Expert: Tony Appleton BDS DPDS - 6/7/2007

Question

Hello Doctor,i had written to you earlier in the day about the root canal treatment advised by my dentist on my lower left wisdom tooth.Actually i had a rather large filling done on the back side(facing the neck) of that same wisdom tooth 4 years ago.However today evening i started on the root canal treatment on the same by my dentist.
.He took out my old cavity and removed the 3 nerves of which he said one was quite bad.And then he cleaned them with a file and then antiseptic solution.He then put a temporary filling.However he has not taken out the panaromic xray of the affected molar,just the small stamp size xray,in which the affected molar is not very clear.Is it ok if he does not take a detailed xray before doing the root canal.After 4 days in my next sitting the cleaning of the canals would be repeated by his assistant.Doctor i would like to know which filling should be used the silver or the white,the dentist said i could choose whichever i wanted.Which would u advise ? Also is it ok if i dont get a post and crown inserted after the root canal treatment on my affected molar(lower left wisdom tooth).As my older(4 years ago) filling(facing my neck) on the same molar was rather large.Or if i wait upto 10 months to a year to insert a crown and post on this molar as it is much cheaper if i get it done from my native country,India.Would there be a risk of this molar getting a fracture or breaking  in this period of 1 year without a crown and post.What is the maximum time i could wait safely for the crown and post to be put on this molar,if i take precautions of not using this wisdom tooth a lot while eating.Also is it better for the molar to get the post and crown inserted during the Root canal treatment or later.If at all a crown and post is required to be put any time,which material should be used,as currently they are many choices.I am 33 years old.Thanks a lot doctor


Answer
Hi Dinesh

The small x-ray that your dentist took is the correct view for root canal treatment. A panoramic doesn't give enough detail of the root structure to be of any value in this instance.

Bearing in mind you will probably be having a crown on this tooth I would suggest a metal filling may be better as it is stronger and cheaper than a white filling. However, really this is a clinical decision and your dentist should advise you of his preference.

As long as you are careful with this tooth it should be OK to wait a year before having a crown done, and again, be guided by your dentist as to what material is best for your crown - he needs to consider the way you bite etc to make that decision.

Regards

Tony Appleton