Dear Dr Backlund,
I've recently had a filling done on a molar. Before I had it done the tooth was sometimes sore when biting anything hard. After the filling was done I still had a problem when biting and it's possibly even worse now. It feels like a general "pressure pain" on this tooth but sometimes it's more of a direct sharp pain.
Going back to my dentist a week later I asked him about having a root canal done. He seemed quite reluctant and explained that molar teeth are quite difficult as the canals bend a lot and it's difficult to always clear out and fill the area. He did spot a very small fracture on the outside and tried to cover it with something but it's made no difference.
Just to note, I'd had a wisdom tooth extracted years before next to this tooth and there were problems getting it out. I'm just wondering whether this would have anything to do with it?
Could you possibly tell me:
1. Is it worth having a root canal done on this tooth (my dentist didn't give a crown as another option and I'm wondering why he didn't?)
2. Should I ask to be referred to a specialist dentist who is more expert at root canals?
3. Is the problem below the tooth as I was having some pain before this filling was done (i.e. a small abscess?)
Many thanks for any advice.
I'm sorry to hear all this is going on. While it is difficult for me to diagnosis your problem without being able to exam you, from what you describe, I suspect the problem is the crack your dentist found. Do you have any temperature sensitivity? If you do, that means the nerve of the tooth is still alive and there are other things to try before committing to a root canal. If you don't feel temperature, especially cold, that could mean the nerve is dead and you would need a root canal. Then I would suggest that you ask for a referral to an endodontist because it sounds like your dentist does not want to do a root canal even if necessary. As a specialist, about all I do is molar teeth and they are NOT difficult, but it does take some experience.
Let's say you do feel cold. If that's the case, in our office we feel that the crack needs to be splinted together. The way that is done is with a VERY good fitting temporary crown and leaving it there for 2-3 months. If all your symptoms go away, then just cement the permanent crown. If you still have problems, then a root canal may be necessary to get you comfortable. Even with all that, there is chance that the tooth may never become comfortable and may need to be removed, however that is a very small percent of the cases, so it is worth the risk to save your tooth.
I hope this explains things. If you need further information, please write back.
Gary Backlund DMD, MSD