Cracked tooth long after root canal
Added: October 20, 2008 - 2:29 PM
By: Patient Email Withheld, Downers Grove, IL
Need Dentist / Specialist:
Yes
Provide Cost Estimate:
Yes
X-rays Available:
No
Case Summary
Root Canal
Broken Tooth
Bridge
Teeth: 29
Last Full Mouth X-Ray: 2 years ago
Last Cleaning: about a year ago
Case Description
I have a pea size spot on the tongue side of tooth #29. This tooth had a root canal done at least 24 years ago and has been an anchor tooth for the bridge for at least 23 years. (this was done in a dental school). The bridge needed to be replaced about 2 years ago. Most recently it was replaced again because the porcelain was chipping off. (this time I went back to yellow gold). This time, the dentist "took a little off the top" of the stub because he said that it would be easier to fit. He did this at the same time that he packed the cord and took the impressions. I had horrible pain from starting when I got home. It hurt to chew. I did find a small piece of the cord two days later when I was flossing. It took about a month for the new bridge to come in. All the while, I was in pain while chewing but the dentist couldn't find anything. Shortly before the new bridge was installed, I developed a pea size white bump on the tongue side of this tooth. X-rays didn't show anything but the dentist now suspects that the tooth is now cracked. What would cause this to happen so many years after the root canal and no pain until recently? Would this show on a X-ray? How is a crack diagnosed if it doesn't show on X-ray? What is the procedure to fix this if it is a crack? Is the new bridge now useless?
I'm sorry that I have so many questions but I've paid over $3,000 for the bridge without insurance and the thought of having to fix this is making me sick. I would appreciate any suggestions on who I should be calling to have this looked at. Do you have any idea what the cost will be? What will happen if I do nothing since it's not causing any pain?
Thanks
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Reply: Cracked tooth long after root canal
added: October 20, 2008 - 7:32 PM
Cost Estimate: $ No Estimate at this time. Additional information required.
I am sorry to hear about your situation. I am glad that you are not in pain. Sometimes, once a tooth receives a root canal, it can develope another cavity that weakens the tooth. If the tooth becomes weak enough, even chewing on soft bread could be enough to fracture it. As for being able to tell you for sure what is going on, I cannot. I would need to evaluate you clinically and radiographically in order to give you your best chance of a diagnosis or prognosis on your tooth. If the tooth is fractured and cannot be saved, you may need an extraction. Again, I am sorry about your troubles and would welcome you to call my office for an appointment.
Reply: Cracked tooth long after root canal
added: October 20, 2008 - 8:32 PM
Cost Estimate: $ No Estimate at this time. Additional information required.
Dear Patient,I understand your frustration. At the same time do realize that for a tooth that has had a root canal at least 24 years ago, it has provided you a very good amount time of service. Based on the symptoms, you most likely do have a cracked root. This type of diagnosis is difficult, due to most of the time not being visible on the x-rays. The symptoms that you have; sinus tract (draining infection) / bump on the gum, pain with chewing are cardinal signs. It is also difficult to diagnose when it happened; this crack may have began as a microfracture while you had your former bridge.If a tooth has a crack, its prognosis / outlook is poor, and needs to be extracted. This problem needs to be addressed because infection causes loss of bone and can spread. Treatment options to replace your missing teeth are 1. dental implants, 2. a new bridge, or 3. removable prosthesis. What is considered the best standard of care, provided you are a good candidate, are dental implants because they can last a lifetime, preserve your bone and look and feel like your own teeth. Oral conditions and dental needs vary, therefore treatment recommendations should be tailored. Decision regarding what would be the best treatment for you should be based on a thorough clinical and x-ray evaluation of the current condition of your teeth and bone, and in addition consideration of what you desire and need to achieve in dental care. Sincerely, Dorothy Anasinski, D.D.S
Reply: Cracked tooth long after root canal
added: October 21, 2008 - 7:39 AM
Cost Estimate: $ No Estimate at this time. Additional information required.
The key words here is "the dentist now suspects that the tooth is cracked". the "crack diagnosis is sometimes used when the DDS has not other explanation for your symptoms. simply put your tooth might not be cracked. Sorry to be short but I thought you should be aware of this fact. Who ever you choose should be experienced with;-root canal therapy- root canal may be corrected at the tip of the tooth/-surgery- you can access the tooth to eval if there is a crack/-Laser therapy- can assist repair/-implant therapy- both placement and Restoration/-*****Occlusion****- your new bridge and temp could be at a differnent height and all of your troubles could be originating from this fact./please check out our website and review our services. I can promide years of experience with all of the above dental skills 20+ years.This is toooooo hard for you to understand and is often misdiagnosed. We just saved two teeth which were mis-diagnosed for extractions by two dentists and one endodontist.Hope this helpsDr Kevin Landers
Reply: Cracked tooth long after root canal
added: October 22, 2008 - 1:11 PM
Cost Estimate: $ No Estimate at this time. Additional information required.
Thank you for your email. From your description, it sounds like you have developed an infection around #29 and it is draining through the little bump you described. Your dentist is correct, it may be a cracked tooth. It may also be that the old root canal filling is leaking and needs to be replaced. Depending on the situation, we will usually try to retreat the root canal and see if that resolves the situation. If not, you may need the tooth extracted and a new bridge or have implants placed. It sounds like a frustrating situation for you but not too unusual given the circumstances and how many years ago the original root canal was done. Let us know if you have questions. Mark Morris DMD
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