Struggles with Root Canal Treatment: Seeking Solutions for Discolored Teeth

Q: Struggles with Root Canal Treatment: Seeking Solutions for Discolored Teeth

Hello QQ： After damage to the dental pulp, bacteria can proliferate within the root canal, and toxins may extend to the apex of the tooth. <br>This can lead to the erosion of the surrounding bone, forming a cyst, which causes the tooth to become mobile. <br>When the lesion is sig

Root canal treatment issues

As a child, I chipped a small corner of my tooth, and as I grew older, the color of the tooth gradually turned yellow.
Feeling something was wrong, I had an X-ray taken and discovered a dark shadow.
The dentist said I needed a root canal treatment.
Since April, I have undergone four treatments, which mainly involved changing the medication.
My tooth condition is quite severe, with a large area of the dark shadow, but I haven't noticed any improvement from the root canal treatments.
The tooth is becoming increasingly yellow, and the gum tissue around the tooth has grown, and the tooth is slightly loose.

I have researched a lot online and learned that a rubber dam is typically used during root canal procedures to maintain cleanliness.
However, during my visits to the dentist, they did not use a rubber dam; instead, they placed a machine in my mouth that continuously made bubbling sounds.
The dentist then removed the previous filling, used files and reamers, applied medication and calcium hydroxide, and then filled the tooth.
After several sessions, the most recent X-ray still showed no reduction in the size of the dark shadow.

Is there still hope for my situation? I am very worried about losing the tooth and needing an implant, especially since it is a front tooth.
The yellow color is unattractive, and I can’t eat hard or sticky foods, which is very inconvenient.

QQ, 10~19 year old female. Ask Date: 2015/08/23

Dr. Huang Zhicheng reply Dentistry

Hello QQ: After damage to the dental pulp, bacteria can proliferate within the root canal, and toxins may extend to the apex of the tooth.
This can lead to the erosion of the surrounding bone, forming a cyst, which causes the tooth to become mobile.
When the lesion is significant, it is often difficult to achieve a successful outcome with root canal treatment alone; sometimes, apical surgery is necessary to retain the tooth.
This procedure must be performed by a specialist in endodontics.
Wishing you peace and health.
Sincerely, Dr.
Huang Chih-Cheng, Director of Dentistry, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/08/23

More Info

It sounds like you're experiencing a challenging situation with your dental health, particularly concerning your root canal treatment and the discoloration of your tooth. Let's break down your concerns and explore potential solutions.

From your description, it seems that you have a history of trauma to the tooth, which has likely contributed to the discoloration and the subsequent need for root canal treatment. The yellowing of the tooth and the presence of a dark shadow on the X-ray suggest that there may be ongoing issues, possibly related to infection or necrosis of the pulp tissue. The fact that you've undergone four treatments without improvement is concerning and indicates that the current approach may not be adequately addressing the underlying problem.

Root canal treatment is designed to remove infected or damaged pulp tissue from within the tooth, followed by cleaning and sealing the canal to prevent further infection. The use of a rubber dam during this procedure is standard practice as it helps maintain a sterile environment, preventing saliva and bacteria from contaminating the area. If your dentist has not been using a rubber dam, this could be a factor in the lack of improvement in your condition.

The persistent dark shadow on your X-ray suggests that there may be a significant infection or abscess at the root of the tooth. This can lead to bone loss around the tooth and may explain the mobility you are experiencing. In cases where root canal therapy alone is insufficient, additional procedures may be necessary. These can include apicoectomy (surgical removal of the tip of the tooth root) or even extraction if the tooth cannot be saved.

Regarding the discoloration, teeth that have undergone trauma or have had root canal treatment can sometimes become discolored due to the breakdown of blood vessels and nerves within the tooth. If the tooth is still viable, internal bleaching may be an option to restore its color. This procedure involves placing a bleaching agent inside the tooth and sealing it temporarily, allowing the agent to work over a period of time.

Given your situation, it is crucial to seek a second opinion from an endodontist, a specialist in root canal treatments. They can provide a more thorough evaluation of your tooth and the surrounding structures. They may recommend advanced imaging techniques, such as a cone beam CT scan, to get a clearer picture of the extent of the infection and the condition of the bone.

In the meantime, to manage your discomfort and protect your tooth, avoid hard and sticky foods, as you mentioned. Over-the-counter pain relievers may help alleviate some discomfort, but they should not replace professional treatment.

In summary, while your current treatment has not yielded the desired results, there are still options available. Seeking a second opinion from a specialist can provide you with a clearer understanding of your situation and potential treatment paths. Remember, preserving your natural tooth is often the best option, but if that is not feasible, dental implants can be a reliable alternative for restoring function and aesthetics.

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