Root canal treatment Archives - Dr. Duane Delaune's Blog

Why Did I Need Root Canal Treatments After Porcelain Veneers

Posted on June 4, 2021 by writeradmin.

I had ten veneers placed on my upper teeth and the same number placed on my bottom. During the diagnostic stage, I was told everything was fine and there were no real risks involved. Since the procedure, I’ve had a lot of pain. My dentist made a few height adjustments, but that did not seem to help. Then, two of the teeth developed an abscess and, when he did the x-rays, it showed my nerves have died, even though they were fine before. Now I have had to have root canal treatments. I’m still in pain and worried more of my nerves will die. My dentist said he’s never had this happen with veneer crowns. What is going on?

Jayla

Dear Jayla,

The first thing I am wondering about is whether you actually received dental crowns instead of porcelain veneers. There are a couple of things that make me things this. First, you called them veneer crowns. That is not a thing. Either you have porcelain veneers or you have dental crowns. There is not a combination. A second inconsistency here is the height adjustments that were made. That is something done with dental crowns. Finally, it is the damage to the nerves.

The Difference in Preparation between Crowns and Veneers

Tooth preparation for porcelain veneers

When a tooth is prepared for porcelain veneers, there is hardly any of the tooth structure removed. Here is an example in the image above. Notice only the surface is affected. Now contrast this with the image below.

Preparation for a Dental Crown

Notice with this tooth, much of the tooth structure had to be removed. It is a much more aggressive preparation and your nerves are at a greater risk as a result. I think this is the treatment you received.

One way to tell is by how far around the tooth your restoration is. With porcelain veneers, it just covers the very front of your teeth and will hug the sides slightly. But, with porcelain crowns, the restoration goes around your entire tooth, including the back.

If your dentist told you that you were getting porcelain veneers, but then gave you porcelain crowns, that is unethical. Plus, if the only reason for the restorations was a smile makeover, porcelain veneers are what you would do— not dental crowns. To be honest, I would tell your dentist he needs to cover the cost of the root canal treatments. I’m sorry this happened to you.

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Is My Dentist Just Trying to Scare Me?

Posted on April 23, 2020 by writeradmin.

I have an abscessed tooth on one of my upper teeth. I called my dentist and asked for antibiotics, but he said he wants me to come in instead. I told him I didn’t want to go anywhere until after the quarantine. He proceeded to tell me he could give me one prescription of antibiotics, but after they run out the infection will return and, if I don’t get it treated, will spread to my brain.

I know most governors have closed dental offices because of COVID-19, except for dental emergencies. Is this just my dentist trying to scare me so he can get some business? I’m sure he needs the business and I understand he’s likely struggling financially, but I don’t want to risk getting this virus so he can make some money.

Mark

Dear Mark,

This isn’t your dentist’s way of trying to get money. He is trying to protect you though. Dental infections are a bit different in that antibiotics alone are not enough. At some point, the pulp of your tooth dies, which prohibits blood flow from reaching the infected tissue.

Your tooth will start to feel better for a bit, but then once the antibiotic runs out, it will return. While that doesn’t guarantee it will spread to your brain, I can pretty much guarantee it will spread. Your jaw is close, not just to your brain, but also your heart and lungs. Any one of those can become life-threatening quickly. That’s just one of the reasons a tooth infection is considered a dental emergency and why even during quarantine it is an allowed treatment.

To treat an infected tooth a dentist has to get in there and physically remove the infected pulp. This can be done in one of two ways. First, he can do a root canal treatment. Second, he can do a tooth extraction.

It is always better to save a tooth, if at all possible. If not, then you have to add the additional procedure and expense of replacing the tooth. If it turns out your tooth can’t be saved and it does have to be extracted, ask your dentist how experienced he is in dental implants. It is by far the best tooth replacement option available. However, it is an advanced procedure and requires a dentist to have significant post-doctoral training.

I know you’re worried about Coronavirus, but I can assure you that your dentist doesn’t want it any more than you do. He’ll take every available precaution for the protection of you, his staff, and himself.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Damage After Crest Whitestrips

Posted on April 1, 2020 by writeradmin.

I had a damaged tooth from years ago that has always been a bit darker than my other teeth. It’s always embarrassed me about my smile. I recently talked to my dentist about it and asked if tooth whitening would be a good idea. He doesn’t offer that service but said that Crest Whitestrips work. After about a week my teeth became sensitive. I went back and he said he thinks I need a root canal treatment. I don’t know why it would. Do you think I need a second opinion? Also, if Crest Whitestrips won’t work for me should I try another dentist who does do teeth whitening?

Calli

Dear Calli,

Teeth whitening trays

Your dentist showed a fundamental lack of understanding about teeth whitening. I’m glad to hear he doesn’t offer the procedure because he’d do one of the simplest cosmetic procedures ever wrong. No matter what type of teeth whitening you do, it will whiten the teeth evenly. So even if this darker tooth got whiter, so would all the other teeth around it. Therefore, the tooth would still be darker than the rest of them.

In this situation, you would need dental bonding or a porcelain veneer. Either one of these procedures would require an expert cosmetic dentist. Your dentist doesn’t qualify. Before we go onto finding an expert cosmetic dentist I want to address your immediate issue.

I would get a second opinion before getting a root canal treatment. Crest Whitestrips aren’t very strong. They do whiten, but it would take a significant number of boxes to match what you would get with a dentist. Even then, you would only have your first six teeth get whitened because that is all the strips will reach. I would be surprised if it caused you to need a root canal treatment. That doesn’t mean you didn’t have something else going on.

Bottom line. Get a second opinion. After that is dealt with, if you decide you want to get that tooth fixed cosmetically, I suggest you go to the mynewsmile.com website. They recommend expert cosmetic dentists by zip code. So you should be able to find one in your area.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.

Is it Normal to Need a Root Canal Because of Porcelain Veneers?

Posted on March 18, 2017 by writeradmin.

I had porcelain veneers placed. I really love them. The change they’ve made to my smile makes me feel beautiful. The only problem I’ve run into is tooth sensitivity, especially cold substances. My dentist said this can happen and I’ll need a root canal treatment. Shouldn’t he have warned me this was a possibility? I’m terrified of the idea of a root canal. Is it absolutely necessary, or ore there other options to explore first?

Corrine – Maryland

Corrine,

The need for a root canal treatment is actually very rare with porcelain veneers. Your teeth are made up of layers. Those layers protect the nerves in your teeth. Exposed or bothered nerves cause the sensitivity. If someone has thin enamel or larger than normal pores, that can lead to sensitivity. Porcelain veneers usually help with that because even though there might be some minor shaving for tooth preparation, the veneer itself adds extra protection.

The nerves respond to their environment. If nothing is going on around it, it will generally stay pretty happy. Initially, when you had your veneers placed, your nerves could have popped their heads up wondering what was going on, but that should have settled down fairly quickly. If several weeks have gone by and it’s still acting up, some investigating needs to be done— before you get a root canal treatment. The cause of the sensitivity needs to be nailed down.

I can think of two things right off the bat which should be looked into.
1. The bond between the veneers and your teeth could be damaged allowing things to get between the teeth.

2. Your bite could be off. If your bite has never been off before, improperly placed veneers can throw it off. If your bite is off, the teeth can be continually bumping up against one another angering the nerve. If it’s from the veneers, some adjustments can be made to repair that.

This blog is brought to you by Dr. Duane Delaune.