Seeking advice RCT Crown Infection/ Canker HELP

[emmadudlyke]

Hi there,

I've attached the X_Ray looking for the source of my infection around my crown.

I received a root canal treatment when I was 19 years old (now 26 years old) and had a metal/ porcelain crown fitted. Everything was working fine, until one Halloween I ate a Black Jack which pulled off the crown straight off a few years back - which I then had re-fitted back by another dentist. Since then I've always felt like it had been slightly not fitted correctly, but I didn't mention anything.

About a year ago my RCT Dentist suggested I get a new Crown (even though they did tell me mine I would only need to change after 10-15 years). For quite a few months now I've been experiencing bad smells whenever I have flossed around my crown (no where else) and 4 months ago a small BUBBLE appeared on my gum next to it and so I pressed it - and this bad smelling liquid oozed out (must be an infection) Now I know every time I floss, the bubble fills up as if I irritate that area, and so I went to my dentist and he took an X-Ray. He said usually it is possible with RCT that they don't clean out all of the decay from the initial treatment and this causes infection, or there is a crack in the root that allows bacteria to grow. The X-Ray showed no cracks on my root and so he gave me an option of drilling through my perfectly fine crown to observe and inconsistencies, OR I pay £100 for a 3D-scan ( but he stressed this option may not confirm the crack or the infection origin). My gut instinct from the beginning was to take anti-biotics or just replace the whole crown and clean up the surface and now after the first procedure - he has confirmed that there was no crack or anything wrong, but has left me now with half-a crown that wasn't entirely cleaned and is filled up with a temporary filling which in my option will leave this area more vulnerable. Instead of finishing of the inspection in one session, I have to go again and finish off what he started - and now replace my entire crown anyway.

After the first treatment, my BUBBLE filled up again and with blood this time and there is still a very bad taste of infection or decay from underneath the crown.

Has any had this experience? I'm not sure what to do because now I'm paying out of my nose for treatments that didn't need to be invasive in the first place.

Any advise would be much appreciated :0 Thankyou

 

[honestdoc]

On the x-ray, it looks like you have cavities or damage on both sides of the crown. With the indicator going down mid root, it looks like a possible vertical root fracture. You cannot see incomplete fractures on x-rays unless the 2 segments are separated. Ask the dentist to perio probe around the area. A positive sign is normal probings until it hits that damaged spot with the probe showing deep readings of narrow width. Consider and prepare for tooth extraction and possible implant in the future.

Molar tooth behind the crown also has cavities. Do you drink a lot of sugary beverages such as soda, sweetened coffee/tea, energy drinks, sports drinks, and/or juices? You have a very high risk of cavities and if not controlled, you will lose more teeth.

 

[emmadudlyke]

Hi there!!

Thanks so much for the response and taking the time to help and share expertise.

I had a long phone call with my dentist today to go through actually what the diagnosis was and how we would proceed. Upon taking out the old root canal yesterday and going to the level of the indicator - he didn’t find any fracture or cracks? It’s a fact, I have a very low level infection but he couldn’t find the source. My gut it that the issue lies on the sides of the crown. Anyway - So I will be going in again to re do the process, sterilise and replace the temporary dressing with a more permanent one until I get a new crown. Is there any antibiotics I can take?

Filling is happening on my next visit, thanks for spotting!

Regarding sugar, and diet - I was 18 and didn’t think about these things and this was when the I caused damage to my teeth. Cross fingers I don’t have any other issues - I don’t eat sweets/ fizzy drinks/ energy drinks/ junk food and have cut out sugar for 2 weeks now bar from my fruit. I floss everyday and have an electrical tooth brush... and occasionally oil pull. I have expertise in nutrition so I guess naturally I avoid these harmful sugary foods.

 

[emmadudlyke]

Do you not think tooth extraction is for high level infection and damage? My dentist said it’s a good thing he didn’t find any cracks or fractures?

I feel like perhaps he’s missing something...

 

[honestdoc]

I feel better about you not consuming excessive sugary beverages and that you are flossing & brushing regularly. We cannot detect root fractures below the bone level. It is up to the dentist to restore the tooth. Make sure the dentist perio probe around the area to make sure the gums and bone are intact. It would be a shame to invest in a crown and have to pull the tooth shortly afterwards. Best wishes!

 

[MattKW]

RCT looks v good. I would be strongly suspecting a vertical crack. You can't fix vertical root fractures, nor can they be detected on any type of x-ray. If your dentist isn't sure, then I would suggest you go see an endodontist before damaging the crown. I certainly wouldn't take out that RCT without very good reasons.