Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Worried About My Tooth

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I had an bit of a fall that resulted in losing about 1/3 of a front tooth. Even the nerve was exposed. I was visiting a friend in a different state at the time. She took me to her dentist who did a root canal treatment. When I got home my dentist checked out the work and said that everything looked good and he put a crown on the tooth, which the last dentist did not do.

Fast forward a year and the crowned tooth became very sensitive to both hot and cold. After a few months, the tooth gradually calmed down, but was still a little sensitive for cold. I’d finally saved up enough to go in and the dentist did an x-ray and exam but could not find anything wrong with the tooth. He decided I needed to see a specialist and sent me to an endodontist.

This specialist did not see anything wrong with the tooth either and thought maybe the problem was me clenching my teeth which could cause pain. He felt I was feeling pain on the tooth next to it. Nothing is being done and I’m worried I can lose this tooth. Have you heard of a situation like this?

Evelyn

Dear Evelyn,

blonde woman holding the side of her jaw in need of an emergency dentist

I’m more puzzled with why neither your dentist or specialist can figure this out than I am about your tooth. First, if I understand what you said correctly, then you had a root canal treatment on a front tooth that removed the nerve. It was also checked by another dentist. In that case, that tooth cannot be the one having sensitivity to hot or cold because it should not have feeling. That doesn’t mean you are not feeling pain, just that it is referred pain, which means coming from a different tooth.

Second, not seeing anything on the x-ray does not surprise me because it would be inflamed. Until it blows up into an infection, there would not be anything to see.

Third, you had a traumatic injury to a front tooth that was rather significant. It is very unlikely that the tooth next to it was not impacted even though it did not lose any structure. Often when a tooth experiences trauma, the damage from that is slow to become obvious. It is not uncommon at all for it to be fine for a few years and then blow up.

I do not think you have a dental emergency on your hands. Because you are not having pain now it either means the tooth has recovered or the adjacent tooth is dying. My suggestion is that you leave it, but have an x-ray at your next check up and then every few years after that. If the tissue does die, then it will mean another root canal treatment on the adjacent tooth.

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

Dentist Advertised as Affordable to Practice on Patients

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I’m a little worried. Part of me is like, “This is my own fault”, and the other part of me thinks the dentist should have done better. I needed a dental crown, but had been putting it off because of the cost. Fast forward to last week. I received an ad by email about a local dentist. He’d just invested in some crown machine and wanted to get some extra practice on it so he was running a special on dental crowns. It sounded like an inexpensive way to get my crown so I jumped on it. First, the appointment took FOREVER. I was in the chair for more than half the day. I would say close to five hours. He kept going back and working on it. I’m a few days past this treatment and my tooth is super sore. Is this normal or could the “affordable” dentist have damaged the tooth?

Laura

Dear Laura,

porcelain crown being placed on prepared tooth
A cheap crown and an affordable crown aren’t the same thing.

There are three possibilities going on here. The first is normal soreness. Your tooth was messed with for quite some time. It’s normal for the tissue around it to be worn out from that and a little swollen. Take some ibuprofen and give it a couple of days. If the swelling and soreness hasn’t gone down then it is time to be seen again.

That leads me to the two other possibilities:

  • You could have an infection.
  • You could have some tooth trauma.

When Affordable Dental Care Goes Wrong

We’ll start with the infection, because it wouldn’t be the dentist’s fault. You mentioned you’d needed a dental crown but put it off because of cost. It is quite likely your decay spread during your procrastination. This could mean it reached the pulp. If that happened, you now have an infection and need a root canal treatment.

You won’t want to put this off because it is considered a dental emergency. The infection will spread, causing wide spread problems and increasing the cost of repairs significantly. The sooner this is looked at, the better.

The final possibility is the tooth suffered some trauma during the extended procedure. It would be hard to prove, if this were the case, but an honest dentist would want to know and fix any problems he or she caused.

Going into it, this dentist was upfront with you that he was practicing. Whenever someone is new to a procedure or method, it does take them longer. Muscle memory takes time to develop.

If you run into this situation again where you need work but don’t have money, look up affordable dentists on the internet. Many of them will be willing to do the work right away but work with you on payment plan options.

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