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Beverly Hills Institute of Dental Esthetics
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Brian LeSage, DDS, FAGD, FAACD

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Can I Get a Dental Implant Instead of a Repeat Root Canal?

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Can I get a dental implant instead of a repeat root canal? I’m so disappointed because my dentist ordered a crown after root canal treatment without telling me. Now it seems the root canal failed. I want the tooth extracted because I had an infection in the tooth that my dentist couldn’t resolve, so she sent me to an oral surgeon. I’ve asked her for an extraction, but she wants to do another root canal to save the tooth so she can use the crown she ordered without my permission. Should I skip her treatment and go back to the oral surgeon? I’d rather pay for an implant than go through another unpredictable procedure from my dentist. Thanks. Samuel from AL

 

Samuel,

It sounds like you’ve been dealing with a very frustrating and uncomfortable situation regarding your lower left molar. We understand your concerns about the persistent pain and the crown being ordered prematurely.

Your hesitation about placing a crown on a tooth that hasn’t fully healed is valid. Standard dental practice involves root canal success and ensuring the tooth is stable and healthy before crown placement. Ordering a crown without your consent is concerning.

Is Your Tooth Ready for a Crown?

A dental crown protects a tooth after successful root canal treatment and restores its function. However, a dentist should only place a crown if the root canal treatment was successful and any infection or discomfort has fully resolved. Preparing a tooth for a crown involves reshaping it on all sides, which can aggravate a sensitive tooth. Placing a crown on a tooth with persistent issues risks trapping an infection and leads to further complications.

What If Problems Persist After a Root Canal?

Dental implant crown, abutment, and root form

A dental implant may be an option for an unsavable tooth

Even with expert care, root canal therapy doesn’t always yield the desired long-term success. Persistent symptoms like pain often indicate an ongoing issue that needs further evaluation. Given the tooth’s history and continued discomfort, you are right to question the value of getting a crown for the tooth.

Consider the following steps to help you decide what to do next:

  • Seek a Specialist Opinion: Consider consulting an endodontist (root canal specialist) for a definitive assessment. A specialist can evaluate the previous treatment and determine if the tooth is savable.
  • Explore Extraction and Replacement: Consult an implant dentist or an oral surgeon to discuss the pros and cons of a dental implant versus attempting to save the tooth again.
  • Communicate with Your Current Dentist: Talk to your dentist about your ongoing symptoms and the ordered crown. Since the crown was fabricated without your approval for a problematic tooth, you should discuss refusing the crown placement and getting a refund for any payments you’ve made.

We hope you find a resolution that effectively addresses your dental health needs. Remember to seek a second opinion if your dentist’s response is unsatisfactory.

 

Brian LeSage, DDS, an accredited fellow of cosmetic dentistry in Beverly Hills, sponsors this post.

Will I Need Another Root Canal?

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I had a root canal on my top left first molar tooth in 2017 and had no problem with it until early this month. Now the tooth hurts every day. The pain is not intense but enough to take a pain reliever to distract me from work. Do I need to see a dentist right away? Will I need a second root canal? – Lydia from Omaha

 

Lydia,

Yes, you should see a dentist. After an exam and X-ray, a dentist will determine whether you need repeat root canal treatment.

What Can You Do About Pain in a Root Canal Tooth?

If you had root canal treatment years ago and now feel pain in the tooth, schedule an appointment to see a dentist as soon as possible. You are probably experiencing root canal failure, and only an examination can determine the cause of your pain.

Is Root Canal Failure Common?

Root canal treatment diagram

Root canal treatment

About one in ten root canal treatments fail. The infection will flare up sometime later if a root canal tooth does not heal completely. Sometimes, curved, hard-to-reach channels get missed during root canal therapy, and infection lingers. Additionally, most general dentists do not have the instruments to reach deep into canals. However, a root canal specialist (endodontist) has the required tools.

What Is the Treatment for Root Canal Failure?

The treatment for root canal failure is to repeat root canal treatment or perform root canal surgery. Although some dentists have advanced training in root canal therapy, most will refer you to a specialist. The endodontist will find the infected root, remove the infection, fill the area, and seal it off. Root canal surgery, or apicoectomy, accesses and treats the tooth through the bone and the root tip instead of the crown.

Also, your tooth may have cracked. After an examination and x-rays, an endodontist will explain if the tooth is savable or requires extraction and a dental implant or alternative tooth replacement.

Brian LeSage, DDS, an accredited fellow of cosmetic dentistry in Beverly Hills, sponsors this post.

Why Do I Still Feel Pain After a Root Canal?

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I am concerned that my root canal failed, and I will need an extraction and a dental implant. My dentist completed the root canal four days ago. I am taking ibuprofen and antibiotics just as she directed me. But I am still in pain. How do I know if I am going through root canal failure? Can my dentist repeat it before removing the tooth and replacing it with an implant? Thank you. Engram from CT

Engram,

Pain after a root canal treatment is not unusual and does not mean the procedure failed. When your dentist cleans an infected tooth pulp, some material can go through the tip and into the tissue that meets your jawbone. Your tooth can become sore, sensitive, and swollen. The sensitivity and inflammation can worsen after you bite or chew.

Should You Be Concerned About Pain After Root Canal Treatment?

Root canal treatment diagram

Root canal treatment

Pain after root canal treatment may peak in a day or two and progressively improve. Although improvement may be slow, schedule an appointment with your dentist if the pain increases or persists.

Some dentists minimize the pain after root canal treatment by adjusting the tooth so the opposing upper or lower tooth will not touch it when you bite. Tooth reduction prevents the painful impact of the tooth that would meet it when you bite down.

Can Your Dentist Repeat Root Canal Treatment?

If a root canal treatment fails, a dentist can repeat it. Sometimes, a dentist will refer you to a root canal specialist (endodontist) for treatment. An endodontist will examine your X-rays to see if your dentist missed any canals or areas. Repeat root canal treatment can help prevent the need for tooth removal and a dental implant.

 

Brian LeSage, DDS, an accredited fellow of cosmetic dentistry in Beverly Hills, sponsors this post.

Did a Repeat Root Canal Crack My Tooth?

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I have a terrible history with my molar teeth. My upper left molar had a root canal last November. It never really felt okay, but the discomfort was bearable. I was not silent about this with my dentist either. She had a ‘watch and wait’ attitude about the whole thing. So, after two weeks, the tooth pain increased. I didn’t want to see my dentist because I was really interested in what a different dentist would say about the whole thing.

I found a dentist who took me immediately, which was good because the pain worsened. The dentist said I needed another root canal which was okay with me because the tooth hurt so bad. Last Friday, while I was eating, I felt the tooth crack. I was torn about going to the emergency dentist again or back to my former dentist, but I did neither. A friend told me about her dentist, who she really likes, so I went there, and he immediately referred me to an endodontist. The endo said the tooth could not be saved. She pulled the tooth, and now I need a dental implant. I asked the endo this question, but I want another opinion: Did the emergency dentist ruin my tooth? – Angel

Angel – Thank you for your question.

Did a Root Repeat Canal Crack Your Tooth?

Diagram of a two dental implants - before and after crown placement

Dental implant

A dentist would have needed to examine and x-ray your tooth before and after the second root canal treatment to determine the state of the tooth. We can’t say whether the emergency dentist damaged the tooth. An endodontist was able to examine your tooth, so unless you have reason to do otherwise, you can trust her assessment of what went wrong. Research the dentist’s credentials and experience to get a successful dental implant and crown to replace your missing tooth.

Why Shouldn’t You Ignore Tooth Pain?

We encourage patients not to let tooth pain linger. The sooner you seek treatment, the easier it will be to restore the tooth. This includes quickly getting to a dentist who accepts emergency visits. Some people feel uneasy about selecting a dentist they have never seen before, and that’s understandable. Try to get recommendations on dentists from friends or family members if you need help looking at a dentist’s website for their credentials and checking patient reviews before a visit. Be sure to get help quickly.

 

Beverly Hills accredited Fellow of cosmetic dentistry, Dr. Brian LeSage, sponsors this post.

 

My tooth is fractured beneath a new crown and needs extraction

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I fractured two front teeth in 2010, and my family dentist did root canals and crowns on both teeth. As the crowns aged, I noticed them more and did not like the way my smile looked. Also, a left molar tooth was aching on and off, so I decided to see another dentist for a smile makeover.

I love the look of the smile makeover, but my left front tooth became sensitive a few months ago, and my dentist said the tooth needs extra care. She noticed a pimple on my gums and referred me to a periodontist for an exam.

My dentist prescribed antibiotics, and the periodontist confirmed that I need extraction. My dentist disagrees about the extraction and is now referring me to a periodontist. I do not want to lose my front teeth, especially after all the work and money I spent on a smile makeover. – Eiso from NV

Eiso,

Although your smile makeover looks beautiful, we wonder if your dentist took x-rays before completing it. If she took x-rays, saw the fracture, and put a crown over the tooth anyway, maybe she did not understand the potential results.

Root fracture on your left central incisor

Thank you for sending us a picture of your x-rays. Your fractured tooth does not look good.

  • Root fracture – In the middle of the tooth root, we see an old, horizontal fracture line that is likely from your original accident. The dentist who did your root canal at that time either did not see the fracture or tried to navigate through it. The necrotic (dead) soft tissue is gone, so the dentist must have removed it and hoped the tooth would heal.
  • Above the fracture – The inside of your tooth looks choppy and eaten away. Some of the root canal filling material is missing. If your gum pimple originates from that area, it suggests an infection is eating at your tooth roots. And if that is true, you will lose the tooth.

Your right central incisor

Diagram of a two dental implants - before and after crown placement

If a dentist or specialist cannot save your tooth, a dental implant is the best treatment option

Your right central incisor (front center) does not look stable either.

  • Root canal filling material – It stops several millimeters before the tooth ends. You have a new crown on the tooth, it might be best not bother the tooth unless you experience a flare-up. We do not see any signs of infection on the x-ray.

Although your dentist missed the diagnosis of your cracked tooth, you need to get it corrected. You can decide if you want an endodontist (root canal specialist) to examine your tooth and try to save it or proceed with the extraction and dental implant.

You can negotiate with your dentist on the cost of continued treatment for your left incisor because she missed the fact that it is fractured and problematic.

Best wishes for a thorough resolution.

 

Dr. Brian LeSage, a Fellow of the Academy of General Dentistry, sponsors this post.

My tooth is fractured beneath a new crown and needs extraction

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