Author Topic: Dental questions  (Read 534 times)

Clare

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Dental questions
« on: January 04, 2020, 06:36:29 pm »
About 8 months ago I had root canal work done on an upper molar, followed by a crown being fitted. Unfortunately I am still getting infections with small fistulas forming once a month or so.

The specialist who did the root canal looked at it again and advised that the tooth should come out.

I saw my usual dentist today who has said that I should live with it unless it gets painful. He asked whether I wanted an implant or denture if/when it does get pulled out as that would help determine when it should come out.

So:

Should the ongoing infections concern me?

Any advice on whether an implant or a denture would be better (leaving aside costs at the moment)?




Re: Dental questions
« Reply #1 on: January 04, 2020, 07:11:59 pm »
Not sure how much help this will be but, I've seen the dentist twice this week.
I had a crown fitted a few months ago and all was fine for a while. Over Christmas, it became very sensitive, first to temperature, then to pressure, then just to touch.
I got a 'turn up and wait' appointment on Monday and was given antibiotics for the infection which was causing the pain. They worked very quickly. I then saw my usual dentist on Friday. He said that there were three possibilities. One was that my bite was incorrect (which it was and he has now fixed). The other two both involved the nerve having died (so a similar situation to yours). He said that sometimes this causes no real problems and you can just live with it. Other times infections can recur and the only option then is to remove the tooth. We didn't get as far as discussing replacing it.

So it would appear that my dentist and yours agree that it there's no pain, don't worry too much.

But we must have a dentist on the forum somewhere.
"No matter how slow you go, you're still lapping everybody on the couch."

Basil

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Re: Dental questions
« Reply #2 on: January 04, 2020, 07:29:31 pm »
But we must have a dentist on the forum somewhere.

Is it safe?   :demon:
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hellymedic

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Re: Dental questions
« Reply #3 on: January 04, 2020, 07:56:12 pm »
I am not a dentist but my understanding is that ongoing infection can increase the amount of bone loss.
This might make an eventual implant more difficult technically, as well as increase the chance of implant infection, unless there's a LONG gap between extraction and implant.
If you are unlikely to follow the implant route, I would hang on to the tooth for as long as it is tolerable.

Re: Dental questions
« Reply #4 on: January 04, 2020, 08:31:00 pm »
I had an infection in a crown on a lower molar, the gum at the side used to get a sort of spot, which I'd pop every couple of days and yellow grunge would come out. Sounds gross, I know. My dentist talked about dentures and implants and tried to talk me into the implant, but the quote was £2300, which I thought was crazy. He mentioned about bone loss etc. Not sure why, but I didn't fancy the denture.
Anyhow, this went on for five years (yes, five). It did get progressively worse (soreness and the tooth got more wobbly) so a couple of years ago, after a change of dentist, I had it pulled out. It came out really easily and almost immediately I felt generally better.
I haven't had anything put in to replace, can't really see the point. 
Bread of heaven, bread of heaven.

Re: Dental questions
« Reply #5 on: January 04, 2020, 08:33:03 pm »
I (unfortunately) have extensive experience of failed root canal treatments.  If fact every single root canal treatment I've ever had (7 in total) has eventually become infected and failed.  This is over a 20-year period.  I've had secondary root canal procedures at an NHS dental hospital - they also failed (which isn't surprising - they are known to have a poor success rate).

Either I've been exceptionally unlucky or the prognosis isn't good.  As Helly said, the longer the infection remains the greater the chance of bone loss and the more complicated (and expensive) an implant becomes.

I've now had 8 implants and counting, including several bone grafts and 2 sinus lifts - and probably another 2 required.  They are expensive and time-consuming but a good way of replacing missing teeth without using dentures.

I haven't had anything put in to replace, can't really see the point.

Depends whether:
a)  You are concerned about your appearance (if the gap is visible)
b)  It's affecting how you bite/chew your food

BTW, the root canal treatments were a result of failed crowns and bridges.  Every single crown I've had has failed, requiring the root canal treatments.  If I was starting out today I would go straight for an implant and cut out the subsequent crown/root canal stages, significantly cutting the net cost, not to mention time and suffering!

hellymedic

  • Just do it!
Re: Dental questions
« Reply #6 on: January 04, 2020, 09:13:58 pm »
For the record, I think I've had root canal treatment in 7 teeth.
None has failed, though I had one tooth extracted 2 years ago, after the second post crown fell out and the root had been split for several years; both dentist and I thought tooth had had its day.
I have crowns on 7 teeth, 6 of which have had root canal treatment.

Kim

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Re: Dental questions
« Reply #7 on: January 04, 2020, 11:59:28 pm »
But we must have a dentist on the forum somewhere.

Own up, who's got a Pinarello?
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Karla

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Re: Dental questions
« Reply #8 on: January 05, 2020, 01:06:48 am »
Not me

I've got four root canals and three crowns though, of which two of the root canals (both in crowned teeth) have failed.  They lasted thirteen or fourteen years before failing.

fboab

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Re: Dental questions
« Reply #9 on: January 05, 2020, 08:34:28 am »
I've had a least 6 root canal treatments. The only crown I've had was a post and crown, following the Christchurch Incident where I basically cracked all the teeth on the lower right - they all failed over the following 8 or 9 months. The post and crown lasted 12 years and the dentist told me they generally last 10ish.

My feeling (& the advice from my dentist) would be to hold on to the tooth for as long as possible. I have 2 teeth which are basically stumps, the dead filled root is just a place holder to keep the bone & gum from deterioration and keep my options open.
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zigzag

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Re: Dental questions
« Reply #10 on: January 05, 2020, 11:51:39 am »
the root canals get filled and sealed after the treatment so they should not be infected, unless the infection is on gums? a dead tooth (i.e. without a nerve inside) becomes weak and brittle over time so the canal treatment is an interim option (for 10-15y) before the tooth needs to come out. i've had several teeth treated that way, and that was my experience. my learning* is that it's always best to look after the teeth and fix holes while they are small!

* i've only taken on board what parents and dentists were saying when i had to deal with consequences of not doing so..

Re: Dental questions
« Reply #11 on: January 05, 2020, 12:17:20 pm »
the root canals get filled and sealed after the treatment so they should not be infected, unless the infection is on gums?

Another reason would be that the root canal treatment wasn't 100% successful in removing every single last bit of infected tissue, so it stays there, locked in and slowly doing its damage.  In the old days they used to put you on a course of strong anti-biotics post treatment in the hope of killing off and nasty debris but that was more in hope than expectation.  Nowadays they (rightly) err towards doing the job properly with out the need for AB's.

As has been said, another common cause of failure is the posts cracking or splitting the root of the tooth.  I've had several of both of these outcomes!

As I say, if you have a good few years ahead of you then maybe better to bite the bullet (!) and skip straight to an implant.  That may be the eventual outcome anyway.

hellymedic

  • Just do it!
Re: Dental questions
« Reply #12 on: January 05, 2020, 01:22:33 pm »
I knew that the root of the twice post-crowned tooth I eventually lost in 2017 was split, for several years before things failed.

Clare

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Re: Dental questions
« Reply #13 on: January 05, 2020, 01:41:58 pm »
Thanks for all the info, I am considering an implant, are they permanent or will they also fail over time?

The guy who did the root canal thinks there was probably already a crack in the tooth which just didn't show. He xrayed and also CT scanned the area and could see no cause for the infection, I was put on ABs once the infection reappeared and am still getting recurrent gum pimples.

Re: Dental questions
« Reply #14 on: January 05, 2020, 04:13:28 pm »
Thanks for all the info, I am considering an implant, are they permanent or will they also fail over time?

The guy who did the root canal thinks there was probably already a crack in the tooth which just didn't show. He xrayed and also CT scanned the area and could see no cause for the infection, I was put on ABs once the infection reappeared and am still getting recurrent gum pimples.

From your (all too familiar) symptoms, Claire, I'd say the tooth is on its way out.  Pimples, pustules and abscesses are sure-fire signs that things are pretty bad down below.  In my experience the tooth will have to come out sooner or later. It's also not good for your general health to have infection present anywhere in the body.

Regarding implants - they have a pretty good life expectancy if you look after them.  My implant guy always tells me "they are not fit and forget!".  I use interdental brushes and a waterpic on a regular basis alongside fairly meticulous general hygiene and brushing.  So far so good - not a single issue with any of them going back around 10 years.