Baton Rouge Dentist

Root canal tooth hurting again?

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Almost three years ago, I had a root canal on an upper right molar. In May, the tooth started hurting on and off. I hesitated to do anything about it because I didn’t want to go to the dentist during the pandemic. But now the pain isn’t on and off. It’s just on and getting worse. I don’t want to lose the tooth. I’m not an established patient with any dentist. Part of my hesitancy is that after a dental cleaning and exam last October, I became very ill the next day with what resulted in a month-long respiratory infection. I still have some chest congestion from it. I’m convinced that I got the infection from the dental office. I decided not to return to that office, but now with a throbbing toothache, I’ll have to find a new dentist. In the middle of Covid-19, I don’t want to keep switching dentists. I want an idea of what’s going on. And can you tell me what to expect from a dentist for treatment options? What’s the best treatment is for a root canal tooth that’s aching? Thanks for your input.  Demetrius from Montgomery, AL

Demetrius,

We understand your hesitancy about going to a dentist. Your failed root canal treatment and illness after a dental appointment can create anxiety. But you likely realize that your throbbing tooth won’t improve without help from a dentist. So what’s causing your pain?

What Is Root Canal Failure?

Diagram of tooth with needing a root canal treatment
Although root canal treatment is usually successful, it sometimes fails

Root canal failure is a condition that occurs when a tooth doesn’t heal completely after root canal treatment. Symptoms eventually resurface and get worse. About one in ten teeth experience root canal failure.

Although Dr. Perry has extensive experience in root canal treatment, he would need to examine your tooth for an accurate diagnosis, it seems that root canal failure is causing your pain.

Why Are the Causes of Root Canal Failure?

Root canal treatment can sometimes fail for several reasons:

  • It’s impossible to see deep inside a tooth.
  • Some teeth have curved, branching roots that are difficult to clean.
  • If a dentist misses some of the infection in curved roots, symptoms will resurface.
  • Curvy, challenging roots require specialized rotary instruments to clean them out. Many general dentists don’t have those tools, so they may not completely clear the tooth. You may be referred to a specialist to complete root canal treatment.

What Is the Treatment for Root Canal Failure?

Treatment for root canal failure is either to perform another root canal treatment or root canal surgery. Most general dentists don’t have advanced training in this area, so an endodontist, or root canal specialist, usually completes the work. The specialist will identify the location of the infection that the dentist missed the first time and remove it or seal it off. Many root canal specialists say that retreatment has a 50% success rate, but the results are often better.

A specialist will also examine the condition of your tooth. If it’s cracked, the chances of saving your tooth decrease. Don’t delay treatment. Search online for a dentist with experience in root canal treatment who will see you right away, examine your tooth, and refer you to a specialist if needed.

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

 

What Can I Do About a Tooth Infection?

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Hello there,

I am in a bit of a predicament. My job does not provide and medical or dental insurance. However, I’ve been battling with what I think is a tooth infection. My face is swollen and puffy, and it aches all the time. My job doesn’t pay a lot, so I don’t have the money to treat this. What can I do?

Christopher, from Kansas City, Kansas

 

Hello Christopher,

It does sound like you have a tooth infection. Your infection may start to drain, which would release some of the swelling you feel, but it probably will not do that without any intervention.

Many communities have low-cost or mobile dental clinics, or allow you to pay on a sliding scale. You can start calling offices to see who is willing to work with you. Universities often have low-cost clinics. However, if your pain becomes worse, you should go to see an emergency dentist. Oral infections, if left untreated, can spread to other parts of your body. If it spreads to your brain, it can become very serious.

While you are looking for a clinic, do not try to treat the infection with antibiotics on your own. Antibiotics cannot treat infections present inside of teeth, only the swelling. You will likely need a root canal or an extraction to fully rid your mouth of the infection. If you take an antibiotic without any sort of treatment plan, the infection may come back, and when it does, it will be resistant to antibiotics. This will make curing the infection even more difficult.

This blog post is brought to you by Baton Rouge emergency dentist, Dr. Ryan P. Perry.

Did an Emergency Dentist Give Me an Unnecessary Root Canal?

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Several months ago, I was experiencing horrible tooth pain. I normally have a fairly high tolerance for pain, so I took some ibuprofen and went on. When the pain became too much to bear, I went to an emergency dentist, knowing that I would likely be in need of a root canal. I was right.

Recently, my sister experienced a tooth pain similar to mine. She too has a high tolerance for pain, and took ibuprofen until it was more than she could handle. At my suggestion, she consulted an emergency dentist, but was told he was in need of a crown.

How could it be that we were both experiencing the same type of pain, yet we received differing prognoses?

Thank you,
Jake

Dear Jake,

Just like all people look different, and are wired differently, all tooth pain is different and can be caused by various issues. An infection can cause pain, as well as a cracked tooth, or a cavity, in addition to a multitude of other reasons. A root canal is generally the result of a decay that reaches the nerve of the tooth, causing it to send out signs of distress of pain or discomfort. This could also be an indication of infection, or a dead tooth.

Therefore, even though two people can experience toothaches, the cause of the pain could be vastly different, yielding different diagnoses and treatment.

Another point to consider is that, even though you say you and your sister have high tolerances for pain, our pain levels are different, as are the signals of pain or discomfort that each person feels.

An emergency dentist can explain your diagnosis, as well as your sister’s. This may help you both to better understand what was going on in your mouth to cause the pain, as well as the reason for it. If the dentists you each saw failed to do this, give the office a call and inquire. This is the only way to truly know and understand.

This article was provided by the office of emergency dentist, Dr. Ryan Perry.

Did the Emergency Dentist Destroy One of My Teeth?

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I went to an emergency dentist because of some pain while I was out of town. I told him what was going on. He couldn’t see what was going on, but said based on my symptoms he feels certain I cracked a tooth. He did a crown. The pain went away for a little bit, but is now hurting again. I looked and the tooth next to the crowned tooth has turned gray. Did the emergency dentist damage it when he gave me the crown?

Lisa L.

Dear Lisa,

It would be unlikely the emergency dentist caused the tooth to die. I can think of a few scenarios which are possible.

The first is a misdiagnosis. Possibly, the graying tooth could be the one bothering you all along and it referred pain to the crowned tooth. If that’s what happened, having another dentist look at the x-rays should be able to tell you for sure. If it turns out it was an obvious misdiagnosis, you can get a refund for your dental crown.

Another possibility is that something damaged the adjacent tooth after your appointment. Admittedly, this is the least likely option. The chance of something causing trauma to a tooth right next to the one you had treated without you realizing it is pretty small. But, it’s worth mentioning as an option.

The most likely option is that both teeth were traumatized at the same time. Sometimes it takes a while for the results of the trauma to show up. So, one tooth was cracked and another possibly had its blood supply cut off. This would cause it to gray slower than the symptoms on the other tooth showed up.

You may never know for sure unless it is a misdiagnosis. However, the dying tooth needs to be addressed. You’ll need a root canal treatment. If you don’t the bacteria it’s harboring will blow up into a tooth infection and you’ll end up with another dental emergency.

This blog is brought to you by Dr. Ryan Perry.

“Affordable Dentist” Rip-off

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I had the side of my face swell up. I knew this was likely some kind of dental emergency, but couldn’t afford to go to my dentist. He’s sort of high end, because, for most part, I believe you get what you pay for. I decided I needed an affordable dentist for this, which I was sure would be a simple procedure that any general dentist could do. Worst case scenario, I’d need a root canal. I was so mistaken. He looked at the tooth and did decide it needed a root canal. He was doing the procedure. I’ve had root canals before, so I know what to expect. This guy was awful. He jerked by face everywhere, grumbled under his breath, and even said a few words I wouldn’t think would be appropriate in a profesional setting. Then there was a crack and he cursed and stormed out of the room. He comes back and says the tooth has to be extracted. I agreed. Then I get a bill and he’d charged me for both procedures, including his botched one. I tried talking to the office about it, but they said I shouldn’t expect him to work for free. Do I have any recourse?

Kerri L. – South Carolina

Kerri,

This is a tricky situation. While he does deserve to be paid for his job, it’s bad form to charge for a botched procedure, especially for a dentist who advertises as an “affordable dentist“. Those patients generally don’t have a lot of discretionary money to begin with. There are three possible options you can do to deal with the billing.

First, I’d try calling and speaking directly to the dentist, instead of the billing department. It’s possible the dentist will admit he shouldn’t have charged you for the root canal treatment gone wrong.

If that doesn’t work, you can bring your x-rays to your regular dentist. Of course, that will require explaining why you went to another dentist. If that makes you uncomfortable, you can always go to a completely different dentist for a second opinion. Some dentists even do free dental exams. IF the dentist says you were misdiagnosed, there’s a good chance you can get your money back.

Barring that, you can try the Better Business Bureau (BBB). Whether you will get any money back will mostly depend on the skill of their dispute resolution specialist.

I’m sorry you’ve had this experience. If you find yourself in another bind, you may just talk to your dentist about the situation. He (or she) would likely allow you to work out a payment plan, especially because you’re an established patient.

This blog is brought to you by Dr. Ryan Perry.

Should the Emergency Dentist Have Given Me a Root Canal?

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My husband had a toothache. He nursed it along for a bit then it blew up. He went to the emergency dentist who gave him a root canal. A few months later, I get a toothache. I nurse it along figuring I’d need a root canal anyway so why waste time now. It blew up on me. I went to the emergency dentist. He did a crown, but no root canal. Which one of us got the wrong treatment?

Abby N. – Indiana

Abby,

It is not a necessity that the emergency dentist gave either of you the wrong treatment. Each tooth infection is a little different. A root canal isn’t necessary unless the decay reaches the center of the tooth or is so close to the nerve that it causes the nerve to send distress signals, which comes in the form of pain or discomfort. They may also be done if the tooth is infected or dead.

It’s possible that in your husband’s case it was necessary, but in yours it wasn’t. Bear in mind, it’s not a good idea to let a toothache limp along. They blow up quickly. Even in 2017, people die from tooth infections that were left too long.

Another reason to not avoid treatment is cost and comfort. The sooner something is dealt with, the easier the treatment, which in turn also means a lower cost. I noticed that both you and your husband only go to an emergency dentist. If you’re fond of this dentist, you could make him your official dentist. With regular check-ups and cleanings, you’re likely to avoid emergency situations.

This blog is brought to you by Dr. Ryan Perry.

Root Canal Can’t be Performed on Front Tooth. What now?

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I have a front tooth that has been such a problem I had two dentists attempt a root canal on the tooth. Unfortunately, the dentists weren’t able to get through the root at the end because of calcium build-up.
Now, I’m researching the idea of having an implant on this tooth. Is this the best choice for this problem or is there another dentist that could get to the end of the root?
– Ted in Louisiana

Ted,
It doesn’t happen a lot but sometimes teeth get blockages in the roots and then it isn’t possible to perform a root canal treatment.

I’d recommend you don’t give up yet on the idea of having this procedure done. Be sure to seek the advice of a root canal specialist (endodontist) and have them try to penetrate the roots. They use fine, ultrasonic tips that can sometimes break through strong calcium build-ups. General dentists do root canal treatments on front teeth when the roots are straight with easy access. When the roots are complicated or hard to reach, a specialist is usually the answer.

Another solution that may work is to surgically seal the root end of the tooth without going through the tooth. This is fairly simple to do with a front tooth and is called an apicoectomy. This may be a good solution to your problem but you do need to consider that when you can’t clean all the dead tissue out of the inside of a tooth, there may be extra complications. I’d recommend you get advice on this from a specialist.

If possible, it’s best to save a tooth as there’s no substitute like your own natural teeth. Be sure to get proper advice from specialists before you do any procedure.

This blog brought to you by Dr. Ryan Perry, Baton Rouge Family Dentist.

I need to find an affordable dentist

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I am writing to see if you can tell me about some kind of agency or something that helps people find affordable dentists. I don’t have dental insurance right now. I found a dentist that does complimentary consultations, but the treatment prices they quoted me were frankly breathtaking. I know I have to have this work done, but I have to locate someone who has more reasonable rates.

I have a broken tooth, and it is really starting to bother me. It has been broken for quite a while, but just recently I’ve noticed swelling, and my face hurts when I wake up in the morning. In the last two days I’ve noticed the pain moving down my jaw, and my ear is bothering me, and my neck.

Can you give me a website or something? I appreciate any pointers.

Jay in Ferrisburg

Dear Jay,

What you describe sounds like an infection in your tooth, and it does indeed need to be treated. If you take antibiotics without first addressing the source of the infection within the tooth, you will make the problem worse. Oral antibiotics cannot reach the source of the infection unless you have a root canal treatment or have the tooth extracted. So even though you have to take care of this within your means, don’t try to cut corners by just taking an antibiotic.

Keep in mind, if you have a root canal treatment on the broken tooth, you may also have to have a porcelain crown placed over the tooth to protect the remaining structure. That will also add significantly to the bottom line.

Search for “affordable dentist” in your area, or just start calling to see who will work with you with payment plans or phased treatments. Some dentists are reluctant to advertise that they are “affordable” because they don’t want to leave the impression that their work is “cheap”. But with some diligence, you will be able to locate a dentist that will work with you.

Post courtesy of Dr. Perry, Baton Rouge dentist.

Son with a broken tooth

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My ten year old son was playing lacrosse and got hit in the mouth with a stick. One of his top front teeth broke off, about 2/3 of the way up, and the other has a diagonal crack in it. I took him to the dentist’s office today, but the dentist wouldn’t even see him. The receptionist says he won’t have time to fix the tooth for 3 more weeks. That is just crazy!

I don’t want to wait for treatment on this. Is it customary to wait this long? Is there some medical reason why it should NOT be treated right away?

Thanks,

Suzy in St. Paul, MN

Dear Suzy,

No medical reason exists to wait. If you still have the piece that broke off, that could help the situation. A talented cosmetic dentist will be able to reattach the piece of tooth.

You should absolutely choose an excellent cosmetic dentist for this procedure, as you want these teeth to look as good as possible.

If you do not have the piece of tooth, direct dental bonding may be an option to repair the broken tooth, or he may need a porcelain crown or two, depending on the severity of the crack in the other tooth. If the roots of the teeth are cracked, he may need root canal treatment. If you consult with an excellent cosmetic dentist, he or she will be able to offer you all of the possible options to get the possible aesthetic result.

Posted courtesy of Baton Rouge dentist Dr. Perry.

Broken tooth must be pulled – do I need an oral surgeon?

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I lost a filling in one of my molars a few years ago. I lived with the missing filling for quite a while, but then the tooth broke, and it got too painful to ignore. I had a root canal treatment done, but never went back in for the dental crown placement, because I just can’t handle that much time in a dentist’s office. The temporary filling fell out about six months later, and I learned to work around the tooth, but recently it has become really painful again. I know I have to go back in, but I can hardly stand the thought of it.

I saw a dentist and he told me the tooth is infected, and that there really isn’t enough of it to save. He said that it has to be pulled, and that the condition of the tooth means they will have to cut both gum and bone. He said it would be best to have an oral surgeon do this under anesthesia, especially given my anxiety about dental work, but that is just not in my budget. He said he COULD do the procedure under a local, but that an oral surgeon would be best.

My question is, can most general dentists competently handle this type of procedure? I don’t want to spend all that extra money to go to an oral surgeon, but every time I think about getting it done my heart pounds and my hands sweat and I feel sick. Pretty intense. I think I’ll calm down some if I think my dentist is really competent to handle this.

William in Orlando

Dear William,

It sounds like you really need to a have a candid conversation with your dentist. Either he is comfortable doing the procedure, or he isn’t, and it sounds as if he will be honest with you about that. It is also encouraging that he has acknowledged that your fear needs to be considered and handled with compassion. You could also consider seeking the services of a dentist that does sedation dentistry, which they may also advertise as gentle dentistry. Very often, the use of nitrous oxide with an oral sedative is the right combination to reduce anxiety and control pain so that the appointment is much less traumatic.

This blog post courtesy of Baton Rouge dentist Dr. Perry.