Do I need a Crown after Root Canal Treatment
This is not the first time I have written on this subject and I keep getting asked this same question.
I understand the question. People have had their root canal treatment and their tooth no longer hurts so why should they have this expensive treatment called a crown. I mean they have just paid enough for the root canal. and the filling.
Well, this past week, another patient of mine came in who had his root canal done a few months ago and the tooth was cracked. Nothing I could do and I had to extract the tooth. Only problem was that this tooth was his last molar on one side and it held his partial denture. Now that the tooth is gone he has a real issue holding that denture. We have repaired the denture to have it hold better but a solution that will let him hold the denture at least the way it was is going to be expensive.
Yes you need the crown after the root canal treatment. It will save you money in the long run.
Enjoying dentistry in Hamilton Ontario Canada
All the best
Dr Ron Barzilay
www.rondentist.com
PS. any questions, just send them as a comment
Showing posts with label Rootcanals. Show all posts
Showing posts with label Rootcanals. Show all posts
Monday, July 15, 2019
Monday, August 21, 2017
I had a Root Canal, I had a Crown and the Tooth still hurts! Why?
I had a root canal treatment. They put the crown on afterwards and now the tooth is still sensitive.
Why does this happen?
Well let us start off by saying that root canal treatment is highly successful but highly successful does mean that there are failures. Even with a success rate in the 90 percentile and above, if you are one of the few where it doesn't work, it is very unpleasant.
Why can a root canal treatment fail? There may be an extra canal or 2 which we did not see and accordingly did not clean and therefore bacteria was left in the tooth. As good as we get, and we are always getting better with greater magnification and better techniques, we still miss canals. Sometimes there maybe a fracture in the tooth which causes ingress of bacteria and dooms the tooth.
These things can happen and even with our best efforts a root canal may fail. Keep in mind, our success rates are always improving and at 90 plus success rate we are not doing to bad.
All the best
Dr Ron Barzilay
enjoying doing Dentistry in Hamilton Ontario
www.rondentist.com
Why does this happen?
Well let us start off by saying that root canal treatment is highly successful but highly successful does mean that there are failures. Even with a success rate in the 90 percentile and above, if you are one of the few where it doesn't work, it is very unpleasant.
Why can a root canal treatment fail? There may be an extra canal or 2 which we did not see and accordingly did not clean and therefore bacteria was left in the tooth. As good as we get, and we are always getting better with greater magnification and better techniques, we still miss canals. Sometimes there maybe a fracture in the tooth which causes ingress of bacteria and dooms the tooth.
These things can happen and even with our best efforts a root canal may fail. Keep in mind, our success rates are always improving and at 90 plus success rate we are not doing to bad.
All the best
Dr Ron Barzilay
enjoying doing Dentistry in Hamilton Ontario
www.rondentist.com
Wednesday, January 9, 2013
It's ok to pull that tooth Doc, I already stopped my Blood thinners!
Doc, it is OK to pull that tooth, I have already stopped my blood thinners!
WELL WHO ASKED YOU TO STOP YOUR BLOOD THINNERS?
Alot of patients coming into the office, are on blood thinners and have a lot of questions. Some patients come into the office and are on blood thinners and already have the answers.
Most people who are taking blood thinners are taking them to prevent blood clots in their blood vessels that could end up moving and blocking major vessels or structures. The ensuing loss of oxygen to the blocked structures could have major consequences for the patient, including death.
This is a concern in dentistry since almost every procedure we do may cause bleeding. From fillings, to cleanings, to extractions, to periodontal surgery, to root canals and so on. In dealing with the thousands of patients that we have here in our office we must always be careful with those patients who have bleeding tendencies.
Bleeding tendencies can be subidivided into those patients who have natural bleeding disorders and those patients whose bleeding is caused by medication that they are taking to "thin" the blood. In this blog I am talking about those patients taking blood thinners as those are the majority we see.
Many patients are taking Warfarin type medications and many are taking Aspirin. Those patients taking Warfarin medications can have a largely increased clotting time. Those patients on Warfarin have a test done called INR (international normalized ratio). This INR is a target goal for coagulation depending on the underlying condition so that a patients' dosage is adjusted to the target goal. In most situations a dentist can still work without having the patient stop his medication. This will depend on the patient specific factors such as the INR, patients overall health, expected bleeding and the length of the procedure.
Many patients are on low dose Aspirin. This usually does not represent a problem and most dental procedures can go ahead without any change.
Patients on Heparin are usually in a hospital setting so that is really not an issue but today there is is LMWHs (low molecular weight heparin) which allows the use of Heparin type medication outside the hospital setting and this may require stopping a patients medication.
After all this, the question really is what should you the patient be doing? The answer is very simple. Speak to your dentist, he will have the answers and if he doesn't he will be in touch with your physicians to dicuss the proper treatment for your specific situation. In most cases you will not have to ask your dentist as your dentist will be discussing it with you. In consultation with your physician he will tell you wether you need to stop medication or continue. Most important never do anything on your own. Stopping your medication even for a short time on your own may have a very negative affect. No matter what you read on the internet or heard on Oprah. Speak to your dentist, because every situation is different and there are no cookie cutter solutions.
All the best
Dr. Ron Barzilay
enjoying dentistry in Hamilton, Ontario Canada
www.rondentist.com
WELL WHO ASKED YOU TO STOP YOUR BLOOD THINNERS?
Alot of patients coming into the office, are on blood thinners and have a lot of questions. Some patients come into the office and are on blood thinners and already have the answers.
Most people who are taking blood thinners are taking them to prevent blood clots in their blood vessels that could end up moving and blocking major vessels or structures. The ensuing loss of oxygen to the blocked structures could have major consequences for the patient, including death.
This is a concern in dentistry since almost every procedure we do may cause bleeding. From fillings, to cleanings, to extractions, to periodontal surgery, to root canals and so on. In dealing with the thousands of patients that we have here in our office we must always be careful with those patients who have bleeding tendencies.
Bleeding tendencies can be subidivided into those patients who have natural bleeding disorders and those patients whose bleeding is caused by medication that they are taking to "thin" the blood. In this blog I am talking about those patients taking blood thinners as those are the majority we see.
Many patients are taking Warfarin type medications and many are taking Aspirin. Those patients taking Warfarin medications can have a largely increased clotting time. Those patients on Warfarin have a test done called INR (international normalized ratio). This INR is a target goal for coagulation depending on the underlying condition so that a patients' dosage is adjusted to the target goal. In most situations a dentist can still work without having the patient stop his medication. This will depend on the patient specific factors such as the INR, patients overall health, expected bleeding and the length of the procedure.
Many patients are on low dose Aspirin. This usually does not represent a problem and most dental procedures can go ahead without any change.
Patients on Heparin are usually in a hospital setting so that is really not an issue but today there is is LMWHs (low molecular weight heparin) which allows the use of Heparin type medication outside the hospital setting and this may require stopping a patients medication.
After all this, the question really is what should you the patient be doing? The answer is very simple. Speak to your dentist, he will have the answers and if he doesn't he will be in touch with your physicians to dicuss the proper treatment for your specific situation. In most cases you will not have to ask your dentist as your dentist will be discussing it with you. In consultation with your physician he will tell you wether you need to stop medication or continue. Most important never do anything on your own. Stopping your medication even for a short time on your own may have a very negative affect. No matter what you read on the internet or heard on Oprah. Speak to your dentist, because every situation is different and there are no cookie cutter solutions.
All the best
Dr. Ron Barzilay
enjoying dentistry in Hamilton, Ontario Canada
www.rondentist.com
Saturday, August 25, 2012
I had a root canal many years ago and since the crown falls out all the time and it bleeds and smells really bad.
Sometimes you get a letter with questions that touch on numerous issues. I received one such letter this past week and I would like to share it with you.
Wow, these are great questions I thought I would put up this letter on the blog for discussion. There are a lot of important issues that have been brought up here that deserve discussion and many things that I have seen throughout my years of practise.
1) Why has this crown been falling off since it was placed. A properly place crown does not fall off. If this crown has been falling off since it was placed we can only assume that it was not placed properly. Meaning that perhaps the underlying tooth is too short to give retention to the crown and if so it may be necessary to lengthen the underling tooth or find retention by another method. Another reason the crown could come off would be if the tooth was rotten underneath but we will assume that this was not the case since it was coming off from the beginning and a new crown would not have decay underneath. My question here to the writer would be, how many years ago was the crown done? and what does falls out all the time mean?
2) Bleeding gums and a bad smell around a crown can mean that the crown is loose and bacteria is getting in around the crown causing inflammation of the gums. ( when you touch inflammed gums they bleed). Also, if the crown is loose and bacteria and debris are getting between the tooth and the crown you can get decay of the tooth and supporation of the debris leading to bad odour.
3) Is the crown falling off related to the missed canal and pain you were having? No. The missed canal will not cause the crown to come off. It most definetly may be the cause of your pain among other possible reasons (such as a moving crown or a cracked tooth).
4) If you get a new crown on the tooth, will it keeping falling out? You must get a new crown on the tooth and if it is done properly should not fall out as the original should not have fallen out. Remember, the crown holding onto a tooth is just related to the physical properties of the tooth. In other words, if the crown has what to hold it will hold. If it doesn't have what to hold we have to start thinking about either making the tooth longer so there is more of what to hold or perhaps extracting the tooth and placing an implant as a regular crown will not hold. You have to ask your dentist flat out "will this crown hold?"
5) Now this last question is really important. The patient say she has a huge hole there and wants to know how to keep it clean so it won't get infected. Her appointment for the new crown is in two weeks. Sometimes a hole is a result of the temporary filling being compressed into the crown space, in which case you may be getting bacterial leakage and you should go back to the dentist to top up the temporary filling. This is simple and not a problem. If for some reason there is no temporary crown or filling then that is a problem as bacteria can percolate through exposed root canals and cause reinfection of the canals. Speak to your dentist regarding this. The last issue here is also, as I have mentioned in point 1, if you are going to be having a new crown done in two weeks, ask your dentist what is different that now that will make the new crown stay on.
All the best
Dr. Ron Barzilay
Enjoying dentistry in Hamilton Ontario
www.rondentist.com
Feel free to post your comments and follow my blog.
Hello Dr Barzilay,
I had a root canal many years ago and since the crown falls out all the time and it bleeds and smells really bad. After telling my dentist over and over again they referred me to a specialist who just found out that the dentist who did the first root canal missed a canal and it got infected that's why i was having so much pain. My question is if i get a crown on it again will it keep falling out? Or did it fall out because it was infected. Also my appointment to get my crown on isnt until 2 weeks from now how do I keep this clean from getting infected again I have a huge hole there it is my number 3 tooth. Thanks
Wow, these are great questions I thought I would put up this letter on the blog for discussion. There are a lot of important issues that have been brought up here that deserve discussion and many things that I have seen throughout my years of practise.
1) Why has this crown been falling off since it was placed. A properly place crown does not fall off. If this crown has been falling off since it was placed we can only assume that it was not placed properly. Meaning that perhaps the underlying tooth is too short to give retention to the crown and if so it may be necessary to lengthen the underling tooth or find retention by another method. Another reason the crown could come off would be if the tooth was rotten underneath but we will assume that this was not the case since it was coming off from the beginning and a new crown would not have decay underneath. My question here to the writer would be, how many years ago was the crown done? and what does falls out all the time mean?
2) Bleeding gums and a bad smell around a crown can mean that the crown is loose and bacteria is getting in around the crown causing inflammation of the gums. ( when you touch inflammed gums they bleed). Also, if the crown is loose and bacteria and debris are getting between the tooth and the crown you can get decay of the tooth and supporation of the debris leading to bad odour.
3) Is the crown falling off related to the missed canal and pain you were having? No. The missed canal will not cause the crown to come off. It most definetly may be the cause of your pain among other possible reasons (such as a moving crown or a cracked tooth).
4) If you get a new crown on the tooth, will it keeping falling out? You must get a new crown on the tooth and if it is done properly should not fall out as the original should not have fallen out. Remember, the crown holding onto a tooth is just related to the physical properties of the tooth. In other words, if the crown has what to hold it will hold. If it doesn't have what to hold we have to start thinking about either making the tooth longer so there is more of what to hold or perhaps extracting the tooth and placing an implant as a regular crown will not hold. You have to ask your dentist flat out "will this crown hold?"
5) Now this last question is really important. The patient say she has a huge hole there and wants to know how to keep it clean so it won't get infected. Her appointment for the new crown is in two weeks. Sometimes a hole is a result of the temporary filling being compressed into the crown space, in which case you may be getting bacterial leakage and you should go back to the dentist to top up the temporary filling. This is simple and not a problem. If for some reason there is no temporary crown or filling then that is a problem as bacteria can percolate through exposed root canals and cause reinfection of the canals. Speak to your dentist regarding this. The last issue here is also, as I have mentioned in point 1, if you are going to be having a new crown done in two weeks, ask your dentist what is different that now that will make the new crown stay on.
All the best
Dr. Ron Barzilay
Enjoying dentistry in Hamilton Ontario
www.rondentist.com
Feel free to post your comments and follow my blog.
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