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Medical Forum / General / Dentistry / February 2005

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Chances of saving a tooth under these circumistances?

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Lisa75 - 13 Feb 2005 21:55 GMT
Hello,
I really appreciate your thorough consideration,
I'm sure many have likely encountered these situations before,

what do you think the prognosis of saving a broken
tooth, (which has caused an abscess)
would be under these situation ..

(if the patient chooses not to extract the tooth, then I guess
,certainly , a root-canal / pulpectomy is to be done soon
to prevent a recurring abscess ..)

Now, if the patient is very hopeful to save the tooth
(by doing a root canal then filling / full crown ...etc)
AND:
1-If the tooth is loose. How good the prognosis would be?
(patient believes it's loose only because of the abscess that has just
happened, it wasn't loose before)
(a retired dentist told me a loose tooth becomes loose
sometimes because of abscess itself and might return as a firm tooth..
not always of course)

2-if the tooth is calcified. ( I mean if there is a barrier of
the calcium compound around the nerve ..
if it's calcified so much, to the degree, that regular
dentist wouldn't do pulpectomy himself but rather
prefer to forward the patient to an
endodontist to do the pulpectomy / or root-canal.

3-if the tooth is calcified and brittle (good dehydration
of the tooth has been missing for (6 months to 1 year),
many call this a "dead tooth"
what would the prognosis of saving the tooth be?

4-if the tooth is loose AND calcified?
What would the prognosis of saving the tooth be?

If you are a DDS or endodontist would you just tell
the patient not to bother, and just to extract the tooth
to save time, stress ... or is it worth it to keep hoping and to try?
(assume the patient is not a millionare :) )
I'm not asking for a golden rule, just your advice,
thank you very much
Joel M. Eichen - 13 Feb 2005 22:25 GMT
>Hello,
>I really appreciate your thorough consideration,
[quoted text clipped - 3 lines]
>tooth, (which has caused an abscess)
>would be under these situation ..

Hi Leeees.

>(if the patient chooses not to extract the tooth, then I guess
>,certainly , a root-canal / pulpectomy is to be done soon
[quoted text clipped - 3 lines]
>(by doing a root canal then filling / full crown ...etc)
>AND:

>1-If the tooth is loose. How good the prognosis would be?

What does the x-ray look like?

All abscessed teeth will become loose. That's the physiology of the
body. In fact, if the tooth does not become loose, the pain remains
excrutiating as there is no where for the bacteria to expand.

This is why when the tooth and gums swell, the patient reports, "NO
PAIN."

>(patient believes it's loose only because of the abscess that has just
>happened, it wasn't loose before)

YUP, see above.

>(a retired dentist told me a loose tooth becomes loose
>sometimes because of abscess itself and might return as a firm tooth..
>not always of course)

YUP.

What is the retired dentist's initials? If its JE, then he is a wise
dentist.

>2-if the tooth is calcified. ( I mean if there is a barrier of
>the calcium compound around the nerve ..
>if it's calcified so much, to the degree, that regular
>dentist wouldn't do pulpectomy himself but rather
>prefer to forward the patient to an
>endodontist to do the pulpectomy / or root-canal.

YUP.

>3-if the tooth is calcified and brittle (good dehydration
>of the tooth has been missing for (6 months to 1 year),
[quoted text clipped - 3 lines]
>4-if the tooth is loose AND calcified?
>What would the prognosis of saving the tooth be?

Still excellent.

The biggie to worry about is the entire tooth cracking off. What does
the restorative challenge look like?

Joel

(JE)

>If you are a DDS or endodontist would you just tell
>the patient not to bother, and just to extract the tooth
>to save time, stress ... or is it worth it to keep hoping and to try?

Depends ,,, on the patient, the tooth, and the expectations!

THE ART of dentistry!

>(assume the patient is not a millionare :) )
>I'm not asking for a golden rule, just your advice,
>thank you very much

Millionaire or no, an implant is often equal to the cost of root
canal, post, crown, crown lengthening, and that's BEFORE it cracks!

So please make a well-measured decision!

Joel
 
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