Expert: Frederick R. Liewehr DDS, MS, FICD - 2/5/2006

Question
I recently had a bridge connected to 2 healthy teeth(the dentist said) after 1 week had some pain but the shape was off went in for adjustment and they said I may need root canal if it keeps up.DO I have to pay for that they were healthy when they put bridge on and even if they weren't that should have been done before the bridge was put on right? Now I have a week to decide am taking advil 3 every 4 hrs for irritation and am angry I have a root canal to go through now probably.

Answer
Hi Carrie,
    I'm sorry that you have this problem, and feel for you. It sounds like you have developed a pulpitis, or inflammation of the pulp ("nerve") in at least one of the teeth involved in the bridge. The question is whether it is temporary or permanent. In some cases, the symptoms will diminish after a week or so. In others, they will not, and these require root canal therapy, which is the removal of the diseased pulp, for you to be comfortable. Occasionally the pain will stop because the pulp dies, and your first clue will be when your dentist takes an x-ray of the tooth and sees changes in the bone.
    As to "fault" in this matter, when you have a bridge placed, the dentist needs to remove a lot of tooth structure in order that the bridge he places is the same size as the tooth was before. Particularly if you have a porcelain coating on the bridge, that can be quite traumatic to the teeth. Usually these teeth have a history of previous cavities and fillings and so forth, which makes it even harder for them to tolerate this stress. So, a fair number of teeth prepared for crowns and bridges will require root canal therapy.
    It might have been better to perform the root canal therapy prior to placement of the bridge, but many patients object to that relatively expensive procedure being done as a preventive measure when they perceive no problem. It is also impossible for the dentist to predict which teeth will develop an irreversible pulpitis and which will not.
    So, at this point, if you don't get relief from the aching very soon, you will need to schedule a root  canal. The good news is that this procedure should take care of your problem and you will be able to enjoy your bridge. Good luck.

Dr. Liewehr