Question:
I'm hoping someone has had a similar situation to mine, because I really
don't know what to do. This all began when I started having pain in a lower
left molar--it's actually a baby tooth that was crowned when I was in high
school (I'm 23 now). I just don't have a permanent tooth in that place! My
general dentist saw nothing on the x-ray, but said since I was having pain I
should see a root canal specialist or a pediatric dentist (because we're
dealing with a baby tooth). I went back to the pediatric dentist who crowned
the tooth. I had to see his partner that day, and he said he saw an
infection of sorts from the x-ray, and put me on a antibiotic. This didn't
seem to help. When I went back to see MY pediatric dentist, he said he
didn't see any infection on the old x-ray. and referred me to a root canal
specialist.
I went in for the root canal, and the guy told me since it's a baby tooth,
the roots have calcified, so he might not be able to find them. Indeed he
could not find the roots, so I went through it and paid for it for nothing.
(Also I'm wondering why he couldn't tell from the X-Ray that my roots had
calcified and he wouldn't be able to find them..) He said now the
alternative is to extract the tooth, get a dental implant, and then crown
it. He told me to set up the extraction with my old pediatric dentist.
I set up the appointment but couldn't get one for a month. The root canal
specialist told me when I had the extraction, that dentist would refer me to
an roal surgeon for the implant. I decided to just take matters into my own
hands--I'm constantly worrying about this--and set up an evaluation appt.
with an oral surgeon I've seen before.
The problem is, the tooth hasn't bothered me at all lately. Even when I went
in for the root canal on Oct 31 it hadn't been bothering me. All the
dentists I've seen say I need to take care of this ASAP. I hate to go
through all this (not to mention the huge issue of how much it all costs,
also taking time off work and making the long drives) if it's not absolutely
necessary. I know some will say that just because it's not hurting now
doens't mean the problem has gone away. I guess I'm worried that if I let it
go, I could develop an abcess and have extreme pain, and have to have an
emergency procedure done. But no one sees anything on the x-rays, and the
roots have calcified--doesn't that mean there isn't a problem??
Answer:
It is unlikely the problem has gone away. This is probably a lower
second primary molar (fifth tooth from the front, right?) as these are
probably (after wisdom teeth) the most commonly permanent teeth to be
congenitally missing.
Most of these teeth are lost eventually anyway, so I doubt I'd go
through heroics to save the tooth. Most often the tooth breaks down, or
loosens up. These don't usually cause terrible toothaches, though I
obviously can't promise you won't be an exception.
If there is no obvious infection on the x-ray and none clinically I see
no harm in waiting, but you should make plans for what you are going to
do when the tooth is eventually lost.
Yes, K is the lower left second primary molar. "On its way out" may be
overstating the case a bit--I have a patient that not long ago lost one
of his primary lower second molars, which I replaced with a fixed
bridge. He was past 50 years old, and I had been watching the tooth
gradually loosen and deteriorate for several years. It is possible that
the root canal may have aided the retention of the tooth for some time,
though the impression I get of calcified canals may mean it will not
have helped much. Still, while I'd certainly get it out if it became
painful again, I wouldn't necessarily be in a big rush--just have plans
for the eventuality.
It is actually tooth K, the 3rd molar from the back
on the lower left side. So you think this may just be my primary tooth on
its way out, and not a problem that warranted a root canal? And the tooth
will eventually just fall out, perhaps?
