Issues months after crown... loose tooth and swelling

[sohcsol]

Hi everyone, new to this forum but I don't know where else to look for opinions and advice. Sorry for the long first post, but thanks to anyone who reads it.

Back in early January I broke my lower right molar on a popcorn kernel. I had not seen a dentist since I moved from out of state, so I picked one close to my work that had good reviews and took my insurance and made an appointment.

All went well at first, they gave me a temporary filling so the broken tooth wouldn't cut into my tongue. Then I got a temp crown. At this point I had had no pain at all in this tooth and could chew with it just fine. But he told me that the break was deep enough that the nerve might die and I might need a root canal on this tooth eventually.

Then the day came in late January that I went for my permanent crown placement. When the dentist forced it down on the broken tooth it hurt a little. Then I noticed it felt too high. They said "that's weird, that never happens" and he went to work filing it down to where he thought it was OK, or until he couldn't afford to spend any more time on it that day. I figured it just felt funny because I would need to get used to it.

Well that wasn't the case. I have bruxism and after a couple nights of grinding on it, I had a terrible toothache. I thought maybe it had abscessed because my entire face and jawbone hurt on that side. The lymph node under my jaw was swollen like a golf ball. I went to an urgent care to get antibiotics and pain meds because it was the weekend, and the dentist couldn't get me back in until the following Wednesday. When I went back to the dentist, he adjusted the bite for about 5-10 minutes and sent me on my way.

After not chewing on that side for a few days it seemed to get better. Then as soon as I started chewing with it again on soft foods, it was like the tooth shifted and suddenly the bite was way too high again. So back to the dentist I went.

This cycle went on for a couple of months, I went back about every two weeks to get the bite adjusted. The dentist explained that the tooth could be moving because the bite wasn't right, I was grinding on it, or some other unknown reason. They actually seemed kind of stumped.

I looked up my symptoms online and they sounded like the result of tooth trauma, or periodontitis. I decided to wait for several weeks after the last bite adjustment, since it doesn't feel too terrible at the moment, and see if the tooth just needed to rest so it could heal. Well it's been four weeks now that I haven't been chewing on it or had any work done, and the tooth is not painful but it is still loose and wiggly if I push on it. I can't chew with it because it moves and starts to hurt. I also have had periods where the gum around it swells up quite a bit, probably after accidentally contacting it or grinding.

I called the dentist again and he said I need to come in for an xray, that I probably need a root canal because the nerve might be dying. We are now 4 months since the original crown placement. I am wanting to go to a different dentist for another opinion because I do not trust him at this point, especially if I need a root canal. I feel that the only reason that I am going through this is because they made the crown wrong in the first place, causing severe damage to the tooth ligaments and probably my jaw bone, which now has a big lump under it and feels sore if I press on it.

Any other opinions or advice I can get on what might be going on with my tooth would be appreciated. Does it seem like this dentist was negligent in giving my an ill-fitting crown and not replacing it, but instead trying to file it down to fit? The bite still doesn't seem perfect, if I bite down all the way it feels like it gets pushed out to the side.

I am especially fearful if I need more work done or a root canal, because no dentist has been able to get me fully numb in my lower molars before.

 

[sohcsol]

Got the second opinion today, from a dentist who I know is reputable in the area at least. His assessment was that it does look like a vertical fracture occurred, probably at the same time I broke the tooth. My symptoms of pain and swelling a few weeks later he said aligns perfectly with that, and that the crown being too high would not have been connected to the other problems I've had. He said essentially he would have gone through the same procedures as the other dentist did to arrive at this point. That there was nothing we could do to fix the tooth but that there was no way of knowing aside from now seeing how much bone loss there has been in such a short period of time.

He says I could try the root canal to see if the tooth would tighten up and it is possible, but unlikely to save it. It would not be worth the cost of doing it and he would just extract it if it were him, but since my first dentist is offering the root canal for free I suppose it is worth a shot.

 

[honestdoc]

Even though the previous dentist offered to do the root canal for free, I would be hesitant because of the unnecessary trauma it can cause and the very low chance for benefit. It would be more predictable to extract.

 

[Deamo55]

I am having the same problem but AFTER a root canal. I just don't get it. My new crown hurts when I try to move it. Swelling in front of my ear now.

 

[sohcsol]

Deamo55, it sounds like you still have an infection or abscess going on somehow after the root canal. Have you had a course of antibiotics?

I went ahead and got my root canal done two days ago on 6/18. I had been on antibiotics for over two weeks prior, and the tooth was already feeling quite a bit better from the swelling going down. He did the root canal with no anesthetic, since as expected the nerve was already dead. The dentist noted that the tooth seemed quite a bit tighter than it was the last time I visited. The xray taken shows that some of the bone loss may have reversed already. I am hopeful that it will continue to tighten up over time now that the root canal is done and it should be able to heal. I have noticed there is no pain in the tooth and it does not move around as much, to the point I can chew some soft foods on that side now.

 

[sohcsol]

Also forgot to mention, I contacted a law office and described to them everything that has occurred so far. They turned down my case due to a low chance of success. So after this and also having a second dentist back up the first ones course of action, I am pretty certain he is not entirely at fault here.

 

[Deamo55]

Deamo55, it sounds like you still have an infection or abscess going on somehow after the root canal. Have you had a course of antibiotics?

I went ahead and got my root canal done two days ago on 6/18. I had been on antibiotics for over two weeks prior, and the tooth was already feeling quite a bit better from the swelling going down. He did the root canal with no anesthetic, since as expected the nerve was already dead. The dentist noted that the tooth seemed quite a bit tighter than it was the last time I visited. The xray taken shows that some of the bone loss may have reversed already. I am hopeful that it will continue to tighten up over time now that the root canal is done and it should be able to heal. I have noticed there is no pain in the tooth and it does not move around as much, to the point I can chew some soft foods on that side now.

I'm just now finishing 10 days of Augmentin. It feels a little better but not completly gone. I just went back to the Endodontist and she did a gum prick test. She doesn't know how it went from a 3 to a 7 in 3 weeks. She wants me to come back in another week hoping that it will settle down. I'm praying so.