Question:
Do root canals go bad, fail, need to be redone, go off or what ever the
right term is? Would having the tip of the canal not being filled with
the canal filling material cause problems? Would a tooth with a bad root
canal hurt like hell for a day or so and then stop hurting?
I am aware that it would be best if I brought the teeth in question to
be inspected in person, but Iack dental insurance. I'm trying to figure
out just how deeply in debt I may become. I have excellent medical
coverage, though, and since the root of the primary tooth in question
(#11) enters the problematic nasal sinus.
Answer:
They sometimes go south. This is why there are os many people in
Florida. They want to follow their teeth.
This is normal. There are nerves in the alveolus (jaw bone).
Not necessarily. My old professor Dr. Kedeshian told me (in his
charming Armenian accent) "It is not important what you put into the
canal. It is important what you take out".
This may be a bit of an overstatement. Leaving a canal unfilled means
that tissue fluid can flow back into the canal space, where it can
decompose and become an irritant. However, I have seen many, many
underfilled canals with no apparent problems afterward.
The only rule is that there are no rules. You may have a chronic
low-grade infection with no perceptable pain ever. Or you may have mild
discomfort with no other evidence clinically or radiographically that
there is any problem.
I thought the jaw bones were the maxilla and the mandible ... Wait, I
think you're telling me that the tooth socket has nerves, even though
the tooth itself shouldn't after a root canal, right? I'm not kidding
when I say I'm full of dumb-ass questions.
In the broadest general terms, are there any warning signs that the
tooth owner would notice, or is this something that, in general terms,
is usually noticed by a professional upon examination?
I wondered, since the last time I had dental insurance, I was told in
tones of doom that that crown, post and canal would cost me even more
money in the future due to the space at the end of the tip. It *is* a
lousy crown, and when it didn't fit, the tech ground down one of my few
intact natural teeth to get my mouth to close around the crown until I
suggested she take down the back of the crown. Should have been my
signal to say thank you and leave, but I didn't know any better then.
But I digress.
Either or both. Right now, my wife is getting discomfort around one
root of an upper molar treated by an endodontist almost a year ago.
She's had the discomfort all that time, more or less unchanged. There
is tenderness over the tip of the root. At this point that is clear
evidence that something isn't right. When the root canal was done,
there was a clear area of bone resorption at the tip of one root. Over
the months it has diminished slightly on x-ray. Shrinking of such a
periapical radiolucency is usually a good sign, but with the discomfort
something will have to be done.
Often I see the reverse--no discomfort, but clear expansion of a
radiolucency. You've got to use all the information you've got, and try
to make the best decision open to you.
