February 08, 2006

Dental Advice? Horror Stories? Successes?

Now I know you are no DDS, most of my readers, because you are busy on blogs. If you were all DDSes, you would either be at some dental conference with your temp hygienist-of-the-week behind your wife's back, studying up on the history of sadomasochism, or off drug shopping online due to your out-of-control vicodin habit.

OKAY, now that we don't have any real dentists left on allied, let me ask you real, first-hand root-canal survivors some questions.

I think I need one. The reason I think I need one is that I have this tooth, one of the back-quadrant, right-lower-side molars, that broke about a year ago. big break, old filling, not much tooth left. SO, I go to my so-so dentist and get the wife who has a twitch, and she tries to very nicely (since i was broke) build my tooth back up into some semblance of a tooth with all that bonding stuff they have now adays.

TWO HOURS LATER it was sort of okay. She admitted that she should have just prepped it for a crown. In the end it would have been better than what she came up with. This sort-of tooth.

So the sort-of tooth lasted about six months before it broke again, and more, and more, as I tried to pretend nothing was happening.

About a month ago it started hurting on and off--really bad with hot or cold. I've gotten good at covering it up with my tongue while drinking anything other than room-temperature beverages. This trick, I'm hoping, will come in handy later in life while I'm in the nursing home trying to figure out how to chew peas.

Anyway, I took my sort-of tooth back to my so-so dentist last week and said well, you better x-ray this because I'm thinking I may need a root canal. At this point, I have a buldge on the outside of my lower jaw. It's red, and hot. I'm also ON an antibiotic already for a sinus infection, so whatever was going on was at least under control if there actually was an infection.

So the nice dental assistant took the x-ray. When she came back in with it I said, "Well, what's it look like to you." She hemmed and hawed and said, "I got what I needed witht he x-ray. it's not all that bad." I said, "Oh good--so I'll live through the weekend?" she laughed and said, "Yah--it's not going to kill you or anything."

So I'm thinking okay. A root canal. That's what I thought.

But then Mr. Happy Dentist comes in and looks at my jaw and says he thinks that's just a lymph node, and that it could just be from chewing differently, and that he sees the little gap at the gumline where everything basically has a straight shot past the gum, and that's why it's hurting. He said he likes to avoid root canals, so let's just do a crown.

But look, the tooth hurts. I can't chew on it. Can't get it hot or cold. And my jaw still hurts, though the swelling has gone down as I finish my 10th day of Levaquin for my other ailment.

SO, do I get a second opinion and go for the root canal here? Or do I let him start on the crown? I've never had a crown on a tooth with live roots. Only after a root canal. So I don't know.

My mother always said, Don't ever get a crown on a tooth without a root canal, because if you need one--and you probably will because sometimes the crown process alone disturbs the nerves--then they have to go through the crown to do it.

THOUGHTS? OPINIONS? Advice for pain drugs and facial swellings?

Okay, thank you. You can let the dentists back in the room now.


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Anonymous said...

I've got one crown on a tooth with live roots. It bothers me occasionally, but not too bad and not too often. But the other five crowns are on teeth with root canal, and they don't bother me at all.

Even for root canal, I don't get any painkillers other than the novocaine the dentist shoots me up with. After it wears off, aspirin does the trick overnight, and I don't usually need anything the next day.

Jeneane Sessum said...

Ralph, is your dentist in the ATL? My one and only root canal was not so good. It was a two-visit, plus temp crown visit, affair with infection. Owe!

Anonymous said...

No, he's up here in New Jersey. Sorry. :-(

Anonymous said...

I'd say get a second opinion because crowns are expensive and you don't want to do one twice. Can they just pop it off if they need to go back and do a root canal? I don't know, but it seems unlikely to me.

My dentist only does root canals that are very trivial. He sends his patients to a guy who does nothing but root canals if it looks like there's more than one branch to deal with.

I suppose the gum gap could account for the pain, and any abscess probably should have been visible in the x-ray, so he may be correct. But I think it's definitely the kind of thing you only want to treat once and get it right the first time. My mom had an expensive crown put in, only to have the remaining tooth (with a root canal) break anyway, some months later. So he's giving her a break on the bridge, I guess.

Sorry to hear you're having problems. I'm spending a fortune on crowns this year, so I'm sympathetic. Insurance, of course, only covers the first $1K, so I've dumped the remainder into a Flex Spending Account, which at least gives me a discount equal to my marginal tax rate.

And I still don't floss every day. ;^/

ajg said...

My sister works for a dentist in Dunwoody and he just did a Root canal and crown for me. He did a great job and found a hidden root. I must say that I am relieved to have it done.

I am with Dave. Crowns are expensive, so get it done right so you won't need more work on that tooth.

Anonymous said...

I've had more root canals and crowns than I can count, and I have two words of advice: 1. GET A NEW DENTIST. 2. Get a root canal before the crown. With a good dentist a root canal doesn't have to hurt. Getting a crown with a ticking time bomb underneath makes no sense at all.

Jeneane Sessum said...

I've got an 11:30 consult w/ another dentist--root canal specialist to see... will report back. Thanks for pushing me to get a second look.

Did i mention i'm terrified of dentists? More on that story later.

Did I mention i don't have dental insurance?

They said $40-$69 for the consult--assume that includes x-ray. Sounds like $ well spent on the front end. So I'm headed over now.



Unknown said...

Your dentist's logic is backwards. He should be doing what's right for you, not him. Sounds to me like the tooth probably needs a root canal. Go see someone who isn't scared to do them and does them well (like an endodontist).

Root canals are often done on teeth with crowns. We usually go through the top of the crown and are able to preserve the crown (with a small filling to patch the hole after). There's usually no change to the strength of the crown after. It's safer to do this with a new crown than to try to take it off.

In your case, however, putting the crown on with the tooth behaving this way, and not seriously considering a root canal, could be negligent.

Jeneane Sessum said...

I'm back! You all are so cool. Who said blogging was dead. okay I might have said it but that was last week.

So I went to a place called The Root Canal Place. One doc. He's done 7,000 root canals. Nice nice guy. Gives you his cell phone number in case you have any problems. Has WICKED COOL technology, including digital x-rays that allowed them to take and retake pictures to try to figure out what is going on.

He (unlike my other dentist) did say that having been on the antibiotics could be masking some of what we saw, which I know is the case because the swelling in my jaw went down when I was on the levaquin for 10 days.

He also did the "cold test" and tapping test on all the teeth on that side (which my other dentist didn't do). What the xrays showed was a problem on the tooth BEHIND the one that is the so-so tooth that my other dentist wants to crown. He said that back teeth can radiate pain forward, so it may be that the pain is coming from the back molar--the one that looks suspect on the xray. He said he wouldn't do the crown on the so-so tooth.

But what he really advised was to make an appt for a couple weeks and see what happens -- if the pain isolates to one or other of those teeth, or if it goes away, or what. If it's still bad, I come in and we test again, and if all is the same, we do the back tooth. He advised not crowning the so-so tooth before the back tooth root canal because (okay i forgot why).

So, for now, I feel pretty good about that. I can wait til the 22 because he said if it swells again or the pain gets worse before then, I can come back sooner.

So, I'm CANCELING the crown for tuesday and we'll go from there.