I had a crown placed on one of my teeth when I was a kid. I fell off my bike and hit the curb. The result was that part of my tooth broke off. At my last routine dentist appointment, my dentist told me that there is an infection starting underneath the crown. I did notice a small white bubble under my tooth. It kind of reminded me of a pimple on my gums. This makes me concerned and now the dentist is telling me that I need to have the tooth extracted. Does this sound right? From my initial research, it looks like a root canal treatment should work for a situation like this. Does this sound like a dental emergency? Please let me know your thoughts.
~Kendra in Connecticut
It is in your best interest to get a second opinion. Some dentists are too eager to remove teeth, even when it’s not entirely necessary. There are many dentists out there that feel differently and will do everything possible to save a tooth. It is difficult for us to give you specific advice without having seen you in person. So, a second opinion is best to either confirm the recommended treatment plan or to provide you with other treatment options.
It is possible that your dentist is correct and that the tooth should be extracted. However, your dentist should have done a better job explaining the rational behind the recommendation. If you get another opinion and you receive the same recommendation, be sure to ask more questions about why a root canal and a dental crown will not work.
There are circumstances where there is too much of the natural tooth that has suffered decay, so a root canal won’t be successful. Or it is possible that the teeth that surround the tooth have drifted or moved out of place, so there isn’t adequate space to fix the tooth. With any kind of dental treatment it is fine to get a second or even a third opinion.
Back in dental school, we learned about the statistics for how many teeth are lost due to gum disease compared to how many are lost from tooth decay. Some dentists feel that there are dentists that are far too eager to extract a tooth. For example, there was a well-known dentist back in the 80s who was affiliated with the American Dental Association, and he was very passionate about saving teeth versus extracting them. His take on it and rational was along the lines of, “You know why so many teeth are lost? Because dentists take them out.” There may be some truth to that. But, it is also possible that many dentists don’t have the high level of skill required to successfully restore a tooth. A porcelain crown on a front tooth can be difficult and it takes extensive training beyond dental school to place a crown on a front tooth that is not only aesthetically-pleasing, but one that functions well.
Also, saving teeth is hard work. There are many factors at play with root canal treatments. In fact, an endodontist is a dentist that specializes in root canal treatments. So, not every dentist is equipped to do a root canal, or a porcelain crown on such a visible area. And then if the tooth really does need to come out due to factors that will not yield a successful result, a dental implant is the best treatment to replace a missing tooth. It will be anchored into your jawbone, which stimulates healthy bone and it will prevent the surrounding teeth from shifting around. A dental implant also looks, feels, and functions just like a natural tooth. So, if you end up with an extracted tooth once this is all said and done, you should schedule a consultation with an experienced implant dentist. Again, not every general dentist has the skills required to successfully place dental implants. It is not a recognized specialty area within dentistry. So, if you end up considering a dental implant to replace the extracted tooth, it would be wise to get multiple opinions.
Thank you for reaching out. Hopefully, this information is helpful as you determine the next steps and what is best for you.
This post is sponsored by Petaluma dentist Dr. Rick Lane.