Dentistry/root canal


QUESTION: I had a root canal on my last back lower molar about 6 weeks ago.  It was a tooth that broke and had infection, after 2 courses of z-pack, my dentist did the root canal.  I have had nothing but pain ever since.  He then put on the crown temporaily. The pain got worse. He has adjusted my bite 3 times thinking that was the reason for the pain.  It just keeps getting worse.  Last week he cleaned the canals out again and the front canal starting draining some infection, 2 days prior to this I had started taking Keflex because he thought it was infected again, even though x-rays showed nothing.  He put medicine and gause in the canals and sent me home.  Said he didnt want anything like the crown covering it so that it could drain.  For 2 days the pain is still there and the taste of the medicine he put in just drained in my stomach and tasted horrible.  Going back in today, God only knows what he is going to do.  I really want the tooth extracted I think it is fractured.  I cant take this pain anymore, can he extract the tooth, or does he need to refer me to an endodnist?  Please help me.

ANSWER: Hi Wendy,

I am very sorry for your terrible ordeal.

Your instincts are correct that now would be a good time to have an Endodontist (or maybe a Periodontist) at least look at you.....whether you get the green light or not from your current dentist.

I like the idea of you going to a specialist such as an Endodontist because they have expertise in a specific area....and obviously you have just earned your right to see a specialist.

General dentists are best at preventive care in that they know at least a little bit about a broad range of treatments for your teeth.....but are usually not expert in one focused area.

There is one thing that concerns me about the work that you have had done.....What did you mean by "he has adjusted my bite 3 times thinking that was the reason for the pain?"   Ummm.....I don't know about that one.  It is very tricky to adjust a bite and not have it upset the careful balance of teeth and facial muscles.

On the the plus side it does seem like he is trying everything he knows to drain the canals and to prevent infection.  I like that he did not put the crown back in there, because that probably would only irritate the area more.

By the time you receive this reply, you may have already gone for your follow-up appointment.  You may want to ask your dentist if he thinks a Endodontist or even a Periodontist would be best.  I am not sure which of those two specialties would be more appropriate.

Please let me know what happens.

Best regards
Patient Point of View

---------- FOLLOW-UP ----------

QUESTION: Thank you for your advise... I really appreciate it.  Here is the problem with asking to see a specialist , I have paid my dentist $1900 for this root canal and crown...I have no dental insurance and no money to pay for anything else... Any suggestions?


I think I am going to have to file this one under lesson's learned.  It sounds like you payed for the entire job up front.  Next time, it would be better to do expensive treatment in installments.

How about this....why not go to a specialist....not to do the actual work, but to get a second opinion?  And if that opinion is somewhere in the ballpark, then let your primary dentist finish the job.

Ultimately, the work is going to have to go to the dentist that can do the job correctly.

Best Regards,
Patient Point of View


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Jonathan at PatientBabble


My area of expertise from the patients point of view would be TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my bite problem. I am not a doctor, but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. ////// I come from a family of dentists. My first house growing up was one of those residential/dentist combination homes and I was around the dental practice all the time. My teeth had always been perfect, and in many respects they still are. I have never had a cavity and my teeth are straight. About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." I have learned a lot over the years as I tried to figure out my problem from the Dentists, Speech Pathologists and assorted doctors that I have visited. I will try and recall information or experiences that may be helpful to you.


Twenty-Five years ago after my wisdom teeth were removed, my bite did not feel right and then had trouble speaking. For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. The years of searching for proper treatment has underscored the importance of understanding the relationship between dental and speech methodologies.///// To this end, and to further my research, I recently attended the American Speech-Language-Hearing Association Convention (ASHA) in Atlanta. At ASHA I learned about a specialty within Speech Pathology termed “Orofacial Myology”. In laymen's terms Orofacial Myology Disorder (OMD) deals with the establishment of correct functional activities of the tongue, lips and jaw. OMD is a motor speech disorder that impacts the normal flow of speech, chewing or swallowing.///// If you believe that your struggles with your teeth also present speech, chewing or swallowing challenges, you may want to seek out a licensed Speech Language Pathologist.....preferably one that has training with Orofacial Myology Disorder.

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Abridged Version of a Letter I Sent to a Health Care Professional (3/14/13): "..In my early 20's I had my wisdom teeth out. Almost immediately within a few days, something did not feel right in my mouth. I had trouble speaking. When I raised my tongue to try and touch my palate, I felt mostly just teeth. It is very cumbersome to talk and my bite also became a little bit off. If feels almost as if someone put a fork in my mouth and said "now try and speak." Very difficult. My articulation is fine, so to an observer I sound normal. But it takes a monumental effort, so I hate situations like talking on the phone or when somebody asks me to "tell them a story." ..I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. They just automatically gravitate to what they have heard about TMJ and assume I am either stressed, or just imagining it. Years later, I look back at all those dentists and doctors and I am amazed at how little they really knew about my condition. I have seen the best dentists, including my dad who is a Orthodontist in New York, to TMJ Dentists in Atlanta and Florida. No one ever suggested that Speech Pathology may be a direction I should explore. ..And I was frustrated by the fact that several MRI's over the years, showed nothing. How could the MRI’s show nothing, and at the same time, I know something does not feel right? I do wear a night guard to sleep in, but it does not fix the trouble that I have when I try to talk. ..I went with a Speech Pathologist friend of mine to the American Speech Language Hearing (ASHA) Convention last October in Atlanta...There was a Speech Pathologist at ASHA who was saying that sometimes when you have your Wisdom Teeth taken out "late" that it could possibly cause damage to the Trigeminal Nerve and surrounding muscles.” POSTSCRIPT: At ASHA, I discovered OROFACIAL MYOLOGY (OMD) which is a specialty in Speech Pathology that addresses Oral Muscular Issues.

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