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Archives for December 2020

His Dentist Does Not Understand Tooth Infections

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I had a root canal treatment a couple of years ago that started hurting. I am not fond of the dentist under the best of circumstances, but I eventually went to the dentist as it became too hard to bear. He did an x-ray and said there is a new infection and did a re-treatment along with an antibiotic. I started to feel better but then a few days ago it started to hurt again. I called the office and my dentist said it takes some people longer to get better than others. It’s been almost two weeks now. What is the longest it should take me to get better?

Paul

Dear Paul,

A woman grabbing her face in pain.

TMJ Disorder can cause a lot of pain

I’m not sure if the dentist you are seeing understands how tooth infections work. It sounded like you said this started to feel better and then began to get worse again. That is a particularly bad sign and means that your tooth infection has flared back up. That is serious and I would consider it a dental emergency.

I’d like you to see a root canal specialist this time. You should be aware that when a root canal treatment fails, the re-treatment will only be successful between 50-75% of the time. It sounds like your second one failed. This will continue to spread until it is treated properly. If the infection cannot be resolved, the only other option is to extract the tooth and replace it.

Please don’t put this off. When you call to schedule your appointment, let them know you are on the wrong antibiotic so they can call in a stronger prescription.

A Word about Dental Anxiety

You mentioned that you are not typically comfortable at the dentist. I want you to know that there are dentists who are especially compassionate with anxious patients and can help you. Not only do they have techniques to put patients at ease, but many of them offer medication that can completely relax you. Most of them will advertise as a sedation dentist. I’d like you to look for one who offers oral conscious sedation. This is administered by a pill. However, it is so strong you will need someone to drive you to and from your appointment.

This blog is brought to you by West Seneca Dentist Dr. Warren Krutchick.

Why Do I Need Root Canals After My Smile Makeover?

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I had ten veneer crowns done on my top teeth and several on the bottom. Since then, I’ve had to have five root canal treatments on those teeth. When I first agreed to this my dentist told me there are no risks with a smile makeover. Since then, it has been a nightmare. I asked him about all these teeth needing root canals and he told me this is a fluke and rarely happens and he doesn’t know why my teeth are responding this way. He has agreed to pay half of the root canal treatment costs. I am worried this will continue to be a problem and one by one a new tooth will “go”. Have you seen this before? What do you recommend I do?

Madison

Dear Madison,

I am curious about the fact that you called them veneer crowns. Do you know if you received porcelain veneers or porcelain crowns? They are two completely different procedures. My big concern here is that you thought you were getting a smile makeover with porcelain veneers, but ended up with porcelain crowns.

teeth prepped for porcelain veneers
With porcelain veneers, hardly any tooth structure needs to be removed. It’s usually about the depth of a fingernail. Then the porcelain is bonded over the prepared teeth. These rarely, if ever have any problems like you are describing. My concern is that isn’t what you’ve received.

teeth prepped for porcelain crowns
Porcelain crowns, on the other hand, require the teeth to be ground down more. In many cases, they are ground down to little nubs. Some dentists are overly aggressive with this tooth preparation. This can lead to pulp exposure and tooth infection like you are describing. Sometimes, if you have significant decay, a large amount of preparation is necessary. That is not the case, however, with smile makeovers.

In that case, I think your dentist should take responsibility for the damage he’s done to your teeth. It also seems like you weren’t told any of these risks upfront, which means he is even more in the wrong here.

Smile makeovers aren’t taught in dental school and many dentists don’t know how to do porcelain veneers. Because of that, they’ll point their patients in the direction of crowns, which they do know how to make from an engineering standpoint. However, without the cosmetic training on the aesthetic side of things, they rarely end up looking good. Whenever someone wants a smile makeover, I always emphasize how important it is they see an expert; someone who has invested a great deal of time in post-doctoral training. If you ever decide to have this makeover redone, I would suggest you go to mynewsmile.com and choose one of the dentists recommended on their site. They are among the top cosmetic dentists in the country.

You’ll have to have the root canal treatments in order to save the teeth. I’m sorry this happened to you. Again, I would tell your dentist he needs to cover the entire cost of the root canal treatments.

This blog is brought to you by West Seneca Dentist Dr. Warren Krutchick.