Root Canals Needed after Fillings, why?

Root Canals Needed after Fillings, why?

Q: Why did I wind up with pain followed by the need for several root canals after I had some fillings done? I had no pain at all before the fillings were done!

A: I don’t know how long you have been reading my column, est. 2004, but I previously wrote a piece entitled: “Why patients leave their dentist.” One of the most popular reasons is the above scenario. (followed by bad breath, being late and an awful bedside manner!)

Let’s use this analogy: You are told at your last physical that there is blood in the urine. You have no symptoms; ZERO.

A CT scan and other tests reveal you have a kidney stone. The doctor performs a procedure to break up and remove the stone. After the procedure you have pain for the first time. Scans show that one of the stones has broken up, but smaller pieces get stuck in the ureters or urethra requiring a second procedure that finally solves the problem.

You have no symptoms. On routine checkup x-rays show you have decay (cavities). The doctor removes deep decay close to the nerve canals of the tooth and fills the tooth with composite resin or porcelain material made in a lab. Days later you have a tooth ache. Further tests reveal the nerve is dying in the tooth or extremely inflamed, warranting root canal treatment which completely solves the problem. Often crowns are needed after the root canals to protect the tooth from fracture.

The problem with dental patients is that these additional procedure result in more fees. In medicine, most health insurance plans cover these extra procedures. Hence the anger with the author of today’s question.

The alternative would have been to ignore the decay and let it get so deep that you wind up with horrible pain and swelling, possible ER visits and losing the whole tooth resulting in dental implants and more fees. Obviously, this is not an intelligent or ethical choice.

Bottom line: 1. Problems that are not causing symptoms still need to be treated. 2. Sometimes more than one procedure is needed to fix the problem. Your dentist did not “drill to deep”, as you next door neighbor told you. He/she performed the standard of care for treating decay.

In my 35+ years of practice, I have found much less need for root canals when we do lab-processed porcelain inlays vs. the white fillings (Bonding/composite resin). However, the fee per tooth could be could be $1000 more vs a filling fee. But, keep in mind, you would still be paying less than having a filling, followed by root canal, followed by a crown.

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