Post Temp Crown and Tooth Survival - Petrified of Root Canal

[toothprobs]

Should I get a root canal before my permanent crown is placed?

The last few months have been trying. My front tooth had a root canal when I was 17, and at 30 (my age now), it was showing signs of weakness. My dentist knew I did not want a crown and told me we'd veneer both my front teeth to make them match. She showed me pics, etc., and then I went in for the procedure. After my temporaries were replaced with the final result, I knew something was wrong and hated the way they looked. I found out she had actually done two crown jobs instead of veneers, and am going through the process of having another dentist fix them. She told me not to wear my invisalign braces, so my teeth moved, and I have to go through more orthodontics before I can get my final crowns placed.

I had extreme pain in the tooth that did not originally have a root canal after the new dentist placed my lovely new temporary crowns (about 2 weeks in). He recommended me to an endo, who said I needed a root canal. The pain died down between that appointment and the root canal appointment, and I chickened out of the root canal process before the doc started drilling. We've been watching it as my dentist thinks I should get one before the final crowns are put on so we don't have to drill through the finals (and to get this all over with), but I don't really want to because the pain has been mild. My endo said there was a 30% chance my tooth would survive without needing one. There is no sign of infection.

My ortho is almost done, so I will need to make a decision in the next 4 weeks. It's been 5 months since the temporaries were put on. Could the pain be from something else, or should I go ahead and get the root canal now before the permanent crowns are placed? My dentist originally thought I wouldn't need one, but once the pain started he said the original dentist overprepped my tooth so my pulp was showing a bit.

I'm petrified to get the root canal now, and don't want two dead front teeth and the risk of implants in 5 years when I'm only 30.

Thanks!

 

[Zzzdentist]

Your dentist should be able to advise you what he thinks is best, but the choice is ultimately yours. If you don't mind waiting in temps, sometimes given more time you and your dentist can tell better how the nerve is doing. The worse case of leaving it without a root canal would be needing to drill through the permanent crown. Sometimes this isn't a big deal, but it can leave the crown a bit weaker depending on the type of crown. Worse worse case might be a need to redo the crown if it breaks.

Your dentist might be able to do some more endodontic tests on the tooth to try to assess it to see whether the nerve is still viable or not.

 

[toothprobs]

Thank you Zzzdentist. The endo keeps doing the cold test, and it's still alive. I was dumb and pushed on it the other day, and now it feels hot or something inside. Do you think flouride wash could help with sensitivity if that's what it is? I think I'm willing to wait, but am scared to have to redo the crown (even though I might have to in 7 years anyway).

 

[Gordon]

Fluoride mouthrinse might help a bit with sensitivity, but it's not really designed to do so.

 

[Zzzdentist]

I wonder if there might be a void or something where fluid could be leaking under the temps resulting in the sensitivity. Has the dentist(s) tried recementing the temps? There was one other person who had some extreme pain in their temps, and I think the problem actually resolved once they had their permanents placed on.

 

[toothprobs]

They haven't tried to re-seal them. They sealed the temps pretty good because I had to go through more orthodontics to re-align my teeth when dentist 1 told me not to wear invisalign for a month during my first set of temps. I remember the first pain I got (which was intense) was after biting hard into a beef burrito. Then after 2 weeks, it settled, and now it only comes up if I aggravate it. My endo said if I waited until the permanent crowns go on, worst case is that they have to drill through that to do the root canal (which my restorative doc does not want to do). You think liquid leaking through could make it sensitive when I push on it? It doesn't really bother me with hot/cold. Thanks!!!!

 

[Zzzdentist]

I'm not certain, but it might be a possibility. Some dentists use non-eugenol containing temporary cements which I hear aren't as comfortable as the eugenol type. It could be a simple matter that the cement may be irritating the dentin underneath when pressure is applied illiciting a reponse. That other person on the forum said their problems disappeared after they had the permanent crowns cemented/bonded on so it most likely was a cement related issue.

You could see if your dentist might be interested in numbing you up, taking the temps off and trying to recement them with Tempbond. It could be a problem with their temp cement. Poorly mixed, uneven ratio amounts, or expired product might be a factor.