I want to make our patients aware of an occasional problem we see in teeth with large, old silver fillings. When the fillings start to corrode and leak, it’s time to put a crown on them. Sometimes, at a later date, the tooth may abscess. The patient may not understand why and ask,” Why did it abscess? Wasn’t the crown supposed to fix the tooth? I don’t understand!’’

The answer is as follows. In the middle of the tooth there is a chamber that houses the nerve and blood vessels (known as the pulp) when a tooth gets its first cavity (possibly as early as 6-10 years old) this is a traumatic experience to the pulp. The dentist removes the decay and fills the tooth. Here is another trauma, but the nerve recuperates and heals.

Years later, that filling starts leaking and needs to be replaced. Again, trauma. Replace the filling, more injury. But the nerve recovers again. Later, this large filling gets old and the tooth needs to be crowned. Another assault on the nerve.

The pulp, with its vast powers of healing usually returns to health. But sometimes with this fifth or sixth traumatic experience, the pulp finally dies and abscesses, fortunately, this only occurs occasionally but the number of times is still significant. All dentists hate to see this happen, but it does occur. If a tooth is going to abscess, it will, crown or no crown.

The good news is, however, with a root canal we can still save that tooth and you can keep it for the rest of your life.