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Root canal treatment after a new crown

User Level:
Patient
Posted by: meers  (3 years ago)
Hello.

I have the following problem:

Ten months ago, my dentist placed an all-ceramic crown over the next-to-last upper molar (on the right side).

I voiced my concerns several times because I had the feeling that the root was still contemplating whether it should act up or keep quiet, but the crown was placed anyway. After a few weeks, I returned to the dentist because I had the feeling that there was something going on underneath the crown, but my dentist dismissed that idea. The last time I saw the dentist because of this was in December. The X-ray didn’t show anything on the tooth, but caries were found underneath one of the fillings in a different tooth in the lower jaw. Since a friend recommended a different dentist, I went to the new dentist. He was great, by the way.

Right now, I’m suffering from a severe toothache underneath the crown. Today, I went to see my old dentist since he made the crown, and he diagnosed me with an inflammation of the root (without any X-ray (?)). After I vented my anger and after some discussion, he offered to place a new crown on the tooth after a root canal treatment (I would only have to pay material costs of 40.00 and he would assume the cost of about 300.00). However, the root canal treatment would cost 600.00.

He opened the crown with a drill (and did so in a pretty wide area) & placed a filling in the tooth.

He probably thought we had a deal with the new crown, because the hole he drilled today isn’t small!

I recently talked to my new dentist, who was appalled by the fact that only a cold test was performed, no X-ray was taken, the tooth was drilled open immediately, and that the root canal treatment is supposed to cost 600.00. He only charges 90.00 for the same treatment.

However, my new dentist is going on vacation next week, so I won’t be able to see him for 2.5 weeks. The problem is as follows now:

I have a hellish toothache that I can’t endure for 2.5 weeks. Today’s filling will supposedly only last a maximum of two weeks, and I’d really like to have a new crown (just having finished paying off the old one!), and not one with a huge filling in it.

My old dentist would probably laugh at me if I proposed having my root canal treatment done somewhere else, but then turn around and request that I accept his offer of a new ceramic crown for 50.00 of material costs.

Did I already mention that I’m suffering from a toothache???
User Level:
Patient
CheckDent
Dear meers,

Now I’ve talked to my new dentist, who was appalled by the fact that only a cold test was performed, no X-ray was taken, the tooth was drilled open immediately, and that the root canal treatment is supposed to cost 600.00. He only charges 90.00 for the same treatment.

Since I can’t compare the two treatments, I can’t tell you whether the price is okay or not. However, the approach – if everything took place that way – is not really “textbook-like.”

However, my new dentist will go on vacation next week, so I won’t be able to see him for 2.5 weeks. The problem now is as follows:
I have a hellish toothache that I can’t endure for 2.5 weeks. Today’s filling will supposedly only last a maximum of two weeks, and I’d really like to have a new crown (just having finished paying off the old one!) and not one with a huge filling in it.
My old dentist would probably laugh at me if I proposed having my root canal treatment done somewhere else, then turn around and request I accept his offer of a new ceramic crown for 50.00 of material costs.
Did I already mention that I’m suffering from a toothache???


I would go to the dentist who made the crown and demand my money back. Then I would go to an endodontist and would have him do everything – first the root canal and then the crown!
User Level:
Patient
Posted by: meers  (3 years ago)
Let me begin by saying that I think that this forum is really great and really helpful.

Thank you very much for your answers!

In the meantime, I went to the second dentist. He took an X-ray and according to him, the root looked immaculate. A cold test, drilling, and further examination of the tooth showed that the tooth is now dead.

I don’t understand this because it reacted so strongly to the cold test on Thursday.

The dentist retrieved two small cotton pads from the open tooth and asked me what the dentist had placed in the tooth. Unfortunately, I wasn’t able to answer his question properly. I only know that there was something with clove on one of the swabs. The dentist said that he would place something in the tooth in order to calm it down and prepare it for the 600.00 root canal treatment.

Now my question is whether it’s possible that the root (which, according to the second dentist, looked immaculate) just died over the weekend or if it’s more likely that the first dentist killed the root?

By the way, the second dentist started the root canal treatment today and cleaned the root canals. Considering the tooth is dead, I'm experiencing rather severe pains. Where are they coming from?

Thank you very much in advance.
User Level:
Patient
Posted by: meers  (3 years ago)
I just called my old dentist and asked him what he placed in the tooth and he said it was Eugenol. If I googled correctly, then he killed the tooth (pulp) this way.

I’m appalled. Shouldn’t he have communicated this?

The root was immaculate on the X-ray. Could there be an inflammation anyway?
User Level:
Patient
CheckDent
Dear meers,

If the dental nerve dies, it occurs in the course of a reaction to an inflammation, or a so-called pulpitis. A pulpitis can’t be seen on an X-ray. In most cases, the clinical finding leads to the conclusion that a pulpitis in the tooth is present, after which the corresponding treatment is initiated; in this case, a root canal treatment.

Because of time constraints, dental nerves are still being killed off with various substances nowadays – e.g., with Toxavit. The patient refers to this as a poisonous lining. As a patient, you will only experience discomfort as long as the acute inflammation of the dental nerve continues. Once the dental nerve dies completely, you’ll have peace again.

Since a root canal treatment normally takes some time and since patients with acute pain don’t arrange for appointments in advance, the dentist often chooses a poisonous lining in order to kill the dental nerve off completely. If this isn’t followed up with a good root canal treatment, then the injured tissue – the necrotic tissue – can cause a bone infection (an infection focus, in the patient’s language).
User Level:
Patient
Posted by: meers  (3 years ago)
Sorry, but unfortunately, I already have another question...

I’ve been to the dentist again because of the severe pain that had already started with the root canal treatment.

The treated tooth has three roots. The doctor treated the tooth with a liquid and placed paper cones in each canal. This time around, unfortunately, he can only find two of the roots. Is that bad?

Apparently, one of the canals is inflamed, because the tooth hurts more and more now and the cheek is a little bit swollen. Unfortunately, the doctor also discovered that he can’t get all the way to the end of the inflamed canal because the root is curved.

I’m taking an antibiotic now (Clinda-Saar/four of them every day) and Ibuprofen 400. If the antibiotic doesn’t have any effect, a root end resection would probably be the next step.

Wouldn’t it be better to perform a resection anyway, before the root canal gets inflamed again in a few years?

In the meantime, the pain has gotten so severe and I’m so desperate that I thinking about simply having the tooth pulled.
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