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broken tooth

User Level:
Patient
Posted by: neffy13  (7 years ago)
Hello,

I accidentally broke a small part of one of my molar teeth on the right side about a year ago while eating pizza and I couldn't seek treatment right away because I was abroad. The dentist I visited a few months ago said it needs a filling although he would need to see an x-ray.. The dentist I visited recently, after seeing the x-ray told me that tooth should possibly needs to be extracted or it would be better if I go to a university hospital so that the gingiva that progressed to grow on top of that tooth needs to be cut or burned before trying a root canal treatment (which I guess would be under general anesthesia to burn a tissue?).. I am shocked.. I wanted to get a second opinion here about how bad the things look... I don't have pain in general although from time to time I have diffuse pain in that area which disappears in a few hours which I thought was provoked from tightly holding my teeth and possible grinding while sleeping because it occurs in the mornings and then disappears.. Probably since the last 6 months, I have been chewing only on one side because it hurts on the other side..

I was also told that I should get my bilateral horizontal wisdom teeth removed.. Considering that I am almost 25 years old and that these teeth haven't caused me any problems (and I was not aware of them until now), I am on the side to let them just be instead of undergoing a major surgery..

It was also added that I have another rotten teeth on the left side in one of the molars which needs filling..

I am relocating to the states possible in one month and wondering how much it would cost to get the mentioned gingiva removal and root canal procedure in the states on average..

Well I guess I had too much to digest in just one dental visit.. Hoping to get a second opinion on the tooth that was suggested for me get a root canal based on the panoramic x-ray..

Thank you very VERY much

X-RAY:
http://postimg.org/image/s52g0jvkf/
(for some reason, I could not upload an image here so I uploaded it elsewhere and posting the link.. Thanks!!
User Level:
Dentist
Hi,
You will definitely need a root canal and crown on the molar, the wisdom teeth have to be extracted because they are not completely impacted and therefore have contact with food and saliva in the mouth which might cause gum inflammation around them called pericoronitis.
Good luck to you.
Posted 7 years ago
User Level:
Dentist
Hi,

I understand that you may have had an overload at one dentist appointment. Thanks for providing the image. I too agree with Dr. Levi that those wisdom teeth need to be dealt with. If you really are not feeling comfortable with your current dentist, try finding another local dentist that a friend or family member have complete confidence in to get a second opinion.
All the best!
Dentistry On Wellington | A Dental Office in Barrie providing complete Family & Cosmetic Dentistry. 
Posted 7 years ago
User Level:
Patient
Posted by: neffy13  (7 years ago)
Thank you very much for the replies Drs. Levi and Neiman. I went to the university hospital and I am bit more confused but closed to coming a fuller understanding of my problem and the treatment options.. Hopefully...

So what they did was this..

First percussion test: Based on the things I have read, I can say that I had mild response. It feels different form the other side. but thats all.

They haven't done cold or hot tests for some reason, perhaps because I don't have such hypersensitivities in general. (eat an ice cream and feel nothing..)

The people who did my primary exam sent me to endodontics.. The people in endo requested EPT and it came out to be +3 which they said is almost near to vital tissue. another question was "does this pain wake you up in the middle of the night" and I said no. Because I never have pain or sensitivity except when I bite on something.. Saying that it is vital, the people in endo sent me for filling...

However, people who do the filling said EPT is not useful if not done on both sides (mine was done on 1 side) and the symetric tooth has also started to decay on the exact same location and the fact that it feels different on percussion means pulpitis is present and canal treatment should be done and it can also be done for vital root...

I went back to endo and they gave me an appointment for 3 weeks later... (would have been 3-4 months if I was not working in the same university.... wonders of developing country...)

From what I have been reading and what was suggested to me by the dentist, my conclusion is that I have pulp polyp (which is apparently very very unusual to have at the age of 25) either because of complication of crown fracture with pulp exposure or the pulp polyp itself caused the fracture and continued to grow later... the people in that university I think will either cut it or burn because they said they don't have laser..

I have read that in general, root canal and extraction are the only two choices for such lesions.. However it does make me wonder, since I don't have hot/cold intolerance, and EPT says the root is vital, I think I am only having reversible pulpitis, which in case of pulp polyp seems unlikely (isn't that supposed to be a result of chronic inflammation?? but I guess could also be potentially caused by mechanical trauma alone since the tooth was broken and exposed for almost more than a year...)

So I am still hoping that it can be saved with just removing the polyp, partial pulpotomy and do filling.. Am I too big a dreamer?

For the impactions, I told my concerns about these operations that I am afraid to be having sensory problems and that lots of bone would be removed etc... He said the sensory impairment would go away with taking vitamin pills and if my jaw breaks they can repair it.. That didn't sound very convincing... so I am still considering it..

Thank you very very much for the replies...
User Level:
Dentist
You need a root canal and crown on the molar, the wisdom teeth have to be extracted because they are not completely impacted. Consult a good dentist in your area. Good Luck!
the simpletooth
family dentistry with purpose
CA
Posted 6 years ago
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