Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Did the Emergency Dentist Damage My Tooth?

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I’m a little worried. I went to an emergency dentist because of a tooth which was in pain. He told me he didn’t see anything visible on the x-ray, but based on my description of symptoms he thought I cracked the tooth. He wanted to crown it first to see if the tooth could be saved. We did that, but the pain is still there. Now the tooth next to it is gray. Did he damage it or misdiagnose it?

Lauren A.

Dear Lauren,

Tulsa Emergency Dentist

A graying tooth means that the tooth is dead or dying. Without seeing an x-ray it would be impossible for me to tell exactly what the problem is, but I can give you three possibilities.

1. Your emergency dentist misdiagnosed the issue and crowned the wrong tooth. It’s always possible for dentists to get things wrong. Everyone is human after all. The only way to tell if this is what happened is to get a second opinion. Have another dentist look at the original x-rays and see if the real problem was visible.

If he did misdiagnose you, it is reasonable for you to expect a refund on all work done, including the appointment and crown. Then, you can have him treat the actual problem or, if you’ve lost faith in him, have the second dentist work on your tooth.

2. This is the least likely scenario, but worth mentioning. There is always the possibility that you happened to have trauma to the tooth adjacent to your crown that is now graying, at a later date. Unlikely, but possible.

3. More likely is the fact that both teeth experienced trauma at the same time, but the second tooth is just now showing evidence. That often happens with graying teeth. One tooth was cracked, which you instantly feel the pain. A second tooth is damaged and the blood flow cut-off, but you don’t realize it until the tooth starts to change colors. This tooth will likely need a root canal treatment and porcelain crown itself.

Why Some People End Up With Dental Emergencies.

This is not the case with everyone, especially patients in your situation where trauma is what sent you to the dentist. But, it’s worth mentioning for other patients out there who may struggle with going to the dentist.

You may find this surprising, but many Americans don’t look forward to going to the dentist. Some, out of intense dental anxiety, avoid it altogether. That often causes more pain and problems than if they came in for check-ups when problems could be caught early.

Fear isn’t the only reason people shrink from coming. Sometimes financial strains make it challenging and it just doesn’t seem important enough for them to go. When that happens, it’s better to find an affordable dentist who’ll work with you financially than to ignore the issue completely and end up with a severely abscessed tooth.

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

Did I Crumble a Tooth?

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My husband and I are in a disagreement as to whether or not I need an emergency dentist. I think I can wait until my appointment on Tuesday, but he thinks I need to be seen right away. I had a root canal treatment almost two weeks ago. I had a business trip so put off getting the crown. My dentist gave me a temporary filling to hold things over. Everything was okay until dinner last night. I was eating Chinese food and started feeling something grainy. I discreetly reached in and some whitish crumbly material was the culprit. My husband thinks my tooth crumbled. I think it’s actually just the temporary filling. If I’m correct, I can wait to see the dentist, right?

Melinda F.

Dear Melinda,

First, let’s see if we can’t figure out who’s got the right end of the stick. If there’s a way for you to peek at the tooth, do so. If the tooth looks intact, but there’s a hole in the center, then you’re talking about the temporary filling falling out. If there’s any disintegration to the tooth, then you’ve got a crumbling tooth.

If it’s just the filling, you can likely wait until your appointment. You may want to take the precaution of getting some temporary dental filling material. You can find it at many pharmacies. Bear in mind, it’s only meant to be used for a few days. So, keep the appointment you have with your dentist to get your dental crown.

If you wait too long after a root canal, the tooth will become brittle and could end up crumbling as your husband suggested. If that happens, they’ll be nothing to crown and you’ll be looking for tooth replacement options.

On the other hand, if the tooth has started crumbling, the sooner you get in to see a dentist the better. In fact, I’d call your dentist right away and let him not what happened. He’ll want to crown the tooth right away if it’s still possible.

This blog is brought ot you by Dr. Ryan Noah.

What Should I do about My Gray Tooth?

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I’ve never had any cavities in my life but just over a year and a half ago, my dentist pointed out that I have a gray tooth. She wasn’t certain if I needed a filling or a root canal and said she wanted to see me again. I never went back because I was anxious about the outcome. The gray tooth is my bottom right molar and it’s partially gray. I have an appointment this week but I feel stressed and think the tooth might be dead. What do you think?
– Brad from Oklahoma

Brad,
When teeth begin to turn gray it can be a sign that the tooth is dying. Since your dentist was unsure if it was a cavity, this was probably not observed in the X-ray of the tooth.

Teeth can die for no reason, however usually dental trauma or decay is the main cause. Most patients experience pain and sensitivity when trauma or decay occurs. If you are not experiencing any pain, the nerve in the tooth could be dead. A tooth can die from a heavy biting force and clenching of the teeth because the blood supply to the nerve becomes reduced causing death to the tooth. Sometimes people think that if the tooth doesn’t hurt, don’t do anything but here may be dead nerve tissue in the tooth. Leaving this tissue gives bacteria a feasting ground to grow, which does lead to an infection.

It is recommended to have your dentist take another X-ray to see if there are any changes in the tooth. If you feel like she is unsure if the tooth is dead or not we would recommend you visit an Endodontist. An Endodontist is a dentist that had more schooling then a typical dentist who solely specializes in root canal treatments. They use more equipment and different techniques to determine if the tooth has died.

For more information about Dr. Noah, visit Region Dental.

 

My Temporary Crowns Hurt

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A few weeks ago, I decided to replace two crowns on my upper left side of my mouth. I was getting food trapped between a large space between the two old crowns. My dentist gave me temporary crowns for three weeks while I waited for my permanent crowns to be created.

Unfortunately for me, week three of wearing the temporary crowns was miserable. The temp crowns smelled and I was in pain. My dentist assured me the pain would dissipate once the new crowns were cemented in my mouth.

I did not experience relief from the pain. Instead, the pain only increased in the days following the placement of the permanent crowns. I saw the dentist again and was told that my bite might be ‘off’ a bit. My dentist did a little drilling to fix the bite and I have noticed that I now hurt in that area. The pain comes and goes and it hurts to chew on the side where the dentist drilled to fix the bite. Is this common? I was assured I don’t need a root canal. What are your thoughts?
– Thomas from Oklahoma

Thomas,
You may experience different types of pain when you wear temporary crowns or have a new crown. Some pain is serious and other forms of pain are not. It’s important you know what pain is okay and what pain requires further attention.

Temporary crowns are better when they are worn less than three weeks. You mentioned in week three that they smelled and hurt. The reason for this is that they were starting to leak and microscopic particles were getting between your teeth and the temporary crowns. These trapped particles also cause pain because they are in direct contact with the porous dentin of your teeth and cause irritation.

Your dentist should’ve explained to you what would happen when your crowns were cemented. When cementing is done, this may cause further irritation and sensitivity may increase immediately after the crowns are done. This should gradually subside and wane. However, if the pain doesn’t go away, the tooth may be too irritated and might need a root canal treatment.

If you’re feeling pain when you chew, this is may be a separate issue and your bite might need to be adjusted until your bite is comfortable. There’s a tiny possibility all the work on your teeth may have caused the pulp in one or both of the teeth to die, which would irritate the ligament that holds the tooth in.

It would be wise to have a checkup and ask that the roots of these teeth be X-rayed to ensure everything is okay.

This blog brought to you by Tulsa dentist, Dr. Noah.

Is a Root Canal the Same as a Root Filling?

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I was at the dentist today and I noticed my left front tooth is extremely sensitive to the touch. The dentist gave me an X-ray but didn’t see anything when the X-ray was reviewed. I was given Amoxicillan and I took this an hour ago and was told to take it three times a day, most likely every eight hours. This is supposed to take away my pain but the tooth still hurts a lot.

The dental office recommended I come back in six weeks as my tooth may need a root filling. Is this the same as a root canal? Should I continue to take Amoxillan every eight hours? What is the best protocol for my situation?

– Frank from Oklahoma

 

Dear Frank,

It sounds like the pain in your tooth is caused from a tooth infection. This may not be visible on an X-ray because it may take a couple of weeks before a dental abscess or infection is visible on an X-ray. Even though you have pain in a tooth, an infection may not be visible on a dental X-ray. Sometimes it takes a couple weeks before an infection/dental abscess is visible on an x-ray.

Amoxicillan, the antibiotic your dentist prescribed, is not just used to reduce pain but also to minimize the chance of a tooth infection. If you are in pain, we advise you to take 800 mg of Ibuprofen every four to six hours and not to exceed more than 2400 mg per day. Take your Amoxicillin three times a day, every eight hours. For example, you might take it at 7:00am, 3:00pm, and 11:00pm to make it convenient for you. It’s also important to note that antibiotics often upset the stomach so you may wish to have a small snack with your medication.

Sometimes the tooth infection is only temporarily cleared up when taking medication. This means that when you see your dentist for a follow-up appointment in about six weeks, your dentist might not be able to determine if your tooth is infected. If it’s hard to have a diagnosis, it’s recommended to postpone any treatment.

The common cold or sinus infection may cause your teeth to hurt as well.

If you’re still suffering from tooth pain after a couple of months, you should make another dental appointment.  If an infection is present, your dentist will probably prescribe another antibiotic and recommend a root canal.

To answer your question, a root canal is the same as a root filling. If this is the treatment recommended following your root canal, you will need to have a porcelain crown placed over the root-canalled tooth to prevent it from breaking and decaying.

This blog brought to you by Dr. Noah, Region Dental.

Why do I feel pain after a root canal?

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Around three and half years ago, I had a tooth that needed to have a root canal and crown. Now, I’m experiencing pain with this tooth but my dentist says the root canal looks good. The dentist did not inform me of any cracks in the tooth so I’m not sure if that’s the problem or if I will lose my tooth. Also, the dentist said my tooth might need a new crown. I think the crown looks good and I don’t see any problems. What do you think?
– Brenda from Oklahoma 

Hi Brenda,
There may be many reasons why you’re experiencing discomfort with your tooth that has had a root canal and crown. One possibility for the pain you’re feeling is that the crown may be placed too high and it may need to be adjusted. If you’re biting hard on a crown tooth and it’s seated too high it can cause the tooth to ache even with a root canal. It’s important your bite be checked.

Did your dentist study your bite to see if the tooth needed adjustments? If not, have them check to see if it needs to be adjusted. If this isn’t the problem, it may be that you may grind or clench your teeth at night when you sleep and may not be aware of the issue.

Clenching and grinding can also cause teeth to hurt. Get your dentist to check and see if there are signs of grinding or clenching. If you have this issue, the dentist should create a night guard for you to protect your teeth and gums. There is a possibility the tooth has a crack within the root, however it is difficult to diagnosis. To confirm this, you will want to have a consultation with an endodontist who specializes in root canal treatments and would give you a better indication if the tooth actually has a crack or not. If your tooth has a crack, it would need to be extracted because there is no way to fix the tooth. If your tooth has to be removed, you have the option of getting a dental implant or dental bridge to replace your missing tooth.

Reasons why a root canal procedure may fail and cause discomfort:
■Sealers used to coat the filling material may wash out, creating a gap within the root canal, therefore causing infection
■If gaps are left at the base of the root and not filled properly, the tooth gets contaminated with bacteria which infects the tooth again
■If the tooth had multiple canals and exit points a spot may be missed and infection can set in
■If the root has small fractures the tooth may get contaminated with bacteria, causing infection which will lead to extraction
■If the tooth is not restored with a properly fitted dental crown then contamination may occur
■Inadequate cleaning, reshaping, or a lack of aseptic techniques of the root may cause root canal failure

As was mentioned before, there are multiple reasons why you’re having pain in your tooth. You should consult your dentist to determine if the bite is too high or to see if you have issues with grinding or clenching. These are two very common reasons for root canal pain. If your issue isn’t resolved, we advise you to see an endodentist who will inform you whether  the tooth is re-infected and needs to be retreated or if the root is cracked and the tooth needs extraction.

For more information about Dr. Noah, visit Region Dental.

How Long Can You Delay a Root Canal?

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I have a tooth that needs a root canal but I don’t feel any pain in the tooth. How long can my root canal be delayed before I get the procedure?
– Jonathan from Oklahoma

Jonathan,

It’s hard to estimate how long you can go without a root canal without seeing your tooth. If your tooth is causing you pain, you need to do the procedure right away. If your tooth hurts a little or hurt recently and the pain went away, you still need to have the root canal as soon as you can schedule it. Pain, past or present indicates an active infection that’s growing and when it comes to your teeth, the sooner you deal with it, the better.
If you notice a pimple in your gums or drainage in your mouth, the same applies. Active infections must be handled promptly. While it’s not an emergency, you want to schedule the procedure soon.

If your tooth hurt a long while ago, or never hurt at all, it may or may not be a problem to delay your procedure. Sometimes a tooth infection slowly eats away at the tooth root and will keep growing until the tooth is destroyed. If you are told the infection is latent and your tooth is fully intact with no active decay, you may be able to wait. Be sure you get expert advice.

This blog sponsored by Dr. Noah of Region Dental

Sensitive crowns

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I had six crowns put on last week. two of them are dryving me crazy!!! Theyre sensitive to everything. hot cold you name it. My dentist says to be patient, but I just think maybe he did something wrong. I got a second opinion. this doc thought “maybe” some of the dentin (?) was exposed. What do I do!!

Brent W. from Little Rock

Brent,

It is not uncommon to have sensitivity after having crowns placed. Sometimes it takes several weeks to get them to settle down. If the dentist wasn’t sure about the dentin, then I am prone to think there wasn’t an obvious problem. My suggestion would be to give it a few more weeks. However, the pain should be getting better, not worse. If things worsen, I would have your dentist double check to see why these two teeth aren’t healing. You may end up needing a root canal treatment.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.