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Dr. Thomas

My Tooth Is Turning Gray After My Dentist Injured It

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My tooth is turning gray after my dentist hit it while removing the tooth next to it (second molar). I got the extraction in July. At the time, my dentist said the tooth looked okay. I saw my dentist two weeks ago because the tooth was darkening. He said that the tooth was dying and probably needed a root canal. I hope the tooth is bruised and will recover. Yesterday, I saw a specialist who said he would recommend a root canal using something called GentleWave, which is more comfortable than the standard treatment. I told him that I would think about it before scheduling the procedure. Why do I need a root canal? How long can I wait to see if the tooth color improves? Thanks, Kandis

Kandis

How Long Can You Delay a Root Canal?

Five steps of root canal treatment

A tooth’s condition can worsen without root canal treatment.

A root canal is the only way to treat a dying or dead tooth. You should not delay it because your tooth’s condition will worsen. The diseased pulp tissue inside the tooth will not go away without root canal treatment. The GentleWave® technology that the endodontist recommends has good reviews in dental publications. If you get prompt treatment, the infection will stop, and you will not need an extraction and dental implant.

Still, we are concerned about your tooth injury. Your dentist is for the damage to the tooth and treatment to save the tooth. Also, your dentist says you probably need root canal treatment. A tooth that experienced trauma and is turning gray needs treatment. An X-ray would confirm the tooth’s condition. We hope your dentist is not unsure whether you need a root canal.

We do not know the details of your incident, If you are unsure about your dentist’s or the endodontist’s recommendation, please get a second opinion from a dentist with advanced root canal training or an endodontist.

 

Sugar Land implant and cosmetic dentist Dr. Siny Thomas sponsors this post.

Why Does My Root Canal Tooth Hurt?

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Man holding the side of his face, portraying a root canal dental emergencyA dentist completed a root canal on my top right premolar in 2018. I had no problems with the tooth until last month. Now the tooth hurts daily, although the pain is not nonstop. How long do I have before I need to see a dentist? Will I need a second root canal on this tooth? Thank you. Mark from Helena, MT

Mark,

Thank you for your question. Dr. Thomas would need to examine and x-ray your tooth to determine if it is reinfected and needs further treatment, but we will explain why a root canal tooth may hurt years after treatment.

Why Does Your Root Canal Tooth Hurt Again?

If your root canal tooth hurts again, it probably means that the tooth did not heal completely, and the infection flared up again. When a dentist does not remove all the infected pulp from a tooth or misses a hidden canal, you can experience future complications. According to the Journal of the American Dental Association, other factors that can contribute to root canal failure include:

  • Under- or over-filling a tooth with dental filler material
  • Perforations in the root canal systems
  • Dental instrument separation, or break off, into the root canal system

How Common Is Root Canal Failure?

Root canal failure occurs in about one in ten procedures. Infection may take months or years to flare up if a tooth does not heal completely. The infection lingers when a dentist cannot see deep inside tooth canals or reach curvy channels. Only dentists with advanced training and endodontists (root canal specialists) have the instruments needed for challenging tooth channels.

What Is the Treatment for Root Canal Failure?

Repeat root canal treatment or root canal surgery is the treatment for root canal failure. If your dentist does not have advanced root canal therapy training, they will refer you to an endodontist. The endodontist will take these steps:

  • Find the infected root
  • Remove the infection
  • Fill the tooth
  • Seal the tooth

During root canal surgery or apicoectomy, a dentist or endodontist will access the tooth through the bone and the root tip instead of the crown.

Schedule an appointment promptly. After an examination and x-rays, an endodontist or dentist trained in root canal therapy will determine whether your tooth is savable. Otherwise, they will recommend tooth removal and a dental implant.

Sugar Land, Texas, dentist Dr. Siny Thomas sponsors this post.

Will I Lose My Tooth If I Don’t Get an Apico?

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Our family spent last week at the beach in FL. A toothache that has been bothering me for the past few months got worse, and my gums around it felt hot. I searched online for a dentist who was willing to see me the same day. The tooth is my lower right first molar that had a root canal two years ago. Although I was taking a chance to find a dentist online, she was pleasant, numbed my gums, and injected a pain reliever. The dentist said I probably need to see an endodontist for a procedure called an apico to save the tooth. The dentist did not give any details about the process but said an apico is like a root canal. Unfortunately, I have only seen a dentist once since COVID, and I moved to Arkansas in July 2021, so I don’t have a dentist here. What is this procedure, and do I need it to save my tooth? Thanks. Walton

Walton,

Thank you for your question.

It is good that the dentist was able to see you right away and relieve your pain. The dentist is referring to an apicoectomy.

What Is an Apicoectomy?

An apicoectomy is a dental procedure that accesses a tooth from its root tip instead of through the crown, as with root canal treatment. If root canal treatment fails, a specialist may recommend an apicoectomy to save the tooth.

A root canal specialist may take these steps to complete the procedure:

  • Numb your gums
  • Make a small incision to expose the tooth’s root tip
  • Use ultrasonic instruments or a dental laser to remove infected tissue
  • Disinfect the area
  • Add bone grafting to fill in areas damaged by the infection
  • Seal the tooth root
  • Close the gum tissue with stitches

The jawbone will heal around the tooth root in a few months.

What Happens If You Delay Treatment?

Delaying an apicoectomy allows the infection to spread further into the bone and possibly to other teeth requiring more complex and costly treatment. If you are unsure whether you need the treatment, schedule a second opinion with an endodontist (root canal specialist) or a dentist with advanced root canal therapy training.

 

Dr. Siny Thomas, a Sugar Land, Texas dentist, sponsors this post. Dr. Thomas is a graduate of the surgical program of the Pikos Institute in Trinity, Florida.

Should My Root Canal Tooth Still Hurt?

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Woman portraying root canal tooth painAfter getting three new crowns last month, my bottom left second molar became so painful that it caused headaches. My dentist took an x-ray and said the tooth was infected, and I would need a root canal. After the root canal, my dentist said she found four canals. Despite antibiotics, the tooth continues to hurt.

My dentist asked me to take antibiotics for another ten days. I feel that something is really wrong, and I do not know if the pain is referring, but now my upper tooth is sensitive. I’m getting so anxious that I do not think nitrous oxide will be enough to get me through this appointment. I am embarrassed, but I need something stronger. Could my tooth still be infected? – Kate from N. Dakota

Kate,

Thank you for your question.

Dr. Thomas would need to examine your teeth and x-rays for an accurate diagnosis. He would also need more information, including what triggers your pain, when you feel it, and whether it is improving a little.

What Are Possible Causes of Post-Root Canal Pain?

If you have pain after root canal treatment, possible causes include:

  • Lingering infection in a canal
  • Referred pain
  • Post-operative inflammation

Lingering infection in a canal

Although most molar teeth have three canals, sometimes a tooth has four or even five. If any of the canals are angled, or your dentist missed a canal, a lingering infection would cause tooth pain.

Referred pain

Another tooth may be the origin of the pain that you feel. If the tooth that hurts is sound, your dentist needs to look at nearby teeth that might refer to pain.

Post-operative inflammation

Root canal treatment can cause inflammation and swelling. When you bite or chew, the opposite tooth (upper or lower) will hit the inflamed tooth, making it hurt even more. It takes time for your body to fight the inflammation.

If the pain is not decreasing or getting worse, schedule an appointment with your dentist. Do not wait until you finish all the antibiotics. Talk to your dentist about finding a level of sedation to match your anxiety.

 

Dr. Siny Thomas, a Sugarland, Texas cosmetic dentist, sponsors this post.