not see one on the xray nor was it inspected after it was removed.
3. How can I get the dentist to check for cracks?
4. As mentioned above, the tooth WAS NOT checked for cracks.

I'll try your suggestions for decreasing the likelyhood of cracks. Especially the bite guard!
Thanx again.

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