Dental abscess under new crown

[dana]

I was treated for a dental abscess when I was 6 months pregnant as a emergency procedure, then 4 months later I was retreated and got a crown on top of this tooh, after 6 months it got infected again!! how can that would be possible? somebody have an idea? I think it is the dentist fault for bad treatment, I do not know what to do, he send me to the endodontist and 2 weeks of ATB but all this it is a lot of pain, more money, time and frustration.
Advices?

[dentistdownunder]

Guess what, no dental procedures have 100% success rate and nothing in dentistry last forever. Even with optimum care there is still a 20-30% risk of failure for root canal done on a tooth with abscess. In this case, the only thing your dentist did wrong was failing to inform you the success/failure rate of root canal, not bad treatment, because even if it's done by the best endodontist in the world it can still fail. Just like getting heart surgery done, ever heard of any cardiac surgeon giving a warranty for 100% successful heart surgery? No? I thought so.

[dentistdownunder]

Advice: Brush twice a daily, floss daily before brushing, have regular dental check up at least once a yr and x rays done every 2 years and reduce the amount of soft drinks consumed.

Dental decay is reversible, if it's found early. If you've done the abovementioned for the past 5 years you wouldn't even need a root canal in the first place.
Contrary to popular belief, pregnancy does not cause decay and no the foetus doesn's suck all the calcium from your teeth. It's mainly cause by change of diet and poor oral hygiene, but the decays would have to be present in the first place as it takes at least 5 yrs to progress from early decay to abscess but could be sped up when diet changed to a high sugar diet and poor oral hygiene.

[Angst2Amity]

I don't think you are being fair! I care for my teeth properly and even take calcium but during pregnancy my teeth cracked. Had numerous root canals, infections under the crowns, under the teeth, lots of retreatment, and finally I lost 3 molars + 4 wisdom teeth. Once the teeth are fractured, bacteria follows the the crack into your jaw and no matter how many root canals you have, it will still follow the cracks. Usually the tooth must go and when it finally does, you're relieved. I have even had to have a $6000 bridge cut off to pull the teeth that was holding them. I am only 32. Taking steroids would sometimes make pus come up around the teeth.

[Angst2Amity]

You should never rule out differences in anatomy. Apparently my teeth crack and no I don't have TMJ or grind or anything else. Why would you tell someone "oh you had this trauma, but if you were smarter it wouldn't have happened" when you don't know anything about them? Uk, I think people come to this website to find some answers not more doctor downtalk.

I had a similiar experience - a root canal and crown, and years later found out that the tooth was cracked and a painless infection had gone into the jaw (large cavity below the tooth). Not diagnosed until pus started oozing around the tooth (even though the jaw cavity showed on dentist x-rays and a doctor's bone scan).

Hey - everyone with lots of abscesses in teeth, get tested for Celiac Sprue. It is a disorder that makes you not absorb minerals and vitamins, making your teeth crack apart. Celiac Sprue can be eliminated by not eating any gluten, in those that have it. Look up celiac.com for more info - just found out I may have it.

This question is directed to any dentist out there. I visited a new dentist yesterday for a comprehensive diagnostic exam, cleaning and full mouth x-ray. This is the first time I've been to a dentist in 3 years - however - I brush my teeth twice a day and floss every night. This dentist showed me a "microscopic spot" at the tip of my root under a molar with a crown. He claims that I could likely have an abcess under this crown. I questioned him about his suspicion because I have had none of the symptoms for a tooth abscess (tooth pain, swelling, etc.) and he stated "patients can have latent tooth absesses that lay dormant for years and then pop without warning". The crown shows no evidence of cracks or damage and has been fine since I got it about 7 years ago. One of his explanations for a cause is that the crown prep work could have been faulty. If that was the case, I would think a problem would have occurred before 7 years.

I don't feel comfortable with his explaination and am considering a second opinion. My feeling is that this dentist office (a large practice in the Washington D.C. area) is trying to sell me an otherwise needless dental procedure because I have dental insurance that will pay for most of it.

Does it sound logical that I could have an abscess without any of the normal symptoms?

You can get another abcess after the tooth in question is fixed. When that happens, you usually have to end up losing the tooth. Even having the tooth repaired again may not help. I know from experience.
And as for that dentist above, I'm glad I'll never have to see him. There is nothing worse than having your teeth fixed by a pious, pompous, self-righteous, know-it-all-dentist. I never knew a doctor who belittled people for being sick. You became a dentist to fix teeth. Operative word here, FIX. Be happy some people don't have good oral hygeine habits. It keeps you paid. And I would advise keeping your mouth shut while your patients have theirs open for you.

X-ray can only HELP with diagnose of root canal infection. It should not be used solely to determine "abcess under this crown." Other testings must be done: cold, hot, EPT, percussion, and/or palpation. Ask your dentist to use these tests to see if it is really pulp related.