Baton Rouge Dentist

Archives for January 2021

My son fell and broke his front tooth. Can a dentist save it?

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My son fell on his face last night and broke one front tooth and cracked the other. He is ten years old. I’m in an odd situation because I quit our family dentist and had not found a new dentist since the pandemic, so I called a few friends and we saw a dentist this morning. The dentist took a quick look at the tooth, said it looks okay and added that he can’t fix the tooth until March, but he also said that the tooth root needs time to desensitize. What does that mean? Should I wait or find another dentist who will see him right away? – Kristen

Kristen,

There is no reason to wait. The dentist you saw would need to explain why he recommends allowing time for your son’s tooth to desensitize. Before treatment, a dentist will desensitize the tooth for a painless procedure. Sometimes a tooth has internal damage that you cannot see. But it seems that the dentist’s exam was too quick to evaluate your son’s tooth. It’s best to get the tooth thoroughly examined and treated.

Repairing a Child’s Broken Tooth with Dental Bonding

A skilled cosmetic dentist can often repair a child’s tooth with dental bonding. Hopefully, you saved the piece of the tooth that broke off. A cosmetic dentist can bond the piece back in place. But if you don’t have the broken piece, we recommend direct dental bonding to fill in the tooth. A cosmetic can seamlessly restore the tooth so you won’t be able to tell where the bonding and tooth meet. The dentist will do the following:

  • Clean the tooth
  • Etch the tooth
  • Apply dental bonding and shape it
  • Harden the bonding with a curing light
  • Further shape and polish the tooth

When your son is older and the tooth pulp shrinks, he may need a dental crown. But for now, find a dentist who will see your son right away and has cosmetic dentistry training and experience.

Before-an-after dental bonding photos for a broken tooth
A cosmetic dentist uses dental bonding for emergency chips and breaks

 

Dr. Ryan Perry, a Baton Rouge dentist, sponsors this post.

Tooth still hurts after a second root canal

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In 2007, I had a root canal on my upper right first molar (tooth #3). Last October, I began to feel pain in the second molar (tooth #2) behind it, which had a large filling in it. My dentist took x-rays and said that I needed a root canal for the second molar. Although I didn’t have pain in the first molar, my dentist saw a black area in the bone above that tooth.

An endodontist completed the root canal on the second molar, and then the first molar began to hurt. Although I had a root canal in 2007 for the first molar, the endodontist said I needed repeat treatment. The second molar improved, but I continued to feel pain in the first molar.

Over the next two months, the endodontist re-medicated both teeth four times. But the first molar still hurts even if I rub my tongue on it. The endodontist is cooperative and says that the tooth has no visible internal or external fractures on the x-ray. He said that the holes at the tooth root are a little large from the 2007 root canal. He pushed filler material through the holes. The dark area above the tooth is not around the roots. It is a pocket in the jaw.

The endodontist thinks that the pain might be from bone loss over the years and a slow-growing infection. Should I ask for an antibiotic to see if the tooth is infected? If the black area is bone loss, will the bone grow back? If it is an infection, will it reinfect my other teeth? I’m concerned about a third root canal on this tooth failing and requiring extraction and an implant. I am still wearing temporary crowns because the endodontist does not want my dentist to restore the teeth with permanent crowns until the pain goes away. I am not confident that this will be resolved. Thank you. Benji from MO

Benji,

Dr. Perry would need to examine your tooth and see your x-rays to give you an accurate diagnosis. But your description sounds like your endodontist is careful and wants to save your tooth. A second or third root canal treatment is more conservative than tooth extraction. And the endodontist’s explanations sound reasonable.

As your tooth heals, the black area on the x-ray will fill in with bone over the next few months. It doesn’t seem that an infection is spreading.

Pain after root canal treatment

If you have pain in a tooth after root canal treatment, your dentist can determine if the pain is from infection or if your bite (the way your upper and lower teeth come in contact) is the problem.

  • Antibiotics decrease pain – If you take an antibiotic and the pain resolves, it usually means that the pain is from an infection rather than a tooth nerve, stress on the tooth, or another factor. Your endodontist might be willing to use antibiotics to determine if an infection is causing the pain.
  • Painful chewing – If you feel pain when you chew, the tooth is too high, and your dentist can reduce it. If your bite is too high, when you chew, that tooth takes more impact than the others and becomes sensitive.
Dental implant
Although a dental implant mimics natural tooth structure, saving a tooth is often the best option

Give your endodontist more time to try to identify the source of the pain. An extraction and a dental implant may not be necessary. Sometimes tooth pain is referred from somewhere else—even an opposing (or lower) tooth.

After your dentist and endodontist are satisfied that they have resolved the issue, you can receive your permanent crowns. If you get the crowns prematurely and the pain persists, your dentist would need to remove the crowns for further treatment.

Ryan Perry, DDS, of Baton Rouge sponsors this post.

 

Read our post, Root Canal Tooth Hurting Again?, for information about causes of root canal failure.