MY TOOTH HURTS BUT MY DENTIST CAN'T FIND THE PROBLEM

 This is a repost of a blog I wrote in 2012.  I am reposting this because it happens so often I just want to refresh your memories or to just sharpen the point. So please have a good read:

A patient comes into the office and says that he is having discomfort on one side. He has hasn't eaten on that side for months if not years.  The culprit tooth has a small filling in it or no filling at all.  In the x-ray the tooth looks perfectly normal.

I am most definetly starting to think CRACKED TOOTH!!

I place pressure on each cusp separately.  On one of the cusps, as the patient opens from pressing, then the tooth starts to hurt.  Yes it is a cracked tooth.

Can you see it on the x-ray?  No you can't since the tooth is fractured and not broken.  When it is fractured the two sides are close together and an X-ray will not pick up the fracture.

Why is it hurting if the sides are still together?  This is because, as you bite down on the tooth, the sides of the tooth are flexing.  At that point fluid moves in and out of the tooth causing pain.

So how do you fix it?  This is the easy or hard part.  It all depends where and how far down the root the tooth is fractured.  To fix this problem you need a crown on the tooth.  By shaving the tooth down and then covering it with a crown (or cap) all the forces of biting will be directed internally and the fractured parts will be held together thus stopping the pain.  To test this, we place a temporary crown on the tooth first.  If the symptoms disappear then we can go ahead with the permanent crown and have reasonable confidence in the outcome.  If the fracture goes further down the root and beyond the crown then the symptoms may persist.  We may need to do a root canal and the symptoms may then disappear.  But overall the prognosis is now guarded.  When the crown does not encompass the entire fracture the tooth may still be flexing and the long term prognosis is questionable.

Does this happen a lot?  Actually it happens quite a bit, even teeth that have never had a filling in them get fractures.  This is called wear and tear.  If you never use your teeth this will never happen to you.  Since most people use their teeth quite a bit and of course many of us also grind our teeth which makes this worse, quite a few of us will experience this throughout our lifetimes.

If you have any questions, you can always send me a note.

All the best

Dr. Ron Barzilay
Hamilton Ontario

www.rondentist.com

Another LOST TOOTH After a Root Canal Treatment

 So today I had to take out another tooth after the patient had a root canal treatment.

So many times patients come in and tell me how they had a root canal treatment and later had to have the tooth extracted as if this was caused by the root canal.  Sometimes root canals do fail and the tooth is lost but most of the time this is not the case.   The overwhelming amount of teeth that I extract after root canal treatment is because after the treatment the tooth was not restored properly.  That means that after the root canal a proper filling was not placed in the tooth and a crown was not placed on the tooth.

After root canal treatment the teeth are weakened and are prone to breakage and this happens a lot.  Unfortunately when this happens many times there is nothing left for us to do but extract the tooth.

So a little bit of friendly dental advice, get the crown after the root canal and protect your investment.

Doing dentistry in Hamilton Ontario

All the best

Dr. Ron Barzilay

https://thehamiltondentist.com/

www.rondentist.com

My Tooth Hurts But My Dentist Can't Find the Problem- Good Chance It is a Cracked Tooth

A patient comes into the office and says that he is having discomfort on one side. He has hasn't eaten on that side for months if not years.  The culprit tooth has a small filling in it or no filling at all.  In the x-ray the tooth looks perfectly normal.

I am most definetly starting to think CRACKED TOOTH!!

I place pressure on each cusp separately.  On one of the cusps, as the patient opens from pressing, then the tooth starts to hurt.  Yes it is a cracked tooth.

Can you see it on the x-ray?  No you can't since the tooth is fractured and not broken.  When it is fractured the two sides are close together and an X-ray will not pick up the fracture.

Why is it hurting if the sides are still together?  This is because, as you bite down on the tooth, the sides of the tooth are flexing.  At that point fluid moves in and out of the tooth causing pain.

So how do you fix it?  This is the easy or hard part.  It all depends where and how far down the root the tooth is fractured.  To fix this problem you need a crown on the tooth.  By shaving the tooth down and then covering it with a crown (or cap) all the forces of biting will be directed internally and the fractured parts will be held together thus stopping the pain.  To test this, we place a temporary crown on the tooth first.  If the symptoms disappear then we can go ahead with the permanent crown and have reasonable confidence in the outcome.  If the fracture goes further down the root and beyond the crown then the symptoms may persist.  We may need to do a root canal and the symptoms may then disappear.  But overall the prognosis is now guarded.  When the crown does not encompass the entire fracture the tooth may still be flexing and the long term prognosis is questionable.

Does this happen a lot?  Actually it happens quite a bit, even teeth that have never had a filling in them get fractures.  This is called wear and tear.  If you never use your teeth this will never happen to you.  Since most people use their teeth quite a bit and of course many of us also grind our teeth which makes this worse, quite a few of us will experience this throughout our lifetimes.

If you have any questions, you can always send me a note.

All the best

Dr. Ron Barzilay
Hamilton Ontario

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