Dr. Hall,

I had root canal treatments on my 3 front teeth when I was 14. Since then the dead teeth have started to discolor. I asked my dentist what I can do to get these teeth whiter and he told me my only option was to have crowns put on them. My dentist put the crowns on but they were a darker grey than my teeth were to start with and so he had to reorder them and re-do the crowns. After several procedures of tugging and pulling and re-doing his work I finally got the right color crowns.

 

Two weeks after the final crowning my front tooth busted off completely, my dentist then put a post in that tooth without giving me any other options such as an implant or bridge. My dentist swears that it was not his fault the tooth busted off and that it was weakened from the root canal, but I feel that it was from the constant tugging and pulling and re-doing the crowns twice that weakened the tooth. I looked online and saw that I could have just had those teeth internally bleached instead of crowned to get them whiter. They have never given me any trouble or pain in the past. Is it standard procedure for a dentist to not offer internal or zoom bleaching as a non invasive option to whiten those teeth instead of the expensive crowns that weakened my teeth throughout the procedure? I would have just had that done if it had been an option!

 

-Amber from Oregon

 

Amber,

Yes, your dentist could have contributed to that tooth breaking off because of all the stress from doing and re-doing the crowns. While he is right that the root canal treatment alone will weaken the tooth to where it can break off, I think there's a good chance that he contributed to that. Actually, I wouldn't have recommended crowns if the only problem is that the teeth were dark. Teeth that have root canal treatments tend to get brittle and so generally it's a good idea to put dental crowns on them to keep them from breaking. However, on a front tooth, the stresses on a tooth aren't vertical but horizontal, so a crown will actually weaken a root canal tooth at the neck of the tooth and make it more susceptible to breaking off completely - if it's a front tooth. I would try bleaching, and if that didn't work, I would have corrected the discoloration with porcelain veneers instead of crowns.

But if you have to do crowns on front teeth with root canals, I would have put dental posts in from the beginning. New flexible posts will strengthen the tooth against breaking off.

At this point, I'd ask this dentist what he plans to do to keep the other teeth from breaking off like this one. And I would insist on a good answer. But then I can be kind of a tough customer. :-).

-Dr. Hall

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By Dr. David Hall

Written by a cosmetic dentist!

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