Can a dentist tell from x-ray images that you need endodontic therapy (i.e. root canal)?

[Qacer]

I'm curious. Will a dentist be able to tell if you need a root canal via x-ray?

I really hate it when health professionals leave certain facts out. A few weeks ago I went for a routine dental examination. I was told that I need some crown, so I says fine. I show up for my crown appointment a few weeks later and they tell me that my file says that I might also need endodontic therapy (commonly known as root canal) on the same tooth. I was like "WTFBBQ! Why wasn't this mentioned a few weeks ago?".

I'm no dentist, but it doesn't make sense for me to get a crown and then a few weeks later have it drilled to carry out the endodontic procedure. This happened to a friend. She had gold fillings done. After that, the dentist told her that she needed endodontic therapy on the same tooth. She ended up getting the procedure done with the gold part drilled and replaced with a silver filling.

Anyway, the dentist was quite annoyed that I opted out of the crown procedure after these facts came to light. I should have probably slapped her with a large trout.

 

[Pepsei]

some dentist does... my dentist did earlier this year. i was in extreme pain from infected nerve so they took an x-ray, "hmmm, looks like you need a root canal"

When you get a root canal, you usually have to have a crown afterwards. but not other ways around. I've had a crown without.

my dentist made my root canal pleasant and the crown afterwards were painless.

since you burn your bridges with your dentist, i'd recommend switching to someone else.

 

[moshquerade]

Originally posted by: Qacer
I'm curious. Will a dentist be able to tell if you need a root canal via x-ray?

Yes.

 

[Wreckem]

Originally posted by: Qacer
I'm curious. Will a dentist be able to tell if you need a root canal via x-ray?

I really hate it when health professionals leave certain facts out. A few weeks ago I went for a routine dental examination. I was told that I need some crown, so I says fine. I show up for my crown appointment a few weeks later and they tell me that my file says that I might also need endodontic therapy (commonly known as root canal) on the same tooth. I was like "WTFBBQ! Why wasn't this mentioned a few weeks ago?".

I'm no dentist, but it doesn't make sense for me to get a crown and then a few weeks later have it drilled to carry out the endodontic procedure. This happened to a friend. She had gold fillings done. After that, the dentist told her that she needed endodontic therapy on the same tooth. She ended up getting the procedure done with the gold part drilled and replaced with a silver filling.

Anyway, the dentist was quite annoyed that I opted out of the crown procedure after these facts came to light. I should have probably slapped her with a large trout.

A crown is a two step process.

Step 1: there is crown prep which is tooth clean up and moldings are taken so the crown can be made. A temproray soft metal crown is usually place on the preped tooth.
Step 2: after several weeks the crown arrives and they put it on.

Ive had two root canals and both times crown prep came first, root canal came second and then the permanent placement of the crown came last.

She had every right to be pissed. You wasted her time, and didnt bother to ask if you were right in your assumptions. Your endontist might be a little annoyed to because now he has to do more work to do the root canal. Its easier for them if the tooth had been cleaned up and preped.

With my last root canal(on the rear molar), my dentist did clean up and prep, slapped a softa metal crown on. Then I went to the endontist, he drilled through the soft metal crown and ~15 minutes later the rootcanal was done. A week after that my crown was permanently seated.

 

[hiromizu]

Oh yea. My dentist showed me exactly how you can tell.

 

[Fritzo]

Yes, that denist wants to do unneeded surgery on you. I would keep an eye on him. You might wake up and your kidneys are gone.

 

[Qacer]

Originally posted by: Wreckem
A crown is a two step process.

Step 1: there is crown prep which is tooth clean up and moldings are taken so the crown can be made. A temproray soft metal crown is usually place on the preped tooth.
Step 2: after several weeks the crown arrives and they put it on.

Ive had two root canals and both times crown prep came first, root canal came second and then the permanent placement of the crown came last.

She had every right to be pissed. You wasted her time, and didnt bother to ask if you were right in your assumptions. Your endontist might be a little annoyed to because now he has to do more work to do the root canal. Its easier for them if the tooth had been cleaned up and preped.

With my last root canal(on the rear molar), my dentist did clean up and prep, slapped a softa metal crown on. Then I went to the endontist, he drilled through the soft metal crown and ~15 minutes later the rootcanal was done. A week after that my crown was permanently seated.

Yeah, but this wasn't your temporary soft metal crown. I would have understood that if she explained it that way. The problem was that she wanted to put a crown in without telling me that I may possibly need a root canal. Plus, she doesn't do root canal.

The assistant had more sense than her. She recommended that I go see a dentist who did root canals. One was in my insurance network. The other one was another dentist that they have a working relationship.

 

[Qacer]

Originally posted by: hiromizu
Oh yea. My dentist showed me exactly how you can tell.

This is my x-ray:
X-ray pics

How can I tell?

 

[Wreckem]

Originally posted by: Qacer

Originally posted by: Wreckem
A crown is a two step process.

Step 1: there is crown prep which is tooth clean up and moldings are taken so the crown can be made. A temproray soft metal crown is usually place on the preped tooth.
Step 2: after several weeks the crown arrives and they put it on.

Ive had two root canals and both times crown prep came first, root canal came second and then the permanent placement of the crown came last.

She had every right to be pissed. You wasted her time, and didnt bother to ask if you were right in your assumptions. Your endontist might be a little annoyed to because now he has to do more work to do the root canal. Its easier for them if the tooth had been cleaned up and preped.

With my last root canal(on the rear molar), my dentist did clean up and prep, slapped a softa metal crown on. Then I went to the endontist, he drilled through the soft metal crown and ~15 minutes later the rootcanal was done. A week after that my crown was permanently seated.

Yeah, but this wasn't your temporary soft metal crown. I would have understood that if she explained it that way. The problem was that she wanted to put a crown in without telling me that I may possibly need a root canal. Plus, she doesn't do root canal.

The assistant had more sense than her. She recommended that I go see a dentist who did root canals. One was in my insurance network. The other one was another dentist that they have a working relationship.

Again, if you WENT to the appointment, she would have did cleanup and prep and then refered you to a endontist prior to putting on the permanent crown. There is no one and done crown appointment. Crowns are all custom done and typically take 3-4 weeks to be made and returned to the Dentist. You WOULD have had a temporary crown after the first appointment.

 

[Qacer]

Originally posted by: Wreckem
Again, if you WENT to the appointment, she would have did cleanup and prep and then refered you to a endontist prior to putting on the permanent crown. There is no one and done crown appointment. Crowns are all custom done and typically take 3-4 weeks to be made and returned to the Dentist. You WOULD have had a temporary crown after the first appointment.

I did GO to the appointment. I was sitting in the dentits' chair waiting for the crown procedure. It was only revealed to me that I may need a root canal before they started. Plus, why the hell would they charge me $500+ after insurance for a temporary soft crown?

It doesn't make sense. I'd rather go crownless for a few weeks before getting a root canal.

 

[RaistlinZ]

Dentists make way more money on root canals than they do on crowns. Dentistry is a businesss just like any other.

The last time I went to my dentist to have a cracked wisdom tooth removed they said the needed to take out my other 3 back molars too just because "you haven't had them taken out yet." :roll: As if removing wisdom teeth is a necessity even if there's nothing wrong with them.

 

[hiromizu]

Originally posted by: Qacer

Originally posted by: hiromizu
Oh yea. My dentist showed me exactly how you can tell.

This is my x-ray:
X-ray pics

How can I tell?

Well he showed me HOW, I still didn't get it

Actually from the looks of it, it's not obvious. Are you feeling any pain? Usually by the time you feel pain it's too late.

 

[Qacer]

Originally posted by: hiromizu

Originally posted by: Qacer

Originally posted by: hiromizu
Oh yea. My dentist showed me exactly how you can tell.

This is my x-ray:
X-ray pics

How can I tell?

Well he showed me HOW, I still didn't get it

Actually from the looks of it, it's not obvious. Are you feeling any pain? Usually by the time you feel pain it's too late.

I have not experience any pain whatsoever. The only pain that I got was not being able to find a dentist who laid out the whole thing in front of me without leaving out details.

Originally, this was started because I wanted to go for a cleaning. Since I had moved to a new area, I didn't have any dental referrals. I just picked the nearest dentist. The first dentist told me that I needed deep cleaning. She would charge $800+. I was skeptical because I got my cleaning just a year ago and carried out my daily teeth maintenance like always, so I went to this other dentist for a second opinion. I did not mention anything about cleaning.

The second dentist said that she recommended a regular cleaning, which I was fine, and also, the crown procedure, which I initially agreed before finding out about the root canal when I showed up for my procedure.

 

[Wreckem]

Originally posted by: Qacer

Originally posted by: Wreckem
Again, if you WENT to the appointment, she would have did cleanup and prep and then refered you to a endontist prior to putting on the permanent crown. There is no one and done crown appointment. Crowns are all custom done and typically take 3-4 weeks to be made and returned to the Dentist. You WOULD have had a temporary crown after the first appointment.

I did GO to the appointment. I was sitting in the dentits' chair waiting for the crown procedure. It was only revealed to me that I may need a root canal before they started. Plus, why the hell would they charge me $500+ after insurance for a temporary soft crown?

It doesn't make sense. I'd rather go crownless for a few weeks before getting a root canal.

Okay to put it mildly you dont understand how dental work is done.

You were waiting to get crown prep done. You paid $500 because you PAY FOR the crown up front. Dentists aren't going to order a crown from a lab and be stuck with a loss if the patient doesnt pay.

This is how it goes.

You go in, they use various drills to cleanup the decay and reshape the remainging tooth. They take two sets of molds. One set is of your bite, the other is to get the shape of the tooth it is going on. They then place on a temporary crown. Send the moulds off to a lab and in 3-4 weeks you get they get the crown. They charge you 100% up front all dental work related to the crown. Dental work that requires multiple visits is ALWAYS paid in full up front. Dentists arent going to be caught holding the bill for crowns, dentures, etc. You arent paying $500 for a temporary crown. Depending on the severity of the infection of the root, they might put medication in the tooth before sealing it up with the temp crown.

The reason she is pissed is you cost her 1-2 hours of billable work.

Now you are going to go get the root canal. Then you are going to have to get the crown prep done and have a temp crown put on, then you are going to have to wait several weeks to get the real crown. Its going to take a lot more time from start to finish.

 

[wwswimming]

Originally posted by: RaistlinZ
Dentists make way more money on root canals than they do on crowns. Dentistry is a businesss just like any other.

The last time I went to my dentist to have a cracked wisdom tooth removed they said the needed to take out my other 3 back molars too just because "you haven't had them taken out yet." :roll: As if removing wisdom teeth is a necessity even if there's nothing wrong with them.

that's why i like going to a dentist at a dental school.

once you get a GOOD student dentist, there is a lot less profit motive involved.

By the way - did you get the Liquid Nitrogen treatment on the root canal yet ?

I think there's a lot to be said for learning some of the dental basics, e.g. the teeth numbering and the terms used to describe caries. Moshquerade knows all this stuff, i picked it up because i had a lot of cavities & gingival decay left over from my sugar-soda-drinking years ( i had my last root beer one week before the 2008 presidential election.)

i'm about to have a collision with the student dentist i admire so much because they want to do a crown on tooth #12, which is on the upper left. i've already had the crown build-up, they removed all the decay and filled it back in. i believe that the tooth is healthier as is, that grinding off the top of the tooth & replacing it with a crown will leave the tooth weaker & me poorer.

plus i have a history of decay at the interface between the crown & the rest of the tooth, i've had 2 crown replacements the last 2 years.

anyway, getting back to the OP's situation -

root canal + crown = OUCH

 

[Wreckem]

Originally posted by: RaistlinZ
Dentists make way more money on root canals than they do on crowns. Dentistry is a businesss just like any other.

The last time I went to my dentist to have a cracked wisdom tooth removed they said the needed to take out my other 3 back molars too just because "you haven't had them taken out yet." :roll: As if removing wisdom teeth is a necessity even if there's nothing wrong with them.

Endontics is a specialty thats why it is more expensive. Although really, without insurance a root canal is $1000(around here), and a porcelin crown is $750.

As for wisdom teeth, if they had no problems, it shouldnt have cost much to have them all removed at one time. And just because they arent causing problems now, doesnt mean they wont in the future. Unless wisdom teeth come in perfectly and your mouth has plenty of room for them, they should be removed.

 

[Wreckem]

Originally posted by: wwswimming

Originally posted by: RaistlinZ
Dentists make way more money on root canals than they do on crowns. Dentistry is a businesss just like any other.

The last time I went to my dentist to have a cracked wisdom tooth removed they said the needed to take out my other 3 back molars too just because "you haven't had them taken out yet." :roll: As if removing wisdom teeth is a necessity even if there's nothing wrong with them.

that's why i like going to a dentist at a dental school.

once you get a GOOD student dentist, there is a lot less profit motive involved.

By the way - did you get the Liquid Nitrogen treatment on the root canal yet ?

I think there's a lot to be said for learning some of the dental basics, e.g. the teeth numbering and the terms used to describe caries. Moshquerade knows all this stuff, i picked it up because i had a lot of cavities & gingival decay left over from my sugar-soda-drinking years ( i had my last root beer one week before the 2008 presidential election.)

i'm about to have a collision with the student dentist i admire so much because they want to do a crown on tooth #12, which is on the upper left. i've already had the crown build-up, they removed all the decay and filled it back in. i believe that the tooth is healthier as is, that grinding off the top of the tooth & replacing it with a crown will leave the tooth weaker & me poorer.

plus i have a history of decay at the interface between the crown & the rest of the tooth, i've had 2 crown replacements the last 2 years.

anyway, getting back to the OP's situation -

root canal + crown = OUCH

Root canals are painless these days, unless they break a file that is. Crown prep hurts worse in most cases.

 

[Qacer]

Originally posted by: Wreckem
Okay to put it mildly you dont understand how dental work is done.

You were waiting to get crown prep done. You paid $500 because you PAY FOR the crown up front. Dentists aren't going to order a crown from a lab and be stuck with a loss if the patient doesnt pay.

This is how it goes.

You go in, they use various drills to cleanup the decay and reshape the remainging tooth. They take two sets of molds. One set is of your bite, the other is to get the shape of the tooth it is going on. They then place on a temporary crown. Send the moulds off to a lab and in 3-4 weeks you get they get the crown. They charge you 100% up front all dental work related to the crown. Dental work that requires multiple visits is ALWAYS paid in full up front. Dentists arent going to be caught holding the bill for crowns, dentures, etc. You arent paying $500 for a temporary crown. Depending on the severity of the infection of the root, they might put medication in the tooth before sealing it up with the temp crown.

The reason she is pissed is you cost her 1-2 hours of billable work.

Now you are going to go get the root canal. Then you are going to have to get the crown prep done and have a temp crown put on, then you are going to have to wait several weeks to get the real crown. Its going to take a lot more time from start to finish.

She's pissed. I'm pissed. That's understandable. Do you think her time is the only time that's worth it? How about wasting PTO to have something not carried out?

The steps that you explain makes it clear. But what I'm still wondering is that: Is it normal for a dentist to NOT tell a patient that they would possibly need root canal if they found out about it weeks earlier before the appointment date?

Anyway, if I already have an existing filling (as seen on the x-ray), why would I need to get a crown on the same tooth only to have it redone after root canal?

 

[Wreckem]

Originally posted by: Qacer

Originally posted by: Wreckem
Okay to put it mildly you dont understand how dental work is done.

You were waiting to get crown prep done. You paid $500 because you PAY FOR the crown up front. Dentists aren't going to order a crown from a lab and be stuck with a loss if the patient doesnt pay.

This is how it goes.

You go in, they use various drills to cleanup the decay and reshape the remainging tooth. They take two sets of molds. One set is of your bite, the other is to get the shape of the tooth it is going on. They then place on a temporary crown. Send the moulds off to a lab and in 3-4 weeks you get they get the crown. They charge you 100% up front all dental work related to the crown. Dental work that requires multiple visits is ALWAYS paid in full up front. Dentists arent going to be caught holding the bill for crowns, dentures, etc. You arent paying $500 for a temporary crown. Depending on the severity of the infection of the root, they might put medication in the tooth before sealing it up with the temp crown.

The reason she is pissed is you cost her 1-2 hours of billable work.

Now you are going to go get the root canal. Then you are going to have to get the crown prep done and have a temp crown put on, then you are going to have to wait several weeks to get the real crown. Its going to take a lot more time from start to finish.

She's pissed. I'm pissed. That's understandable. Do you think her time is the only time that's worth it? How about wasting PTO to have something not carried out?

The steps that you explain makes it clear. But what I'm still wondering is that: Is it normal for a dentist to NOT tell a patient that they would possibly need root canal if they found out about it weeks earlier before the appointment date?

Anyway, if I already have an existing filling (as seen on the x-ray), why would I need to get a crown on the same tooth only to have it redone after root canal?

I dont know why your dentist didnt at the very least tell you you might have needed a root canal. As for the rest, its simple, like I said you would get the root canal before the crown is permenantly placed.

The first visit, the dentist would have removed the filling and cleaned up any decay that existed. Then they would have put a temporary crown on. The endontist would have done the rootcanal, and then your new crown would have been put on.

On the three root canals(last two molars on the left, last molar on the right) Ive had, Ive always had crown prep, root canal, placement of the crown.

Let just says, Ive had a lot of dental work done in the last year. Its cost me a pretty penny even with insurance.

 

[Qacer]

Originally posted by: Wreckem
I dont know why your dentist didnt at the very least tell you you might have needed a root canal. As for the rest, its simple, like I said you would get the root canal before the crown is permenantly placed.

The first visit, the dentist would have removed the filling and cleaned up any decay that existed. Then they would have put a temporary crown on. The endontist would have done the rootcanal, and then your new crown would have been put on.

On the three root canals(last two molars on the left, last molar on the right) Ive had, Ive always had crown prep, root canal, placement of the crown.

Yeah, they had "root canal" written down on my file when I initially went in for the check up. I had scheduled a cleaning and crown procedure with them; the crown being first and the cleaning next. Not once was root canal mentioned. Only when I got there for my crown appointment did the assistant mentioned it to me.

If I would have known, I would have schedule the crown appointment a bit later to save up some money for the entire procedure (i.e. crown + root canal).

 

[Reckoner]

Wreckem, I don't understand why the dentist wouldn't have explained the process to Qacer just to avoid the confusion he had at the time. It could've avoided this whole scenario.

 

[Wreckem]

Originally posted by: Reckoner
Wreckem, I don't understand why the dentist wouldn't have explained the process to Qacer just to avoid the confusion he had at the time. It could've avoided this whole scenario.

I dont know why either. My dentist gave me an itemized list of what needed(or what might be needed)done and the approx. cost with the insurance I had.

 

[MikeyIs4Dcats]

Sounds like she made a mistake and forgot to tell you or thought she had mentioned it.

Either way, you still don't seem to understand the crown process. Had you asked her to explain it, you likely would have saved her the lost time, and yourself lost time and money.

 

[Taejin]

Originally posted by: RaistlinZ
Dentists make way more money on root canals than they do on crowns. Dentistry is a businesss just like any other.

The last time I went to my dentist to have a cracked wisdom tooth removed they said the needed to take out my other 3 back molars too just because "you haven't had them taken out yet." :roll: As if removing wisdom teeth is a necessity even if there's nothing wrong with them.

uh, actually, the reason they remove wisdom teeth is so that it doesn't crowd your other teeth (and cause the wisdom teeth are not necessary). It helps with the health of your mouth in general.

 

[Wreckem]

Originally posted by: Taejin

Originally posted by: RaistlinZ
Dentists make way more money on root canals than they do on crowns. Dentistry is a businesss just like any other.

The last time I went to my dentist to have a cracked wisdom tooth removed they said the needed to take out my other 3 back molars too just because "you haven't had them taken out yet." :roll: As if removing wisdom teeth is a necessity even if there's nothing wrong with them.

uh, actually, the reason they remove wisdom teeth is so that it doesn't crowd your other teeth (and cause the wisdom teeth are not necessary). It helps with the health of your mouth in general.

Overcrowding by wisdom teeth can cause the rear molars to start cracking. Thats what happened to me on one side. That and I didnt do anything about the cracked teeth for several years. The other side the wisdom tooth grew into the roots of the molar in front of it. No money and no insurance at the time. Finally had it all taken care of. None of it would have happened if I had my wisdom teeth out when most usually do(between 18-21).