Q: I am upset. I had paid for a brand new crown, only to wind up needing a root canal after it started hurting. The doctor had to drill a hole through the new crown that I just paid for, plus the extra expense! Why would this happen?
A: Good. A great topic for my series on “Why patients change dentists”. I have to place this one in the top five reasons on why patients leave. (This and: breath like vomit married landfill, B.O. like the Jersey Turnpike near the IKEA store and a personality like a small soap dish.)
As much as G-d has designed some really perfect stuff, such as the Grand Canyon and Sofia Vergara, he messed up on one thing: the dental pulp. The soft center of a tooth provides the cells needed to form the tooth in utero, but once the tooth is formed it is a nuisance. It’s not the Big G’s fault. He did not know processed sugar was going to be invented and that humans were not going to floss.
Once decay, periodontal disease or fracture attacks a tooth, just the act of the doctor removing it can often cause the nerve in the pulp to die and abscess, requiring root canal treatment. You cannot leave the tooth untreated either, as you will wind up in the hospital with a facial space infection or from jumping out of a window to stop the pain of an acute abscess. Therefore: any dental work, crown, filling, inlays, veneers, bridges CAN result in the need for root canal treatment.
When our endodontist, Dr. Kennedy, performs a root canal on our patients, she does it under a surgical microscope. The hole through your crown is so tiny, she seals it up with a small white resin filling called a core. This saves your crown.
You might be able to prevent the need for a root canal by having your dentist apply Gluma (5% glutaraldehyde ) to the tooth after drilling out the old dental work and decay.This removes the bacteria and plugs up the tiny pores called tubules in the dentin and helps stop the death of the nerve and post op sensitivity.
Dr. Mitchell Josephs practices Implant, Cosmetic and General Dentistry with an emphasis on implants, porcelain veneers, and complex crown and bridge treatment. He is on staff at JFK Medical Center and is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. He completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.