Tooth crown causing problems?

ANGLICANPAT

I appreciate the dentists on here cant answer specifically for MY teeth, but Im wondering if they could tell me generally speaking, if they have come across compacted pus under a crown causing repeated infection/ pain in the gum , and have just cleaned out the crown and reglued it on rather than performing RCT?
My gold crown fell off a few days ago revealing solid gunge inside, and Ive since, had no pain at all even when I chew with the black stump left behind. I chickened out of RCT as the specialist couldnt anaesthetize the gum sufficiently , and Im left facing extraction instead. Dont want to go the extraction/bridge route if its a possibility that sometimes a gunged up crown can be the reason for all the toothache. Any general observations on this possibility please?

Toothsmith

I'm a bit unsure of your terminology, but pus is a product of infection. So if you have pus, you have infection. Infection causes pus, not the other way round.

Infection causes different levels of pain. I've seen many infections where the patient has no symptoms whatsoever. It's possible too for infections to cause low grade pain over a long period of time, and it's possible for an infection to cause a screaming toothache. The same infection can also go from one type of pain to a worse type at the drop of a hat, and it can also seem to 'get better'.

The bottom line though is that it will not go away unless you get something done about it, and don't sweep it under the carpet. It might be root filling (RCT) it might be extraction, but something needs to be done.

If you decide to have it out, it's not always necessary to have something to replace it. But your own dentist will be best placed to advise you there.

ANGLICANPAT

Sorry, Toothsmith, you're right, I didnt express that well. I meant I wondered if biting down on a crown that had got a build up of old pus inside it from a previous infection (for which antibiotics was taken) could actually be causing enough pain/pressure/irritation under the tooth to restart a new infection each time. It doesnt sound like it, from your answer , but fear is driving me to explore everything that might save me having to have anything worse than necessary done lol! It feels so comfortable now the crown has gone, I think its giving me false ideas-but as you say, it does just flare up and may well do so again by the sound of it--'groans'. Many thanks.

trumpton

I had a similar thing with an infection under a crown. Once the crown is removed the infection can drain into your mouth, so it's less painful. My dentist tried really hard to save the tooth and, over about a year, I had a few courses of antibiotics to get rid of the infection, after which he would replace the crown. It would come back again though, so eventually I had the tooth removed.

It's at the back so not really noticeable, but obviously cosmetic appearance will be a factor in deciding whether to extract or not. You can have implants or a bridge if you want.

I would say that you would need a course of antibiotics to clear the infection and then maybe replace the crown and see how it goes.

Do you have a funny taste in your mouth? That could be the pus/gunk draining into it from the infection. If you just stick the crown back on without the infection having cleared, it will just flare up as the pus has nowhere to go.

Maybe you are private, but NHS dentistry is ridiculously good value - I had many visits, courses of antibiotics, and eventually an extraction and it all cost £42.

suburbanwifey

ANGLICANPAT wrote: »

I appreciate the dentists on here cant answer specifically for MY teeth, but Im wondering if they could tell me generally speaking, if they have come across compacted pus under a crown causing repeated infection/ pain in the gum , and have just cleaned out the crown and reglued it on rather than performing RCT?
My gold crown fell off a few days ago revealing solid gunge inside, and Ive since, had no pain at all even when I chew with the black stump left behind. I chickened out of RCT as the specialist couldnt anaesthetize the gum sufficiently , and Im left facing extraction instead. Dont want to go the extraction/bridge route if its a possibility that sometimes a gunged up crown can be the reason for all the toothache. Any general observations on this possibility please?

To be honest with you, when a crowned tooth has gone bad, its gotta come out at some stage. I had a tooth break whilst eating garlic bread in a Glasgow restaurant 9 years ago. It broke clean in half, an emergency dentist (always happens at a weekend!) packed it until a local private dentist could crown it a few months later. The crown was always wobbly and I hated biting down on that tooth. it was never right since. Seven months ago another dentist told me there was NO option but to remove the tooth when a abscess in it caused so much pain and infection that I could barely think. I was on antibiotics for a week with the severity of the abscess. I had to have the tooth pulled which you can imagine is not nice for a female (no idea if you are a guy or a gal)

I'm 4 months into the implant procedure, with a gap left my option was bridge or implant - bridges end up crowning next door teeth and don't cost that much less - I opted to go for an implant at a whopping cost of 1,800 pounds but after a decade of hell with that tooth, I will have a new tooth that should last me out

If its bad, rotten and you are getting pus, you will end up losing it. If finances allow (or if they don't, what price your looks?) go for an implant. Not pleasant but a permanent solution I had the titanium implant procedure (took 45 minutes) a week ago, now on another course of 1 weeks (2 lots) if antibiotics and then when fully fused with the bone and healed (3 months or so) will have crown made, measured and fitted.

I feel for you!

In total that tooth has cost me 2.8K with the original crown, removal and now an implant. I hate that tooth LOL but can't wait for the implant to be finished

ANGLICANPAT

Suburbanwifey and Trumpton- thanks to both . The concensus of opinion seems to be that one way or another , eventually the tooth must go! Ugh!. I had considered having nothing, having a bridge , but hadnt thought of an implant. I am NHS , the extraction would be about £40 odd but anything else the dentist does I suspect will be charged privately , but we will see once I have summoned up the courage to go for the extraction. At least if the anaesthetic doesnt work again, extraction lasts only a minute or so against the hour or more of root canal treatment.

mtbbuxton

Sorry to hear you're having so much trouble. I've had some experience of local anaesthetic not working and was told it's because I have high bone density. It only happens on the lower jaw and my dentist now gives me a nerve block if he needs to work on those teeth. It means I have a lop-sided face for several hours, but at least my teeth don't hurt.
I spent many years with a phobia of dental treatment (my childhood Dentist used a metal file on my teeth - he thought it was less traumatic, I can guarantee it wasn't :eek:) but now have an excellent relationship with my current dentist. I changed Practices a few times to find somebody I felt comfortable with, but it was worth it in the end and my greatest fear now is that he'll move away!

M x

suburbanwifey

ANGLICANPAT wrote: »

Suburbanwifey and Trumpton- thanks to both . The concensus of opinion seems to be that one way or another , eventually the tooth must go! Ugh!. I had considered having nothing, having a bridge , but hadnt thought of an implant. I am NHS , the extraction would be about £40 odd but anything else the dentist does I suspect will be charged privately , but we will see once I have summoned up the courage to go for the extraction. At least if the anaesthetic doesnt work again, extraction lasts only a minute or so against the hour or more of root canal treatment.

Strangely enough when I used to go to a NHS Dentist the anesthetic didn't work. At all. When I changed to a private dentist, they used a different anesthetic. I think NHS use the cheapest there is. NO one (NHS) could numb to painlessness me but private dentists can. Evidence speaks for itself. It cost me a horrible 450 pounds to get the bad tooth/crown extracted, I was horrified at the price but I honestly felt no pain and I was treated so gently I barely noticed it. NHS is rough, tumble, as quick as possible and as cheaply as possible. I dislike the prices of private dentists but to be pain free and have nice teeth its a sacrifice I'm prepared to make. I wouldn't wreck surrounding teeth to get a bridge, go for an implant if you can. I've spent more on a computer so I am shocked I moan so much at the price, a tooth (implant) will last for life whereas even my Apple machines will need replacing within 10 years max. Its all about priorities. Hubby had a abscess and he went to a NHS Dentist - the horrible man whipped it out! in 4 minutes, no antibiotics, had him swallow the pus and vile tasting crap. I was disgusted. Tooth could have been crowned but its cheaper for NHS to extract. I would never trust an NHS dentist to do what is best for you if I was you. Just my thoughts. You get what you pay for in this money controlled world, especially with dentistry. Don't try to keep the bad tooth longer than you can, dental infection can impact your entire health, your brain and your heart. Infection that spreads in the mouth can kill. Prioritize dealing with that bad tooth. Lose it and then recover and decide what to do.

welshdent

suburban I can categorically assure you totally and utterly there is NO difference in anaesthetic! We pretty much all use a combination of lignocaine/lidocaine, articaine/septanest, scandonest/mepivicaine or citanest. I dont know if any others and we certainly do not use the cheapest we can get if it is inferior. When a tooth is extremely irritated or infected then it can take a lot to numb it and at that stage it may not even be possible. When the nerve finally dies off then the anaesthetic will work OR if the infection if quietened down with anaesthetics or drainage then it will work. The type we use doesnt come in to it really.
Also if a tooth is infected then it absolutely can NOT be crowned. It would need a root filling but a root filling in an already infected tooth has a lower prognosis than one were the nerve is on the way out or recently died off. Absolutely agree with the sentiments you have on the prioritisation there is just a little more to it with the specific points you made

suburbanwifey

welshdent wrote: »

suburban I can categorically assure you totally and utterly there is NO difference in anaesthetic! We pretty much all use a combination of lignocaine/lidocaine, articaine/septanest, scandonest/mepivicaine or citanest. I dont know if any others and we certainly do not use the cheapest we can get if it is inferior. When a tooth is extremely irritated or infected then it can take a lot to numb it and at that stage it may not even be possible. When the nerve finally dies off then the anaesthetic will work OR if the infection if quietened down with anaesthetics or drainage then it will work. The type we use doesnt come in to it really.
Also if a tooth is infected then it absolutely can NOT be crowned. It would need a root filling but a root filling in an already infected tooth has a lower prognosis than one were the nerve is on the way out or recently died off. Absolutely agree with the sentiments you have on the prioritisation there is just a little more to it with the specific points you made

You make valid points however, my experience differs. Three times I was attempted to be anesthetized by an NHS dentist - this was for fillings! not extraction, crowning or any other bigger procedure. They injected me and I still felt pain. Private dentist told me they use a better quality stuff when I asked him why his injection numbed me to no pain and NHS didn't. So not sure I can agree with you. I had this experience at NHS dentist, so did my husband. I now use private dentist and they do not lie, no pain. When I had the titanium implant last week dentist told me it was a new anesthetic, even better so they must bring out newer, better ones. I felt nothing.

Hubby was in and out in 6 minutes for a look at what problem was, told needed extraction and to take it out. It was rushed. I was also told it was dangerous for the NHS dentist to have not given hubby antibiotics when his face was so swollen and in so much pain, the infection was so bad. Dentist just pulled it and said 'swallow it it won't kill you' This is why I pay for private, he was treated like an animal in my opinion. I appreciate not all NHS dentistry is like this though, so not bashing them all, just making a point. In my opinion, the evidence of my experience tells me they do use lesser and cheaper anesthesia.

welshdent

By all means disagree but I DO have the benefit of actually doing the job and I really do promise you that we do NOT use inferior anaesthetics. In fact. I dont even know what they could even possible CALL inferior. What I CAN tell you is I have known of a number of cases where numbing a tooth has not been possible for fillings. Usually when the nerve is irreversibly inflamed.