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*AurorasEnvy*
I have a tooth question for you 
My sister is a dental hygenist and has been telling me for quite some time that I am probably going to need a root canal sooner than I would like (I have gotten my fathers teeth, yay me). I noticed earlier today that the tooth in question (if it helps any, it's an upper tooth, premolar I believe) is not looking good, it appears to be darker on the outer edges of the tooth and it's tender when I push on it. I know that a root canal is probably coming and I'm planning on scheduling an appointment in the new year to have it looked over but is there anything you would suggest I do in the mean time, if there is even anything I can do. I brush twice daily with aquafresh and try to floss but don't always. Thanks for the help!!
Re: *AurorasEnvy*
Sure thing! =]
First off, is there a reason why she said she thought you would need a root canal? Is there a cavity in it or was there some trauma to the area at some point (i.e., car accident, hit in the face, etc?)
Either way, I will say that in teeth where the nerve has died that they sometimes start to take on a grey/brown hue. Or if there is a large cavity in between the teeth, sometimes you can start to see a dark area creeping out toward the outer edges.
If its tender when you push on it, it's likely that the nerve has completely died and the tooth is starting to develop an abscess. Basically, when the nerve dies it starts to decay/decompose and develop an infection. The only place for all the byproducts of this reaction to go is out a small hole at the very root tip of the tooth, and into the jawbone. As this infection gets bigger & develops into an abscess, it builds a lot of pressure, which is where the tenderness to pressure comes from. Think of it like pushing on a big pimple that has nowhere to drain.
Unfortunately at this point, there is really nothing you can do to make it much better. Keeping it as clean as possible with brushing & flossing is about it, but either way the problem will progress. I'd have it looked at ASAP - you never know when it will start swelling rapidly, I've had a lot of patients just say that they woke up with a golf-ball sized swelling, their eye swollen nearly shut, etc. as the infection spreads. If it becomes a major issue before you can get an appointment, an antibiotic will take any swelling down and give you some reprieve from the pressure tenderness, but it'll come back relatively soon after you finish the antibiotic.
As much as people complain about root canal treatment, generally speaking it really isn't any different than having a filling done as far as pain goes. The biggest difference IMO is just that it takes a lot longer to fix the tooth with root canal treatment instead of a filling, sometimes multiple appointments. I think the reason why it gets such a bad rap is because A) a lot of people are in severe pain before needing RCT, and thus associate that bad pain with RCT and
local anesthetics in dentistry haven't been around for more than 50 years or so. There are people living today (although elderly) who would remember having RCT without anesthetic, which WOULD be terrible - and I think the stigma has stuck around.
That being said, the longer someone waits the worse it is. Infection lowers the effectiveness of local anesthetics, so if someone waits until it gets really bad it can be difficult to numb the tooth completely. If the infection is really bad, I'll have to I&D (generally only with topical gel anesthetic, so it can hurt a bit) and then have the patient on an antibiotic before we can even do anything.
Anyways, sorry I can't really offer any real help. Just get it looked at ASAP and let me know if you have any more questions =]
Drinking wine makes any situation better, so I'll go with a thumbs up on that suggestion =]
As far as being predisposed - some people just naturally have a higher population of the bacteria strains that put them at higher risk for cavities. Just like some people have a higher population of bacteria that put them at higher risk for cavities. Not to say that you are hopelessly doomed to always get cavities, but for some it does take more effort at home and more specialized products to prevent them. I prescribe a high fluoride content toothpaste for people (even adults) if they seem to have a higher cavity rate than normal. Might be something to ask your dentist about next time you see them.