Back in 2022 - Another Broken Tooth

HI Everyone,

Well I took a long break from writing this blog over Covid but it is time to get back to writing.  

Covid is still raging on and I haven't gone skiing in two years but we definitely have been doing dentistry for the last two years.  It has been done with a few more precautions than before but basically people are having the same problems and at the end of the day need treatment.

So the latest emergency I had was a patient who had broken a tooth.  I had told this patient that they needed a crown on this tooth for a number of years.  Not because this tooth had already had a root canal treatment  but because this tooth was a back tooth that the patient had been grinding on for years and now I could see the fracture areas starting to become visible.  I had warned the patient but you know how it is, if it doesn't hurt then why do I need the crown. or if it isn't broken why fix it.  Well at the end of the day you have to believe and trust the person who is telling you these things or else you may suffer the consequences.  The consequence here was minor.  We were able to fix the tooth and then put on a crown so it wouldn't break any further.  Of course it could have been worse and the tooth could have been lost.

Moral of the story, do what needs to be done and if you are not sure get a second opinion but don't wait for bad things to happen.

All the best

Still doing dentistry in Hamilton Ontario Canada

Dr. Ron Barzilay

www.rondentist.com

Do I need a Crown after Root Canal Treatment

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

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

I HAD A ROOT CANAL - WHY DOES MY TOOTH STILL HURT?

I HAD A ROOT CANAL - WHY DOES MY TOOTH STILL HURT?

I have heard this question many times from new patients coming into the practise or from emergency patients having problems with a tooth.  Of course the answer is never simple and always depends on the circumstances.
When someone has had a root canal treatment the tooth is now altered and may not feel exactly the way it did before.  The questions we must ask:  Is the tooth functional?  Can you eat on it without discomfort?  If you answer yes to both then there is no problem.  If the answer is no then there is a problem and that is what we will deal with in this blog.
Lets start with the simple.  If you just had a root canal yesterday and your tooth is hurting it is most likely some post op discomfort and it will most likely resolve shortly.  You can even get some swelling after the treatment which may need an antibiotic but then will resolve.
What we really want to discuss here is the tooth that had root canal treatment a while ago and you still can't eat on it.  General success of root canal treatment is in the very high range.  If a root canal treatment does not succeed there can be a number of reasons which in general amounts to bacteria still being in the root canal system.  This can happen because there may be an extra canal (or two) which we didn't find.  It can also be because the root canal system is so convoluted that we couldn't clean out the entire root canal system well enough.  Another reason that a root canal may fail is due to a fracture in the tooth which may never have been noticed.
So probably the more important question in all this is what can be done?
This question usually involves a discussion with your dentist because the answer is not always black and white.  If the root canal looks like it was done poorly then you would consider redoing it.  The results could be very good.  If the root canal looks like it was done well then you have to consider the cost benefit of redoing the root canal or apical surgery (all in an attempt to stop bacterial leakage into the surrounding tissues) versus extraction and implant placement. I have simplified things but as I said earlier this will involve a discussion between you and your dentist as to the proper course of action depending on your individual circumstances.

Having fun doing Dentistry in Hamilton Ontario

All the best
Dr. Ron Barzilay
www.rondentist.com

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