Why Did My Mother's Tooth Turn Black and Crack After Treatment?

Q: Why Did My Mother's Tooth Turn Black and Crack After Treatment?

Ms. <br>Wei： Hello, dentists will try to preserve as many teeth as possible for patients, as retaining more teeth makes the fabrication of dentures easier. <br>However, if it is determined from the beginning that a tooth cannot be saved, it must be extracted to prevent infection.

After dental treatment, the teeth have turned black and cracked!

Hello, Doctor.
I am inquiring on behalf of my mother.
She is 63 years old.
When she was younger, her front tooth was broken by a stone that was hit by a car.
After undergoing root canal treatment, everything was fine for several decades until two years ago when she started experiencing pain in her gums and went to see a dentist.
This led to a series of treatments, and eventually, two adjacent teeth became infected.
A small clinic recommended that she go to a larger hospital for further treatment, or else she would lose her teeth.

Thus, my mother went to the large hospital and continued her treatment.
They were very detailed in their approach, with different treatments from September of last year to April of this year, and each time she saw a different doctor.
It was frustrating that there was no handover of her medical records! One doctor performed the root canal treatment, while another handled the fillings.
At the beginning of this month, when she went for the final filling, the doctor suddenly asked why her tooth hadn’t healed (referring to the root canal treatment).
My mother replied that she was there to get it fixed, and at that moment, the doctor didn’t even know that all the previous treatments had been done at their hospital! Eventually, they reviewed her medical records and then said that her tooth was cracked and might need to be extracted for an implant.
My mother was shocked.
The doctor said it was because she had damaged it by biting down.
However, the doctor had never mentioned that root canal treatment could weaken the tooth, that surgical intervention could make the tooth thinner and more brittle, or that she needed to be cautious about her bite or consider a crown.
As a result, my mother’s tooth cracked! Now her gums are swollen and painful!
The issue is that the initial reason for seeking treatment was to avoid extraction and to save the tooth, but now it seems she may still need to have it extracted.
Additionally, there are two adjacent teeth that were supposedly treated and filled, but they never mentioned needing crowns at that time.
Now they are saying that crowns would be better! However, doesn’t getting crowns require reducing the size of the teeth? Wouldn’t that potentially harm the original teeth? I am a bit confused and would like to consult with the doctor.

Currently, my mother has one front tooth that is black and cracked, and there are two treated teeth on the left side for which the doctor also recommends crowns.
The black tooth needs to be extracted and replaced with an implant, which is quoted at 80,000 to 140,000 TWD.
The crowns would also cost 15,000 TWD each, totaling 30,000 TWD.
This is a financial burden for our family.
I remember there used to be a dental bridge option that required adding one more tooth, totaling four teeth, which would only cost around 60,000 TWD.
However, this hospital did not mention this option.
Is it no longer available?
It seems that the doctors did not inform us about the need for crowns after root canal treatment, leading us to believe that continuous treatment would restore the teeth, which ultimately resulted in further damage.
Does the hospital bear no responsibility for this? It took so much time running back and forth for treatments.
If they had advised us to extract the tooth from the beginning, we wouldn’t have spent so much time going to the hospital.

P.S.
I apologize for the lengthy message.
Thank you, Doctor.

Miss Wei, 40~49 year old female. Ask Date: 2017/04/24

Dr. Zhu Guanyu reply Dentistry

Ms.
Wei: Hello, dentists will try to preserve as many teeth as possible for patients, as retaining more teeth makes the fabrication of dentures easier.
However, if it is determined from the beginning that a tooth cannot be saved, it must be extracted to prevent infection.
When a dentist assesses whether a tooth can be preserved, there are many factors to consider, including the amount of remaining tooth structure, the potential for future restoration, the patient's overall health, existing conditions and medical history, oral hygiene habits, cavity rate, dietary habits, and more.
When a tooth is on the borderline between being treatable and untreatable, and the patient wishes to keep the tooth, the dentist will usually make every effort to treat it.
However, if the treatment process is prolonged, there can be many variables that may ultimately lead to the tooth being unsalvageable, especially if the patient accidentally bites down on something hard and cracks the tooth or if the tooth develops new cavities.
Regarding dental bridges, a strong supporting tooth is necessary to create a bridge.
If the adjacent teeth in the edentulous area are in poor condition or if the gap is too long, it will not be possible to fabricate an ideal bridge.
If you have any questions about subsequent treatments, please feel free to come to our department for further examination.
Thank you for your inquiry.
Wishing you peace and health.
Sincerely, Dr.
Kuan-Yu Chu, Chief of Dentistry, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/04/24

More Info

I'm sorry to hear about your mother's dental issues. It sounds like a complicated situation, and I understand your concerns regarding the treatment she has received. Let’s break down the issues surrounding her tooth turning black and cracking after treatment, as well as the implications of root canal therapy and the need for crowns.

Firstly, the discoloration of a tooth after root canal treatment is not uncommon. When a tooth undergoes root canal therapy, the pulp (the innermost part of the tooth containing nerves and blood vessels) is removed. Sometimes, the remaining tooth structure can become discolored due to various factors, including the presence of necrotic (dead) tissue, the type of filling material used, or even staining from food and beverages. In your mother's case, the blackening of her tooth could be attributed to the remnants of necrotic tissue that were not completely removed during the procedure or due to the materials used in the root canal treatment.

The cracking of the tooth is another significant concern. After a root canal, the tooth can become more brittle, especially if a crown is not placed afterward. The lack of a crown can leave the tooth vulnerable to fractures from normal chewing forces. It’s essential to understand that teeth that have undergone root canal treatment often require crowns to provide structural support and prevent future fractures. If the dentist did not inform your mother about the necessity of a crown after the root canal, this could be seen as a lapse in communication and patient care.

Regarding the need for crowns, it is true that placing a crown often requires some reduction of the tooth structure. However, this reduction is necessary to ensure that the crown fits properly and provides adequate protection to the remaining tooth. While it may seem counterintuitive to reduce the tooth further, the goal is to preserve the tooth's functionality and prevent more extensive damage in the future.

As for the financial aspect, dental treatments can indeed be costly, and it’s understandable that the proposed costs for implants and crowns may be a burden. Dental bridges are an alternative to implants, but they also require healthy adjacent teeth to serve as anchors. If the surrounding teeth are not in good condition, a bridge may not be a viable option. It’s essential to have a thorough discussion with the dentist about all available options, including the pros and cons of each, to make an informed decision that fits within your budget.

In terms of the hospital's responsibility, if there was a lack of communication regarding the treatment plan and the necessity of crowns, it could be argued that there was a failure in providing adequate patient education. Patients should be fully informed about their treatment options, potential outcomes, and the importance of follow-up care. If your mother felt that she was not adequately informed, it may be worth discussing her concerns with the dental practice or seeking a second opinion from another dentist.

In conclusion, your mother's situation is complex, and it highlights the importance of clear communication between patients and healthcare providers. It’s crucial for patients to feel empowered to ask questions and seek clarification about their treatment plans. If your mother is experiencing pain and swelling in her gums, it is advisable to seek immediate dental care to address any potential infections or complications. Additionally, exploring all treatment options, including financial assistance or payment plans, may help alleviate some of the financial stress associated with her dental care.

Similar Q&A

Understanding Root Canal Treatment: Addressing Post-Procedure Complications

Hello, about three to four years ago, I had a root canal treatment. Since then, I have had a few cracks in that tooth, but there haven't been any significant issues. Recently, I noticed a small black spot on that tooth, and when I used an interdental brush to poke at it, it ...

Dr. Zeng Guanghui reply Dentistry
Teeth that have undergone root canal treatment can develop cavities in the crown area if proper oral hygiene is not maintained, leading to crown damage or fracture. Additionally, teeth that have had root canal therapy tend to have more brittle dentin, making them more susceptible...

Understanding Tooth Sensitivity After Dental Treatment: Causes and Solutions

Hello Doctor, I have a second lower molar on the right side that was filled when I was a child. About four years ago, I noticed a black line, but after several visits to the dentist, they all said it was fine. Last year, I started experiencing pain when biting down on harder food...

Dr. Lin Jiayong reply Dentistry
Hello, everything seems to be proceeding normally at the moment. The doctor is very attentive and has considered many issues. The rubber dam is indeed more likely to be used during root canal treatment. It is advisable to follow the doctor's current instructions. You may als...

Bleeding While Brushing and Flossing After Root Canal Treatment: What to Know

Hello Doctor: About seven years ago, I underwent root canal treatment. Five years ago, that tooth cracked while chewing food, and the dentist used a black filling material to repair it. Since then, I have not experienced any pain or bleeding. However, in the past two days, I have...

Dr. Huang Zhicheng reply Dentistry
Hello, based on the above situation, you should go to a clinic for an X-ray to obtain a detailed diagnosis. Since your tooth was previously filled due to a crack, it cannot be ruled out that it may have cracked again. As you are currently abroad, please avoid biting down on hard ...

Concerns About Black Substance After Dental Crown Procedure

Hello Doctor: My question is a bit lengthy, and I appreciate your time in reading it. About 8 years ago, I had a root canal treatment on my lower right molar. At that time, I did not immediately get a crown, only a filling. Later, I noticed a black substance at the interface betw...

Dr. Lin Jiayong reply Dentistry
Hello: Whether discolored enamel needs to be removed should be determined by the treating dentist in a clinical setting. The main factors to consider are the hardness of the discolored enamel. If it is already very hard, it usually indicates that bacteria can no longer penetrate ...