Question:
About three weeks have passed since my final root canal therapy session. The
first ten or so days of these three weeks were mostly agony. My endontist
'filed' down the tooth, and, at my urging to be prescribed something for the
pain, put me on anti-biotics, codeine, and an Ibuprofen-class anti-inflammatory
(the last two were not simultaneous, however). I have been off all of these
for about a week. I am a tad headachy at times, but not enough to want to take
anything. I probably grind my teeth at night, though I am now avoiding
sleeping on my stomach, as that seems to aggravate or possibly even cause this.
I avoid chewing on the root canal side of my mouth.
I have not yet made an appointment for a crown on this second-from-the-back
molar. The reason is that I am under the (misguided?) impression that enough
time has not elapsed to be sure I don't need more root canal work (or, worst
case I suppose, an extraction).
I cannot bear the thought of starting a crown and then finding my root canal
therapy didn't work, so my endontist will have to get back in the picture,
drill through the crown, clean more canals, etc. Would it be okay to postpone
starting a crown for a few more weeks, as long as I am careful with this side
of my mouth?
Answer:
I tell my patients 4-6 weeks free of symptoms if symptoms were
present beforehand, so long as the tooth in question has been
temporized in a structurally sound enough manner to minimize the chance
of fracture (not 100%) until the tooth is comfortable. If still in
doubt, a stainless steel temp that becomes the sacrificial lamb in case
the endo needs to be re-treated...you won't be destroying a new crown.
There are no guarantees in dentistry or medicine. No one can predict with
100% accuracy what will happen to your tooth. One can only go by statistics
and hope that you fall within the normal range. Most teeth after root canal
treatment are fine. Occasionally one will act up. Those that act up will
usually do so within 2-3 weeks of completion. Once 3-4 weeks have passed
with no problems, you should be home free. But,,,,,,,,,, your tooth could
have a tiny fracture in it which gradually grows over the next 2-3 years and
then requires extraction. The longer you go without the crown, the greater
the possibility of developing fractures.
See???? No easy answers. Allow 3-6 wks to pass after completion of the
root canal procedure, then advance full speed into crowns for peace of mind.
Indeed!
Last figures I saw placed the success rate for endodontic surgery at about
50%.
Someone please correct me if new figures are different.
Sometimes a tooth can be saved by surgically treating the root tip. These
then can have a normal life expectancy.
Too many people go away and let things stand for months to years when
all efforts to save the tooth are hopeless. If you wait a few more
weeks, I don't think you should put yourself into too much trouble.
Sure, but make sure that the dentist or endodontist has ground down
the top of the tooth BIG TIME right out of occlusion. Why? The thing
can crack with one good bite! It happens. Of course, then it becomes
your problem. -- waited too long, etc.
So your thinking is right but get the professional to go along with
your decision.
