AboutGary Backlund, DMD, MSD Expertise I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.
Experience 25 years practicing as a specialist
Organizations American Association of Endodonists, Past President Washington State Association of Endodontists.
You were kind enough to respond to my last question regarding pain in a previously rct tooth, #30. You told me the pain must be coming from another tooth. It was, it was #28 and I did have a root canal done on that last week.
My problem now is I am getting a throbbing pain in #30 that comes after I eat anything cold. I should preface this by saying that last month I was head butted by one of my dogs in a freak accident. At the time, I didn't think anything of it, but then suddenly I started having dental problems. Since then, I have had to have some adjustments made to my bite, and I think that may have contributed to my needing that root canal.
I went to my dentist today to get the temp filling replaced on #28 and told him that #30 has not changed. He did a bite test with a stick - no pain, cold test - no pain. Xray showed no cracks, but he said I still may have a crack not showing, and recommended that I waite a couple of weeks and if I still have a problem, then the tooth would have to be extracted. He said since what I am experiencing is a throbbing pain, that it is not a good sign. I asked if there could be something going on with a tooth on top, but I'm feeling it in that tooth, and he said he didn't think so.
What I don't understand is why, when I eat, as an example, pudding or cold cereal with milk, exactly 1 min. after I'm finished, the throbbing starts and lasts for 5 or 10 min, yet when my dentist applied cold to the tooth, nothing happened?
Could you please give me your opinion as to what I should be doing next?
Thank you very much,
LuAnne
ANSWER: Hi LuAnne,
Thanks for the kind words...glad I could help last time. Maybe I can make it two for two.....
When a tooth has had a root canal, there is no way for it to feel cold. You sensitivity is coming from another tooth. It could be coming from anywhere, upper or lower, but ONLY on that side of your mouth. Pain NEVER crosses the midline of your face. I would suggest that you take a piece of ice and touch all the teeth, upper & lower, on that side. I think you will soon figure out where the problem is. DO NOT let your dentist extract #30 until you figure out where the cold is coming from, because that will not improve your cold sensitivity if #30 is removed.
If you have trouble testing your teeth, I would ask for a referral to an endodontist. I would bet almost anything that you will be looking at another root canal.
Let me know how you do. Good luck!
Gary Backlund DMD, MSD
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QUESTION: Thank you Dr. Backlund for answering me so quickly.
In your opinion, do the symptoms sound like it could be a fractured root like my dentist is telling me?
I plan on going to the endodontist on my own because I don't want to lose a tooth if I don't have to.
Thank you again for your time.
LuAnne
ANSWER: Hi again LuAnne,
A fractured tooth is always a possibility, but you don't have those symptoms. If your dentist is focused on tooth #30 and you are experiencing cold sensitivity, then you guys are talking about two different teeth. From what you said earlier, you have cold tenderness and that is NOT coming from tooth #30. A fracture can cause a tooth to be temperature sensitive, but not one with a previous root canal....there's no mechanism to transfer cold from the outside of the tooth to the nerves at the end of the tooth. I think your best bet is a 2nd opinion from an endodontist.
Hope this clarifies things better.
Gary Backlund DMD, MSD
---------- FOLLOW-UP ----------
QUESTION: Hello Dr. Backlund,
Thank you for answering all my questions.
I went to the endodontist on my own. He told me the same thing you did, not to let the dentist pull #30. He told me to wait a couple of weeks and the pain would settle in the problem tooth. It did, it was #31. The same tooth that the endodontist did the RCT on in March of this year, and it's the same tooth that my dentist of 33 years insisted that I didn't need a crown on it when I went to him for the permanent filling. He said he was using a special filling and it would be fine. The endodontist opened it up and said the filling was cracked and had I had the crown on it when I got head butted by my dog, it would not have cracked. He said he didn't see any cracks in the tooth. I had to have another RCT on it on 7/1.
That evening I started having severe pain in #28 that my dentist did the RCT on on 6/5. It reminded me of an abcessed tooth I had years ago. I called the endodontist the next day and he took me in. He X rayed the tooth and showed me the xray. I'm not a dentist, but I could clearly see that the canal was not done completely. The endodontist also pointed out that the canal should have appeared white like the other root canals, and this was dark. I don't remember exactly, but he said something about the filling not being correct and the dentist missed 4 either cm or mm of root. So, that day I had to have another root canal on a tooth that just had a root canal less than a month ago. 2 root canals in one week. To say I am very upset is putting it mildly.
To top it off, when I went to my dentist after the accident with my dog, he said some of my teeth were out of alignment and did a bite adjustment. He did a bite adjustment the last two times I was there. I had told him about the pain in #31 and his answer was a bite adjustment. Now my teeth hurt and some are actually rubbing against each other. I can't tell you the pain I have been in for the past month. The endodontist said the dentist should have never done an adjustment.
I told my endodontist that I would not be going back to that dentist and he agreed. He told me he sees his work. I got a referral from his office, from his partner, for a new dentist and I'm going to call him first thing in the morning.
I have never had so many problems with my teeth as I have had the past 2 months. I'm hoping the new dentist can correct my bite. I have not been able to eat solid food for a couple of weeks now because of the pain.
My question are: how long should I have discomfort from these root canals? #31 is very sore and every once in a while will throb. Is it possible for the endodontist to see root cracks with the microscope? Is it possible that the root could still be cracked? What happens when the bite is off? Will it cause me to need more RCT.
Thank you for taking the time to read this lengthy letter.
Answer Hi again LuAnne,
Well, it sounds like you are making progress in resolving all these problems...maybe not fast enough....but you're on the right track!
The questions you are asking now are very difficult for me to answer since I can't exam you or know EXACTLY what treatment was done and what the condition of the teeth were. You need to ask your endodontist how long your tooth should be sore...I can't help there at all. As for the crack, anytime a tooth stays sore, a crack is always a possibility. Cracka re very hard to diagnosis, but can sometimes be seen with a microscope. Once again, you should address that to your endodontist. When a bite is off, it can cause future problems. It all depends on how far out ofd alaignment the bite is. To cause further root canals, it would have to be off by a lot. In most cases, a small bite adjustment won't have much effect.
I know I haven't given you very good answers, but your questions really require an exam. It sounds like you have found a great endodontist. Trust his/her advice and move forward. You'r egetting there...it just will take some time.
