root canal Archives - 5 Star Dental Group

Do I Need a Repeat Root Canal for an Abscess?

Posted on March 12, 2024 by AllSmiles.

The temporary filling fell out of my upper left canine tooth, which developed an abscess. My dentist said I needed another root canal to get rid of the abscess. If the abscess is not painful, why can’t I take more antibiotics to get rid of it? Do I really need another root canal? Thanks. Warren from MI

Warren,

Yes, you need another root canal to remove the abscess.

Can Antibiotics Remove a Tooth Abscess?

Antibiotics can fight an infection in your bloodstream. However, they cannot remove a tooth infection because there is no blood circulation inside the tooth. Although antibiotics can temporarily remove the abscess from your gum and bone, it will return when you stop taking the medication. A cycle of taking antibiotics increases your risk of breeding antibiotic-resistant bacteria in your body.

Infections of the jawbone, particularly the upper jaw, are risky because they can spread to the eye or the brain. Also, oral bacteria in a tooth promote decay from the inside out. If left untreated, a tooth will be unrestorable.

How Does an Abscess Develop in a Root Canal Tooth?

If a temporary filling falls out of a root canal tooth, bacteria from saliva can get into the tooth. Saliva can break down the seal of the root canal, reinfecting the tooth. After root canal treatment, a dentist must seal the tooth root with a filling material and cement and protect the seal with a temporary filling.

Five-step diagram of root canal treatment: accessing tooth, from removing the infection to filling and sealing the tooth

Root canal treatment removes tooth infection

After placing the temporary filling, your dentist should schedule your final restoration with a dental crown or permanent filling. Temporary fillings are easy to take off and not made to last long, so if you don’t get a final restoration promptly, it can fall out, leading to reinfection.

We encourage you to schedule an appointment for repeat root canal treatment and promptly get a crown or permanent filling according to your dentist’s recommendations.

San Antonio dentists Dr. Gilberto Tostado and Dr. Karina Acuña sponsor this post. Read about what they do to provide patients with some of the best dental care in San Antonio.

Why Do I Need Root Canals If I Floss and Brush Daily?

Posted on November 30, 2023 by AllSmiles.

Although I floss and brush my teeth daily, I still need root canals on two teeth. I’m frustrated because my dentist started my Invisalign treatment 2 months ago. And now I’m having problems with my teeth. One tooth had a filling that failed, and the other tooth had a crown on it. Both teeth were getting sensitive. My dentist and I decided to do the root canals, let my teeth relax, and resume Invisalign. I’m worried about my teeth because I’m only 31 years old. I also grind my teeth at night. But I don’t want to go through orthodontic treatment, spend thousands of dollars on it, and still need extractions because I have bad teeth. – Chelsea

Chelsea,

Why Do You Need Root Canals If You Floss and Brush Daily?

You may still need root canal treatment even if you floss and brush daily if your teeth are weak or sensitive. For example, grinding your teeth stresses them and can make them sensitive.

According to the Nation Institute of Craniofacial Research, bruxism or teeth grinding affects teeth in the following ways:

Creates cracks or chips
Causes pain or sensitivity
Loosens teeth
Wears away tooth enamel

Other factors that can weaken teeth include:

Binge eating
Excessive alcohol use
Nail biting
Smoking
Sugary foods and drinks

Dental implant

It’s worth interrupting Invisalign treatment to take care of your teeth. Otherwise, pressure from the aligners moving your teeth can cause more irritation. Without treatment, a tooth infection will progress, so it’s best to treat it immediately to avoid losing the tooth and needing dental implants.

Successful root canal treatment lasts a lifetime. You don’t need to worry about losing teeth and wasting money on orthodontic treatment. Proper tooth alignment promotes better oral health.

Our advice is that you continue to receive good dental care. It sounds like your dentist is concerned about your oral health. Let her follow through with root canal treatment and stabilize your oral health. You can resume Invisalign with healthy teeth.

Should I Request an Implant Denture Or a Bridge?

Posted on May 15, 2023 by AllSmiles.

Should I request an implant denture over root canals and a bridge? I have a four-piece bridge for two missing teeth, both my right and left center teeth. Both teeth have posts, but the post in the right central incisor broke, and the other behind it needs a root canal. I am concerned that my teeth are too fragile for another bridge. When I saw a dentist two weeks ago, she mentioned that she would watch three other teeth that may need root canals soon. I am so tired of patchwork teeth. I can’t afford to replace the bad teeth with a dental implant, but with so many teeth that need repair and missing second molars, is an implant denture the most logical option for me? The dentist didn’t mention a denture, but I am tired of my teeth and smile. Thank you. Floritzell from Miami

Floritzell,

Thank you for contacting Five Star Dental Group of San Antonio regarding an implant denture. Dr. Tostado or Dr. Acuña must examine and x-ray your teeth to evaluate their condition and recommend treatment. But we will provide general guidelines.

What Is the Treatment for a Broken Tooth Post?

Treatment for a broken tooth post depends on the condition of the tooth. Below are a few factors to consider:

Location of the break – A post that breaks at the gumline limits the techniques a dentist can use to remove it.
Tooth structure – If dentists lack clear access to a post, they may drill away tooth structure around it. The tooth will be smaller and weaker, making replacing the post with a new one difficult.
Existing restorations – When a post tooth is part of a dental bridge, the dentist must remove the bridge to access the tooth.

Should You Request an Implant Denture or a Bridge?

Upper implant denture with natural-looking teeth, available in San Antonio from Gilberto Tosatdo, DMD

Upper implant overdenture

Preserving healthy natural teeth is preferred to removing your remaining teeth and replacing your dental bridge with an implant denture. Factors to consider include:

How many upper teeth you have left
The condition of your teeth
Your oral health and function
Whether your teeth can support another dental bridge
Whether you qualify for dental implants to support a denture

A dentist may recommend replacing your dental bridge with individual implants.

Request an Implant Overdenture Consultation

If you are interested in an implant overdenture, consult with a prosthodontist (a specialist in tooth restoration and replacement). After a comprehensive exam, x-rays, and a 3-D CT scan, the dentist will explain your options for restoring your teeth and smile.

San Antonio dentists Dr. Gilberto Tostado and Dr. Karina Acuña sponsor this post.

Dental Practice Did the Wrong Treatment. Can I Get a Refund?

Posted on March 11, 2022 by AllSmiles.

I’ve been a patient at a large dental chain for the past four years. Depending on my circumstances, I’ve had work done at two locations – one close to home and the other near work. When I recently visited the office near my house, the dentist asked me who placed fillings on two molar teeth because they looked deteriorated on my x-rays. She said that I probably needed root canal treatment and crowns.

After I told the dentist that I received the fillings at the same practice to replace old silver fillings with white ones, she was silent for a few seconds. She explained that if I didn’t get root canals and new crowns, an infection would worsen the situation.

I got a second opinion at a dental practice that is not a chain. The dentist confirmed that I need root canal treatment and crowns. I’m not sure why the chain dental practice didn’t recognize that before wasting my money on fillings. How can I get a refund before leaving this practice? Thank you. Gerard from Memphis

Gerard,

Thank you for contacting us. We are sorry to hear about your experience. Placing composite fillings takes more skill and time than placing silver fillings. But composite fillings are healthier for teeth, and when completed correctly by a cosmetic dentist, the fillings preserve tooth structure and seal out bacteria. But if you needed crowns instead of fillings, a dentist misjudged the condition of your teeth.

We recommend getting another second opinion to confirm that you need root canal treatment and dental crowns. Ask for a copy of your dental records from the chain dental practice.

Also, be upfront about getting another second opinion. If you want to get the work done from the first dentist from whom you received a second opinion, explain that you’re upset about the confusion. Also, ask if they will help you get a refund from the chain for placing defective composite fillings or placing them when you need crowns.

After your new second opinion, if the dentist agrees that you need root canal treatment and crowns, ask your new dentist to call the dentist who placed the fillings. Your dentist should explain:

You received two independent second opinions
Both dentists confirm that you need root canal treatment and crowns.
You want a refund.

If the dentist from the chain dental practice doesn’t want to issue a refund, you can do three things:

Explain that you will post online reviews on social media and any review platforms the practice uses.
Tell the dentist that you will file a complaint with the state dental board.
Explain that you will speak with an attorney, although you probably don’t have a big malpractice case.

Although we can’t guarantee that the dentist will refund you, you can try.

Large dental practices usually have high overhead costs and are driven to be profitable. They often hire many dentists who come and go. Depending on which day of the week you have an appointment, you may receive care from multiple dentists. It can be challenging to establish a relationship with one dentist you trust. But all large practices are not the same. Some consistently offer high-quality care.

Generally, dentists at smaller practices have a higher level of care, ethics, and professionalism. We hope your new dentist will restore your teeth well and help you regain good oral health and a great smile.

San Antonio prosthodontist and cosmetic dentist Dr. Gilberto Tostado sponsors this post.

Why Are My Crowns Are Sensitive to Heat?

Posted on January 6, 2022 by AllSmiles.

I have implant crowns and three crowns on my natural teeth. The crowns on my natural teeth are more than 20 years old. The crowns are on my left front tooth and the two teeth behind them. Two of the teeth are sensitive to heat. Maybe I notice it more now that the weather is cooler, and I have been eating more soup and drinking more tea. The pain is increasing. My dentist is from Portugal and is out of the country on holiday until February 12. He takes the trip yearly. Is this something that can wait, or should I see another dentist? – Thank you. Nathan from Austin, TX

Nathan,

Sudden pain and sensitivity to heat are symptoms of a dying tooth. Your sensitive teeth are infected. As the tissue inside the tooth swells, it releases gasses. When the tooth is exposed to hot temperatures, the pressure increases, and so does your pain.

What Causes an Infection Beneath Dental Crowns?

Decay beneath your crowns or exposed root surfaces might be the cause of irritation and infection in your teeth.

A dentist needs to remove your crowns to examine your teeth and see their condition. Afterward, root canal treatment will remove the dead pulp. And a dentist can replace the pulp with a filler material. And you will need new crowns. Ask the dentist to check the remaining old crown on the third tooth, too. Beneath the crown, your tooth may be irritated and at risk for infection like the others.

How Long Does a Dental Implant Take?

Getting a dental implant from start to finish takes three to nine months. The process takes time because of several phases. Depending on your situation, you can expect several steps:

Initial consultation – Your dentist or oral surgeon will complete an exam and a 3-D x-ray to ensure you are a candidate for implants.
Tooth removal – Surgically removing your teeth takes about 30 minutes unless there are complications.
Implant surgery – Inserting implants through your gum and jawbone takes one to two hours per implant.
Healing – You will wait three to four months while the implant and bone fuse.
Periodic checkups – Your surgeon or dentist will check the surgical sites for proper healing during the healing process.
Final crown – After the healing period, your dentist will take images of your mouth for a lab to make the final implant crowns. Your dentist will attach crowns to the implants.

Dental implant and crown

San Antonio dentist, Gilbert Tostado, DDS sponsors this post.

Will root canal treatment damage my porcelain veneers?

Posted on February 4, 2021 by AllSmiles.

Two of my eight porcelain veneers have a periapical abscess. I thought I had a sinus infection, but my teeth are causing the problem. My dentist referred me to an endodontist for root canals. I am concerned about losing the veneers or having them turn dark. I know the endodontist is a root canal specialist who will focus on the infection—not how my veneers look afterward—but I must get the condition under control. What do you suggest for my veneers? – Thank you. Genesis

Genesis,

Thank you for your inquiry. It is good that you recognize the need to remove the infection and resolve the periapical abscess (pus-filled sac at the tooth root). Otherwise, it will remain in your bone and spread. We are concerned about what led to needing root canal treatment after getting porcelain veneers—and for two teeth.

Porcelain veneer preparation and root canal treatment

It is unusual to require root canal treatment after you receive porcelain veneers. Skilled cosmetic dentists conservatively prepare teeth for porcelain veneers—removing a half millimeter or less of your tooth enamel. With this approach, infection and root canal treatment are extremely rare. But if a dentist aggressively prepares teeth and removes all the enamel, a stub is left. And the dentin (layer beneath the enamel) is exposed.

Some dentists prepare teeth and place full crowns, calling them porcelain veneers instead. Aggressive preparation increases the risk of tooth stress, irritation, and infection that results in the need for root canal treatment. We hope that aggressive tooth preparation is not the cause of infection in your teeth.

Root canal treatment for teeth with porcelain veneers

Before and after porcelain veneers photos from San Antonio dentist Gilberto Tostado

A skilled cosmetic dentist understands how to work with porcelain veneers and conceal dark teeth beneath them. Photos above courtesy of Gilberto Tostado, DDS

A tooth turns dark after root canal treatment, and darkness will show through your veneers, which have some translucence. But most tooth darkening comes from root canal filling material and cement that a dentist leaves in your tooth. But your endodontist and a family dentist will not know that.

A cosmetic dentist takes these steps to retain the color of your veneers:

Clean out root canal filling materials and cement from the tooth
Place a flexible, white fiberglass post deep into the root
Fill the space with light-colored composite

The results can last five to ten years. And if your dentist placed your veneers correctly, you should not lose them.

If you have any hesitancy about your dentist’s ability to resolve the color issue with your porcelain veneers, you can visit a skilled cosmetic dentist to discuss your options.

Gilberto Tostado, DDS of San Antonio, TX, sponsors this post.

I needed a root canal but my dentist overlooked it

Posted on October 8, 2020 by AllSmiles.

In August, my dentist put a crown over one of my upper right molars. The tooth was cracked and had an old silver filling in. The dentist had problems getting my tooth numb, so it felt like electric shocks when she was drilling.

When the dentist checked my bite with my crown, I told her that it was uncomfortable and hurt to bite down. She adjusted the crown twice while I was there. And when I still wasn’t happy with it, she told me to give it a couple of weeks. It hurt to floss around the crown. I gave it a couple of weeks, and nothing improved. In mid-October, I called the office again, complained, and insisted on a new crown. My dentist adjusted the crown instead and started talking about two more crowns that I needed.

I declined getting two more crowns until I knew that the first one was okay. My dentist asked me to wait two more weeks after adjusting to the crown. Shouldn’t a crown fit correctly when I leave the dental office? Anyway, the crown still wasn’t right, so I had another appointment with my dentist. She removed the crown and said I need root canal treatment. I am wondering if this is an issue my dentist should have noticed before placing a crown. Now she says that the tooth has a periapical abscess.

My dentist has not offered a refund or admitted that she misjudged the condition of my tooth. I want to get a refund before switching dentists. Do you have any advice? Bronwyn from Tennessee

Bronwyn,

Although Dr. Tostado would need to examine your tooth and see your x-rays for an accurate diagnosis, we will explain what we can, based on the information you gave us.

A cracked tooth with an old filling

When a tooth cracks, it often needs treatment in addition to a crown. If a tooth has internal damage, putting a crown over it won’t make the injury go away.

A cracked tooth is t risk for root canal treatment.
Some sensitivity after getting a crown is normal, but it shouldn’t linger. And you should not feel pain.
A crown that is made and placed well will blend with your bit without you noticing it.
Your dentist should have told you that you might need a root canal in the future.

Based on your conversation with your dentist, it seems that she was more concerned about completing all your dental work rather than getting it right.

But getting a refund, I think, is going to be tricky in your situation. To do that, you would need

Can You Get a Refund from Your Dentist?

It is possible to get a refund from your dentist if you can prove that your dentist didn’t meet the standard of care that she promised. You have several ways to try to get a refund. Although you may not have a case against your dentist for wanting to continue treatment with two more crowns, your new faulty crown might give you a good chance.

A lawsuit – A lawsuit requires that you can prove your dentist’s negligence. Your description sounds like your dental was negligent, but the details you gave us aren’t enough to determine if she is liable. A malpractice or consumer rights attorney can decide that for you.
Complain to the dental board – Although you can file a complaint, the Tennessee state dental board might consider your case as a dental procedure that went bad. Although it seems that your dentist doesn’t know how to adjust your bite, she did not drastically deviate from protocol.
Online reviews – You can tell your dentist that you will leave negative online reviews about your experience. Check her current online reviews. If they are mostly positive, a negative review will concern her. Otherwise, it might not have an impact.

Periapical Abscess and Root Canal Treatment

A periapical abscess is a collection of pus at your tooth root that results from an infection. It means that the pulp—living tissue, vessels, and nerves—inside the tooth is dead. Dead nerves inside a tooth mean that you won’t feel any pain inside the tooth from root canal treatment.

After root canal treatment, a dentist must ensure the crown fits well to avoid TMJ issues

But an upper molar tooth is more challenging to treat. An endodontist (root canal specialist) can treat your tooth, and you won’t need an extraction. If you ask a dentist to extract the tooth, you will need to replace it. Otherwise, your teeth will begin to drift, disrupt your bite, and possibly cause TMJ (temporomandibular joint) issues. TMJ symptoms affect more than your teeth. Symptoms can include:

Earaches
Headaches
Jaw stiffness, clicking, or pain
Neck pain
Dizziness
Painful talking, yawning, or chewing
Tinnitus (ear ringing)

Our Recommendation

It seems that you are uncomfortable with your dentist. We recommend that you get a second opinion from a dentist with advanced training in occlusion and bite. The dentist will understand how to achieve harmony between your teeth so you can speak and eat comfortably.

And you may need a referral to a root canal specialist to save your tooth and avoid the need for a dental implant or partial denture.

We wish you the best. Please let us know the results.

Gilberto Tostado, DDS, of San Antonio, TX, sponsors this post.

Is It Normal to Need Root Canals after getting Porcelain Crowns?

Posted on June 5, 2020 by AllSmiles.

Hi there,

I decided to get porcelain crowns a few years ago. My dentist said I needed a full-mouth restoration, and that there would not be any negative side effects. However, after the long intense process of getting extractions and crowns, a few of the crowns started hurting. I went back to my dentist several times for adjustments. When the pain went away, an abscess formed! An X-ray showed I needed root canals because of nerve damage. If I’d known about the risk of nerve damage, I may not have gone ahead with the crowns…

My dentist agreed to do several of the root canals I needed free of charge. However, more teeth have started hurting and even abscessing. I know they will most likely need root canals too, and I’m worried about the future. Will I need root canals on every crowned tooth? This whole process has been a nightmare. What can I do?

Thank you,

Stari, from Chicago, IL

Hi Stari,

When your dentist made your crowns, he ground down a lot of your natural teeth. If your dentist is not skilled at placing crowns, there is a rise of exposing the pulp inside your tooth. Exposed pulp can cause pain or become infected. If this happens, a root canal is the only way to remove the infection. Any teeth with decay or heavy fillings can increase the risk of infection as well. Teeth in poor condition may not be suited for crowns, and an extraction followed by a dental implant may have been a better course of action.

Your dentist should have definitely informed you of the risks prior to your smile makeover, so that you could make a fully informed decision. Since he did not, paying to fix the damage is the least he can do. It seems that by offering to pay, he feels some degree of responsibility for your situation.

Any problems with your crowns will have likely become apparent a few months after surgery. Since you’re a few years post-surgery, you are probably done with needing root canals. Should you need any more root canals, your dentist should continue to pay for them. If any of those crowns need replacing, opt for another cosmetic dentist for a second opinion.

This blog post is brought to you by San Antonio cosmetic dentist, Dr. Gilberto Tostada, of 5 Star Dental Group.