Expert: Mark Bornfeld DDS - 4/11/2007

Question
The dentist did a full mouth and jaw xray today and I have one particular tooth in the bottom front -- where awhile ago a piece of this tooth chipped near the gum line because some floss got ahold of it.  Well the dentist looked at the x-ray and said that the tooth definately needed a root canal.    Today he chisled away at it and had a special device that burned away gum tissue which had grown in the vacant space where the tooth chipped.  Well I guess the dentist said my tooth was hallow and the tooth was decaying at the roots and referred me to a specialist who is going to have to do some procedure where he may have to install implants and save teh tooth.  The dentist said I might have to have the tooth extracted or get a root canal.  What I don't understand is that I don't have any pain whatsoever and the dentist says I need a root canal.  He put a temporary filling on my tooth and I told him to just patch it up and put a regular filling, but said he wouldn't and I have to go to a specialist.  What I don't understand is -- why do need to go to a specialist and get a root canal on the tooth when I have no pain associated with the tooth?  Doesn't make any sense to me.  I mean, if there is decay in the roots and the tooth is going to fall out eventually according to the doctor(by the way it looks like a perfectly healthy tooth on the outside)why bother with all of this especially since I have no pain with the tooth.

Answer
Dear Adam,

Relying on symptoms to determine what is wrong just doesn't work; otherwise, there would be no need for examinations, x-rays, and any of the other diagnostic services that dentists provide. The bottom line is that pain is an unreliable indicator, and significant infection can be present without any symptoms.

Whether it makes sense to salvage the tooth is another thing entirely, and it is a question that should be determined prior to embarking on a complicated treatment. This determination must be made based on the specifics of your case, and whether the tooth can be restored to the point that it is structurally reliable. This is something that only a dentist can determine, and it you have any qualms about the treatment plan that was presented to you, I would encourage you to seek an independent second opinion from another dentist.

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY