Do I need to do anything about the tooth that just fell out?

December 28, 2012 8:05 PM

I had a root canal on a tooth a couple years ago, and never got a crown on it. Most of the rest of the tooth just fell out. Do I need to do anything about it?

There are still small pieces of the tooth left, but not much. I'm not in any pain, but the gum feels tender, unsurprisingly.

I just told a friend of mine about it, and she tells me that she has a couple of teeth that are in a similar situation, and her dentists don't seem to be worried about them. She says that since I had a root canal, the tooth is already dead, and the gum has already started to heal under it; she says that I'm at a slight risk of a surface infection, but not of a serious infection like a living broken tooth can get.

Is she right? I'd like to avoid going to the dentist, if possible, because a.) I'm kinda terrified of dentists, and b.) I'm living off my savings right now, and I'm uninsured, so I can't really afford one.

Thanks in advance. Please be gentle if you think I'm being an idiot; I'm pretty freaked out at the moment.

posted by webmutant to health & fitness (14 answers total)

I'd a friend without dental insurance a couple years back that needed some work done. I mentioned it to my (really great) dentist, who told me to have him get in touch with her. I'm not sure what kind of a deal they worked out, but he got his teeth fixed without having to borrow money.

I think many medical professionals are open to helping folks out when they can. Maybe it's worth a call or two?
posted by carterk at 8:19 PM on December 28, 2012 [1 favorite]

I'd be vigorously washing that mouth out with something antiseptic every time I consumed anything except water. Those pieces of dead tooth are conduits.

You are not stupid. You are financially stressed. Salt, dissolved in warm water. You need to get those shards out when you can.
posted by Mr. Yuck at 8:25 PM on December 28, 2012

You should get the shards out because of risk of infection. Dentists are very good about working out payment plans. I recently had to take my Mom in to have this work done and it cost $700 without insurance. I know that is a lot, but if you get infected it's going to cost way more.
posted by agatha_magatha at 8:28 PM on December 28, 2012

Your friend is partially right - the root canal helps protect you against dental infection, by removing the root of the tooth, you're theoretically taking away the route that bacteria would use to get from the tooth surface as it decays down into the deeper tissue layers. So having had the root canal should help reduce the risk of infection in the area. But not all root canals are perfect, you did not get yours finished by having it sealed with a crown, and you may still have some of the inner parts of the tooth intact there. And as your friend pointed out, you can still get the gums around the tooth infected, even if the root is totally gone.

If I were you I would try to find a dentist in the area who is good with financial issues and 'gentle dentistry', or any nearby dental school where you might be able to get it looked at for cheap. In my experience, people who are terrified of dentists are the most likely to end up with a serious dental infection, because they are too afraid to have any problem in their mouth checked out and they tend to let problems progress too far, and they don't get preventative care/maintenance cleanings done. This certainly is not a dental emergency but I do think it's worth getting checked out.
posted by treehorn+bunny at 8:35 PM on December 28, 2012 [3 favorites]

I had a root canal that failed about 4-5 years ago that I ignored until suddenly there was a giant abscess in my jaw. Almost $20,000 later I have had a number of extractions and (iirc) 4 separate bone grafts, one or two of which were autologous and extremely unpleasant. Now I have a significant amount of titanium in my jaw and a couple of implants.

At the very, very VERY least you should have someone LOOK at it.
posted by elizardbits at 10:09 PM on December 28, 2012 [3 favorites]

IANYD-

I lived with a broken tooth for about ten years and was fine, I got it fixed when I had some money and felt it looked bad.

But towards 8 years I had problems with the area because the trauma that had broken the tooth had affected the area, not just the tooth. Anyway, if you see an abscess go to an endodontist. My abscess looked like a little zit and hung on for about 8 months before I ever actually felt any pain and went to the endodontist.

If I were you, based on yucky experience, I would have made it a priority to take care of in the next year or so, but if I saw an abscess I would get it fixed.
posted by misspony at 10:41 PM on December 28, 2012

When you say most of the tooth just fell out, what you likely mean is most of the tooth above the gumline, right? teeth are like icebergs, there's a lot more under the gum/bone than you might realize, and without an x-ray or exam you don't really know what condition that part of the tooth is in; is it decayed? infected?
Any spot of untreated decay significantly increases the risk that you will get decay in other areas, any untreated infection can have effects not just on the health of your mouth, but on your entire body.
Have it examined, get a treatment plan/estimate. Realize from that point that that will be the least expensive that the problem will ever be.
If you wait it will very very likely become a painful problem, and then it will also be an inconvenience as well as an expense.
posted by OHenryPacey at 10:51 PM on December 28, 2012 [1 favorite]

The root canal killed the tooth by mechanically removing the nerve and blood supply to the tooth. This does not at all make the tooth or the bone or gum tissue immune to infection rather it stops a dying tooth from aching.

Were it me in your position I would have an assessment and probably by a periodontist as I think they are better versed in all the various systems that can potentially be affected in this situation. Such an examination likely will include an x-ray as they will want to see the condition of the underlying bone.

In the Seattle are, such an appraisal should cost no more than $100 without X-ray and $300-500 with an X-ray (at least that has been my experience).

My two cents.
posted by bz at 11:38 PM on December 28, 2012

I did something quite similar - had a root canal, never got a crown on it, tooth broke off. Nothing happened to my tooth, and, eventually, when I ended up breaking two more teeth, the dentist removed the remains of the tooth (because it'd get in the way of the bridge, and there wasn't enough above the gum line to be a stabilising point for the bridge).

So things were fine for me.

I'd just keep an eye on it, and if it starts to hurt, get your ass to a dentist.

Also, if you're scared of dentists, make sure you say that when you visit. There are dentists who do this kind of work on small children and the like, and are very calming and happy to work with you through it all.
posted by Katemonkey at 3:01 AM on December 29, 2012

I had crown break on a tooth that had a root canal. Although the crown was replaced, bacteria did manage to get into the root area and cause an infection that was eating away at my jaw. The result was a painful extraction, bone graft and implant. At least have a dentist look at it and determine what danger, if any, it represents. The alternative is much, much worse.
posted by tommasz at 5:05 AM on December 29, 2012

You're in Seattle, right? As far as gentleness I can recommend Dr. Cederbaum and Dr. Mac Murray. Their staff is kind and never makes me feel like I'm being a big baby, even when I burst into tears -- twice! -- after trying nitrous.

I don't know what their financial plans are like, but it's worth giving them a call.
posted by The corpse in the library at 7:39 AM on December 29, 2012

I had a problem like this and the root got badly infected and it did not hurt! I knew it was infected because my gum swelled and I could feel a boil-like bump on my gum. It can ruin the bones in your jaw and spread to the rest of your body.

Pulling a tooth is kind of cheap, about $300 (I realize that can be a huge amount). By cheap, I mean cheaper that the root canal and crowning. Also, amazingly, pulling a tooth with no nerves is not painful! You should go and have it pulled.

Is there a dental clinic in your area? Many schools that teach dentistry and/or dental hygiene have clinics. They charge on a sliding scale and if you are broke, you may not have to pay anything. My small community has a dental clinic that would do this for you for free (but you would have to fly to Maui).
posted by fifilaru at 6:55 PM on December 29, 2012

You're in Seattle? You should call Stacy Gilmore DDS, she specializes in patients with fear issues and helped out my uninsured friend. And she's a terrific dentist.
posted by carterk at 9:51 PM on December 29, 2012

I lived w/ a broken tooth for nearly two years before the abscess that grew began causing serious pain. Keep clean, but I think it'd be good at some point to see a dentist about extraction so they can get the root and reduce chances of infection.
posted by dwbrant at 1:28 PM on January 3