About Mark Bornfeld DDS Expertise I can respond to all questions dealing with the practice of dentistry, from both the dentist`s and patient`s perspective. I am knowledgeable about all dental disciplines, from cosmetic dentistry to surgery, from restorative dentistry to root canal treatment. I have strong opinions about controversial issues in dental practice, including those topics which directly impact on the reputation of the profession in the eyes of both the lay public and our health profession colleagues.
Experience
Past/Present Clients Editor, Queens County Academy of General Dentistry newsletter; contributor to Dentistry.com 29 years practicing general dentistry partnered with brother Steve as one-half of the DentalTwins®
Question I had a root canal last week and my dentist can't see me until more than three weeks from now to put in a crown. Until then, he put in a temporary filling, telling me not to brush it or chew with it, and I have been very careful to follow his directions.
I noticed that most of the temporary filling has worn away already, where before it was covering almost my entire tooth in a thick layer, it now barely covers the center of the bottom of the tooth (I'm sorry that I am not very technical with the description). I have also been experiencing some pain since yesterday. I called my dentist about it, and he said it sounded like it was indeed wearing away and told me to refill my prescription for antibiotics, but I did not need to come in to have it checked out. I read elsewhere on the internet that if the temp filling isn't there, there is nothing to protect the hole in my tooth and infection might easily develop, requiring another root canal.
I am concerned that I have to go three weeks with temporary filling that seems to be almost gone already and cannot afford to pay for another root canal and a crown nor do I wish to deal with an infection. Should I try to see another dentist or am I worrying too much?
Answer Dear Liz,
Although there has recently been increasing evidence that an effective seal at the top of the tooth is important for a successful root canal outcome, the time element of this factor is somewhat vague. The root canal filling (within the root) provides at least a partial barrier to the penetration of bacteria into critical areas, and a few weeks' delay in crown placement would not be expected to significantly affect the status of the tooth despite loss of the temporary filling.
I have been somewhat skeptical of the recent emphasis on prompt crown placement, since the root canal treatment itself involves an effort to hermetically seal the canal; the restoration at the chewing surface would seem to be superfluous, at least in this regard. The cynical observer might even interpret the recent emphasis on prompt tooth restoration as an attempt to shift blame for an unfavorable root canal result from the endodontist to the restorative dentist. However, the pervasiveness of the current emphasis on prompt restoration is somewhat difficult to ignore, and one must assume there is some validity here.
Although I do not think a brief period of exposure after loss of the temporary filling would pose a significant risk, this should be a non-issue. It takes little more than one minute to observe the tooth and, if necessary, shore up the temporary filling until the crown can be delivered. (By the way, the administration of antibiotics is not a valid substitute for repair of the temporary filling.) Your dentist should take the time to see to your needs, and I believe you should be able to prevail upon him to do so. A failure to be responsive to your request should tell you something-- even if that something is that you should seek dental care elsewhere.
Hope this helps...
Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY
