Expert: Tony Appleton BDS DPDS - 11/10/2008

Question
My daughter broke her jaw when she was 10 yrs old. She is now 16. Within the past yr her dentist discovered in a xray that her front top tooth has no bone or root in it and the other tooth next to it has too much bone and root. We were referred to a Specialist in Endodontics. He did a root canal twice on the same tooth and said everything would be okay because of the root canal. Lately she has been having pain in that tooth. The other day we seen her ortho to have her routine check up on her braces when they took the wire off they discovered her tooth was very very lose. At this point it's just hanging there. If it wasnt for the braces it would just come out. I dont know what to do?? I feel like the Endodnotic specialist that we are seeing has done nothing for her. Needless to say she is in tears. I have been worried sick and I dont know who to turn to at this point. Will she lose this tooth? Please help us.

Answer
Hi Jan

I'm afraid that treatment is not always successful, and that it is not necassarily the endodontist at fault, rather this was probably caused by the original injury 6 years ago.

I can't say whether or not your daughter will lose the tooth, but you have to weigh up what is going to be the best for her future.  If this tooth has had 2 x root canal treatments, and has no bone support, then even if it could be saved now, what will it be like in 10 or 20 years?  In other words if you bear in mind the poor long term prognosis of the tooth then the best treatment anyway may be to lose the tooth and address the issue of replacement now.

There will be several options, but you need your dentist to explain them to you.  It may be that the orthodontist can close the gap, or it may be that you opt to have the tooth replaced with an implant.

Talk this through with your dentist.

Regards

Tony Appleton