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Dentistry/Recovery concerns following trauma to upper front tooth and root canal

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I received a sporting injury two and a half weeks ago - I have since had root canal treatment started (9 days ago) - but I would appreciate some advice on recovery times etc. as I am concerned that the tooth still feels quite odd and I don't know if this is normal.  I have had previous bad dental experiences and some independent advice might help put my mind at ease or at least prepare me for my next appointment/what is to come.

The injury resulted in knocking one of my top front teeth back, into a slightly different position (angled slightly inwards) and cut my lip open.  The tooth was not wobbly, there was some pain, but it mostly felt numb after the blow.  

I saw an emergency dentist that day who x-rayed the tooth and tried to push it back into position.  She was able to move it a little, but not all the way so it is still slightly crooked. She advised there was no fracture but it was likely the nerve would die and require root canal treatment, but I would need to wait and see.  She said the tooth did not need splinting as not wobbly.  

A few days later I noticed the tooth looked slightly discoloured and got an appointment which was 9 days after the trauma, I advised my dentist of what had happened and explained the tooth still felt quite numb, although seemed to be gradually improving.  The dentist took x rays, said a root canal was required and carried out the first part of treatment - she advised discolouration was due to internal bleeding (the discolouration is quite noticeable/dark at the top part of the tooth, but much less noticeable at the bottom of the tooth).  I currently have a temporary filling and am due to return in a day for this to be replaced with a permanent filling (I was not prescribed antibiotics to take - I guess this makes sense as I assume infection was not a factor given how recent the trauma was).

I am concerned that the tooth still feels very 'odd' though - I guess I thought it might improve more quickly after the root canal. I did get some dull aching/throbbing pain for 3-4 days after the root canal which passed, which I guess was to be expected. The numb feeling did not disappear right after the root canal, but has gradually been going away, particularly over the last 2-3 days, and in turn the tooth feels more sensitive (to pressure, but not temperature), but I am also feeling more pain if I press the tooth gently (or bite down - I have been avoiding eating with it though). I guess this may be part of the healing process as ligaments and tissues around the tooth may take some time to heal from the trauma?  But I really don't know what is normal in these circumstances, or if the increased sensitivity/pain may be indicative of a problem?

If I do not touch the tooth it feels a little uncomfortable, but not really painful. I have not been taking painkillers. I can feel it more when I talk or smile/laugh, but mostly the issue is when gentle pressure is applied, or teeth brushed etc.  The pain is not too extreme, although I have not applied any strong pressure to the tooth.

If you can give me any advice as to whether this is normal recovery after this type of trauma, and how long recovery might take (weeks/months?) that would be much appreciated.

Also, is the discolouration likely to improve once the temporary filling is removed and permanent filling is in place?  Or will I need to look into bleaching/veneers assuming the tooth all settles down ok?

Answer
Tooth should have the root canal therapy completed . It's important to not have it interfering with your bite. Another words when you bite down with nothing in your mouth it should not be hitting first. Restoration can be a laminate it crown with post depending on integrity of remaining tooth. Everything you describe sounds within normal limits.

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Rafael Mosery,D.D.S.

Expertise

I`m a practicing general dentist for 29 years. Member of ADA,NYSDA,SDDS. In addition I am a fellow of the ICOI.My emphasis is on Implant Dentistry .I would be happy to answer questions regarding implant dentistry as well as general dental questions. Ofcourse within the limitations of no clinical exam and the absence of radiographs .

Experience

Private practice for 29 years. Have kept up to date with continuing education throughout that time.




Organizations
ADA,NYDSA,SDDS,ICOI fellow,Penninsula Hospital Dental Society

Education/Credentials
NYU College of Dentistry DDS 1984 NYU College of Dentistry Surgical and prosthetic implantology program 1999-2001

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