Complications of Fixed Dentures and Root Fractures

Q: Complications of Fixed Dentures and Root Fractures

Hello： 1. It's uncertain; a treatment plan can only be established after examining the actual oral condition and X-rays. 2. You can seek a second or third opinion before starting treatment. 3. No, however, dentures are considered out-of-pocket expenses, and ty

Fixed dentures and issues related to root fractures?

Hello, Doctor.
I have a tooth (number 45) that has undergone root canal treatment, had a post placed, and received a zirconia crown.
It has been almost two years since the procedure.
Recently, I have experienced occasional mild discomfort (for about a week), and one day, while drinking ice water, I felt severe pain (on a scale of 1 to 10, it reached 7) that lasted for about five minutes before returning to normal.
After that, I also felt discomfort when biting down on food.

I visited my dentist, who noted that my gums were inflamed.
An X-ray was taken, and the dentist mentioned that the tooth had experienced some trauma and was injured.
I was advised to eat on the opposite side for two weeks and then switch to soft foods, avoiding hard foods to prevent the risk of fracture, which could lead to extraction.
(Prior to the pain, I had not experienced any trauma or eaten hard foods, but I have been under a lot of stress lately, and I wonder if I might be grinding my teeth unconsciously while sleeping.)
It has been over ten days since then, and I feel some improvement; I haven't had any sudden pain, although I still feel discomfort occasionally when using dental floss.
Light tapping with my fingers also causes some discomfort, especially when pressing on my face (around the chin and tooth root area).
During a follow-up visit at the same clinic for other cavities (with a different dentist), I was again advised that I should only eat soft foods with that tooth, or else I risk fracture and extraction.
My questions are:
1.
If I were to redo the crown or undergo further root canal treatment, is it possible to save this tooth and restore its function to allow me to eat peanuts and nuts?
2.
Would it be beneficial to seek evaluation at a different clinic?
3.
Would seeing a different dentist cause any issues for the other dentists (such as with insurance coverage)?
I feel like I have a ticking time bomb in my mouth, and it's causing me some anxiety.
I apologize for the lengthy message, but I appreciate your advice.
Thank you, and I wish you and your family peace, health, happiness, and success.
Thank you!

Xiansheng, 20~29 year old female. Ask Date: 2022/08/25

Dr. Lin Jiayong reply Dentistry

Hello: 1.
It's uncertain; a treatment plan can only be established after examining the actual oral condition and X-rays.
2.
You can seek a second or third opinion before starting treatment.
3.
No, however, dentures are considered out-of-pocket expenses, and typically, the original clinic will be asked to remove them or provide a referral.

Reply Date: 2022/08/25

More Info

Understanding the complications associated with fixed dentures and root fractures is crucial for maintaining oral health and making informed decisions about dental treatments. Based on your description, it seems you are experiencing discomfort in a tooth that has undergone root canal treatment and has a zirconia crown. The pain you described, especially when consuming cold beverages, could indicate several underlying issues that need to be addressed.

Potential Complications
1. Root Fractures: A root fracture can occur due to trauma or excessive force applied to the tooth. This can lead to pain, discomfort, and even infection if the fracture extends into the root canal. The fact that you mentioned experiencing pain after drinking cold water suggests that there may be an issue with the tooth's vitality or structural integrity.

2. Periapical Inflammation: The inflammation of the gums around the tooth, as noted by your dentist, can be a sign of infection or irritation. This could be due to a failing root canal treatment, where bacteria have re-entered the root canal system, or from the fracture itself.

3. Crown Failure: Sometimes, the crown may not fit properly or may have developed cracks, leading to discomfort. If the crown is compromised, it may not provide adequate protection to the underlying tooth structure.

4. Bruxism: You mentioned the possibility of grinding your teeth at night due to stress. Bruxism can exert excessive pressure on teeth, leading to fractures or discomfort. This condition often requires intervention, such as a night guard, to protect the teeth.

Treatment Options
1. Re-evaluation and Diagnosis: It is essential to have a thorough examination, possibly including advanced imaging like a cone-beam CT scan, to assess the extent of any fractures or infections. This will help determine the best course of action.

2. Root Canal Retreatment: If the root canal treatment is deemed unsuccessful, retreatment may be necessary. This involves removing the existing filling material, cleaning the canal, and sealing it again.
3. Crown Replacement: If the crown is found to be defective or improperly fitted, replacing it may alleviate discomfort and protect the tooth better.

4. Extraction: In cases where the tooth is severely compromised and cannot be saved, extraction may be the only option. This would be followed by discussing prosthetic options, such as implants or bridges.

5. Consultation with a Specialist: If you feel uncertain about the diagnosis or treatment plan, seeking a second opinion from an endodontist (a specialist in root canal treatment) or a prosthodontist (a specialist in crowns and dentures) can provide clarity and additional treatment options.

Considerations for Seeking a Second Opinion
- Insurance and Coverage: If you are concerned about insurance coverage, it is advisable to check with your provider regarding coverage for consultations with specialists. Most insurance plans allow for second opinions, but it's best to confirm.

- Communication with Your Dentist: If you decide to seek a second opinion, it’s generally a good practice to inform your current dentist. This can help maintain a collaborative approach to your care and ensure that all parties are aware of your treatment history.

- Mental Health: Feeling anxious about your dental situation is understandable, especially when it feels like a "ticking time bomb." It may be beneficial to discuss your concerns with your dentist or a mental health professional, particularly if stress is contributing to bruxism or other dental issues.

Conclusion
In summary, the discomfort you are experiencing could stem from various complications related to your fixed denture and root canal treatment. It is essential to address these issues promptly to avoid further complications. Seeking a second opinion can provide you with peace of mind and additional treatment options. Remember, maintaining open communication with your dental care providers is key to achieving the best outcomes for your oral health.

Similar Q&A

Understanding Complications After Root Canal Treatment: Causes and Solutions

My mother underwent root canal treatment on her molar three months ago, which resulted in gum issues and facial nerve paralysis. After consulting various specialists, most attributed the symptoms to nerve damage. She is currently following the doctor's instructions for medic...

Dr. Xu Zhenglong reply Dentistry
1. If there is already an apical infection before root canal treatment, it can lead to complications such as cellulitis. Additionally, viral infections and prolonged exposure to cold air can potentially damage the facial area and even the nerves. 2. During root canal treatment,...

Solutions for Misfitting Dentures: Addressing Common Dental Issues

What are the corrective measures for ill-fitting dentures? Currently, I have replaced four upper anterior teeth and lateral incisors with all-ceramic crowns for aesthetic reasons. After wearing the temporary denture for the first time, I reported to the dentist that my teeth appe...

Dr. Lin Jiayong reply Dentistry
Hello: According to what you mentioned, another physician has improved the condition of your swollen and cracked lower lip, and there is a plan to create a new model. If this physician and the original physician are working at the same facility or clinic, it should be easier to a...

Fixing Issues with Porcelain Crowns: Addressing Bite and Speech Problems

A few months ago, I developed cracks in my front teeth, and I accidentally bit down on a metal chopstick, resulting in damage to the two central teeth. They are also tilted to the sides, and there is some dark discoloration near the gums. I am considering getting dentures, but si...

Dr. Lin Jiayong reply Dentistry
Hello: Before it is permanently bonded, there is still an opportunity to make adjustments to the shape and color. It is recommended to discuss this with the original dentist, as it may have been intentionally designed to avoid occlusion, thereby reducing the risk of fracturing ag...

Responsibility in Dental Procedures: What Happens When Things Go Wrong?

The front tooth (tooth 11) needs to undergo an implant surgery due to fracture. The doctor strongly recommends a full porcelain crown for the anterior teeth (positions 13, 12, 11, 21, 22, 23) to enhance aesthetics. However, I recall that the remaining tooth root from a previous c...

Dr. Huang Tingfang reply Dentistry
Dear Ms. Mia, Hello! As mentioned, the fiberglass-reinforced post was removed along with the temporary crown. This is quite serious! Is it the case that the post was pulled out by the dentist, or was it the root that was too short? If it's the former, then the root may need...