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Medical Forum / General / Dentistry / April 2009

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Minor pain - chewing compression on a root canal tooth with buildup     and post

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Argonne1 - 12 Apr 2009 06:16 GMT
I'm 70 years old and recently broke off the top portion of a root
canal tooth with crown (Number 20).

My dentist smoothed off the remaining tooth structure, did a buildup
and inserted a post.  Then, put on a new crown.

I'm missing some back teeth, so I rely more than usual on tooth
Number 20 for chewing.

When I chew on that tooth, especially some harder or tougher to chew
foods, I often experience minor pain about 20 minutes after meals.  In
an hour or so, the minor pain usually subsides.  The tooth is not
sensitive to hot or cold or even chewing while in the process.  The
minor pain comes afterward.

My question:  Despite the tooth being root canaled, do there exist
pain receptors around the tooth or gums or ligaments or bone??
which can cause this minor reactive pain, and if so, is there anything
I can do about it short of extracting the tooth?

Thanks very much.

Rob in Arizona
Amatus Cremona - 12 Apr 2009 21:17 GMT
Pain receptors remain in the ligament holding the tooth to the bone.

You probably have cracked the root.  Try posting the radiograph where we can
view it.

Signature

/

Amatus

/

> I'm 70 years old and recently broke off the top portion of a root
> canal tooth with crown (Number 20).
[quoted text clipped - 19 lines]
>
> Rob in Arizona
Argonne1 - 12 Apr 2009 22:39 GMT
Amatus,

Thanks for reply.

My dentist x-rayed the tooth and root a week ago and
said that the root didn't appear cracked as that was my
guess.

Is it possible that the crack doesn't show on the x-ray?

Thanks,

Rob

> Pain receptors remain in the ligament holding the tooth to the bone.
>
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>
> - Show quoted text -
Dartos - 14 Apr 2009 14:18 GMT
> Amatus,
>
[quoted text clipped - 9 lines]
>
> Rob

Yes, but it is also possible that the 'old' root canal is
not doing it's job and may just need to be retreated.  After
placing a post and new crown, that is not good news, but
it still may be the case.

Had one of these 4-5 years ago.  Tried to save the patient
some money by trusting another dentist's old endo that
looked 'OK' on film.  Put the post and new restoration on
and it gave trouble almost immediately.

Took the crown off, got the post out, redid the endo, new
post, new crown....but it has worked!

D
Argonne1 - 18 Apr 2009 08:12 GMT
> > Amatus,
>
[quoted text clipped - 24 lines]
>
> D

Thanks for the added input.  Certainly among the list of
possibilities.  I've had endos go bad in the past and have benefited
from a redo.

However, in my case, I did some more troubleshooting since my dentist
and I both agreed that the problem might be one of gum abrasion since
the pain was quite minor (a 1 on a scale of ten) and not a steady
pain. Also, no sensitivity to hot or cold.  As a result, I checked the
pulse setting on my WaterPik and turned it down a couple of notches.
In the past, a too powerful pulse, believe it or not, was responsible
for gum irritation.

Voila!  It worked.  That was four days ago and no more discomfort
since.

Sometimes, solutions require thinking outside the box.
New B. - 19 Apr 2009 00:12 GMT
>Tried to save the patient
>some money by trusting another dentist's old endo that
>looked 'OK' on film.  

Admirable, have done the same.

>Put the post and new restoration on
>and it gave trouble almost immediately.

Have had similar results, in certain cases.
Am more selective now.

>Took the crown off, got the post out, redid the endo, new
>post, new crown....but it has worked!

I applaud your treatment, actions.  and success !
But mostly your 'nerve' to tackle such a case.

You have proven that an astute practitioner can salvage
a case without reverting to referral or extraction.

Good case report mate !

>D
 
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