I had root canals done on my front two teeth when I was 19. I'm now 50. I had those teeth internally bleached twice. 12 years ago it was successful. Four years ago, less so. I have been advised to redo the root canals so that I can rebleach them as the best option to whiten but with no guarantees! I can't do veneers as the teeth protrude.Some say crowns at the front are risky. Has anyone had success with the redoing root.canals and bleaching? Any best advice the front of my face? Thank you.
Redoing Root Canals for a Better Bleaching Option?
Doctor Answers (6)
I would not recommend re-doing root canals for bleaching purposes
I would not recommend to re-do the root canals unless there is a problem with the old root canals. If the old root canals are still good, then you may re-do internal bleaching but just make sure there is an adequate seal of the canal so the bleaching agent does not get into the root. You do have to be carefull of external root resorption (as mentioned by others). You should discuss this further with an endodontist (root canal specialist).
You also have the option of aligning the teeth with Invisalign or braces to bring them back to the point where you can do veneers. In fact you can RE-trude them to the point that the veneers preparation would be very shallow.
Crowns can be a bit risky due to the weakening of the tooth structure from the root canal and the crown preparation. This depends on how much tooth structure you have left. I would assume that since you had the original root canals done at 19yrs old, that the hole for the root canal is big due to a large pulp chamber at that age. So this would be a problem and may end up with very little tooth structure under the crowns. However, crowns would provide a good esthetic solution.
Second opinions are good
Protruding teeth are not usually a reason to exclude porcelain veneers, so perhaps another exam with an experienced cosmetic dentist should be considered.
Having said that, these teeth have had root canal therapy and internal bleaching done twice. Each time the teeth have become weaker and would benefit from full crowns. Internal bleaching becomes less effective each time, and the severely caustic chemicals used very likely will cause internal resorption (leading to loss of teeth).
I would suggest a consultation from an endodontist, but if the root canal therapies are OK, I would recommend crowns and leaving the root canals alone.
Root canal treatment and internal bleaching
In the situation when internal bleaching was already performed, the possibility of internal root resorption is extremely high. In such case aesthetic anterior crowns can be a better solution - long-term and safe.
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Internal bleaching VS veneers and crowns
You have already bleached them internally, and if the root canals are fine, I would suggest to leave them alone. bleaching internally will cause internal resorption , something you do not want to risk.
I have placed may veneers FOR protruded teeth to correct their positioning as well as achieving better cosmetic result.
If you have had root canals and you are 50 now, your teeth might actually benefit from crowns. GO to a n experienced cosmetic dentist and she/he will give you your best options.
Root canal redo for bleaching
From your history I would not reccommend redoing root canal for bleaching purposes (unless there is a need for that such as endodontic pathology). Endodontic filler can be removed from the crown portion of the tooth and this will not affect bleaching of coronal portion. But since you have bleached twice already and you are not happy about the outcome, then this treatment modality is not for you. You should consider something more permanent like veneers or crowns. The fact that your teeth protrude is not contraindication for fabrication of veneers. I would reccommend to find a restorative specialit - prosthodontist and go for consultation. Good luck!
Crowns may be best option
Like many have said, I'd leave your root canals alone. If they are not infected, there would be no need to redo them. As for internally bleaching for a 3rd time, I would also not do this. With root canals being done on these teeth 30 years ago, it is more then likely they are brittle, and could use the extra protection of a full coverage porcelain crown. Between the dentist and the lab they use, you should get the shape and color you are looking for.