Dental Help

[Sesame Seed]

1) Can somebody tell me what happens (preferably from personal experience) if you fail to get the necessary root canal therapy done on a tooth (molar) that has formed an abscess? There's no pain associated with it. Would I be compromising my bite by getting the root canal here? In what way would my health be compromised if I don't get it done?

2) I have a molar on the opposite side that has completely disintegrated and the remaining bone is rotten down to the gum (the result of soothing pain with whiskey). No pain (just foul breath). How could this tooth have been saved? Should I get the remaining parts removed? What are the potential issues (bite/pain/teeth shifting)?

 

[sho'nuff]

i dont really know but i believe some serious health issues can arise from not properly taking care of your teeth like that. i seriously recommend you go see a dentist soon.

 

[Sesame Seed]

I did. I'm scheduled to get root canal soon, but it doesn't seem to make sense. If i don't get it, I'll have my tooth for about 2/3 years before it breaks and there's no pain 'cause the nerve has had it . If I get it, it may ruin my bite instantly + there's a strong chance that it may fail and I'll have to get it extracted.

I've had root canal on my front tooth, so I know what I'm talking about as far as affecting your bite goes. I wouldn't dare bite down on it on the off chance that it might fracture. I've also heard some bad things about root canal therapy in general (they may need to be removed during some surgeries/ it traps the bacteria in your tooth without a way of leaving the body).

As for my rotten tooth down to the gum, it’s been that way for 5/6 years easy. No pain, no nothing. If I extract it, it will put pressure on the neighboring teeth. That tooth is proof that you can call their bluff.

 

[DDSJohnny]

1: not addressing a tooth which has a dead nerve is asking for an active infection to get worse. worse case scenario: the infection spreads to other parts of your body and causes severe complications. while this is true of any part of your body that can get infected, it is as, if not more dangerous in the head/neck region because of the "danger spaces" in the head that have vital structures/nerves and/or proximity to the brain. just because there's no pain associated with it doesn't mean that everything is fine and dandy.

2: i can't tell you if the tooth is restorable or not but what you're describing doesn't sound very good. if your description is any indication, it sounds like the tooth needs to be pulled and either replaced with an implant, a bridge, or a partial denture.

if you get a root canal on a back tooth, i'd recommend getting a crown (cap) put on it. since the dentist takes out a lot of tooth structure to remove the nerve tissue, it's much more prone to fracture since the human bite generates quite a bit of force (the back teeth anyway). after a while of enduring that force, something's gonna give. with that crown, it prevents this problem (mostly). while very rare, i've had a couple patients that have fractured their crowned tooth down to the root after biting down on something, usually something very hard (one patient was biting down on a piece of concrete; go figure).

front teeth don't always require a crown as you don't do much chewing with them. thus less force is put on the tooth as they aren't designed to generate lots of force. in some cases, crowns would be recommended for front teeth.

i don't understand what you mean about putting pressure on the neighboring teeth if you get the rotted tooth extracted. care to explain? also, what do you mean about the root canal screwing up your bite? these statements aren't making any sense to me at all.

if you take care of your teeth, there's no reason why the root canal shouldn't last you the rest of your life rather than the 2-3 years that you say (for example, i have a patient that is 93 that had a root canal done when she was 65 and she's still got that tooth and is only missing her wisdom teeth) however, it sounds like taking care of your teeth is not very high on your priority list.

 

[Sesame Seed]

Wow! This is great. Thanks for the advice.

1. How safe is the root canal treatment? Doesn't it just trap the bacteria in your body?

2. The rotten tooth is just about completely gone. There are two rotten remains left sticking out of the gum (I imagine it's the root of the tooth). I do need to get it extracted, but why hasn't it caused me any bother so far? Also, is an implant, bridge or partial denture necessary? Can't the spot be bare? I guess that's what I'm referring to when I talk about the neighboring teeth. Wouldn't the gap cause damage because there's nothing supporting the teeth on either side?

3. Is a crown for the root canal tooth permanent or am I able to remove it? I'd prefer something that I don't have to mess around with.

4. I'm worried that the root canal treatment will basically make my tooth useless. I don't want to be eating on the other side (the side of rotten missing tooth). I still want to be eating steak and other hard stuff on my preferred side (which I can still do now despite needing the root canal treatment). Basically, I'm worried that it's going to be much worse after the procedure.

5. Do you think my rotten missing tooth may have needed root canal treatment at some point? Do they usually break and rot like over time if you don't get it done? Well, I've had it for over 5/6 years so why am I getting the root canal done and potentially making the other side worse? I don't understand.

 

[DDSJohnny]

1: root canals succeed 90-95% of the time. when a dentist performs a root canal, it is taking out all the nerve tissue and bacteria present in the canal space of the tooth. there may be some infection left in the underlying bone, but the source of the infection is gone and now your body can naturally take care of the bacteria. things may be sped up with antibiotics, but the bone around the root tip has undergone some damage. it'll take time to heal completely (some dentists recommend a 1 year recall appt from the date of the root canal to check how it's progressing). there shouldn't be any pain keeping you up at night however.

2: the nerve is probably dead. thus, there can be no pain transmitted because the nerve network is toast. however, it is a source of bacteria and the underlying bone will begin to show symptoms after time. the time varies with each patient because of pain tolerance and the fact that we can't predict the nature of the bacteria (how fast it grows, etc). you don't need to restore it, but teeth behind it will drift forward and teeth opposing it will drift upward/downward into that space. this complicates things if you decide to restore it later. it's possible that the opposing/adjacent tooth may have to be extracted even if it's perfectly fine. there's no danger in letting the teeth drift, but i wouldn't recommend it if you plan to restore it eventually. better sooner than later.

3: the crown is pretty much permanent. dentists take away tooth structure so that the crown will retentive and the crown is put into place with a durable cement. you'll have to keep the margins as clean as you can, but you shouldn't have any problems biting down on the crown unless your bite is really messed up.

4: if you do the root canal and crown it, you shouldn't have any worries on the crown fracturing. this is very rare and usually happens in cases where there is an unusually great amount of force hitting on that tooth. you can bite, chew, etc as you wish, and you shouldn't have any problems with it. again, i add the disclaimer that it is possible if your bite is really messed up.

5: i don't get this question. if you're referring to the tooth that is bombed out and at the gumline, then it is possible that it may have needed a root canal. teeth break and rot over time if you don't take care of your teeth, especially when you have cavities. when you have a cavity, it keeps progressing until the source of the bacteria is gone; hence the need for fillings. regular cleanings, check-ups, and x-rays are an essential part of caring for your teeth.

it's never too late to start, but this may mean that you may end up putting more money into your teeth since you've neglected them for so long. and if you're thinking that you want to just pull all your teeth and have a denture made for you, you are 100% WRONG. you'll never be able to bite into an apple or sandwich (or other hard foods in fact) ever again (you'll have to cut them up into little pieces) as you lose about 90% of your biting force when you switch to dentures. imagine having a piece of plastic stuck to the roof of your mouth. is that something you think is fun? dentures are not like real teeth and you'll hate them. but they are an alternative to having nothing. implants are also an option, but be prepared to pay a pretty penny as implants are not only a long process, but extremely expensive. expect treatment to last about a year at the very least.

 

[Sesame Seed]

Originally Posted by DDSJohnny

it's never too late to start, but this may mean that you may end up putting more money into your teeth since you've neglected them for so long. and if you're thinking that you want to just pull all your teeth and have a denture made for you, you are 100% WRONG. you'll never be able to bite into an apple or sandwich (or other hard foods in fact) ever again (you'll have to cut them up into little pieces) as you lose about 90% of your biting force when you switch to dentures. imagine having a piece of plastic stuck to the roof of your mouth. is that something you think is fun? dentures are not like real teeth and you'll hate them. but they are an alternative to having nothing. implants are also an option, but be prepared to pay a pretty penny as implants are not only a long process, but extremely expensive. expect treatment to last about a year at the very least.

Thanks. I definitely don't want that. There's nothing like your natural teeth. It's just that my dentist told me not to bite down on my only tooth that has had root canal treatment (up front). If I can't use it, what use is it? Hopefully, I will be able to eat as usual when I get the root canal on the molar. I've been told to wait a year before we'll be able to assess it (and add the crown). I don't want to be unable to eat properly for a year.

 

[DDSJohnny]

any reason on why to wait a year? sure the tooth is stabilized but without the crown, you're taking the risk of the tooth fracturing. just FYI, you can re-do a root canal through a crown if needed. again, let me reiterate: while we dentists can never guarantee root canal success, 90-95%(depending on which research literature you're reading) are indeed successful. don't take a chance. if you're gonna have the root canal, get the crown.

 

[dfagdfsh]

I have a question since this seems to be a thread with a dental response: I have a few random black spots on the side of some of my teeth. They aren't cavities.. is this just staining, or what?

 

[DDSJohnny]

Originally Posted by Teger

I have a question since this seems to be a thread with a dental response: I have a few random black spots on the side of some of my teeth. They aren't cavities.. is this just staining, or what?

do you have any silver fillings in your mouth? could be cavities, or could be amalgam staining, could be something much more serious. best thing to do is go to the dentist and get it checked out.

 

[dfagdfsh]

I actually did check it out and they told me it was nothing and I shouldn't worry about it - no cavities. I do have fillings, but they are all the composite (whatever looks like tooth color?)

 

[Sesame Seed]

Originally Posted by DDSJohnny

any reason on why to wait a year? sure the tooth is stabilized but without the crown, you're taking the risk of the tooth fracturing. just FYI, you can re-do a root canal through a crown if needed. again, let me reiterate: while we dentists can never guarantee root canal success, 90-95%(depending on which research literature you're reading) are indeed successful. don't take a chance. if you're gonna have the root canal, get the crown.

Well, I needed the root canal three years ago. I saw an abscess in the area about a month ago and made a booking with the dentist. He felt confident about the root canal, but then the X-ray showed the damage was extensive. He said it's a 50/50 chance and that it would take a year before we know if it's cleared up. I was told not to worry about the crown until this time because I'd be paying all this money (checkup, root canal, and crown) for a tooth that may ultimately need to be extracted.

 

[JakeTS86]

Originally Posted by Teger

I have a question since this seems to be a thread with a dental response: I have a few random black spots on the side of some of my teeth. They aren't cavities.. is this just staining, or what?

This can sometimes be due to arrested cavity development, where the tooth begins to decay but your fluoride toothpaste repairs the lesion before it gets right through the enamel. It leaves a dark patch on the surface of the tooth but is not actually a cavity. Just make sure that you brush these areas properly with fluoride toothpaste. Electric toothbrushes are meant to be better than manuals too.

 

[johnie88]

I think you'd better go to dentist with your problem ))