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Medical Forum / General / Dentistry / May 2008saving a difficult tooth
tooth #3, I had a root canal last September. Leaving it as is for several months (bad idea, I know), I finally got fitted for a crown. The dentist found further decay (caries, I guess), and tried to clean it out. He said he "followed it", and drilled until faced with entering the root, which would mean losing the tooth. So he stopped there, getting 90% of the decay (his estimate). Then he capped it with some white filing, and now I have the crown. He said the filling and crown would hopefully deprive the bacteria of oxygen, preventing further decay. Anybody have any experience with such a situation? Prognosis? -- Rich > tooth #3, I had a root canal last September. > Leaving it as is for several months (bad idea, [quoted text clipped - 17 lines] > -- > Rich I'm not understanding why all the decay wasn't removed. Ordinarily, one might leave minimal caries at the base of a cavity preparation if it is thought removing the last bit of decay will expose the pulp. This is called an indirect pulp cap. But you've already had the root canal done. I can only guess--perhaps removing the decay would lead to a root perforation--perhaps in the furcation between the roots. If so, I wouldn't think the tooth would have a great prognosis. But I'm only guessing here--I'd have to see the tooth, and/or an x-ray. Steve > > tooth #3, I had a root canal last September. > > Leaving it as is for several months (bad idea, [quoted text clipped - 14 lines] > > Anybody have any experience with such > > a situation? > I'm not understanding why all the decay wasn't > removed. Ordinarily, one might leave minimal caries > at the base of a cavity preparation if it > is thought removing the last bit of decay will expose the > pulp. This is called an indirect pulp cap. I'm not sure, I can only report what he told me: drilling further - "following the decay" - would threaten the tooth. > But you've already had the root canal done. > I can only guess--perhaps removing the decay > would lead to a root perforation-- > perhaps in the furcation between the roots. If so, > I wouldn't think the tooth would > have a great prognosis. It's probably something like that. The prognosis is poor because of the decay left behind? The bacteria is anaerobic? The tooth will rot completely, even without oxygen? What is a furcation? > But I'm only guessing here-- > I'd have to see the tooth, and/or an x-ray. Of course, no one expects actual diagnosis when he comes here with such questions. What I'm looking for, is the spectrum of possibilities, given the data; A to C, or A to G, or A to N... Or, in some cases, there may be hesitation regarding the dentist's recommendation. Then, the question becomes whether his opinion seems plausible, under the described circumstances. If it sounds fishy, one might consider seeking a second opinion. Thank you for your time. -- Rich >>> tooth #3, I had a root canal last September. >>> Leaving it as is for several months (bad idea, [quoted text clipped - 34 lines] > anaerobic? The tooth will rot completely, > even without oxygen? Speculating now--either the decay would perforate the root, causing an infection, or the tooth is so compromised structurally that normal chewing forces have a significant chance of fracturing the restored tooth. In either of these cases, leaving the decay wouldn't seem to improve the prognosis--the tooth sounds questionable. > What is a furcation? Furcation is the separation between multiple roots--so that (for instance) a lower molar with typically 2 distinct roots, the bifurcation is that space below the crown where the two roots separate. >> But I'm only guessing here-- >> I'd have to see the tooth, and/or an x-ray. [quoted text clipped - 14 lines] > > Thank you for your time. Considering the investment of time and money you can make, I think a second opinion is almost always a good idea. Steve > -- > Rich  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 probably poor. Signature/ Amatus / > tooth #3, I had a root canal last September. > Leaving it as is for several months (bad idea, [quoted text clipped - 17 lines] > -- > Rich |
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