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

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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

“Because of your smile, you make life more beautiful.”
– Thích Nhất Hạnh

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