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Do I Need a Root Canal or an Extraction and Implant?

Dental implant with components identified - crown, abutment, and root formThree years ago, my wife and I got in an accident that released the airbags in our van. I took a hard blow to my face, and since then, my front left tooth has been sensitive on and off. My dentist said she would watch the tooth, but it began to turn dark last fall. I saw my dentist last week for the first time since Covid, and she referred me to an endodontist for a root canal. The endodontist will complete the root canal next week. Will the root canal improve the tooth color, or will I need to see a cosmetic dentist? Should I get an extraction and dental implant anyway? – Thank you. Gordon from St. Petersburg, FL

Gordon,

Thank you for your question.

Will Root Canal Treatment Lighten a Dark Tooth?

Root canal treatment will not lighten a dark tooth. It often makes a tooth darker. Why would root canal treatment darken a tooth? When a dentist leaves root canal filling material and cement in the portion of the tooth above the gumline, the tooth darkens.

Preventing a Tooth from Darkening After Root Canal Treatment

Your dentist can minimize the darkening effects of root canal treatment with these steps:

  • Remove root canal filling and cement from the tooth crown
  • Bleach the tooth internally
  • Seal the bleaching solution inside the tooth
  • Insert a flexible fiberglass post in the tooth and fill the tooth with composite, or correct the color with a porcelain veneer

When most of the structure is left on a front tooth, preparing it for a crown can weaken and increase the risk of breaking it. A cosmetic dentist can correct the color with a porcelain veneer after root canal treatment if your front tooth is intact.

Unless your tooth is severely damaged and the endodontist (a root canal specialist) cannot save it, it is best to preserve it and avoid extraction and a dental implant. We recommend scheduling a second opinion with an advanced cosmetic dentist to examine your tooth and discuss your treatment options.

 

Moline, Illinois dentist, Dr. Thomas Goebel, sponsors this post.

Why Are My Gums Bleeding Around My Crowns?

I got five new crowns three years ago, and I think I may be allergic to them now. For the past few months, I have noticed bleeding between two crowns and my gums. My dentist says my crowns are GC LiSi Press ceramic, so it is unlikely that it’s an allergy. Is it possible that I am allergic to the material? What could be irritating my gums? Will I need new crowns, or am I at risk of losing my teeth? Thanks for your help. Jayla T. from TX

Jayla,

Thank you for your question.

Dr. Goebel would need to examine your crowns and gums to determine what is irritating your gums. We will provide information on sensitivities to lithium disilicate.

What Are GC LiSi Press Crowns?

GC LiSi Press crowns are ceramic, lithium disilicate crowns. You would unlikely be allergic to only two of your five GC LiSi Press crowns. We have not heard reports of lithium disilicate allergies, but it is not impossible for someone may react to it.

What Causes Bleeding Around Dental Crowns?

Diagram of dental implant components and a dental implant in the bone next to a natural tooth
Dental crown irritation should not be a cause for tooth removal and an implant

Food particles caught between your gums or a functional problem with the crowns near your gumline may cause bleeding and irritation. When you floss, try to discern whether anything around your crowns is catching the floss or preventing it from moving freely. Snagging floss usually means your dentist must correct an overhang or ledge on the crowns.

It is unlikely that your concerns are related to a condition leading to tooth loss and the need for replacement options, such as a dental implant.

Schedule an appointment with your dentist for an examination. If your dentist cannot resolve the issue, get a second opinion from a skilled cosmetic dentist.

Moline, Illinois dentist, Dr. Thomas Goebel sponsors this post.