Tag Archives: root canal treatement

Is an extraction instead of a root canal necessary?

I scheduled an appointment for a dental exam and teeth whitening consultation. The exam included an x-ray, and the dentist said he isn’t comfortable doing teeth whitening yet because one of my top left molars that already has a crown on it no longer has a canal. The tooth has been uncomfortable for a few months, but I didn’t think it was that serious. My dentist prescribed antibiotics and said that since the tooth doesn’t have a canal, he can’t do root canal treatment. If the tooth doesn’t improve from antibiotics, he recommends extraction. I’ve read many times that it is always better to keep your natural teeth. My dentist didn’t give me any options. Are there alternatives to an extraction? – Thank you. Latha

Latha,

Although Dr. Lacy would need to examine your tooth and x-rays for an accurate diagnosis, we are not comfortable with your dentist’s evaluation.

Antibiotics for tooth discomfort

Your tooth cannot be treated with antibiotics alone. A dentist might use antibiotics as a diagnostic tool.

  • Tooth pain that improves with antibiotics – If tooth pain goes away with antibiotic treatment, you have a tooth infection. Treatment options can include root canal treatment or extraction. But if your dentist does not treat the tooth and remove the infection, after you stop taking the medication, the symptoms will return.
  • Tooth pain that does not improve with antibiotics – When antibiotics do not resolve tooth pain, it is an indication that a tooth infection is not the source. Your dentist would need to find the cause before recommending treatment.

A tooth without a canal?

If a dentist tells you that your tooth does not have a canal, two possible factors include:

  • Upper molar teeth have a lot of bone around them, making it difficult to see the root canal, so your dentist’s assessment might not be correct.
  • Tooth irritation causes a buildup of dentin (layer beneath tooth enamel) inside the tooth pulp and canals. The buildup narrows the canals and can make them more challenging to see on an x-ray.

Saving your natural tooth

If you want to save your tooth, we recommend getting a second opinion. Look for an endodontist (root canal specialist) or ask your dentist for a referral to an endodontist. Be aware that your dentist might refer you to a friend who will agree with your dentist’s assessment. You may want an independent opinion.

Photo of upper and lower teeth whitening trays in a blue case; for information on free teeth whitening from the office Plano dentist Dr. Miranda Lacy.
Only begin teeth whitening treatment if your teeth are healthy

After an examination and x-ray, an endodontist will explain if it’s possible to save your tooth and the results you can expect with root canal treatment. It is wise to postpone your plans for teeth whitening until your tooth is healthy. Otherwise, it may become further irritated.

Miranda Lacy, DDS, a Plano, TX, female dentist sponsors this post.

Three Causes of Tooth Pulp Sensitivity and Irritation

In early February, one of my bottom molar teeth cracked. The tooth had an old filling in it, and I felt it crack while I was at dinner with friends. At the time, I had only been in AZ for about two months. I relocated and still don’t have a job yet, so I found a dentist with reasonable fees. She said I needed a crown. She prepared the tooth and put on a temporary crown. The crown made my gums sore, and it hurt to chew on that side of my mouth. I also told my dentist that I felt some sensitivity in the tooth whenever I drink anything cold.

That issue wasn’t resolved before she placed my permanent crown later in January. The pain got worse, so I returned to the dentist she took x-rays and poked around the crown to see if I felt any pain or pressure. Of course, my tooth didn’t respond to any of her tricks, so she told me to wait two or three months for it to settle down. My tooth hurts daily. It’s not constant pain, but it hurts and is now sensitive to hot food. I’ve entered my symptoms in Google, and everything I read sounds like I need root canal treatment. Is my tooth dying? Thank you. Eun-ae M. from Flagstaff

Eun-ae,

Thank you for describing your symptoms and the history of your tooth pain. We recommend that you call an endodontist, or root canal specialist.

Side-by-side diagram of an infected tooth being cleaned out with root canal treatment (left) and a healthy tooth to the right.
Root canal treatment can save your cracked tooth

But without criticizing your dentist, we want to clarify a few facts.

Causes of Tooth Pulp Irritation and Sensitivity

  • Cracked tooth – A crack can easily affect the tooth pulp (living tissue, nerves, and blood vessels) inside your tooth. An infection can cause inflammation that chokes the pulp and makes it die.
  • Aggressive preparation for a crown – Significant sensitivity after your dentist prepares a tooth for a crown can result from improperly sealing the temporary crown or aggressive tooth preparation. But a tooth can be coated with a desensitizing product to limit the discomfort.
  • Cementing the crown – A temporary crown on a molar tooth should be made of durable material and bonded with soothing cement to help the tooth nerves calm down. Permanently cementing an already irritated tooth can cause further complications and the need for root canal treatment. The increased sensitivity you’re feeling might be due to changes in the tooth ligament near the root. An endodontist can see that, but most general dentists won’t recognize it as an issue.

Instead of allowing your general dentist to do any more work on your teeth, we recommend that you see a specialist.

This post is sponsored by Plano, TX female dentist Dr. Miranda Lacy.

I’ve had a toothache for a few days

I’ve had a toothache for a few days and I am wondering what I can do. Thanks for your help. – Rob

Rob – At times, a toothache is caused by food that is trapped between the teeth, or between the teeth and gums. If food is trapped, thoroughly flossing may release it and relieve your toothache.

A toothache is often a sign of a tooth infection. If the pulp of your tooth is infected, it will need to be cleaned out with a root canal treatment. An infected tooth should not go untreated. The infection will continue to spread. It can spread into the bone and into your bloodstream.

Schedule an appointment with your dentist to determine the cause of your toothache, along with the appropriate treatment for it.

This post is courtesy of Plano dentist Dr. Miranda Lacy.

Should the tooth be extracted or should I receive a root canal?

Last year I had a filling replaced in tooth for the third time. About 4 months later I had pain in the tooth again. My dentist gave me a root canal and put a cap on the tooth. Every thing was ok until last month when the tooth started hurting again. Now my dentist says I need another root canal treatment. Should I have just gotten the tooth pulled? – Greg G.

Greg – An endodontist specializes in root canal treatments. So visit an endodontist for advice on whether or not a root canal treatment is best, or if the tooth should be extracted. If the tooth can be saved, it will be less expensive to preserve it than to extract it and replace it with a dental implant or a dental bridge.

The empty space from an extracted tooth should not be left that way. When a tooth is missing, adjacent or opposing tooth will drift into the space and cause additional oral health issues.

The second opinion from an endodontist will help you make an informed decision.

This blog post is sponsored by Plano dentist Dr. Miranda Lacy.