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QUESTION: Severe throbbing pain after root canal process some one please help me . Not able to sleep or be normal .  
I had this pain on my teeth ( upper left second near my wisdom tooth which already had filing on it) when a food particle gets struck and when I remove it my gums starts bleeding and the pain gets reduced . It happened everyday and the pain got to extreme so I visited a dentist near by my home . He suggested me for a root canal . On my 1 st sitting he opened my filling  and days after he did root canal process . Right after the process the throbbing pain started and my gums got swollen and the pain radiated to Near by teeth. I visited my doctor the next day he said I got gums problem and prescribed me Ornidazole ointment but the pain didn't reduce . He asked me for another sitting a week after and re-treated my root canal process and the pain got stopped . After a week he called me for the next sitting to reduce the tooth structure and take measurements for the crown he suggested me 3 types of crown PFM, EMAX and zirconia . I preferred EMAX . Right after reaching home the throbbing pain started again and the pain is radiating to ear. Nose , cheek, head and neck evealso my gums got little swelling and this pain is disturbing me from being normal . I am feeling some changes on my heart beat it either skips or beats hardly .  No sleep and no interest to eat also.  Please someone help me to get out from the pain . 

ANSWER: Thank you for your question.
As I state  with every question, that without a full clinical and radiographic examination it is really impossible to provide an accurate, detailed treatment plan.
When a patient has post operative pain following root canal treatment, there are several potential causes.
In your particular situation, the best choice is to return to the dentist who performed the procedure,and have an evaluation. You absolutely should not proceed with restoration of the tooth until your discomfort is resolved.My suggestion is that if your dentist is unable to clear up the problem, you should request a referral to a endodontic specialist for diagnosis  and treatment. If there is not one in your area you should seek out care of a endodontist at a dental school.This individual has the training to diagnose your situation.
In general, when a patient has post operative pain this can be caused by your immune  systems response to the bacterial infiltrate in the bone, the trauma of the treatment procedure or additional issues. In addition, a
Maxillary Molar tooth such as yours can have multiple roots and multiple canals. It is important that all of these are adequately instrumented and sealed to resolve an issue. Also, on occasion an adjacent  tooth may be causing your root canal pain, and need treatment.
The most common reason for pain after root canal therapy is hitting high in the bite on the treated tooth. This can cause severe pain. The treatment for this is usually  reduction of the bite, placing the  patient on anti-inflammatory medication and possibly antibiotics.
I wish you the best of luck with your care. I hope you are able to easily resolve your discomfort.

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X-ray
X-ray  
QUESTION: Thank you for your answer Doctor. its really helpful . i went to a endodontist he suggested me to do another root canal process as in the previous treatment one of the canal was left untreated. he explained me the drawbacks of doing this , if the tooth can't withstand or an crack happened while treating the tooth goes for an extraction. I am really worried now if it leads to an extraction. will it be fine if i didn re-treat it and fix the crown ? so that i can avoid the extraction? . I am attaching my X-ray below can you please check and suggest me .

Regards,
Bobby R

Answer
You absolutely should follow the advice of the endodontist. You should proceed with root canal retreatment. This will afford you the best prognosis. Any time a root canal is performed the tooth is more brittle. This is why it is recommended to have the tooth restored with a crown. There is always the risk of extraction with any tooth. This can be the result of gum disease, micro cracks, crown and or root fracture.The best outcome and prognosis is to always try to save teeth. In this case root canal retreatment is the most conservative choice of therapy.You should not have a crown placed on a tooth where the root canal prognosis is poor. If canals are left untreated and retreatment is not performed, you will lose the tooth.

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robert block

Expertise

I would prefer to answer questions related in my specialty of Endodontics( ROOT CANAL THERAPY) I am a Board Certified Endodontist with a special interest in advanced surgical endodontic procedures. I know root canals create a lot of apprehension in patients, and they usually have many questions about the procedure. I can address patient concerns either before or after their root canal treatment. I also have re-treated numerous patients who have had previous endodontic treatment. As a result of these clinical failures,and the increase in the use of dental implants, its important patients understand the alternatives of therapy. There are often many components to treatment that interrelate the disciplines of endodontics, periodontics and restorative dentistry.Patients frequently question the importance of considering all facets in a clinical regimen. Hopefully, I would be able to educate and contribute some information from the endodontic perspective.

Experience

Diplomate American Board of Endodontics, 35 years plus private practice experience. Formerly Professor and Chairman, Department of Endodontics at US dental school. Editorial journal reviewer for the endodontic section of The Journal of American Dental Association. Serve as a reviewer on several editorial boards.

Organizations
American Association of Endodontists, College of Diplomates, American Board of Endodontics

Publications
Over 150 publications, abstracts, case reports, chapters in textbooks. J. Dental Research, J. of Endodontics, J. of Oral Surgery Oral Medicine Oral Pathology,The NEXTDDS J.For example: The Single File Approach for Predictable Endodontic Canal Instrumentation:The Wave One, THE NEXTDDS J. 4-2:13-17 Fall 2014 Non Surgical Management of an Endodontic Failure Utilizing Contemporary Technology, www.THENEXTDDS 5-1:60-63 Spring 2015 Are You Still Using Formocresol? An Update, Tn. Dent. J. 89-4:14-19 Fall 2009 Management of Endodontic Failures, Oral Surg.vol.66:711-Dec.1988

Education/Credentials
BA. DePauw University, DDS. University of Michigan, MS. Medical College of Virginia, Virginia Commonwealth University, Gen. Practice Resident, University of Connecticut, Endodontic Resident Medical College of Virginia, Virginia Commonwealth University

Awards and Honors
Numerous Awards and Honors, Edward P. Hatton Award( Int. Assoc. of Dental Research), Endodontic Memorial Research Award ( American Association of Endodontics) Outstanding Endodontic Department Teaching Award (given by dental students)Fellow American Academy of Dental Science

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