My 18-year-old daughter had her lower permanent retainer taken off 3 weeks ago. She had been wearing it for almost 3 years after having braces for 18 months. During the removal, tooth #25 was injured and it is now receded and slightly grey. It is painful for her to bite anything with it and hurts when she wears her removable retainer when water gets under the retainer. Her dentist took an x-ray—which looks fine to me, but based on doing a cold test he thinks her tooth is dead or dying and recommends a root canal. The endodontist he recommended does not use the GentleWave technology. She is leaving for college in 2 weeks and wants to follow the dentist’s recommendation but I am hoping the tooth is just bruised and inflammed and can recover. Would you wait on doing a root canal or is there an alternative to heal the tooth?
Caprice from South Carolina
I found your website searching for tooth root x-ray.
(See Dr. Hall’s answer below.)
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I have a direct answer to your question first, but then I have a couple other concerns that I’ll get to.
First, for the direct answer: no, if a tooth is dying or dead there is no other way to heal it other than a root canal. The problem is that since the inside of the tooth is a very confined area with no space for the living tissue to swell or to bring in antibodies to fight an infection, once it becomes diseased the only solution is to remove that tissue, which is what a root canal treatment is.
But I have a couple of other concerns about your daughter’s case, and an additional point.
My first other concern: I’m really curious about how this tooth was injured in the process of removing the retainer. I’m guessing that this must have been a fixed retainer that was bonded to the teeth but still, removing it should be a fairly routine procedure. Your dentist, of course, would be liable for the damage to the tooth and should be paying for the root canal treatment.
Next, I’m concerned about the diagnostic skills displayed here. You are saying the dentist thinks the tooth needs a root canal. If you’re meaning that the dentist is unsure of the diagnosis, that leaves me wondering. The tooth suffered some trauma after which it has begun right away to turn gray and is sensitive to biting and sensitive to cold. That’s enough right there for a definitive diagnosis of a dying tooth. And then the x-ray will show definite signs of a diseased pulp, if the dentist has sufficient diagnostic skills to properly read the x-ray. So I’m hoping you’re just using soft language and not telling me that the dentist is hedging on this diagnosis. If your dentist is unsure, I’d get a second opinion, maybe from an endodontist.
I’m not getting strong feelings of competence about this dentist of your daughter’s. I’m hoping there is more to the story here to explain these possible lapses.
Finally, you have no requirement to go to the endodontist your dentist recommends. Even if he is paying for it, you can find an endodontist on your own. This new GentleWave technology is attractive and is getting good reviews in the dental literature. If you want to find an endodontist who uses this technology, you’re within your rights to go looking.
I’m sorry for what happened to your daughter’s tooth, and wish her well.
– Dr. Hall
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