How Long Can I Put Off a Root Canal Treatment?
If I have a tooth that needs a root canal treatment, how long can I put it off before I have to get one? I’ve been swamped with work and I can’t afford to take any time off right now.
Everett
Dear Everett,
While I cannot give you definitive timelines, I can give you some general guidelines. Please bear in mind that I have not examined you or even seen any x-rays, so this is just based on general information. Everyone’s body is different. If you want definitive advice, then it is important you see a dentist and let them examine you.
If your tooth is hurting, even a little bit, then you need to have the root canal done. This mean that you have an active infection. Another red flag is if there is a pimple on your gums. This is known as an abscessed tooth.
Depending on how severe your pain is, I would not necessarily call it a dental emergency, but you do want to get this scheduled or it will turn into one. So, don’t put off having this attended to.
Believe it or not, multiple people still die from tooth infections every year. When left untreated, a tooth infection will continue to spread outside of your mouth. If it reaches your heart or brain, what could have simply dealt with becomes life threatening.
If you do not have an active infection, then you are probably safe to wait. I’ve known people who waited years to get their root canal treatment. However, they did say that when they finally got it done, they noticed that they felt much better in general than they had in years.
I want to make sure that you are aware that by waiting, you risk external resorption. This is a condition where the infection eats away at the root of your tooth. When this happens the tooth is no longer able to be saved. Then, you are stuck with an extraction and the need to replace the tooth.
If you don’t replace the tooth, then the adjacent teeth will shift or tip into the empty space. This will throw off your bite and can lead to painful TMJ disorder.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Will Household Bleach Whiten Teeth?
If I am looking to whiten my teeth but don’t really want to go to the dentist, would using household bleach to rinse around in your mouth whiten them? I’m looking for options to improve my smile but am new to town and haven’t really set up with a dentist yet.
Avelyn
Dear Avelyn,
Bleach, such as Clorox used in laundry, is a base. Another base you may have heard of is Lye. It’s a rather strong corrosive that will destroy living tissue. In fact, dentists often use it in root canal treatments. An active ingredient in bleach, is sodium hypochlorite. This cleanser can be used inside a tooth to get rid of any dead organic material left in a tooth. While it dissolves the organic material, it also cleanses the inside of the tooth, like a disinfectant. This isn’t dentists using cheap-o material. It is actually a process taught in dental school.
If you swish it around in your mouth, then you are going to be damaging any tissue you have in your mouth, including your cheeks and gums. The only safe and effective way to whiten your teeth is with professional teeth whitening.
Second, when bleach comes in contact with certain types of other chemicals, it is a reaction which actually turns it into a deadly gas. You would not want to breathe those vapors in.
I would use this as an opportunity to find your new dentist. You will have to have your teeth thoroughly cleaned before you whiten them anyway. If you don’t do that, then your results will be splotchy.
While you are looking for a dentist, is a good time to assess what type of services you need. The dental world has really grown. While teeth whitening is, technically, a cosmetic procedure, it is the easiest of the cosmetic procedures and pretty much any dentist can do it. However, if you are going to want any of the more advanced procedures, such as porcelain veneers, then you will want a dentist with advanced post-doctoral training in smile makeovers. These are not adequately taught in dental school and a dentist has to invest in training after they graduate to get the training they need.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Using Antibiotics for a Tooth Infection
Almost two weeks ago I went to the dentist for an infected tooth. It was pretty bad and even my cheek was swelling. He gave me some antibiotics, which I took in full. The swelling was almost gone. A few days later it started back up again. Do I go back to the dentist or do I just need a refill on my antibiotics?
Peter
Dear Peter,
I think there was a miscommunication with your dentist. The antibiotic should have been just to get your tooth infection under control and tide you over until the infection can be properly dealt with. It is not meant to, nor can it, heal your infected tooth. The only way to cure a tooth infection is for a dentist to physically remove the infected tooth pulp. There are two ways to properly do this. The first is by extracting the tooth completely. This should be a last resort because natural tooth structure is always best; plus tooth replacements, especially the good ones, are expensive. The second option is a root canal treatment.
Hopefully, it was just a matter of you not hearing your dentist say that you would need a follow up appointment to do the real treatment, though the front desk should have mentioned it when you were checking out. If your dentist did not plan on any follow up treatment, then you need a new dentist because this one does not understand tooth infections.
It is particularly concerning that this started to get better and has now blown up again. I would consider this a dental emergency. Call your dentist as soon as the office is open and tell them what is going on. If they don’t get you in that day, then call around to some other dentists and see who will given the situation.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Delayed Treatment for an Infected Wisdom Tooth
I had some minor pain in a back tooth and went to see my dentist. He told me a wisdom tooth is infected. He gave me some antibiotics and referred me to a specialist. The antibiotics were very helpful. When the specialist saw me, he recommended I remove all of my wisdom teeth but he cannot schedule me for about a month. Since then, the antibiotics have run out and I can feel the pain coming back. Will he be able to treat me if the infection is back?
MaryAnne
Dear MaryAnne,
While you cannot rely on antibiotics alone to solve a tooth infection, in your case, it will be okay to call the specialist and tell him you have run out and need enough to get you through until your procedure. Let him know that you can already tell the infection is returning. He should have no problem writing you a refill on your prescription.
Do not wait to get it refilled. These infections are serious. Generally, they require urgent dental care, but it is okay to keep the infection at bay in the short term with medication. As I mentioned before, it will not heal the infection. The only way to do that is to physically remove the infected pulp of the tooth. Without proper treatment, this can turn life threatening. Our jaws are quite close to our brains and throats. You don’t want the infection reaching either of those places.
To remove the infected pulp there are two treatments: a root canal treatment and a tooth exraction. Generally, a root canal treatment is preferred in order to save a tooth. It is unnecessary on a wisdom tooth, however. This is because you can remove a wisdom tooth without needing to replace it.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Misdiagnosis by an Emergency Dentist Caused a Lot of Pain
I had a tooth that was giving me pain and sensitivity to cold. I am new to the area so I do not have a regular dentist yet. I went to a dentist who advertised as a dental emergency specialist. I went in and he said my wisdom teeth are impacted. I told him that tooth 19 seemed to be the problem, but he said it is definitely the wisdom tooth and that one of them either needs to be extracted or filled. I opted for the filling. This made my pain even worse. I went back and he adjusted the tooth and wrote me a prescription pain medication. All that did was make me loopy. Once the prescription wore off I was in even worse shape. I called back and he said to have the tooth extracted. I told him the pain didn’t feel close to the wisdom tooth at all but he insisted that was the problem. I had the tooth extracted and was again prescribed painkillers along with antibiotics this time. I was okay for a bit while the medicines lasted. Once they ran out, though, I was in complete misery. I finally went to the ER and they did an x-ray and told me that I had an abscessed tooth. I got fed up with this dentist and went to see an oral surgeon out of pocket. He told me it was tooth 19 (shocker) and that it is now too late to save it, so I had that extracted too. I’m so frustrated because I had to do several unnecessary appointments, including the ER, and ended up losing two teeth. Do I have any recourse for this or do I just have to suck it up?
Trent
Dear Trent,
What a nightmare! You certainly have some recourse here. In short, what this dentist did is malpractice. First, I’m going to tell you what to require of him, then I will tell you what mistakes he made.
The first thing I would do is tell this dentist he needs to cover the expenses not only for your extra visits to the oral surgeon and ER, but also for the cost of an implant and a crown to replace your missing first molar, as well as any bone grafting that may be necessary with a dentist of your choosing. If he refuses, tell him you will contact a lawyer and add pain and suffering to the amount. I feel fairly certain his insurance company will tell him to settle quickly.
This “Emergency Dentist’s” Mistakes
Let’s start with the fact that there is no emergency dentist specialty. Any general dentist can schedule emergency appointments and treat patients. He misled you with that. Second, at your initial appointment with cold bringing pain to the tooth, he should have advised you that you would likely need a root canal treatment. I have no idea why he was bringing up your wisdom teeth with these types of symptoms. Then, with your second appointment when you are still having problems, he adjusts your bite? Really? The prescription for antibiotics tells me he either suspected an infection or was just throwing around treatment options willy-nilly. Plus, antibiotics never completely cure a tooth infection. The job of antibiotics is to hold the infection at bay while you are awaiting an appointment for your treatment. By the final appointment, there should have been no doubt. I don’t know how he passed his courses in dental school.
You may be wondering why I’m having you include the tooth replacement in there with what your dentist should cover. It is because if he would have treated this in a timely manner, there is a good possibility you could have saved the tooth. Now that it is out, it must be replaced. Otherwise, the remaining teeth will drift or tip into the space. This will throw off your bite and can lead to painful TMJ Disorder. A dental implant is the best replacement available.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Antibiotics for Tooth Infections
I have a toothache that has me so distracted I am having a hard time getting any work done. I am in the middle of a huge merger and DO NOT have time to see a dentist. I do have a doctor that will write me a prescription for just about anything. I just need to tell him what type of meds I need. Can you help me with that?
B.W.
Dear B.W.,
First, I’m just going to say what your doctor is doing is not only against medical ethics but super dangerous. While I am sure that it is handy to have a doctor willing to do that, I do worry. That being said, an antibiotic will not solve your problem. Instead, it will just be a temporary reprieve. Once the antibiotics run out, your tooth infection will come back with a vengeance.
The only way that you can stop a tooth infection is by having a dentist physically go in and remove the infected pulp. This is because a tooth infection kills the tooth and there is no longer blood flow to the tooth, which means the antibiotic will have no effect on the root of the infection.
You have two choices in truly dealing with a tooth infection. The first is to have a root canal treatment where the dentist goes in and removes the infected pulp. From there you are generally given a dental crown. The good news is that this saves your tooth. It is always better to have as much natural tooth structure as possible.
The second option is if the tooth cannot be saved and the decay and infection have gotten too far. When that happens, the tooth has to be extracted and you will need to replace the tooth. If that happens, I recommend you get a dental implant to replace it. That is the closest to having a healthy natural tooth in your mouth again.
I know you are short on time, but if you let this spread, it can turn from a dental emergency to a medical one. Think about how close your jaw is to your brain and heart. People still die from tooth infections because they allow the infection to spread. I know you are busy, but I really do not want you to put this off. You could call the dentist and ask him to prescribe you an antibiotic, but it will only buy you a short period of time.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
My new crown has been hurting for months
In January, my dentist put a crown over a top left molar that was cracked, sensitive, and had an old silver filling in it. During the procedure, my dentist had trouble getting the tooth numb, so drilling it was quite painful. When the dentist checked my bite, I told her that it hurt to chew on that side. Later during the week, I told the dentist that it was also painful to brush the tooth and floss around it. She never mentioned that I might need root canal treatment.
The dental office told me that the tooth was irritated and would settle down. I return to the office, and my dentist adjusted the crown. She said that if it did not feel better, she would readjust. I delayed the appointment due to the pandemic, but my tooth became quite painful in a few weeks. My dentist adjusted the crown again, and although it was somewhat better, it was still uncomfortable.
Last week when I saw the dentist, she said the tooth has a periapical abscess, and I need an extraction. My dentist has no explanation of why she didn’t see that the tooth was declining during my follow-up visits. How can I request a refund for the same-day crown? And is the same-day crown process the reason I had so many problems? – Thank you. Quinn from Indiana
Quinn,
Thank you for your inquiry.
Based on your description, it sounds like your dentist was somewhat negligent for several reasons:
- Cracked tooth – Your molar tooth was already cracked and at risk of needing root canal treatment. Your dentist should have mentioned the possibility of needing root canal treatment.
- Sensitivity – Some sensitivity after crown placement is common, but the pain you experienced was abnormal.
- Your bite – When your dentist checked your bite, she should have worked to get it right. A crown should blend with your bite so well that you cannot tell the difference between it and your natural teeth.
Requesting a Refund for a Dental Crown
You can request a refund for your crown for several reasons:
- Your dentist did not explain that you might need root canal treatment
- Your dentist placed the crown on a sensitive tooth without addressing the sensitivity
- The same-day crown does not function well and did not function properly when your dentist first checked your bite
- Your dentist did not attempt to treat the tooth despite your complaints further
Several ways to motivate your dentist to refund you include:
- Report the issue to your dental insurance company, if applicable
- File a complaint with the state dental board
- Leave negative online reviews
Consider Root Canal Treatment from a Specialist
Root canal treatment on a tooth with a periapical abscess is worth a try. It may save your tooth—especially if you allow an endodontist, a root canal specialist, to treat it. If there is a chance of saving your tooth, why not consider it? Otherwise, after an extraction, you will need a dental implant or bridge to replace the missing tooth.
Without an implant or a bridge to replace your extracted tooth, you can experience some or all these issues:
- Your adjacent teeth and the tooth opposing the missing one will drift into the space
- You will begin to experience TMJ issues
- Tooth movement can create a need for orthodontic treatment
Get a Second Opinion
We recommend that you get a second opinion from an experienced dentist. A conscientious dentist wants to preserve your teeth and your oral health. Request an examination, discuss your treatment options, and weigh the pros and cons of tooth extraction.
Timothy J. Goebel, DDS, a Moline, IL dentist, sponsors this post.