Baton Rouge Dentist

Dentist Won’t Whiten My Teeth Unless I Get a Root Canal

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My dentist will not whiten my teeth unless I get a root canal. My first molar needs a root canal, but I want my teeth whitened first. I even asked my dentist to extract the tooth and let’s move on to whitening, but she won’t do it. A root canal and crown cost more than I am ready to pay for right now. Even with dental insurance, my out-of-pocket cost will be almost $1,000. Don’t I have the right to get the treatment that I want? Abel from Charleston, WV

Abel,

Thank you for contacting us.

Dr. Szarek would need to examine your tooth and x-rays to provide an accurate diagnosis and treatment options.

What Are the Effects of First Molar Tooth Extraction?

If your dentist removes a first molar tooth as you wish, it will affect your chewing efficiency and bite. Without replacing the tooth, neighboring teeth will shift, creating the need for orthodontic treatment. Then, your dentist would rightly recommend replacing the tooth with a dental implant to prevent the misalignment of other teeth and the need for braces.

First Molar Root Canal Therapy

Saving your first molar with root canal treatment makes sense and costs less than extraction in the long term. We recommend talking to your dentist about the pros and cons of root canal versus tooth removal. If you have a tooth infection, prompt root canal treatment will prevent the infection from spreading to other teeth or your jawbone. Your dentist can explain why you need root canal therapy if she has not already done so.

Get a Second Opinion

Remember that another dentist may agree with your current dentist that root canal treatment is the priority for your oral health. If you and your dentist cannot agree on treatment, you can consider getting a second opinion on your first molar tooth and teeth whitening options. Before your appointment, send a copy of your dental records and x-rays to the second opinion dentist.

Dentists commit to protecting your oral health. Many may not agree to a course of treatment that puts your oral health at risk. You may need to see another provider if you insist on your preferences. Although you have the right to the treatment you want, be sure that you understand how delaying a procedure affects your short- and long-term oral health.

 

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

Before-and-after Kor teeth whitening photos
The KöR Whitening System gets dramatic results. Your dentist will ensure your teeth are healthy first.
Photos courtesy of KöR Whitening

Cracked Your Tooth? How to Decide If Your Dentist or a Specialist Is Best

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In early March, I received two white fillings – one on a top left molar and the other on a bottom left molar. Both fillings felt okay at first. But about three weeks later, I began to feel pressure shocks whenever I bite down on that side of my mouth. I returned to my dentist, and he shaved some of the filling.

The pain only improved a little, so I had another appointment with my dentist last week. He removed one of the fillings because he thought there might be a crack in my tooth. My dentist said the decay was deep, and there was a small crack in my tooth, but he would fill it with composite. If the tooth doesn’t improve, he will recommend root canal treatment.

I still get shocks in the tooth when I mistakenly chew on the left side of my mouth. Sometimes the tooth hurts if I touch it with my tongue. Does this tooth need to be extracted, or will a root canal help? I’m scheduled to get my teeth whitened next month, but I think that I should wait until my dentist resolves my tooth pain. – Thanks. Benjamin, Witchita, KS

Benjamin,

Dr. Perry would need to examine and x-ray your tooth for an accurate diagnosis. We noticed your location, and an examination in our office isn’t practical. Based on your description, your tooth might be cracked, infected, or both. A tooth that is pain free until weeks after the filling is often cracked or infected. It is good that your dentist placed a white composite filling because amalgam can irritate and weaken the tooth.

Concerns About Your Cracked Tooth

  1. Treatment for a cracked tooth – If your dentist saw a crack in your tooth, he should have protected it with a dental crown, not a filling. Without a crown, the crack will spread, and your tooth will eventually break.
  2. Reasons to see a specialist – When your dentist doesn’t have advanced training and experience in root canal treatment, he or she might lack the skill, training, and tools needed for successful treatment. If your tooth pain persists, we recommend that you visit an endodontist, or root canal specialist. Endodontists routinely perform root canal treatments. And they have advanced training and specialized tools—that most general or family dentists don’t have—to minimize the risk of root canal failure and the need for extracting the tooth.
  3. Extract only when necessary – Whenever possible, it’s best to save the tooth if it doesn’t compromise your oral tooth. If your dentist extracts the tooth without replacing it with a dental bridge or an implant, your body will resorb the bone in the space. And other teeth in the vicinity will start to shift.
  4. Effects of teeth bleaching gel – Your tooth is already sensitive and irritated. Bleaching gel and the teeth whitening process will increase your symptoms.

Request a Referral or Get a Second Opinion

Diagram of tooth with needing a root canal treatment
If a tooth is infected or craked, complete root canal treatment before teeth whitening

Ask your dentist for a referral to an endodontist. If he won’t refer you, schedule an appointment with another general dentist for a second opinion. Take your recent x-ray and dental records with you. A dentist with experience in root canal treatment can give you an accurate diagnosis, explain your treatment options, and refer you to a specialist if needed.

Delay Your Teeth Whitening Appointment

Conscientious dentists offer teeth whitening to patients whose teeth and gums are healthy. You can prevent further irritation to your teeth by delaying teeth whitening treatment until the issue with your tooth is resolved. Although dentists use a special gel to reduce sensitivity during bleaching, if a tooth is already sensitive from damage, it’s best to wait.

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