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Medical Forum / General / Dentistry / May 2006Tooth still is very sensitive after root canal
Hi, I posted on this back about 5 months ago but it is still bothering me so I'm back again. This is the history: I had some sensitivity with #30, went in for an xray, was told I needed a crown. The dentist did xrays and said it was iffy as to whether I needed a root canal or not, but it might be a good idea to get one before doing the crown as opposed to doing it after wards, but it was my choice. He sent me to an endo who did some tests and said he also could not be 100% sure but he was leaning towards it needing a root canal. I went with the root canal. It was a very difficult one (on my end; i.e; very painful, long session)(others I had before were a snap compared to this one; this was one of those that give meaning to the fear people feel when you utter the words "root canal"). After it was over, I continued to feel sensitivity there. Called the endo and he said he looked at the post-endo xray and he was sure it was fine, the sensitivity will go away with time. A month passes, I still feel sensitivity. Like when I tap it with my toothbrush, it hurts, not a sharp horrible pain, but a small uncomfortable pain. I insist on going back for him to look at it, again. He takes another xray or two, looks at it, does some testing on it and says it's perfect. Meanwhile I also went to a new dentist and had this dentist look at xrays of it. She said it looked to be a perfect root canal. So here I am 5 months later, and this tooth STILL is very sensitive to being hit with my toothbrush, tapped with my fingernail, spoon, fork, etc... Granted, it's no big problem, but I keep thinking there MUST BE SOMETHING WRONG or why would I feel something in a tooth that has no nerve? Am I just being a hypochondriac about this tooth? is it just normal for a tooth to have post-root canal sensitivity for 6 months or more? (I use sensitive toothpaste and have for a few months.) Any advice or opinions is welcome. Thanks in advance. > Hi, I posted on this back about 5 months ago but it is still bothering > me so I'm back again. [quoted text clipped - 38 lines] > > Any advice or opinions is welcome. Thanks in advance. Root canals sometimes fail. Sometimes you find out why when you extract the tooth; sometimes you never find out. With operating microscopes, the incidence of missed canals is less than it was; probably now the biggest reason for previously unexplained failure is some occult fracture of the root system. My wife lost an upper first molar like this just last week--it had been bothering her for about a year and a half since having a very pretty root canal done by and endodontist. Apicoectomy wasn't an option because of proximity to the sinus. Steve So, when I explain my symptoms to the endo, and he says it's no problem, there's nothing wrong, is he just b.s.'ing me, and he knows there is some "occult fracture" or such and that the rct was a failure? OR does he really think it is fine, that this is sometimes "normal"? And are you saying that the tooth may prove to be fine, even though it hurts a little sometimes when tapped, that it MAY not have to be extracted or gone back into? that it may just be this way the rest of my life, or might calm down? Or, is it just a matter of time til it has to be extracted? Thanks for your time! > So, when I explain my symptoms to the endo, and he says it's no > problem, there's nothing wrong, is he just b.s.'ing me, and he knows [quoted text clipped - 9 lines] > > Thanks for your time! I honestly don't know. Even in my wife's case, x-ray evidence showed that a distinct dark area at the tip of the root (presumptive infected area) progressively faded. So there was a disconnect between x-ray evidence and symptoms. Some of these teeth remain symptomatic forever without showing any other sign of problems. If the discomfort is slight, I sometimes retain the tooth indefinitely. If there is a crack, sooner or later things deteriorate--clinically, on the x-ray--or both. I would not presume B.S.--you can only see what you can see. But while I myself would urge you to give this more time esp. if the discomfort is mild, your discomfort should not be discounted. It should be monitored, and any decisions should be based on both the clinical picture and your own perception of just how much this is bothering you, and your tolerance for waiting. Steve On occasion this sort of thing happens. I encounter a patient like this on average maybe once every 3 years. Sometimes there is an unfilled canal sometimes a fracture. Sometimes its an adjacent tooth that is giving the pain, Sometimes its the bite either the new crown is too high or the tooth is in a traumatic bite. Like Dr Bornfeld says time will reveal the cause. Having a root canal look pretty on the x-ray does not mean that the problem was solved. I believe you should wait before considering drastic unscientific and desperate measures such as extraction because if the problem was not the tooth you can not put it back. Did you have a new crown placed over the root canal? If so what type was it? you may also want to make sure you have good contacts on either side of the crown. You can check this with floss, the crown should floss like your other teeth. If the contact is not as tight food impaction can irritate your gums and give you the symptoms you describe. > On occasion this sort of thing happens. I encounter a patient like this > on average maybe once every 3 years. [quoted text clipped - 11 lines] > floss like your other teeth. If the contact is not as tight food > impaction can irritate your gums and give you the symptoms you describe. All good points, Alex. Steve >On occasion this sort of thing happens. I encounter a patient like this >on average maybe once every 3 years. [quoted text clipped - 11 lines] >floss like your other teeth. If the contact is not as tight food >impaction can irritate your gums and give you the symptoms you describe. Thanks much for the info. Figures, I'd be one of these "once in 3 years" patients. Luck with dental work is something I seem not to have at all. It's not the bite: there is no opposing tooth on this crown! I am in the process of beginning to get implants but as yet there is no bite there. I am not considering anything drastic. I intend to live with it. I just wondered if there was any recommended treatment or tests I should get. I see that the recommendation is to just wait, so that is what I will do. I did have a new crown placed over the root canal. what type? Porcelain, I believe. Is that what you mean? By "food impaction" you mean, is food getting stuck in between the new crown and the old tooth next to it? I'm not sure but that does not seem to be the case. Before I got the new crown I had a temporary crown on there for awhile. The temp crown bothered me more, and then after a while, it calmed down to almost nothing. For some reason the permanent crown bothers me more than the temp. did and is not calming down as quickly. I wonder if it might be because there was more trauma involved in installing the perm. crown? I mean, they screwed around with it a lot getting it to fit right, put in on and off several times, etc... Anyway, apparently there is really nothing I can do but wait ... and HOPE that the sensitivity goes away and that I do not lose this tooth! I have the same situation on tooth #19 where I had a root canal done on a tooth with an existing gold crown. about 8 months ago. It's slightly sensitive to percussion, like tapping on it with my finger, both on the top of the tooth and on the side. But surprisingly, it doesn't bother me when I eat, even something like almonds. I know that it is not a problem with any remaining pulp because any sensitivity to cold (which is what I had before) is completely gone. The endo told me that what I was most likely sensing was the ligament adjacent to the tooth This must be a common problem because II also had the exact same thing on #30 after an RC was done, i.e. no more cold sensitivity but sensitive to percussion. This tooth, though, was utlimately replaced by an implant/crown so no more problem. > >On occasion this sort of thing happens. I encounter a patient like this > >on average maybe once every 3 years. [quoted text clipped - 40 lines] > Anyway, apparently there is really nothing I can do but wait ... and > HOPE that the sensitivity goes away and that I do not lose this tooth! >I have the same situation on tooth #19 where I had a root canal done on >a tooth with an existing gold crown. about 8 months ago. It's slightly [quoted text clipped - 12 lines] >sensitive to percussion. This tooth, though, was utlimately replaced >by an implant/crown so no more problem. Thanks for the info. what does that mean, that I am sensing "the ligament adjactent to the tooth"? Can anyone explain that to me, and is this correct - or could be correct - in the opinion of the dentists here? check the bite, it might have a premature contact or interferance? in that case syntoms are pain, sensitivity to cold drinks and hot drinks....the Dr needs to check the lateral movements and see if there's no interferance  SignatureDarthPollo |
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