His Dentist Messed Up this Root Canal

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My husband was in an accident that landed him in the ER. There was damage to one of his teeth, but the dentist wanted to wait two weeks to treat it. By that time there was some tooth discoloration. When he finally got to it there was not any pain, but the dentist did feel some dried blood in there. No treatment was done except to fit him for a temporary crown, which was then replaced by a permanent one a few weeks later. About seven weeks after that, he was in severe pain and we ended up with an emergency dental appointment. The dentist started a root canal treatment and then gave him a 5-day course of amoxicillin, which eased his pain for a few days. However, the pain returned and by the time the root canal was completed about eight days later, he was in massive pain again. A couple of weeks later, my husband is still in pain and barely able to work. This is a man who LOVES his job. I was concerned and took him back to the dentist, who thought the problem must be the tooth next to the one he’d treated. He did a root canal on that tooth. Again, no resolution. What do I do to help my husband? I feel like he’s being tortured.

Agatha

Dear Agatha,

Man grabbing his cheek in pain

What a horror story! I am sorry that your husband was put through this. I am also a bit flabbergasted by your dentist. He handled this situation wrong from the beginning. I’m going to be blunt and tell you that you are not with the best dentist for your family and you’d be better served looking for a new one.

The fact that the tooth was discolored along with the dried blood he encountered were very clear indications that this tooth needed a root canal treatment. Had he done it then, there would have been much less of a chance of post-operative complications. Why he just crowned a tooth that needed a root canal is beyond me. This is emergency dental care 101.

Next, after your husband had an infection blow up on him, your dentist started the root canal treatment, but only gave him enough antibiotic to last a few days. The antibiotic should have been enough to last until a few days after the treatment was completed. Otherwise you risk a bigger blow up of the infection, which is exactly what happened to your husband. Additionally, amoxicillin is not the ideal antibiotic for a tooth infection.

Then, when your husband is still in pain, he unnecessarily does a root canal on another tooth. At this point, I would get an emergency appointment with an endodontist. They are root canal specialists. Yes, a general dentist can handle this, but you don’t have time to look for another one. This needs to be seen right away. Explain to their office what happened and see if they can get you in that day. If they can’t, they should at the very least provide him with pain relief and an antibiotic to last until they can. By opening the tooth to take the pressure off of the infected pulp, your husband should feel almost immediate relief. Hopefully, this tooth can still be saved.

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Is a Tooth Infection Dangerous?

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I have been taking an antibiotic for a problem with what I think is my tooth, but it does not seem to be getting any better. A little over a week ago, I broke a molar. I thought it would be okay but I have been having a lot of pain in the jaw area. Then, it started to hurt in my cheek. Today, it started hurting in my sinuses. I don’t understand why this antibiotic is not working. Is this dangerous or should I just keep taking the antibiotic?

George

Dear George,

Man grabbing his cheek in pain

Yes, this is dangerous and I believe your tooth is infected and the infection is spreading. At this point, I would consider it a dental emergency because this seems to be spreading faster than I would expect. You do not want it to reach your brain.

I’m curious as to who prescribed you the antibiotic. If it was a dentist, he or she should have also made sure that you knew there would be a follow up appointment needed. Antibiotics alone do not cure a tooth infection. It is only truly dealt with when a dentist gets in there and removes the infected pulp.

This is done one of two ways. The first is with a root canal treatment. The second is by extracting the tooth. It is ideal if you can save the tooth by having a root canal treatment.

Please do not put this off. If for some reason your tooth cannot be saved and you have to extract it, it will also be important that you replace that tooth. Otherwise, the other teeth will drift or tip into the empty space. This will throw off your bite, which will lead to pain and possibly TMJ disorder.

The best tooth replacement is a dental implant. Hopefully, it will not come to that.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Can I Put Off A Root Canal Treatment

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I don’t have a lot of money at the moment and it is even worse with the holidays at the moment. I know it is important to treat it and I will. I’m just hoping that I can put it off until maybe March, when my tax refund comes in.

Bernard

Dear Bernard,

Man grabbing his cheek in pain

It will be really hard to diangose this without seeing you. However, I can give you some basic principles that may help you navigate this. The first thing to remember is that if it is hurting you need to see a dentist right away. That’s important even if it stopped hurting but is hurting again. This is a sign of an active infection which is considered a dental emergency. You won’t need to go in today, but will want to get in fairly soon. An Active infection grows and can become life threating. Another sign of an active infection is if there is a pimple on your gums.

If it is not hurting, you may be able to wait. I could not tell you how long because each infection is different. I know of a patient who had an arrested infection for about eight years. She didn’t even realize it. Once we did the root canal treatment, she felt better. She had no idea that the unexplained achiness and general malaise she had been feeling was due to an infected tooth.

There is an additional risk to waiting that you should be aware of. In some cases, there is external resorption where the infection slowly eats away at the root of the tooth. This makes the tooth unsaveable. The only option you’ll have then is a tooth extraction and replacement.

If you are in a situation with an active infection, I suggest that you call around to some local dentists and see if they’d be willing to work with you on payments. This way you can get the treatment you need, but pay it out slowly until your refund come in.

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Sometimes You Should Not Trust a Dentist

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I went to a new dentist because I’d been having a bit of tooth pain. I recently was tranfered and my regular dentist is three hour away now. The new dentist did an x-ray and said that there is decay on a tooth that already has a filling. He then proceeded to say that only about 10% of the tooth is viable and it would need to be extracted. He had me schedule the extraction appointment right then and said after the extraction, I’d need to schedule another appointment for bone grafting and a dental implant.

I am all for taking care of dental decay, but I just have a weird feeling that this is overkill. Am I right in thinking that something is hinky here or are my doubts because I am uncomfortable with what is forthcoming? I’ve never lost a tooth before and it would be disingenuous to say that it doesn’t bother me.

Brandy

Dear Brandy,

Man in pain grabbing his jaw.

Bear in mind that I have not examined you, but I do think you have a right to be sceptical here. If the decay and infection had gotten that bad you would not be just now feeling some pain. You would have been having pain for months. An additional issue here is the amount of decay he is saying. If that were accurate, he would not have needed an x-ray to show him. It would be obvious. In fact, it would be very likely that the filling would have fallen into the decayed tooth.

My suggestion is that you cancel this extraction appointment and get a second opinion. There are dentists who will work in non-established patients in the case of dental emergencies the same day. When you do go, make sure it is a blind second opinion. Don’t tell them who the dentist is that diagnosed you or what he said. Just tell them exactly what you told the original dentist. This way their opinion is unbiased.

I suspect you will be able to save the tooth. However, if it turns out the tooth really does need to be extracted, then a dental implant is the best replacement option. Just take some time and make sure you get a qualified dentist to do the procedure. It is not adeqately taught in dental school and does require some post-doctoral training.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Antibiotics for a Tooth Infection

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I need some advice on what to do about my tooth. I went to the dentist last week because my tooth was infected. The swelling went all the way up to my eye. He gave me some pretty strong antibiotics, which I’ve taken religiously. Everything started to get better. However, since the medicine ran out things have gotten bad again, including the swelling. Do I call to get a refill or does this mean that I was on the wrong antibiotic?

Andy

Dear Andy,

Man grabbing his cheek in pain

I am hoping that there has been some miscommunication between you and your dentist. Otherwise, it means your dentist has a profound misunderstanding of how tooth infections work. That is not a good quality to have in your dentist. Antibiotics alone will not cure a tooth infection. The infected pulp has to be physically removed by the dentist. This is typically done by either a root canal treatment or a tooth extraction. A root canal treatment is preferable because it saves the root of your tooth. However, sometimes the tooth is not saveable. In that case, an extraction is necessary. You would also need to replace the tooth so you don’t end up with tipping or shifting that throws off your bite. Leaving it open could lead to painful TMJ Disorder. 

In your case, he probably prescribed the antibiotics in order to get your infection under control. That would not have been the treatment. Instead, they would schedule an additional appointment for you to have the root canal treatment. Hopefully, it is not too late and your tooth can still be saved.

In your place, I suggest that you call your dentist and schedule an emergency visit. If he just gives you more antibiotics, make sure that the appointment to treat the tooth is on the books for BEFORE your medication runs out. If they don’t do that, it means you need a new dentist. 

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Can I Save My Teeth?

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I have a filling on two teeth which are adjacent to each other. I started having pain with those teeth. Eventually, the pain got so bad that I went to see a dentist. I will admit to not liking to go unless it is necessary. I do get one cleaning a year, but that’s about all I can handle. The dentist did an x-ray and told me that there is an abscess and the teeth will need to be pulled. I’m sort of a wreck over this. I don’t like the idea of not having those teeth. Is there any way to save them?

Kelly

Dear Kelly,

woman grabbing her jaw in pain

I am sorry you are in so much pain. What I would like you to do is get a second opinion on these teeth. Just because you have an abscessed tooth does not mean that the tooth has to be extracted. Unless the tooth is too far gone to be saved, the typical solution is to do a root canal treatment. This cleans out the infected pulp of the tooth. In most cases, you will also need a dental crown but this allows you to save your tooth.

I’m having some doubts that your teeth are as far gone as to necessitate an extraction. If they were that bad I do not think an x-ray would even have been necessary. To be honest, some dentists are just more willing to put in the work to save teeth than others.

You mentioned that you do not like going to the dentist. That is usually a sign of dental anxiety and is more common than people realize. When you get your second opinion, I would like you to see a sedation dentist. They can provide you with some medication which will allow you to feel completely relaxed in the dental chair.

If it does turn out that you need your teeth extracted, you will want to replace them as soon as possible. If you don’t, the adjacent teeth will drift and tip into the empty space, which can lead to painful TMJ Disorder. If it comes to that, the best tooth replacement is a dental implant.

Don’t put off getting this double checked. You do not want it to turn into a dental emergency.
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Are Cracks in Porcelain Crowns a Dental Emergency?

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I’ve had four porcelain crowns on my front teeth for a bit over ten years. One of them has always had a slight defect, but you couldn’t see it, just feel it if you rubbed your tongue over it. Now, I can feel it AND see it. It looks like a little line toward the bottom of the crown. Would this be considered a dental emergency? I don’t want it to break when I am out in public.

Carol

Dear Carol,

Woman covering her mouth

I’m glad you wrote. I would not consider this a dental emergency, but I would start making plans to get this replaced. There are a couple of considerations here.

  • Do you just want to replace all of them at the same time, or just one at a time as needed?
  • Are you happy with the color of your teeth?
  • If you choose to do them one at a time as needed, is your dentist an expert cosmetic dentist?

There are some benefits to doing them all at once, but the obvious drawback is that it will cost significantly more money. So, are the benefits worth the cost? First, you won’t have to worry about when they are going to need to be replaced because you have already taken care of them. Second, you won’t have to run to the dentist every time one of them is nearing the end of its life. You can go in and get them all replaced, one appointment and you’re done. Whether that is worth it is dependent on your individual circumstances.

I wouldn’t necessarily recommend replacing them all if they were just a few years old, but you’ve had yours for a while. Just don’t get them all replaced because your dentist says that is the only way to match them. That is an indicator that he or she is not an expert cosmetic dentist and you want front teeth that are beautiful.

I mentioned tooth color earlier. The color the crowns are made with is permanent. If you are happy with the current shade of your teeth then you are good to go. If you are considering teeth whitening then the time to have it done is before you have your crowns made. This way the shade can match the new color. Teeth whitening does not change the color of crowns so if you decide to do it later, you will have to replace the crowns again in order to get them to match.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Should I Wait Until COVID-19 Passes to Get a Tooth Extracted?

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I’ve had a fractured tooth but was putting off getting the crown. Now there is an abscess. I heard we’re supposed to put off dental care until after the quarantine is over. Do I wait on this? I’m absolutely miserable. Now my face is starting to swell. Can I just take antibiotics? What is your recommendation?

Pam

Dear Pam,

Woman holding her jaw in pain in need of an emergency dentist.

The directive is to avoid the dentist for routine procedures, depending on the state in which you reside. However, in this case, you are not dealing with anything routine. This would be in the category of emergency dental care. I wouldn’t put off getting this dealt with. Your face is already swelling, which means it has spread past your gums. If it reaches your heart, lungs, or brain it will become life-threatening quickly.

Antibiotics and Dental Infections

As for using antibiotics as a solution without seeing the dentist, that won’t work. They are used as a temporary means of getting the infection under control, but will not rid your body of the infection completely. Instead, you’ll feel better for a while, but when the antibiotics are completed, your infection will blow back up. This is because as the infection spreads through the pulp of your tooth, the pulp dies and is no longer receiving any blood flow. Without blood flow, there is no way for the antibiotic to reach the root causes of the infection.

The only true way to remove a dental infection is for the dentist to go in there and physically removed the infected tissue. There are two ways to do this. The first is with a root canal treatment. The dentist will remove the infected pulp and usually cover the tooth with a crown because it will become brittle and need protection. The depth and location of the fracture on your tooth may determine whether or not this is a possible solution for you.

Your second option is to have the tooth extracted. However, that complicates the issue because you’ll need to replace that tooth. The ideal replacement would be a dental implant. Given the current pandemic, you’d likely have to wait on that until things calm down. You can temporarily get a dental flipper to hold it in place.

This blog is brought to you by Marietta, GA Dentist Dr. Cristi Cheek.