Experience Former Clinical Instructor of Comprehensive Dentistry, and Prosthodontic Department New York University School of Dentistry. Also former instructor of Preventive Dentistry Columbia University School of Dentistry.
Education/Credentials 1980 DDS New York University College of Dentistry
1981 GPR Manhattan VA Hospital
Awards and Honors OKU 1980 Honor Society
1980 Long Island Academy of Odontology award for highest combined Academic and Clinical Achievement.
In 1997 he was elected to Fellowship into the International Academy for Dental Facial Esthetics
After a root canal, you know how some people do not need crowns, especially on front teeth, and instead a permanent filling is placed on the back of the tooth, where the hole is drilled? I'm talking a top front tooth here. Well, if the permanent filling is sore around that area, and the tooth aches without anything done to it, meaning it hurts when being left alone all day long, can the permanent filling cause that kind of pain, when it is maybe misaligned or something is up with the permanent filling? What about the filling inside, which is the orange-pinkish filling? Can that cause the tooth to ache. The reason I ask is because a couple days ago, my dentist examined my tooth and she told me that if my tooth ached all day long without any stimulation to it, then it would have to be something inside the tooth, and can't be something on the surface. Is that true? If so, then the permanent filling is not the cause then, even though it's sore around that area only?
ANSWER: Dear Belle,
Any tooth can hurt if a filling is high. If when you bite down and you hit the filling before the other teeth hit it can cause pain in the ligaments holding your tooth. If that is the problem, a simple adjustment of the filling could help.
Your dentist may be right that the pain is not coming from the bite. It is possible for a patient to have pain after a root canal is completed. This pain can come from a number of sources.
Sometimes there is inflammation periapically (around the apex of the tooth) caused by the root canal procedure or the irritating of the sealer used at the final session. Patients experiencing this are instructed to take Ibuprofen and the soreness usually goes away, assuming the root canal is a success.
Another cause of pain is that the root canal is not a success. This could be due to an undetected crack in the root or just a less than adequate obturation of the root canal system. Oburation refers to the use of gutta percha('the pink stuff') to fill the entire root canal system. If there are significant voids in the fill it can cause a failure. Bacteria can populate these voids and cause infection.
Ask your dentist about whether you may have a high bite. If it he doesn't feel that is the problem, and your pain continues for more than two weeks without improvement, or if you have any swelling, you should either return to your dentist or seek a second opinion from a root canal specialist- an endodontist.
I hope this information is helpful and please feel free to contact me again with any dental questions in the future.
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QUESTION: Hi Dr. Spindel,
Thanks for getting back to me. Nope, I don't have bite issues or anything. there is something going on with my tooth and I would hope the endodontist would be able to figure it out, but I'm just wondering, can the permanent filling cause the tooth to ache, without any provoking the tooth to hurt? My dentist just told me that if the tooth just hurts all by itself without anything done to it, then it has to be something inside, and can't be anything on the surface. Yet, it is only sore around the permanent filling, but my whole entire tooth aches without anything provoking the pain. I hope that makes sense. So what my dentist said...is that really true, and why would it only be sore around the permanent filling or the back side of the tooth, but also have the whole tooth to ache. So the cause wouldn't be the permanent filling?
And also, are you saying the pinkish oragne root canal filling could possibly cause the tooth to ache like this?
Thank you, I look forward to your reply. I hope I am making sense. If not, I'll try again.
Answer Dear Belle,
It sounds like your dentist is correct. It is not the filling, since the tooth after a root canal has no vital pulp tissue so it can not feel anything. The only nerve endings are adjacent to the tooth in the periodontal ligaments. These ligaments attach the the tooth to the surrounding bone and they are certainly the source of your pain.
The real unknown at this point is why are they hurting. Do you have irritation after the root canal or do you have an active infection? I suggest you seek a consultation with an endodontist.
I am not sure why pushing on the back of the tooth hurts. I would think that the tooth should be sensitive to pressure in general.
I hope this information is helpful and please feel free to contact mw with future dental questions.
