I need some advice about an incident with my tooth. I have a 30+ year old crown. I was in for a checkup and my dentist said that I have decay under the crown and he will need to do a root canal treatment. I didn’t have any signs of a tooth infection. No abcess. No pain. For more than two hours this dentist worked on the root canal through the back of the crown. At that point, he closed it up with a filling and said the canal was too calcified for him to do anything and he needs to send me to a specialist. He arranged the appointment. Because he indicated I am in no pain, the specialist opted to make my appointment a few weeks away. In the meantime, my crown broke off with part of the tooth inside. I am retired and living on a very strict budget. The longer I live, the stricter it gets. I can’t afford to do unnecessary work at this point. Do I still try the root canal or do I extract it and get a replacement?
Ben
Dear Ben,
I am sorry this happened to you. Before I answer what to do with this tooth, I want to make sure you understand that your dentist has some culpability in this. He weakened the tooth with all the work and did nothing to strengthen it, nor did he tell the endodontist what transpired or I am certain he or she would have gotten you in sooner. He needs to accept responsibility and help you pay for any repairs.
It is possible you can still have a crown on this, even with part of the tooth missing. He needs to take off the crown and remove the decay. This will make it much simpler to locate the canal. It is possible using a specific type of dental post in the root canal to support the tooth, you can then replace the crown. However, I do not have confidence your dentist can do this properly. It requires a specific technique in order to protect your tooth against rotational forces in your bite. I would keep your appointment with the endodontist and let him or her look at it.
If that doesn’t work, then the only other way to deal with this is to extract the tooth and then replace it. The ideal replacement will be a dental implant in that case.
Best of luck.
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