Repeat Root Canal Failed But My Dentist Still Ordered a Crown

My dentist did a repeat root canal on a bottom left molar. After the root canal, an infection lingered for almost two months. An oral surgeon helped me get rid of the infection and said that my dentist should wait before putting a crown on. The tooth hurts again, so I think the infection returned, but my dentist already had the crown made without my permission.

I prefer an extraction and implant because the tooth is problematic and has interfered with my routine so much. Besides, if the tooth still hurts after a repeat root canal, I think putting a crown on it is a waste of money. Why would my dentist order a crown for a tooth that won’t heal? – Aspen from Illinois

Aspen,

You are correct. Your dentist should not have ordered the crown without your permission and without ensuring that your tooth healed. And you can refuse the crown because the tooth has not recovered.

When Should You Get a Crown on a Root Canal Tooth?

You can feel comfortable getting a crown on a root canal tooth when your dentist is sure that the treatment is successful. Preparing the tooth for a crown will further aggravate the tooth. And covering the tooth with a crown wastes your time and money.

Sometimes, root canal treatment can fail despite a dentist’s best efforts. But your dentist’s judgment was flawed in ordering a crown for a tooth that did not heal. Your dentist took a risk and is responsible for it. We recommend asking for a refund for lab fees or other fees that you paid toward the crown.

Should You Try to Save Your Tooth?

If your tooth is savable, perhaps a root canal specialist (endodontist) can save it. But as the number of root canal treatments increases, the likelihood of saving the tooth decreases. If you prefer an extraction, you can schedule an appointment for a second opinion from a cosmetic and implant dentist.

Diagram with five states of root canal treatment
Repeat root canal failure may require an extraction and dental implant

Burba Dental Partners of Salem, Massachusetts, sponsors this post. Read about what our dentists do to offer some of the best dental care in the Boston area.

Why Does My Temporary Bridge Make My Face and Jaw Hurt?

Although the bridge was still comfortable, my dentist recommended replacing it before I began to have problems. She took impressions of my mouth and placed a temporary bridge. But I take ibuprofen every day because the bridge hurts. The entire left side of my mouth and jaw hurt. It hurt to speak and chew more than anything, and my gums are slightly swollen.

My dentist took x-rays and said they look okay. But she cannot explain my pain. Of course, I am not allowing my dentist to request the final bridge because this temporary bridge hurts so bad. My dentist recommended an endodontist, but I do not have an appointment until early next month. Based on my description, why would a temporary bridge cause ongoing pain? Thank you. Lyle from Rhode Island

Lyle,

Thank you for your question. One of our dentists would need to examine your bridge, teeth, and x-rays for an accurate diagnosis. But we will explain three factors that might cause a temporary bridge to hurt.

Why Would a Temporary Bridge Hurt?

A temporary bridge can hurt because your teeth are sensitive after preparation or irritated by bacteria, or the bridge is not in the optimal position.

  • Sensitive teeth after preparation – Placing a bridge requires shaving down teeth on the sides and top so the ends of the bridge will fit over them. Teeth prepared for a bridge can ache, be sensitive to cold and hot temperatures, food, and drinks. Removing a bridge and preparing teeth from one are traumatic events.
  • Irritation from bacteria – If a dentist finds decay beneath a bridge or its components, bacteria could have infected and irritated your teeth.
  • Bridge position – If a bridge does not fit well, it can affect your bite. When you eat, the opposite teeth (upper or lower) can hit the bridge teeth harder than normal and make them ache. You can feel jaw or neck pain and get headaches, too.

Referring You to a Root Canal Specialist

When a dentist cannot identify the cause of your pain, they may refer you to a root canal specialist (endodontist). The endodontist will examine your teeth and possible x-ray and test their sensitivity.

Although some dentists delay making the permanent bridge, others place it with temporary cement. It gives the dentist time to observe your teeth and see if the sensitivity resolves. An x-ray will show whether the tissue inside the tooth is infected or died and requires root canal treatment. And a root canal specialist can help your dentist find the cause of your pain.

Best wishes for a progressive recovery.

The Salem, Massachusetts dentists at Burba Dental sponsor this post. Explore why patients say they are among the best dentists in the Boston area.

Concerns about replacing dental bonding with veneers

I’ve had composite on four front teeth for almost 20 years. It got old and discolored, and now my new dentist recommends veneers because they are easier for him. I’m not sure if I want to get veneers based on what is easiest for my dentist. I know that porcelain veneers might require some shaving of my teeth. But if the dentist removes my bonding, will it damage my tooth enamel? – Thank you. Mark from Maryland

Mark,

Thank you for your question.

Can You Remove Dental Bonding?

A skilled cosmetic dentist can remove dental bonding without damaging tooth enamel.

  • Flexible sandpaper discs will accommodate tooth shape, remove bonding, and polish your teeth.
  • Carbide polishing drills remove bonding without harming the material. But your dentist will need to use a sandpaper disc to remove any streaks left behind.
  • Air-abrasion equipment can gently remove bonding

Replacing Dental Bonding with Veneers

A dentist can replace your dental bonding with veneers. But it is your choice. If you do not need porcelain veneers for the imperfections in your teeth—or if you do not want them—your dentist should not try to convince you to get them.

Porcelain veneers

Porcelain veneer

Porcelain veneers often require moving a small amount of tooth enamel to prepare your teeth for them. But if your bonding is old, removing and replacing it is more conservative than getting porcelain veneers.

Dental bonding

Cosmetic dentists apply dental bonding by hand while you sit in the dental chair. Blending and applying bonding bonding requires advanced training and skill.

If your dentist does not have advanced cosmetic dentistry training or is uncomfortable with dental bonding, we recommend getting a second opinion. A skilled cosmetic dentist will examine your teeth, discuss your options, and explain the results you can expect with dental bonding vs. porcelain veneers.

The Salem, Massachusetts cosmetic dentists  at Burba Dental Partners, sponsored this post.  Read about how they strive to offer some of the best dental care in the Boston area.