Expert: Mark Bornfeld DDS - 10/4/2007

Question
Hi doctor. I had a root canal performed on 9/25/07 on my lower left, second one in molar (sorry i don't know the number). I was told that one of my canals was calcified. My dentist told me that I can go see an endontist or she can finish off the root canal as best she can and see what happens. I opted for the later. I went back yesterday for the post and core build-up. I had no pain all week, other than some soreness that I attributed to the root canal procedure. As i ate lunch today my tooth was fine. A little tenderness but no pain. but after i was done eating, for about 1 minute I had a lot of pain in that tooth, then it went away. I have some throbbing in the tooth, but no pain when i touch, press, push on it. It's not sensitive to hot or cold right now. I'm just wondering what may be causing this, as the rest of the root canal was performed not even 24 hours ago,and if I should give it a few days before i contact my dentist again. Thank you very much for your help.

Answer
Dear Brian,

It is far too soon to infer any reliable information from subjective symptoms. Even a successful root canal is often followed by soreness, tenderness to biting pressure, and other unpleasant sensations; it is almost impossible to perform a root canal therapy without provoking at least some inflammation in the tooth and surrounding tissues.

Only time will tell whether your root canal has concluded with a favorable result. I advise you to monitor the nature and severity of the symptoms over time, and to try to get a sense for whether there is any improvement. Granted, complete resolution of the symptoms may take several weeks, but you should be able to determine if things are improving within a week or two at most.

I can't determine whether your decision to complete the root canal without a specialty referral was wise. In my practice, I will almost always refer a patient to a specialist if I can't achieve what I want to, which in your case would be to bypass any obstructions in the canals. A failure to fully negotiate the entire length of a root canal will definitely reduce expectations for a successful outcome, and I do believe that a dentist owes his patient no less than the greatest available probability for success. There is no guarantee that an endodontist will be able to succeed where a general dentist failed, but there is no doubt that the greater skills and experience of a specialist will translate into better odds for the patient.

I hope your decision turns out to be the right one...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY