AboutFrederick R. Liewehr DDS, MS, FICD Expertise I can answer your questions about root canal therapy in general. PLEASE DO NOT ask me to diagnose your particular problems or recommend treatment as I cannot do this without examining you and seeing your x-rays.
Experience I am a Board-certified endodontist, former university department Chairman, teach dental residents, and have a private practice.
Question On June 26th, 2006 I had splinted crown on teeth 30 and 31
removed and some dental carie with a filling drilled out on these teeth and new crowns fitted but before they were placed on (individually this time )I had such extreme pain after the removal of old crown(never had a bit of pain before all was disturbed just a bad taste, I had two root canals done on these teeth at individual times but done as one session per tooth by a board certified endodontist. The crowns were placed finally in August, and I have had extreme pain on esp tooth 30 Went to another endodontist who checked xrays and said that all looked well but made several adjustments carefully with carbon paper because crowns were very high.I am still having lots of pain when any pressure is applied on that tooth 30 and especially at night when my jaw must change position when I relax. I do not grit or grind my teeth The 2nd endodontist is considering the dx of a fractured tooth/root not apparent on xrays. What would be your consensus and will an oral surgeon be able to help. Do you think the tooth OR teeth will have to be removed to alleviate all this pain. I keep wondering if its not a failed root canal instead but don't want to go through another and have that fail too if that is what it is. The first endodontist only claims that I have inflammation and it will go away in time though its been almost 6mos and he said that I can't feel in that tooth since its "dead" but I DO feel all that pain and 2nd endodontist confirmed by response to biting and tapping pressure. Please advise soon. Thank you
Answer It is pretty difficult for me to diagnose your problem without seeing you and your x-rays, Deana. However, I'll tell you what I think based on what you have told me. You say you have extreme pain. Now, to me, "extreme pain" means you can't take it. I don't guess you are having extreme pain now, or you wouldn't be writing a calm letter. I think you have some pain when you bite, from what you say. Evidently your crown(s) was/were "high". Did the pain improve after the adjustment was made? Does your tooth/teeth still hurt when you bit? It sound like it. If so, your crown are still in hyperocclusion, and that is keeping your haw sore. I can't see the tooth, so fracture is a possibility. Unlikely, however, if the teeth were crowned (unless it was an old crack before the crown was made). Does it need to be retreated? I couldn't say without reading an x-ray.
The inflammation thing is unlikely. They usually settle down to whether they will stay in a week or two. Now, if you are banging when you bite, that could make it stay sore, but probably not this long. There would be pain in the bone and periodontal ligament that you feel when you bite, not pain in the pulp (which is gone) as any board-certified endodontist would know.
So, I would have the tooth adjusted until you can function without pain, and then I would eat a soft diet for a week, trying non to use it. It may get better. If it doesn't, have him transilluminate, stain, etc. to try to locate a crack. If not, then maybe periapical surgery after a thorough study of your teeth radiographically. Good luck!
