Baton Rouge Dentist

How long can I wait to get a root canal if I don’t feel pain?

Posted on by .

I’m trying to figure out when I need a root canal if I don’t feel any pain. I am job searching, and if the tooth can wait, I would prefer to postpone it. My left first molar tooth is discolored, and my dentist says that the tooth is infected. She wants to complete a root canal and cover the tooth with a crown. If the tooth does not hurt, is this really urgent? – Thank you. Marcus from OK

 

Marcus,

Thank you for your inquiry. Your dentist is right; a dark infected tooth requires treatment.

Why Is Your Tooth Turning Dark?

Diagram of abscessed tooth in need of emergency dental care and root canal treatment
A dead tooth need urgent dental care to stop the infection

Your tooth can turn dark from infection. When the tooth pulp (the living tissue inside) dies, it turns dark, and the discoloration shows through your tooth. Tooth pulp contains tissue and nerves, so you will not feel pain if the tooth is dead.

Can You Delay Root Canal Treatment?

Although you do not feel pain, your tooth infection is lingering. A dark tooth means that you have probably had the infection for some time. It can spread into your bone or your bloodstream. Although you may not feel pain, other symptoms of a long-term tooth infection include:

  • A foul taste or smell in your mouth
  • Difficulty breathing or swallowing
  • Swelling in your face or cheek
  • Tenderness or swelling under your jaw or in your neck (lymph nodes)
  • Fever
  • Gum disease
  • Dehydration
  • Stomach pain
  • Fatigue

A dead tooth is an urgent matter because the infection can poison other parts of your body.

What Can You Expect with Root Canal Treatment?

Root canal treatment is painless, but your tooth will be weak. And your dentist must protect it.

  • Painless – A skilled dentist uses a local anesthetic for painless root canal treatment. But if your tooth is dead, you will not feel any nerve pain.
  • Foul smell – A tooth that has been dead for years has a bad smell. You will probably notice it and be happy that your dentist removed the infection.
  • Protecting the tooth afterward – If you have a strict budget, you do not have to get a dental crown right away. Instead, ask your dentist to complete the root canal and protect your tooth until you can afford a crown.

After the dentist completes the treatment, you will probably feel better. You might have mild symptoms that you ignored or did not associate with your tooth.

Best wishes.

Ryan Perry, DDS of Baton Rouge, sponsors this post. For more information read our post, Does a Root Canal Tooth Always Need a Crown?

My dentist doesn’t know what to do for my cracked tooth

Posted on by .

One of my right lower molars has a filling in it. The tooth cracked last Friday, but my dentist’s office is closed on Friday. I found an appointment with another dentist to look at it and see if anything needed to be done to save it. The dentist said it didn’t look like I would lose it, so I followed up with my dentist on Monday. My dentist then referred me to an endodontist who suggested that I get the filling replaced with a crown. My dentist wanted the endodontist to remove the filling to see the depth of the crack. When I returned to my dentist, he tried to mend the crack. Now the tooth is very sensitive. My dentist does not want to put a crown over the tooth. I suggested that he refer me to another endodontist. My dentist seems a little clueless, but maybe because he is young and in a big practice. Anyway, should I go with a crown or see another specialist? – Thank you. Clay from MS

 

Clay,

Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry.Dr. Perry would need to examine and x-ray your tooth for an accurate diagnosis. Cracks in teeth can be tricky, but we will provide some insight. You were wise to see a dentist right away to ensure your tooth was stable enough to see your regular dentist.

Types of Cracks in Teeth

Cracks in teeth have varying degrees of severity. But cracks differ from fractures. When tooth pieces move independently, the tooth is fractured.

Types of tooth cracks

  • Superficial crack in the enamel
  • Deep crack beneath the enamel
  • Crack into the tooth pulp
  • And tooth cracks can vary in location and can be vertical or horizontal.

Restoring a Cracked Tooth

There are different ways to protect your tooth depending on the extent of the crack. But if your tooth is sensitive, it may be infected. Your dentist or an endodontist will need to determine if root canal treatment is required.

  • Porcelain onlay – An onlay is a custom-made restoration that covers a portion of a tooth. If you have a horizontal crack on just one cusp, or peak, of your tooth, an onlay can cover it. But an onlay is not strong enough to stabilize a vertical crack.
  • Gold onlay – Gold is durable, and a gold onlay can cover the entire chewing surface of a tooth to protect it.
  • Dental crown – It will cover and protect the entire tooth.

 

Consider Getting a Second Opinion

Your dentist and the endodontist disagree on which treatment is best for your tooth. Consider getting a second opinion from another dentist. You can also ask your dentist for a referral to another endodontist for a second opinion.

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

Horrible toothache and headache, but my dentist sees no problem

Posted on by .

In January, my dentist did a root canal on an upper right molar tooth. The tooth felt better afterward but has not been symptom free. Two weeks ago, I felt a flare-up of pain that felt like it affected the tooth next to the root canal tooth, and I have a headache, too. I returned to my dentist on Monday, and she took x-rays. She says that both teeth look fine. She suggested that I see a neurologist. I do not think my dentist is investigating enough. Why a neurologist?  Thank you. Bryson from Arkansas

Bryson,

Although Dr. Perry would need to examine your tooth and x-ray to give you an accurate diagnosis, we can offer insight that might help you decide what to do next.

Pain from a tooth that looks healthy

Man in his 40s with a headache and toothache holding the side of his face
Headache and toothache pain are not always easy to diagnose

It is not uncommon to feel pain in a tooth that looks healthy in a visual examination and on an x-ray. Some causes of tooth pain include:

  • Referred pain – Infection from a tooth can refer to an opposite upper or lower tooth. Or it can feel like the pain is coming from an adjacent tooth. But pain does not refer from one side of the mouth to the other.
  • Neuralgia – Chronic nerve pain can transfer in your face, jaw, teeth, or gums. Although the condition is usually not the cause of a toothache and headache, a nerve problem can feel like a toothache. That is why your dentist recommended that you see a neurologist.
  • Infection – A sinus infection can cause headaches and pain that feels like a toothache. The maxillary sinus is near the roots of upper teeth and can press on the roots, causing a toothache sensation. Sinus pain can also transfer to a lower tooth.
  • Other health issues – Some conditions that can feel like a toothache and cause headaches include jaw pain, clenching or grinding your teeth, or gum disease. According to the American Migraine Foundation, TMJ (temporomandibular joint) disorders can contribute to chronic headaches.

If you feel that your dentist is not a good listener or rushed for a diagnosis, we suggest getting a second opinion. You can get a second opinion from another dentist or a root canal specialist (endodontist).

Are your tooth pain and headache a dental emergency?

Sudden or lingering toothache – If you have a sudden or lingering toothache and headache but no recent dental work, see a dentist right away. Toothaches are most often a symptom of infection.

Toothache after dental work – If you had root canal treatment or other dental work that seems to be your pain source, contact the dentist who completed the treatment. If the pain persists beyond the healing period or gets worse, consider it an emergency.

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

 

Both my front teeth broke. Can a dentist save them?

Posted on by .

I broke both front teeth today. The roots are still intact. I’m checking into an emergency appointment for a dentist to examine them. I know I can get a partial or a bridge, but are root canals and crowns an option, too? Thanks – Kyle

Kyle,

Although Dr. Perry would need to examine and x-ray your teeth for an accurate diagnosis, it may be possible to save broken front teeth with root canals and crowns.

Saving Broken Front Teeth with Root Canal Treatment

Depending on the extent of damage to your broken front teeth, root canal treatment may save them. But not all dentists are willing—or know how—to save teeth with severe breaks. And with the availability of dental implants, most dentists will recommend extractions and implants. A dentist who is interested in preserving your natural teeth might take the following steps if it’s an option:

  • Complete root canal treatment to remove the tooth pulp and prevent infection
  • Put two flexible posts in each root canal tooth to add strength and resistance to rotational forces
  • Attach a crown to the posts

Risks with Posts and Crowns

One risk with post-supported crowns is that rigid metal posts can crack tooth roots. Force on a post can transfer deep into tooth roots and crack them. Many dentists who perform this procedure prefer flexible posts for front teeth, like carbon fiber or fiberglass. Flexible posts are more likely to absorb the stress without breaking your tooth roots.

A flexible post in a rooth canal tootth to build it up in preparation for a dental crown
Sometimes a flexible post can help save a front tooth

We recommend that you look for a dentist with advanced experience and training. Saving your teeth with posts and crowns might not be an option, though. And if a dentist is not experienced with the technique, insisting that they use it anyway can cause more harm than good.

Remember your options:

Please do your research to find two experienced dentists who will see you when their office opens. Get their opinions on treatment options and the results you can expect and schedule treatment promptly. Don’t let the problem linger because it can get worse.

 

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

What to do about a repeatedly rude dentist

Posted on by .

After the anesthetic wore off from a root canal, the pain was horrible. Swelling and terrible pain lasted three days. My dentist prescribed Flagyl. I saw my dentist a week later, and he told me to keep staying the medication because the root looks fine.

My pain didn’t stop, so I had an emergency appointment with another dentist. They recommended that I see a neurologist. The neurologist says I have trigeminal neuralgia and should let my dentist know. I called my dental office, and they said that the dentist wanted to talk to me in person. He spoke rudely and told me that he had nothing to do with my nerve pain.

When I scheduled my dental crown appointment, the nurse said I need clearance to see the dentist, and without it, I won’t get a crown from their office. I’m waiting to hear from my dentist, but I wonder why I’m being treated so rudely. I didn’t accuse my dentist of anything. Should I trust him to place the crown? Thank you. Heather

 

Heather,

What you describe is odd and rude behavior from your dentist. We suggest that you switch to another dentist and ask for a refund for incomplete work. Although emergency dental visits are appropriate in many cases, you need a doctor who will take time to identify the source of your pain.

Doctors usually prescribe Flagyl for the lower GI tract and vaginal infections. It is an alternative antibiotic when other types won’t work for oral infection. Flagyl has a limited spectrum and is usually combined with amoxicillin or another.

Man frowning and holding the side of his face; for Baton Rouge emergency dentistry from Dr. Ryan Perry.
Sometimes, an emergency dental appointment isn’t enough

Trigeminal neuralgia causes extreme facial pain when an area of the face is touched or stimulated. Strangely, a neurologist diagnosed your case based on your dental incident alone. But why would your dentist become rude and defensive? We can’t answer that, but your dentist’s office doesn’t seem like a trustworthy place to get a new crown.

You can report the “non-visit” to your dental insurance company. You can ask for a refund. If your dentist doesn’t cooperate, you can report the incident to the state dental board.

 

Ryan Perry DDS, a Baton Rouge family dentist, sponsors this post.

My dental crown keeps falling off

Posted on by .

My dentist did a root canal on an upper right tooth about 12 years ago. Two years ago, the crown fell off, and my dentist replaced it. Since that time, the crown fell off three times, and my dentist cemented it back on. But my crown still feels a little loose. Not much tooth is left beneath the crown. Is this recementing something that I need to accept? The next time it falls off, I’m tempted to find a completely different dentist who takes urgent appointments to see if they can do any better than my dentist.

Thanks. Rebeka from Virginia

Rebeka,

When a crown keeps falling off, the problem is usually the design of the crown preparation. If that’s true in your case, you might need a new crown.

When a Root Canal Tooth Is Badly Broken

When a root canal tooth doesn’t have much structure left, a dentist can’t prepare the tooth properly. Some dentists use this method to improve crown retention:

  • Remove some of the root canal filler material
  • Place a flexible fiberglass post about 2/3 the tooth length into the canal and cement it in place
  • Bond core material to the post and tooth
  • Bond the crown to the built-up tooth

A flexible post in a rooth canal tootth to build it up in preparation for a dental crownIt won’t help to see another dentist for an emergency appointment because your situation can’t be corrected that quickly. The resolution takes forethought, time, and skill. The photographs on this page, courtesy of Dentistry Today, are an example of a treatment option that might work for your case.

If a dentist builds up your tooth with a post and composite, the tooth should retain a crown. But you need some remaining tooth structure for this to work. If crown retention only comes from the post, normal function and twisting stress will break the post, and the crown will fall off.

Bonding built up a tooth and postLook for an experienced dentist, schedule a consultation, and ask about treatment options.

 

 

Ryan Perry DDS, a Baton Rouge family dentist, sponsors this post.

Root canal tooth hurting again?

Posted on by .

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.

 

Root Canal or Extraction – How to Decide Which Is Best

Posted on by .

In January, my dentist put a crown on an upper right molar with a cracked silver filling. He said the filling had expanded and was putting pressure on my tooth. The tooth was too weak to do another filling. I agreed to the crown, but the entire procedure was uncomfortable, my dentist couldn’t numb my gums enough, and I could feel the drilling. My dentist didn’t mention that the tooth might need a root canal later.

When my dentist tested by bite, it was painful and didn’t feel right. He couldn’t get it right to my satisfaction, so he told me to give it a few days. It was painful to chew on the tooth and to brush it and floss around it. I called my dentist’s office and left a message for my dentist. A dental assistant returned my call and said that the dentist thinks the sensitivity is normal and would decrease in a few weeks.

I had an appointment for a second crown in early March, so I thought that would be a good time for my dentist to check the first crown. During the visit, my dentist looked at the crown and put a numbing solution on it. Although he didn’t volunteer to adjust the crown, I asked, and he did, but the crown was still painful. My dentists insisted that my bite needed to be adjusted, and the crown would feel fine. Due to the pandemic, I had to reschedule twice before I could see the dentist. Now that I’ve seen my dentist, he says that the tooth has a periapical abscess. I am sure that my dentist could have done something to prevent this. Now I need an extraction. I feel that I should receive a refund, but my dentist hasn’t offered it. Will you please tell me how to get a refund from my dentist successfully? Thank you. Callie from Pensacola, FL

Callie,

We are sorry to read about your disappointing experience with your dentist. Your concern I understandable. Your dentist should have told you that root canal treatment might be needed.

We’ll share some information with you that might help in the future. Although you’ve already spent time and money on your molar tooth, we recommend getting a second opinion. An advanced cosmetic dentist will explain your options for a crown and how he or she can make treatment affordable—especially since you’ve already incurred expenses with a faulty crown. And you might need to see an endodontist (root canal specialist) to preserve your tooth instead of extracting it.

Cracked Teeth and Root Canal Treatment

  • A cracked tooth risks needing root canal treatment
  • After you receive a crown, some sensitivity to temperature changes is normal; prolonged pain is not.
  • A bite that’s off and pain when you chew are problematic. When a dentist places a crown correctly, it will blend with your bite, and you won’t notice that you have a crown.

It’s alarming that you returned to your dentist, complained about the crown, and didn’t receive prompt attention. Your dentist only wanted to give you a second crown. It seems that your dentist’s priority is collecting fees, not protecting your oral health.

Trying to Get a Refund

Although your dentist might not agree to give you a refund, there are some things you can do that might motivate him. But weigh the pros and cons first, which we describe below.

  • Online reviews – Check your dentist’s online reviews. If they don’t have many bad reviews, if you threaten to add a negative one, it may get his attention. But if there are already several bad reviews and your dentist hasn’t responded to them online, adding your complaint probably isn’t a motivator for getting a refund.
  • Complain to the dental board – Although you could complain to the dental board, your dentist’s action isn’t unusual. Your situation could be viewed as a routine dental procedure that wasn’t successful.
  • File a lawsuit – If a dentist departs from the standard of care, they can be held legally liable. Based on your description, it doesn’t sound like your dentist did that. Although your dentist might have been careless, every dentist has placed crowns and had a tooth react afterward. It seems inappropriate for your dentist to place a crown on a second tooth without resolving the issue on the first one, but if the second tooth was damaged, delaying crown placement can create more problems.

Consider Getting a Root Canal

Diagram of tooth with needing a root canal treatment
A root canal may help save your tooth. Check with a skilled dentist to discuss how treatment can be made affordable for you.

If your tooth now has a periapical abscess, the tissue inside the tooth is dead, so root canal treatment will be painless—even without local anesthetic. We recommend that you see another dentist or an endodontist (root canal specialist). An endodontist has advanced training and technology to increase the chances of successful root canal treatment. If there are any challenges in the canals of your teeth, an endodontist can handle it.

What About Extraction?

Extraction is more invasive and traumatic than a root canal. A missing tooth affects your oral health in several ways:

  • Teeth keep each other aligned. When a tooth is missing, the surrounding and opposing teeth will drift into the space and create orthodontic issues.
  • Your bite will be disrupted.
  • You can eventually experience TMJ disorder.

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

Why Aren’t Antibiotics Working?

Posted on by .

Hi,

I was prescribed antibiotics by my dentist for a possible tooth infection. My gums were red and painful, and even my face was swollen a bit. I’ve taken them a few times a day for the past two weeks. The swelling went down for awhile, but now it’s back and worse than before. My cheek is swollen and yellow-ish, and there’s a weird taste in my mouth. Do I need to go to an emergency dentist? I’m not sure what they will do besides give me more antibiotics. What else can I do?

Thank you,

Jake, from Big Arm, Montana

 

Hi Jake,

I’m sorry to hear about your situation. Antibiotics aren’t the only treatment for tooth infections – they are a part of it. Once the infection is under control, then your dentist start your treatment plan. One treatment would be to extract the tooth, but a more common treatment is a root canal, which would open and drain the source of the infection. Once your infection is cleaned out, you should feel relief. Your infection sounds serious, so it’s unclear why your dentist has not done anything about it. If your pain worsens, go see an emergency dentist.

It sounds like your dentist does not fully understand tooth infections. Infections come when the organic material inside your tooth dies. Antibiotics are one treatment, but dead tissue receives no circulation, so a root canal or extraction is necessary. The antibiotics alone cannot clear out the infection. If you just take antibiotics without any treatment plan, you risk creating antibiotic-resistant bacteria in your mouth. This can cause complications, so you want to follow-up with your dentist, or a second opinion from an emergency dentist.

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?

Posted on by .

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.