Common Dental Issues: Expert Advice on Tooth Concerns and Treatments

Dental issues

Hello Dr.
Lin, I have a few questions regarding dental issues.
A friend of mine went for a routine dental check-up where the dentist performed a basic examination and took X-rays.
He has a dental prosthesis that needed to be redone.
After its removal, it was noted that he had previously undergone root canal treatment and had a post placed for stabilization.
The dentist indicated that the condition was acceptable and that no further treatment was necessary, only a simple replacement of the prosthesis.
However, my friend noticed that the remaining small tooth where the post was placed is black.
When he asked the dentist, he was told that this discoloration is due to the nerve being removed and that it cannot be completely ground down.
Should he really not be concerned about this?
Additionally, he is contemplating a tooth that has undergone root canal treatment but has gradually deteriorated and discolored, appearing to have some small transparent cracks.
The X-ray shows some curvature in the root.
He is unsure which treatment option to pursue.
Different dentists have provided varying recommendations; he could opt for porcelain veneers or possibly a crown, which would require some reduction of the tooth structure.
Would tooth whitening be able to improve the appearance of that tooth without causing significant differences in the overall look? We would appreciate your advice.
Thank you!

Yangguang, 30~39 year old female. Ask Date: 2006/10/23

Dr. Lin Qingye reply Dentistry

Dear Miss Sunshine,
Dental treatment requires a comprehensive evaluation and thorough examination to develop the best treatment plan.
In addition to an intraoral examination, X-rays are typically needed to assist in diagnosis.
It is essential to accurately assess the condition of the teeth to make an informed judgment.
Since I have not personally seen your friend's dental condition, I can only suggest that if you have any doubts, you should discuss them with the attending dentist or consult a family dental specialist for advice, which would be more beneficial for him.

Wishing you a speedy recovery.

Dr.
Lin

Reply Date: 2006/10/23

More Info

Dear Friend,
Thank you for reaching out with your dental concerns. It sounds like your friend is dealing with a complex situation involving previous dental work, and I appreciate the opportunity to provide some insights based on the information you've shared.

Firstly, regarding the tooth that has undergone root canal treatment and has a post (the "pin" used to support a crown), it is not uncommon for the remaining tooth structure to appear dark or discolored after the nerve has been removed. This discoloration is typically due to the breakdown of the tooth's internal structure and is not necessarily a cause for alarm, especially if the tooth is stable and asymptomatic. However, it is essential to monitor the tooth for any signs of infection or further deterioration. If the dentist has assessed that the tooth is structurally sound enough to support a new crown or prosthetic, then it is likely that they believe it can function adequately without further intervention.

As for the tooth that has undergone root canal treatment but is showing signs of discoloration and small cracks, this is a more concerning issue. The presence of cracks can indicate that the tooth is under stress, which may lead to further complications, including fractures or the need for extraction. The options for treatment in this case typically include:
1. Dental Crown: If the tooth is still structurally sound, placing a crown can provide strength and restore function. This is often the preferred method for teeth that have undergone root canal therapy, especially if there are visible cracks or discoloration.

2. Veneers: If the tooth is not significantly compromised and the primary concern is aesthetic, a porcelain veneer might be an option. However, veneers are usually more suitable for teeth that are not heavily restored or compromised.

3. Bleaching: Internal bleaching can sometimes be performed on discolored teeth that have undergone root canal treatment. This process involves placing a bleaching agent inside the tooth to lighten its color. However, this method may not address structural issues like cracks.

4. Extraction: If the tooth is severely compromised and cannot be restored, extraction may be necessary. This is usually a last resort when other treatments are not viable.

Your friend should have a thorough discussion with their dentist about the best course of action. It is crucial to consider the long-term prognosis of the tooth and the potential need for future treatments. If there is uncertainty, seeking a second opinion from an endodontist (a specialist in root canal treatments) or a prosthodontist (a specialist in restoring and replacing teeth) may provide additional clarity.

In summary, while the dark coloration of the tooth after root canal treatment is not uncommon, the presence of cracks and discoloration in another tooth warrants careful evaluation. Your friend should weigh the options of crowns, veneers, or bleaching with their dentist, considering both functional and aesthetic outcomes. Regular follow-ups and monitoring will be essential to ensure that any treatment chosen remains effective over time.

I hope this information helps clarify your friend's situation and assists in making informed decisions regarding their dental health. Please feel free to reach out with any further questions or concerns.

Best regards,
Doctor Q&A Teams

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