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Medical Forum / General / Dentistry / May 2009Do I really need a root canal?
I've written about this tooth before, and got some very helpful advice - so I'm back again with a new question. To recap, I've had a temp crown on #4 for a year now. It was crowned about 10 years ago, and my previous dentist broke the crown last May. At the time there were no indications of anything wrong on x-ray, and financial considerations led me to try to extend the life of the temp crown since then. (I was never able to find a dentist willing to do the stainless prefab crown that was previously suggested, and I called more than a dozen of them - so I am still in the same position as I was when I last posted). I've recently had a new x-ray of the tooth, and am told there is some dark area around the top end of the root as you look at the x-ray (don't know if that's the top of the root or the bottom). I have to be frank, I cannot see what they are telling me is a dark area, but I defer to their expertise. I am totally asymptomatic, but they tell me that I MUST have RCT before I get the new crown, since it will surely become symptomatic in the future, and thus would I would be wasting my money to crown it now without doing the RCT, only to have to do the RCT and get a new crown once it becomes symptomatic. I'll be paying for a second opinion soon, but do the dentists here have the same opinion? Do you ever see these dark areas never become symptomatic, or do they always eventually flare up and necessitate RCT? I'm hoping for the former, since the latter effectively doubles the expense I was already trying to delay for as long as possible. If I'm doomed (so to speak) anyway, is there any further damage I may do by just waiting until it flares up and I am forced to take care of it? Thanks once again for all the good advice you guys dish out. :-) Most dark areas at the tip of a root on an x-ray image indicate a tooth in need of RCT. Now way to tell about yours without seeing the image.  Signature/ Amatus / > I've written about this tooth before, and got some very helpful advice - > so I'm [quoted text clipped - 44 lines] > > Thanks once again for all the good advice you guys dish out. :-) >Most dark areas at the tip of a root on an x-ray image indicate a tooth in >need of RCT. Now way to tell about yours without seeing the image. I'm going to try to get a copy that I can post. In the meantime, what is actually going on with those dark areas? The term abscess was used, but I when I asked what that meant, why I felt no pain/symptoms, and whether it could ever clear up on its own, the dentist blew me off. (Searching for a new dentist this week). Thanks again. >> Most dark areas at the tip of a root on an x-ray image indicate a tooth in >> need of RCT. Now way to tell about yours without seeing the image. [quoted text clipped - 6 lines] > > Thanks again. It is not going to clear up on it's own. It may not become symptomatic (but certainly may), but the infection will not heal until the source (a dead, infected pulp) is removed, either by root canal or extraction. It should be treated, one way or the other. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >>> Most dark areas at the tip of a root on an x-ray image indicate a tooth in >>> need of RCT. Now way to tell about yours without seeing the image. [quoted text clipped - 13 lines] > >Steve Thanks, Steve. I didn't realize that it was an "infection." That's a surprise to me. Guess it's not a 'treat with an antibiotic" type infection. Bummer.....:-( You'd also recommend that I should not crown it unless I treat it first, right? Thanks again. >>>> Most dark areas at the tip of a root on an x-ray image indicate a tooth in >>>> need of RCT. Now way to tell about yours without seeing the image. [quoted text clipped - 19 lines] > > Thanks again. Correct. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 On May 4, 9:57 am, Mark & Steven Bornfeld <bornfeldm...@dentaltwins.com> wrote: > indig...@help.com wrote: > [quoted text clipped - 12 lines] > (but certainly may), but the infection will not heal until the source (a > dead, infected pulp) is removed, either by root canal or extraction. Does the ADA agree that an extraction will remove infection? Also could someone answer me why fillings lose weight? I say it's because they lose mercury?? what say the ADA? > On May 4, 9:57 am, Mark & Steven Bornfeld > <bornfeldm...@dentaltwins.com> wrote: [quoted text clipped - 16 lines] > they lose mercury?? > what say the ADA? Hi, Clinton--hope you're doing OK. Steve abscess = infection (that took me years to learn). I'm with you. Find a dentist who explains things so you can understand. SignatureChristopher A. Young Learn more about Jesus www.lds.org . On Sun, 3 May 2009 19:38:47 -0400, "Amatus Cremona" <Nicola@sottovocce.com> wrote: >Most dark areas at the tip of a root on an x-ray image >indicate a tooth in >need of RCT. Now way to tell about yours without seeing >the image. I'm going to try to get a copy that I can post. In the meantime, what is actually going on with those dark areas? The term abscess was used, but I when I asked what that meant, why I felt no pain/symptoms, and whether it could ever clear up on its own, the dentist blew me off. (Searching for a new dentist this week). Thanks again. On Tue, 5 May 2009 08:01:14 -0400, "Stormin Mormon" >Learn more about Jesus > www.lds.org Hey, we just wrote a new bible: http://www.reimbibel.de But only for the courageous... ;O) SignatureDIE ERSTE REIMBIBEL SEIT DEM MITTELALTER http://www.reimbibel.de Dear Indigent Person, Your particular case could be anything in the whole world. It might be cancer, it might be a genetic defect, it might be normal anatomy, it might be an infection, it might be the result of gangrene inside the tooth pulp, it might be imaginary. Without an image, I cannot guess. Without seeing you in person, I cannot offer a diagnosis. Assuming we are dealing the a dead pulp (the most common cause of dark areas at the root tip), then it will only respond to either RCT or extraction. The pulp dies from a lack of blood flow into the tooth (many possible reasons). Without blood flow, you cannot get any white blood cells into the tooth to attack the dead tissue. Without blood flow, you cannot get any antibiotic into the tooth if there is an infection. You will have to trust someone at some point. Signature/ Amatus / > > On Sun, 3 May 2009 19:38:47 -0400, "Amatus Cremona" [quoted text clipped - 14 lines] > > Thanks again. >Most dark areas at the tip of a root on an x-ray image indicate a tooth in >need of RCT. Now way to tell about yours without seeing the image. Agreed. >Most dark areas at the tip of a root on an x-ray image indicate a tooth in >need of RCT. Now way to tell about yours without seeing the image. Here is an image of the tooth: http://img223.imageshack.us/img223/9216/77958859.jpg Thanks again for your help. >> Most dark areas at the tip of a root on an x-ray image indicate a tooth in >> need of RCT. Now way to tell about yours without seeing the image. [quoted text clipped - 4 lines] > > Thanks again for your help. The tooth definitely needs a root canal. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >>> Most dark areas at the tip of a root on an x-ray image indicate a tooth in >>> need of RCT. Now way to tell about yours without seeing the image. [quoted text clipped - 8 lines] > >Steve Thank you, Steve. I just came back from meeting a new guy, and I now have a huge man-crush. :-) He took his own x-ray, spent lots of time with me, explained everything in detail in a very relaxed manner, and answered every question I had. I couldn't have asked for more, really. But (there's always a but, right?) he doesn't do root canals (he's a prosthodontist) and he's expensive (at least for me). His charge for the crown and post/core is about $2050, but he's going to give me a discount down to about $1550, and the RTC with an endo he recommended will be about $1000. Those (discounted) prices are apparently the norm here in South Florida for those procedures, as I had already called around and priced the procedures with a number of local practitioners not using insurance. I'm now confident I've been given the correct diagnosis, so I'm off to sell a kidney. Once I recover I'll be ready for treatment. :-) Thanks to you and the gang for all of the help. Just curious, and I'm not a dentist. I did see the tooth minus the crown (easy call). And some dark area where the root would be. Does the dark area indicate dead tissue? I promise not to take up dentistry. But, I do enjoy learning. SignatureChristopher A. Young Learn more about Jesus www.lds.org . > http://img223.imageshack.us/img223/9216/77958859.jpg > > Thanks again for your help. The tooth definitely needs a root canal. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Just curious, and I'm not a dentist. I did see the tooth > minus the crown (easy call). And some dark area where the > root would be. Does the dark area indicate dead tissue? I > promise not to take up dentistry. But, I do enjoy learning. You can't see the dead tissue on x-ray. What you can see is a diffuse somewhat darker area surrounding the tip of the root. This darkness is caused by destruction of the bone overlying the tip of the root, where the infection and it's metabolic byproducts have exited the root into the bone. Steve Hmmm. After reading your reply three times, it does barely begin to make sense. Of course, I don't have the medical training. Glad you understand such things. And willing to share your understanding. SignatureChristopher A. Young Learn more about Jesus www.lds.org . Stormin Mormon wrote: > Just curious, and I'm not a dentist. I did see the tooth > minus the crown (easy call). And some dark area where the > root would be. Does the dark area indicate dead tissue? I > promise not to take up dentistry. But, I do enjoy > learning. You can't see the dead tissue on x-ray. What you can see is a diffuse somewhat darker area surrounding the tip of the root. This darkness is caused by destruction of the bone overlying the tip of the root, where the infection and it's metabolic byproducts have exited the root into the bone. Steve >>Most dark areas at the tip of a root on an x-ray image indicate a tooth in >>need of RCT. Now way to tell about yours without seeing the image. [quoted text clipped - 4 lines] > >Thanks again for your help. Dude, that tooth needs RCT or Ext ! Look People drive fast on bald tires! If there are changes in the xray at the tip of the root, it is a bad sign. A good temp crown on the tooth can buy you time, but it has to be a good one and you cannot chew on it! If you make a new perm crown and later on you need to do the root canal tx, you may need to have a new crown made again. Charles Friedman DDS >I've written about this tooth before, and got some very helpful advice - so I'm >back again with a new question. [quoted text clipped - 25 lines] > >Thanks once again for all the good advice you guys dish out. :-) |
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