Expert: Mark Bornfeld DDS - 12/10/2007

Question
Dear Dr. Bornfeld,

I had gone to a "new" dentist to have a root canal tooth finished with a permanent filling. The root canal was done through a tooth with a crown.

Upon examination of the tooth, and xray (which was taken)the dentist expressed concern that the root canal was "soft."

He suggested that I return to the dental surgeon who performed the root canal for a consultation. I will be seeing the surgeon on Monday.

It has been about 2 1/2 months since the root canal, and I am not experiencing any discomfort or pain.

My question(s) are this:

1.- I had gone to this dentist initially to get the tooth sealed. He put a Sedative filling in the hole in the top of my tooth. About eight hours later, I look at the tooth and the filling was gone, the tooth has the open hole in it. What give's, should this have fallen out?

2.- The dentist also suggested, after the consultation and "repair" to the root canal if required - he suggest the removal of the crown, sealing the tooth and putting a new crown on the tooth. Is it necessary to do this, if the crown is okay, can the opening be correctly sealed with the crown in place.

Thanks for your assistance.

Answer
Dear stephan,

1.- I had gone to this dentist initially to get the tooth sealed. He put a Sedative filling in the hole in the top of my tooth. About eight hours later, I look at the tooth and the filling was gone, the tooth has the open hole in it. What give's, should this have fallen out?
A: No, I don't believe that the filling was intended to fall out. However, these things do happen if a patient inadvertently chews on a freshly-placed filling before it has completely set. This does happen occasionally, especially if the sedative filling is placed while the tooth has been anesthetized; often times, a patient doesn't realize he is chewing on a tooth when he is numb.

2.- The dentist also suggested, after the consultation and "repair" to the root canal if required - he suggest the removal of the crown, sealing the tooth and putting a new crown on the tooth. Is it necessary to do this, if the crown is okay, can the opening be correctly sealed with the crown in place.
A: That depends on the condition of the tooth under the crown. If there is sufficient remaining tooth structure, and there hasn't been any tooth decay at the crown margin, and there is no significant breakage of the crown due to the access opening drilled through it for the purpose of performing the root canal-- then there is no reason why the crown can't simply be sealed by the placement of a filling in the opening. However, the tooth and crown must fulfill all these criteria, or it may be necessary to re-make the crown.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY