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QUESTION ABOUT NEWLY ROOT CANALED AND CROWNED TOOTH ... I

 
Dr.Fazeli Niaki's Avatar
  • Answered by:Dr.Fazeli Niaki
  • Dentist - Prosthodontist
  • Positive Feedback: 96.0 %
  • Accepted Answers: 69
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Customer Question

QUESTION ABOUT NEWLY ROOT CANALED AND CROWNED TOOTH ...

I HAVE HAD 3 ROOT CANALS AND CROWNS IN MY LIFE. THE FIRST WAS MANY MANY YEARS AG0 (MAYBE 15 - 20?) AND I CAN'T EVEN TELL WHICH ONE IT IS - IT FEELS JUST
LIKE THE OTHER TEETH. THE LAST TWO I HAD DONE IN THE LAST 3 MONTHS. BOTH OF THESE FEEL VERY SLIGHTLY PAINFUL WHEN I BITE DOWN. I WENT TO THE DENTIST ABOUT THE LAST ONE, BECAUSE THAT ONE SEEMS TO BOTHER ME MORE, AND HE SEES NO GAPS ON THE XRAY AND HE SAYS IT LOOKS FINE. HE IS WILLING TO REDO THE CROWN AT NO COST IF IT IS BOTHERING ME - BUT I HATE TO SPEND THE TIME ON THAT (MINE AND HIS) IF THIS IS JUST NORMAL, BECAUSE IT REALLY ISN'T BOTHERING ME THAT MUCH. MY QUESTION IS WHY WOULD I FEEL ANYTHING AT ALL THOUGH, IF THE NERVE IS DEAD? THANK YOU!

 

Optional Information:
Person's Gender: Female
Person's Age: 52

Already Tried:
DENTIST

Submitted: 296 days and 2 hours ago.
Category: Dental
Value: $15
Status: CLOSED

Accepted Answer

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Expert:  Dr.Fazeli Niaki replied 296 days and 1 hours ago.


Dr.Fazeli Niaki :

Thank you for your question. I'll do my best to answer it for you.
There are a number of causes of pain after the completion of a root canal treatment. After a root canal is completed although no living pulp tissue remains inside the tooth, but nerve endings remain in the ligaments that attach the tooth to the surrounding bone. These ligaments have nerve fiber associated with them that can feel pain. They are the source of pain after a root canal treatment.
One of the main cause of pain is inflammation of the periapical tissues post root canal. This inflammation may be due to extruded sealer during the root canal therapy or over instrumentation during the endodontic procedure. Sometimes the root canal files go past the apical terminus and can either inject some debris periapically or just damage the ligaments. This inflammation usually resolves by itself given enough time.

Another source of pain is a high bite and this can easily be corrected by your dentist. If a patient bites down, with no food in their mouth and their root canaled tooth hurts, then the bite should be adjusted. Teeth undergoing root canals should be not be in a heavy occlusion and it can lead to pain likely to your case.

Also pain can be because of a persistent infection or a root fracture. If a root canal is completed, but an infection still is present around the periapical area then a retreatment may be indicated especially if significant time has gone by without a resolution of the infection. Sometimes an infection can be caused by a fracture of the tooth in question and in that case the tooth.
By the way as a dentist specialized in prosthodontics, I recommend you to wait a couple of days (up to 14 days) and if you still feeling pain or discomfort visit your dentist and ask for retreatment but I think pain will soon over.

I hope you get well soon.

If you have any more questions, I am happy to help as much as possible so feel free to ask.

Customer :

HELLO - THANK YOU FOR YOUR RESPONSE ... THE FIRST TOOTH THAT I ONLY FEEL MILD DISCOMFORT WITH WAS COMPLETED WITH CROWN 3 MONTHS AGO. THE 2ND TOOTH

COMPLETED ALMOST 2 MONTHS AGO. THERE IS NO BITE PROBLEMS INDICATING THE TOOTH IS TOO HIGH. THE IS ONLY VERY VERY MILD PAIN WHEN BITING ON FOOD. LESS FOR THE FIRST TOOTH, AND MORE FOR THE 2ND TOOTH DONE. IN ADDITION, IF I TAP MY TEETH OR PRESS MY FINGER WITH PRESSURE ALONG THE SIDE, THEY ALL FEEL THE SAME - BUT THE CROWNED TEETH FEEL DIFFERENT -- A LITTLE SORE.

Dr.Fazeli Niaki :

Thank you for your question,

Dr.Fazeli Niaki :

I recommend you to wait for almost 1 more month, if your pain get worse or you have any sign of inflammation such as fever, I highly recommend you to ask your dentist to redo the root canal therapy but if it is mild pain, it can be normal.

Dr.Fazeli Niaki :

In case of root canal failure, re-root canal treatment, Apicoectomy or tooth extraction may also be required to remove the infection from the tooth.

Dr.Fazeli Niaki :

by the way If the treatment has failed, the dentist will evaluate the condition of the tooth and the reasons of the root canal complications, in order to decide if the tooth can be saved.
Unfortunately, in some cases of failure the tooth can not be saved and it has to be extracted. A bridge, implant or a partial denture has to replace the lost tooth.

Dr.Fazeli Niaki :

I hope you get well soon.

If you have any more questions, I am happy to help as much as possible so feel free to ask.

Customer :

HELLO - THANK YOU! WHAT WOULD BE SIGNS THAT THE ROOT CANAL HAS FAILED? IS

Customer :

IT NORMAL FOR THE TOOTH TO ALWAYS BE SENSITIVE UPON BITING ON HARD THINGS?

Dr.Fazeli Niaki :

Thank you for your question

Dr.Fazeli Niaki :


most of the time tooth pain and tenderness or swelling of the gums in the area of treated tooth and in other cases, problems such as a new infection can develop without any symptoms.

Dr.Fazeli Niaki :

no it is not normal

Dr.Fazeli Niaki :

sensitiveness cause usually is a exposed dentine. a dentine contains little tunnels that link to the nerves on the inside of the tooth, and when dentine is exposed, these nerves are easily stimulated, resulting in pain.

Dr.Fazeli Niaki :

but at the case of root canal therapy, the tooth can be sensitive for some days or even 1 month

Dr.Fazeli Niaki :

I hope you get well soon.

If you have any more questions, I am happy to help as much as possible so feel free to ask.

Dr.Fazeli Niaki :

by the way follow up visit after root canal therapy and x-rays are very important in determining the success or possible complication of a it. X-rays will help us to detect any sign of inflammation in or around the tooth that could indicate root canal complications.

Customer :

BUT MORE THAN A MONTH?

Dr.Fazeli Niaki :

Thank you for your question

Dr.Fazeli Niaki :

it is different in each individual

Dr.Fazeli Niaki :

sometimes the tooth is sensitive for more than 1 month

Dr.Fazeli Niaki :

but usually it take less

Dr.Fazeli Niaki :

so it can be different in each individual

Dr.Fazeli Niaki :

If you have any more questions, I am happy to help as much as possible so feel free to ask.

Customer :

HI ~ I'M SORRY FOR THE DELAY, I DIDN'T SEE YOUR RESPONSE. I REALIZE THAT SENSIVITY TIME MAY BE DIFFERENT FOR EACH INDIVIDUAL, BUT IF THERE IS SLIGHT PAIN TO BITE DOWN (SIMILAR TO THE PAIN BEFORE THE ROOT CANAL AND CROWN), AT WHAT POINT DO YOU FEEL IT WOULD BE REASONABLE TO REQUEST THAT THE CROWN BE REDONE? OBVIOUSLY IT WAS VERY EXPENSIVE FOR ME TO HAVE DONE, AND AT SOME POINT IT WILL BE CHARGEABLE IF IT DECAYS IN A YEAR OR TWO, SO THAT IS MY CONCERN. THANKS !

Dr.Fazeli Niaki :

Thank you for your question

Dr.Fazeli Niaki :

Slight pain or sensitiveness can not be the reason for a retreatment

Dr.Fazeli Niaki :

on the base of your complaints I recommend you to wait for couple of days or some weeks

Dr.Fazeli Niaki :

your bite has been changed

Dr.Fazeli Niaki :

and it needs the adaptation

Dr.Fazeli Niaki :

antagonist teeth are under the stress

Dr.Fazeli Niaki :

and the extra pressure and retained defect of surrounding tissue will be gone in couple of weeks

Dr.Fazeli Niaki :

As a prosthodontist, I suggest you to be more patient about your teeth

Dr.Fazeli Niaki :

I am quite sure it will gone

Dr.Fazeli Niaki :

had many similar cases that never call me back after adaptation of teeth and oral tissue

Dr.Fazeli Niaki :

I think the border for redo a crown is a permanent pain and a defect in the crown ,antagonist tooth or surrounding tissue of root under X-ray

Dr.Fazeli Niaki :

I hope my answer is useful and informative to you.

Dr.Fazeli Niaki :

If you have any more questions, I am happy to help as much as possible so feel free to ask.

Customer :

Thank you for your responses.

Customer :

Expert TypeDentist - Prosthodontist
Category: Dental
Pos. Feedback: 96.0 %
Accepts: 69
Answered: 7/23/2012

Experience: Doctor of Dental Medicine, MClin Dent Prosthodontics

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