Hey Dr Hall! I have had two dentists tell me I had a tooth with a huge cavity on the inside. They said they could not believe I was not in severe pain. That was about two weeks ago. Today I felt some kind of pulse pain under the tooth in the gum. Is it fixing to get me? They said it’s gonna break half or more off and I’ll be in the severe pain then! The first dentist took an x-ray and told me this. Not too sure, I went to the 2nd dentist. He said the same thing. What would be cheaper and better the root canal or pull it and get implant. The tooth above was a botched root canal crown and the post kept falling out. It was botched from the start. So I’m getting an implant there.
– Trina
(See Dr. Hall’s answer below.)
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Trina,
Since the diagnosis was confirmed by two dentists, it must be correct. What they are telling you is cavity on the inside of a tooth would be what dentists in professional circles would call internal resorption, which I mentioned in the post you were commenting on.
It is a fairly rare condition and is likely caused by some irritation causing the pulp of the tooth to be inflamed.
Here is an x-ray showing this internal resorption, courtesy of Dr. Fang-Chi Li at Taipei Medical University.
The best way to treat this, in my opinion, is to save the tooth with root canal treatment. I think it’s always preferable to save your natural tooth when possible. But with the bad experience you have had with a failed root canal, I wouldn’t blame you for having it extracted and an implant placed.
Here is an x-ray of the repair that Dr. Fang-Chi Li made of the tooth pictured above. This tooth should last the patient a good long time.
If the internal resorption has progressed to where it perforates the root of the tooth, restoration becomes more complicated. Not only is it tricky to seal the perforation, but with so much of the inside of the tooth gone, it becomes seriously weakened and vulnerable to breaking off. In that case, I would recommend replacing the tooth with an implant.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.