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Tooth #18

User Level:
Patient
Posted by: suzieq058  (5 years ago)
Tooth #18 broke at the gum-line back in July. Shallow temp put on by new dentist. Radiating jaw pain while away on vacation. Dentist suggested root canal and crown lengthening. Two-phase endodontic work done in August. Dealt with canker sores and jaw discomfort as a result. Periodontist performed crown lengthening two weeks later in early September. Experienced jaw swelling as well as gum discomfort while stitches dissolved. Temp fell off three times between procedures. Dentist put on second temp to accommodate longer tooth. Persistent swelling, jaw discomfort continues, percussion tenderness and tooth is bite sensitive. Frequent burning sensation in gums around tooth which are somewhat inflamed. Periodontist’s follow-up stated tissue looks okay. Sent back to endodontist and problem must be with gums as x-ray revealed no change. Going in circles here! Dentist wants to treat conservatively and move forward with restoration process. I am reluctant to finalize with a crown. End of October; still uncomfortable and very frustrated. Dental benefits maxed out and tooth is costing small fortune out-of-pocket. Amidst all, trying to conduct job search. Help – where do I turn, your thoughts?
User Level:
Dentist
Tooth #18 broke at the gum-line back in July. Shallow temp put on by new dentist. Radiating jaw pain while away on vacation. Dentist suggested root canal and crown lengthening. Two-phase endodontic work done in August. Dealt with canker sores and jaw discomfort as a result. Periodontist performed crown lengthening two weeks later in early September. Experienced jaw swelling as well as gum discomfort while stitches dissolved. Temp fell off three times between procedures. Dentist put on second temp to accommodate longer tooth. Persistent swelling, jaw discomfort continues, percussion tenderness and tooth is bite sensitive. Frequent burning sensation in gums around tooth which are somewhat inflamed. Periodontist’s follow-up stated tissue looks okay. Sent back to endodontist and problem must be with gums as x-ray revealed no change. Going in circles here! Dentist wants to treat conservatively and move forward with restoration process. I am reluctant to finalize with a crown. End of October; still uncomfortable and very frustrated. Dental benefits maxed out and tooth is costing small fortune out-of-pocket. Amidst all, trying to conduct job search. Help – where do I turn, your thoughts?

I can understand your concern. When crown lengthening needs doing on a second molar in addition to root canal, I think about doing an implant instead. Perhaps this would have been wiser, in retrospect. I have no reason why you are having trouble after having these two procedures done. You might have an endodontist look at the tooth to see if anything is wrong with the root canal. I agree with you, that the tooth should not be restored until it is symptom-free. A crown is sure not going to make the pain go away.
Posted 5 years ago
User Level:
Patient
Posted by: suzieq058  (5 years ago)
Thank you so much for your response. My dentist believes it is possible that I am having an allergic reaction to the cement and/or the provisional. He does not want me to worry about how it feels until after the permanent crown is done. He also claims that it is common to have percussion tenderness in an RC'd tooth. My dentist took over an existing practice this past summer, and I was not able to build a relationship prior to my emergency. Unfortunately, so far I do not have a lot of faith in him or his referred specialists. Thanks again for your unbiased opinion.
User Level:
Dentist
Thank you so much for your response. My dentist believes it is possible that I am having an allergic reaction to the cement and/or the provisional. He does not want me to worry about how it feels until after the permanent crown is done. He also claims that it is common to have percussion tenderness in an RC'd tooth. My dentist took over an existing practice this past summer, and I was not able to build a relationship prior to my emergency. Unfortunately, so far I do not have a lot of faith in him or his referred specialists. Thanks again for your unbiased opinion.

A healed root canal tooth should NOT have percussion sensitivity. I have never had a patient have an allergic reaction to cement, but anything is possible.

Remember that every textbook recommends waiting 3 MONTHS after any gum surgery before any permanent crown is placed. The gums must heal completely.

Remember a second molar so broken down that it needed crown lengthening will have a hard time retaining a crown. I suggest a cast post before a crown is done. Too many crowns I have seen break off of 2nd molars that were merely resting on amalgam or composite fillings.

Ask your dentist this: If he does the final post and crown and the tooth still hurts, will he refund the money for root canal and crown? Once a crown is placed, the tooth will have much more pressure put upon it. Perhaps a better strategy is to merely place a temporary crown which loads the tooth, and see if the pain goes away. If it does not, there is no reason to do the permanent crown!!!!!!!!!!!
Posted 5 years ago
User Level:
Patient
Posted by: suzieq058  (5 years ago)
Here is an update on Tooth #18 in case anyone is interested. After final restoration (permanent crown with temporary cement) in early November, I still had bite sensitivity. In January, I decided to move forward and had the tooth extracted by an oral surgeon. Sure enough, it was cracked. No charge, of course, for the restoration by my dentist. As well, I received partial reimbursement of the root canal by the endodontist. The socket has healed and after many months of aggravation, I am happy to report that I have finally put this ordeal behind me.
User Level:
Dentist
Here is an update on Tooth #18 in case anyone is interested. After final restoration (permanent crown with temporary cement) in early November, I still had bite sensitivity. In January, I decided to move forward and had the tooth extracted by an oral surgeon. Sure enough, it was cracked. No charge, of course, for the restoration by my dentist. As well, I received partial reimbursement of the root canal by the endodontist. The socket has healed and after many months of aggravation, I am happy to report that I have finally put this ordeal behind me.

It was sad that you lost the tooth. That was very, very generous of the endodontist to give you a partial refund, as it would have been difficult for him to know there was a crack, or how far the crack went under the gums. He tried his best for you, which is all any of us healers can do. Sometimes the body does not cooperate.
Posted 5 years ago
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