Expert: Mark Bornfeld DDS - 12/17/2006

Question
Hello Dr. Bornfeld, I hope you can give me some insight please.  I had a painful tooth, the dentist said he will give a root canal and then crown the tooth.  The tooth had the root canal, but was still painful at the slightest touch or pressure even of a toothbrush.   The dentist said that the pain would go away, well 3 weeks it still was painful but we decided to prep for the crown.   2 weeks while wearing the temporary crown and the pain was getting worse!  I went to another dentist and his x-ray showed that the gutta percha went up out of both roots and into my tissues and bone.   I went back to the first dentist and he pulled the tooth and I made him take another x-ray about a week later as I still had pressure up into my face.   His x-ray shows that there is still something there.   The dentist said that it is just Thermafill and that my body will dissolve it in time.   I still have this pressure in my face and when I push on it it goes straight down to the missing tooth area.  The tooth that was pulled is the top right, just next to the canine or incisors.  I can feel pressure when I put my finger next to my nose above my upper lip.  So Dr. Bornfeld, have you heard of Thermafill and should this stuff be taken out by an endodontist? Thank you for you help.  Sherry

Answer
Dear Sherry,

Thermafill is chemically and biologically inert, and residual material in the socket would not in itself account for your persistent pain. Before recommending a proper course of action, it will be necessary to determine just what is going on.

For example, if the sinus was perforated during either the root canal therapy or the extraction, it may have caused a sinus infection that needs to be treated. Alternatively, there may be some pathological tissue that remains in the socket, or some devitalized bone, or perhaps even an adjacent tooth that has some problem that is yet to be diagnosed.

I think you are most likely to get a proper diagnosis if you request a referral to an oral surgeon. He will be able to clean out the area surrounding the extraction socket if that is warranted, or suggest whatever alternative treatment is appropriate when the full nature of your symptoms has been clarified.

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY