What Happens If Dental Treatment Fails?
Back in the day, not too long ago, in fact, extracting teeth was common practice. Today’s dentistry aims higher. The line of thinking is always to try and hang onto your own teeth, as there is nothing better. How do we do this?
The first step is to take our children with us when we visit the dentist. This way, children will observe their parents undergo treatment and associate it with nothing sinister. Once the child is comfortable with this clinical scenario, they proceed with a dental check-up. This is repeated biannually and, in time, children associate a dental check-up with routine health management.
Unfortunately, not all patients have a good set of teeth. This is either due to their genetic make-up or irresponsible behaviour towards their dentition. Luckily, today there are many treatment modalities which we employ enabling us to fix our teeth and hang onto them for longer. Treatments include gum treatment or restorative treatment, which might include fillings, crowns and root canal treatment. Surgical treatment may also be used to remove sub-gingival inflammatory tissue enabling the tooth and its surrounding tissue to heal. Irrespective of all these fancy treatments, issues do arise and occasionally treatments fail. Patients are often disheartened that after all their time and effort, not to mention the costs incurred, their teeth may still be lost. The failure rate is normally very low but it does exist. This may be due to poor treatment, reinfection or lack of adequate aftercare. In most cases, it is quite easy to point out which it is but in some others not quite so.
CASE STUDY
A young lady in her mid-20s bites into something hard and cracks her upper front tooth. A large chunk of the crown fractures leaving the nerve of the tooth exposed. She proceeded to have root canal therapy, followed by a crown, to restore it to normal aesthetics and function. Even though on radiograph the root canal therapy looked to have been performed well, the tooth remained tender. A second root canal treatment was performed but the symptoms persisted. A surgical procedure was then performed to section off the upper third of the root. This still left the tooth tender. After six months of treatment, radiographs, antibiotic prescriptions and more, it was decided to remove the tooth and start afresh with an implant.
When the tooth was removed a root fracture line previously invisible on clinical or radiographic examination was clearly seen on the side of the root. This was the likely cause of the persistent discomfort and was completely out of reach of the practitioner. The implant treatment was successful and the patient’s symptoms resolved at once.
The sequence of events in the above case study is quite rare. At times even the best-looking treatment presents problems as it did here, and at times the worst looking treatment presents none. What’s important is to be well informed about all types of treatment options. Knowing their risks, benefits and limitations as well as their costs and timeframes is a must. However, patients must also trust their practitioner and leave themselves be guided. Ask your dentist!
