Expert: Frederick R. Liewehr DDS, MS, FICD - 11/24/2013
Question I have a very narrow mouth and was told many years ago I should have braces but at that time my parents could not afford it so I am wondering if that is why now I am having so many issues with my teeth.In the last 10 years, I have had several crowns done and as many as 4=5 root canals done.Now having just finished another root canal a few weeks ago, I am having some pain under a bridge that I am sure from the way it feels will need a root canal too.Is this normal to be having so many problems and needing another root canal??? I recently took out dental insurance but the crowns and root canals aren't covered until having been on the plan for 6 months and then only a small portion pays for these services.Is there something I could be doing to help me from having to have so much done all the time.Maybe switching different dentist???
Answer I really can't answer this question, because I have not seen you. However, the only case I could imagine where lack of orthodontic treatment would contribute to caries incidence would be in an extremely crowded anterior where one could not brush and floss due to the crowding. It is the rare person who has that situation. As for all the crowns and root canals, it is certainly true that some dentists over treat, for various reasons. I see many crowns placed that in my judgment are not needed, but I am very conservative because I know that simply removing the amount of tooth structure necessary to fit the crown can cause problems in and of itself, specifically creating the need for endodontic therapy. Some dentists have the endo done prophylactically because this may happen, which sometimes is a good idea. So, not knowing your situation I cannot possibly tell you if you have been over treated or not. I can tell you that it is very unlikely that not having braces has anything to do with your situation. More likely you need to improve your oral hygiene. As for switching dentists, you can always get a second opinion from another dentist if you are concerned.
I can answer your questions about root canal therapy in general. PLEASE DO NOT ask me to diagnose your particular problems or recommend treatment as I cannot do this without examining you and seeing your x-rays.
I am a Board-certified endodontist, former university department Chairman, teach dental residents, and have a private practice.