Baton Rouge Dentist

Root Canal or Extraction – How to Decide Which Is Best

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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?

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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?

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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.

Are CEREC crowns cheap because they are quick?

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I am suffering from a toothache that is similar to one I had about a year ago. To fix it then, I ended up getting a root canal and a crown. The process took three appointments: one for the actual root canal, one to go back and get my crown, and one more to make an adjustment on the crown. I’m pretty sure that I may end up getting a root canal and crown again. I have noticed signs for “Crowns in a day.” One appointment instead of three sounds great. I’m worried, though, that it’s going to be a cheap crown that won’t last. Usually, if it sounds too good to be true, it is. Should I avoid these quick-crown dentists?

Shelby, Richardson, TX

Dear Shelby,

It’s natural to question the value of something done quickly. In many instances, “fast” does cause you to consider quality. For example, if your home is built too quickly, you may question whether the builders did their best work.

How are CEREC crowns made so quickly?

In the case of the “Crowns in a day,” or CEREC crowns, the quality isn’t questioned because it is done quickly. The reason they are able to do it in a day is that they mill the crown in their office. Using computer programs, the dentist is able to match the colors and the shape of your tooth and to make the crown while you are in his chair.

When the dentist is finished with your root canal, the crown can be fitted and you go home with it. By having a CEREC machine in the office, it cuts out the steps of sending off your crown specs to a different ceramist to create it and waiting for it to come back to the dentist to place over your tooth.

With that said, the quality of CEREC crowns isn’t undermined by the time spent to create them, but possibly by the dentist behind it. Any dentist can have a crown-making machine in their office. That doesn’t automatically mean they are a master at using it. It takes training and experience to be able to create a crown that is going to match with your other teeth in shape and color and look as natural as possible. So before just going to any CEREC crown dentist, do your homework. Go to the dentist’s office and look at examples their work so you can get the best results possible.

This post is sponsored by Dr. Ryan Perry in Baton Rouge, LA.

Will it ruin a new crown to grind down a high spot?

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I recently had a root canal and got a crown on a molar on the bottom and now my bite is off. It doesn’t feel like it used to. My teeth don’t fit together the same when I bite or clench my jaw. I think it needs to be ground down or something, but my dentist thinks I’ll get used to it and I just have to give it time. Will it ruin my crown if the dentist grinds it down? Is that why my dentist doesn’t want to fix it?

Kay, Denver, Colorado

Dear Kay,

That’s too bad that your dentist is asking you to be patient instead of trying to adjust your dental crown. Unfortunately, when dentists do that, it is often a sign that they aren’t comfortable or knowledgeable about the correction.

The way your upper and lower teeth meet when you chew, and how your teeth function together, is called occlusion. When you get a crown, the shape of the crown is similar to, but most likely not exactly like, the contour of the original tooth, and the occlusion may be different. Over time, you may get used to your new bite, but in some instances, when the bite is off, it can cause unusual stress on the teeth. This stress can lead to bone loss or contribute to TMJ disorders.

When a new crown feels off, most dentists will simply fix it so it isn’t so high. There is a special “registration paper” that the dentist would ask you to tap and bite your teeth together on. When there is a part of the tooth that hits before the rest of the tooth, the dentist will grind the tooth in that spot to fix it. It doesn’t hurt the crown to grind down small spots that may be causing discomfort. This is a common practice with crowns.

You have a couple of options. You can wait as suggested and see if your bite adjusts if you have had a good experience otherwise with your dentist. If you do go back and ask again to adjust the crown and he is hesitant, don’t push it. It may end up worse than leaving the crown as it is.

If you don’t have any ties that bind with this dentist, it may not hurt to get a second opinion.

This post is sponsored by Dr. Ryan Perry in Baton Rouge, Louisiana.

Would pulling a tooth and covering it be better than a root canal?

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I had a friend who had a snap-in set of teeth to cover a bad tooth in the front. I’m wondering if there is something similar for a tooth in the back. I keep struggling with a tooth on the bottom of my mouth. I have had cavities and fillings, and now my dentist says I either have to have a root canal on it or an implant. I’m thinking it might be easier just to pull the thing and cover it up. What do you think?

Althea, Mississippi

Dear Althea,

While it is frustrating to keep having work done on the same tooth, a snap-on smile is not the answer. Snap-on smiles are meant for temporary tooth fixes. Because they are meant to be temporary, they aren’t very durable or strong, especially not in the place of a molar that takes the brunt of the work chewing your foods. They are not particularly cheap, either.

Also, there are complications that can arise from extracting the tooth. Anytime a tooth is pulled, the body naturally thinks the bone in that area isn’t needed anymore. The minerals in the bone will eventually be reabsorbed into the body, leaving that spot prone to deformation. It may also affect the teeth around that spot as it leaves room for them to shift, changing your bite.

Your dentist may have suggested a dental implant for that tooth if you mentioned extracting it. If you put an implant in, it will slow down or stop the bone loss because the base of the implant is in the bone and lets the body know it is still needed.

Really root canal is probably your best bet as it is the simplest option. It can take care of the needs of your tooth and most likely be the most cost-effective. Typically a tooth that gets a root canal also gets a crown. This is a strong covering that will allow you to still chew like you are used to without fear of it breaking.

If you want other options, depending on the location of the tooth, a partial denture or a bridge may work. Speak to your dentist about your options when you have your next appointment.

This post is sponsored by Dr. Ryan Perry of Baton Rouge, LA.

 

 

 

My Tooth Crumbled. What Do I Do?

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I had a root canal and temporary filling done. I’m supposed to go in for the crown on Wednesday, but it seems my tooth has crumbled. I was eating and suddenly I felt bits of tooth in my food.  My dentist warned me I wouldn’t be able to put off getting the crown, but this is sooner than expected. Do I need to see an emergency dentist?

Barth – New Mexico

Barth,

Of course, I can’t tell you with certainty without seeing you, but I suspect it isn’t your tooth crumbling, but the temporary filling coming out. Look in the tooth. Is there a hole in the center? That’s where your filling should be.

If that is the case, you won’t need an . Instead, you can just get some store bought tooth filling to tide you over until your appointment on Wednesday. It’s meant for situations specifically like yours.

However, if you look back there and the tooth is gone, then yes, you’ve got a problem. Call your dentist. They likely have a protocol for situations like these and may have you come in early.

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

How long does bonding from an emergency dentist last?

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I had a fall and chipped my tooth. I went to see an emergency dentist. He put some kind of bonding on it to close the chip and sent me home.  How long will that bonding last?

Sadie M. – Alabama

Sadie,

It’s likely that the emergency dentist did composite dental bonding to repair your chipped tooth. If that’s the case, then it will last for years.  However, I hope your emergency dentist suggested you go to your dentist for follow up treatment. Not because of the bonding, but because of the trauma.

There’s always a chance the blood flow was cut off in accident. It may not show up right away, but it will cause the tooth to die and need a root canal.

You’d want to be aware of this before it causes an abscess.

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.

Is my toothache causing a swollen cheek?

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My tooth has been hurting the last couple of weeks and now my cheek is getting swollen. Is this related and how?
– Maureen from Louisiana

 

 

Dear Maureen,

Your situation sounds like you have an infected tooth with an abscess. The tooth is either cracked or has a cavity that has grown and spread to the pulp of the tooth and this is causing your problem.  If this happens, an abscess forms, causing the tooth to ache, become temperature sensitive, and creates pain when you chew. Abscesses may spread from the tooth into the jaw bone. If the infection breaks through the jaw bone, it spreads into muscles and skin. In your situation, this would be – your cheek.

We recommend you visit your dentist as soon as you can as you must treat this serious infection properly. Your dentist will prescribe antibiotics to treat the abscess and you must take the entire prescription even if your symptoms decrease after a few days. If there’s a crack in your tooth that spreads down into the root of the tooth, an extraction has to be done. If you need to extract the tooth, you may be a good candidate for a dental implant or bridge. However, if the tooth has a cavity in the pulp of the tooth, a root canal is necessary. After the root canal is performed, a dental crown is needed to protect the tooth from breaking. Because there’s no blood supply to the tooth after a root canal, the tooth is weak so the crown is added to maintain the tooth’s strength.

This blog brought to you by Baton Rouge family dentist, Dr. Ryan P. Perry.