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43 years old; NO pain in teeth; very small piece of tooth #3

 
Dr Mariana's Avatar
  • Answered by:Dr Mariana
  • Orthodontist
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Customer Question

43 years old; NO pain in teeth; very small piece of tooth #3 broke off so I went to dentist (Careington network). Told that I needed crown on tooth #3 and crown on tooth #30 due to significant decay. Had both (temp) crowns put in on April 23; pain ever since. Now I'm told one or both teeth may need a root canal if pain doesn't go away. My question is if I was experiencing no pain prior to crown work, is it normal to end up with two possible root canals afterwards?? Could dentist have caused the ongoing pain by something he did during the excavating (drilling) process, and now can claim that pain means that I need root canals?? Thank you for input.

Regards,

Frustrated and Confused

 

Optional Information:
Person's Gender: Male
Person's Age: 43

Submitted: 341 days and 6 hours ago.
Category: Dental
Value: $49
Status: CLOSED
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Expert:  Dr Mariana replied 341 days and 6 hours ago.

Hi, I am here to help you.
If the pain is related to chewing (pressure) , then the problem might be that the crown/crowns are to high and when you chew, you put more force on these teeth. This causes the tissue that supports them to inflame, causing pain.
If the pain is caused by hot and/or cold food and beverages then it is related to the nerve of the teeth and may be an indication of the need of root canal treatments…
Either the cavity or the process might have cause the inflammation. If the cavity underneath the filling was deep, even though it was painless, it is the job of the dentist to completely clean it out. Without having looked at the tooth or at X-rays, this is as much as I can tell you. Could it have been cause by the drilling? Certainly… but it could have also been the extent of the decay…

I hope this helps!
Dr Mariana Levy

Customer replied 341 days and 5 hours ago.

There is no pain when I chew; no pain due to hot or cold beverages; no pain when brushing teeth. Just constant throbbing sensitivity for 2 weeks. returned to dentist after 1 week because of pain and he did percussion 'test', resulting in no pain. He was unable to conclude if root canal(s) are necessary. Pain has continued for another week.

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Expert:  Dr Mariana replied 341 days and 5 hours ago.

I don't think I understand… You have constant and spontaneous pain, but it does not hurt when you chew? Could you clarify?

Customer replied 341 days and 5 hours ago.

The pain is underneath the 2 teeth. The temporary crowns must be protecting the nerves from further pain from pressure, chewing, hot, cold, etc. It just feels like a bad toothache, but 2 weeks after crown work?? Seems like the drilling has awaken nerve sensitivity that didn't exist before. But if I needed root canal, wouldn't the dentist have known and recommended that before he began the expensive crown procedures?

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Expert:  Dr Mariana replied 341 days and 5 hours ago.

Ok, It is clearer now that the pain is a tooth nerve inflammation (pulpitis). The procedure could have caused it… it sometimes happens that when an old filtrated filling is removed, the nerve does not resist the procedure .. and the nerve ends up getting inflamed and dying. As I explained , it could have been the cavity or the procedure itself. He should have at least explain the possibility that this may happen, I agree, however, many times, a root canal treatment is not necessary, so it is not done on as a preventive measure…
If he cannot determine the need of root canal treatment, you can go to an endodontist (a root canal specialist ) to evaluate the teeth. You can use the following link to locate one close to your area

http://www.aae.org/Patients/Find.aspx

I hope this clarifies the situation

Dr Mariana Levy

Customer replied 341 days and 5 hours ago.

Thank you. Your feedback was helpful. It had been 8 years since my last dentist visit and I picked this dentist from Careington Discount Plan network. After 2 weeks of discomfort, questions and uncertainty, I was starting to lose confidence in dentist. Hopefully the pulpitis will subside in time for the permanent crowns to be put on this Thursday.

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Expert:  Dr Mariana replied 341 days and 5 hours ago.

I'm glad I cold help you! If the symptoms get worse, it is a sign you need to have a second opinion

Let me know how it goes…

Dr Mariana Levy

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Expert:  Dr Mariana replied 338 days and 3 hours ago.

Hi, I was wondering how you were doing with your symptoms… Are they getting better? I hope so!
Please, do not hesitate to ask any follow up questions!
Dr Mariana Levy

I hope you found my answer helpful, please click on the GREEN ACCEPT button below for my answer. This is necessary for me to be paid for my work and so that I can get credit for assisting you. Your question will not close, and you will still have the opportunity to follow-up if needed. Leaving a positive feedback is not required, but doing so is certainly appreciated!

Customer replied 337 days and 3 hours ago.

I still have the two temp crowns; have an appointment tomorrow (Thurs) to either put in the permanent crowns or consider root canal. After our last conversation, I went to office Monday and dental assistant put the temp back on. That relieved the pain due to exposed nerve under tooth. I still have mild discomfort overall, although it's hard to pinpoint where exactly it's coming from. I am hoping it is the pulpitis you mentioned and it will continue to get better.


 


My concern now is whether I have the permanent crowns put on or do I wait another week to see if pain goes away entirely. It has gotten better, but not completely. Also, should I see an endodontist, even though this dentist says he does root canals all the time?


 


I will follow up again after appt tomorrow and I will ACCEPT your advise so you get credit for your feedback.


 


SC

Accepted Answer

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Expert:  Dr Mariana replied 337 days and 3 hours ago.

Firstly, I would solve the problem of the sensitivity before doing the permanent crowns…
If the teeth end up needing root canals, you best bet will be an endodontist. This is an specialist that do this type of procedure ONLY. The have 2 or 3 extra years of training on root canals. I would advice you to have them done by one… Let me know how it went! Dr Mariana LevyDr Mariana41039.0284884259

Expert TypeOrthodontist
Category: Dental
Pos. Feedback: 97.7 %
Accepts: 693
Answered: 5/10/2012

Experience: Orthodontist and Pediatric Dentist since 1990

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Expert:  Dr Mariana replied 329 days and 3 hours ago.

Hi!
How did it go? Did you get an appointment with an endodontist?

 
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