I have a question about a crowned tooth that had a root canal at least 12 years ago. The last time I had x-rays taken a shadowy area was noticable at the base of the root canal. I have no symptoms, pain, or swelling. However, I do have a gumline cavaity at the base of the crown.I'm being told that I should see and endodontist and have the old root canal cleaned out and disinfected. There also appears to be a piece of file in the canal, but I've been told it's too far down to retrieve by going through the top of the tooth.Since I am not having any symptoms, can I just leave it alone? The tooth in question is the vary last molar on the bottom right.
Thanks for using JustAnswer. You know I am all for the patient. As long as you know that there may be a problem at a later time, if my patient wants to wait then I don't have a problem with it. I have several patients now that are in the same boat with you. I have been watching those same type problems for years in some cases and still no problems. So, I believe since you have been pain free and no swelling, you can probably wait. My concern would be to get the cavity filled or you may not be able to keep it later. Of course this is opinion and have not seen the tooth, so can only speak from my experience on the subject. Best of Luck! Dr. Cliff
Thank you so much for you answering my question. I guess my dilema is the fact that I do have a cavity. If it weren't for that, I don't believe I would be worried about it. I'm torn as to what to do.
I've been told that having the canal clean, filled, etc. by an endodontis may prevent an abscess. Meaning, that "shadowy" area could be the start of an abscess. If I don't do it, that I may end up with a worse problem and a surgical procedure would have to be done going in through the side, through the bone.
I am a good dental patient and go every 6 months. I hate to boil it all down to money, but I really don't want to pay 1,700 dollars for the root canal treatment, then another 1,100 dollars for the crown, only to still have an abscess in the future and have to have that other procedure.
I would probably be more concerned if it were a front tooth, but since it's the last molar, wouldn't just pulling it solve all these problems.
If it were you or one of you family members, what would you advise them to do if it were the back molar, tooth crowned, gumline cavity, with signs of a 12 year old root canal problem. No symptoms, no pain, no swelling or other sensitivity.
Also, how quickly would an abscess errupt if indeed the shadowy area is an abscess and am I putting the bone/jaw in jeaprody by not doing anything?
Again, I very much appreciate your opinion as I am uncertain on this issue.
First thing is I would find another endodontist for a quote. $1700 is a little. They are around $950 for a molar here in GA. Crown fee is about right on. If it were me, and I was not having any problems with the tooth, having a file broken in the tooth and deep gum line cavity, I would probably do the same thing you are doing... I would wait till it hurt and then take it out. There is no guarantee the cavity is not on the root, if it is then it would be very hard to fix it. The abscess may never appear on your gums. If an abscess is developing, it is hard to say when or how much time you have before it hurts, but if it has been a wheel and you haven't had problems, it could be a while before it bothers you. Dr. Cliff
OK, so I'm hearing it would be OK to just let it ride without further damage. Another option would be to go ahead and have the crown taken off and the cavity taken of and just wear a temporary crown for as long as I can, have another set of x-rays in 6 months and if there is no change and I am still not having any symptoms, then put on a permanet crown. Or, just leave the temp. on as long as possible.
Exactly, if you are symptom free I would consider getting the permanent crown put on instead of staying in a temporary. They tend to leak over time and cause you more problems. So I would get that permanent crown as long as everything was still ok. Dr. Cliff
I very much appreciate all of your advice. The dentist and the endodontist are advising me to go ahead have the root canal treatment done to get rid of or prevent the abscess and to try and retrieve the file fragment.
I had the root canal 12 years ago and I have no pain or swelling. I'm all for prevention, but I'm just on the fence about this one.
I guess I'll have the cavity fixed and crown done and just take my chances. What is the worst case scenario in that case?
You can proceed with the filling and new crown, but just remember if you get the crown and 6 months down the road if you need that root canal, you will have to have a hole filled in that new crown to do it. You might ask your dentist to glue the crown on with temporary cement so it can be taken off later without messing the new crown up. Who knows....that tooth may be fine for a couple of years. Dr. Cliff
OK, great. I had the root canal 12 years ago, but they wanted to do a treatment where they clean it out, disinfect it and fill it. I like the idea of the temporary cement for a while just in case something happens, I can save the crown.
You have been a tremdous help and I appreciate it!