Q: Do I need a new crown after a root canal is done through my old one?
V.S. in Eagle Rock
A: Yes and no. (There. That narrows it down!) If the crown or bridge was recently made and upon examination and digital X-ray evaluation it appears sound, a permanent filling (called a core build-up) can be bonded into the hole. However, if the crown or bridge is old and shows leakage, decay, fractures or excessive gum recession, it is better to make a new one. Statistically, the number one cause of an abscess is “coronal leakage”: the washing out of cement over time, allowing decay to form underneath the crown, infecting the nerve canals. As in medicine, there is no harm in seeking a second opinion to help you make the decision.
Wednesday, September 15, 2010
Thursday, September 9, 2010
Trismus Prevention
Q: After having what I thought was routine crown-work on my lower back teeth, the following day I could barely open my mouth to eat. What did the doctor do to me?!!.........Phil in Canoga Park
A: Chill, Phil. You’re scaring me with those two exclamation points. One I can take, but two sends me to the shrink. Often after mandibular block injections, required to anesthetize the back lower teeth, the common side effect “trismus” occurs. (In your case, it’s “trismus in July”.) Often multiple injections are needed to numb these posterior teeth due to a tricky network of nerves that must be reached. Limited opening, muscle spasms, stiffness and pain. This is caused by inflammation of the muscle fibers, hemorrhage into the muscles of mastication or low grade infection. This will all go away. In the mean time, your dentist might recommend warm compresses, 800mg of Ibuprofen, muscle relaxants (Flexeril, Diazepam), salt water rinses, antibiotics, and in severe cases, a steroid such as Methylprednisone. Complete recovery can take several weeks.
A: Chill, Phil. You’re scaring me with those two exclamation points. One I can take, but two sends me to the shrink. Often after mandibular block injections, required to anesthetize the back lower teeth, the common side effect “trismus” occurs. (In your case, it’s “trismus in July”.) Often multiple injections are needed to numb these posterior teeth due to a tricky network of nerves that must be reached. Limited opening, muscle spasms, stiffness and pain. This is caused by inflammation of the muscle fibers, hemorrhage into the muscles of mastication or low grade infection. This will all go away. In the mean time, your dentist might recommend warm compresses, 800mg of Ibuprofen, muscle relaxants (Flexeril, Diazepam), salt water rinses, antibiotics, and in severe cases, a steroid such as Methylprednisone. Complete recovery can take several weeks.
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