Expert: Frederick R. Liewehr DDS, MS, FICD - 4/24/2006

Question
Hi, I hope you can help. I had a root canal treatment completed on my right canine five months ago. This treatment was done by a well respected London Endodontist and is, in the opinion of my Prosthodontist, a perfect result.
A bridge has now been fitted using this tooth as an anchor. However, after all this time the tooth remains sensitive to the touch but not to the bite! Biting or putting pressure on the tooth presents no pain at all but if I rub against the tooth, which is now covered by the bridge, with my tongue or with a finger I feel sharp twinges of pain. Neither the Prosthodontist nor the Endodontist appear to be able to offer an explanation. Have you come across this before?
Any help you can offer as to the cause or resolution would really be appreciated.  

Answer
Hi Tom,
    Gosh, I'm usually pretty good at guessing on these e-mail questions, but you have me stumped. I wonder if the other abutment tooth, which is maybe the second premolar (assuming it is a 3-unit bridge)has a vital pulp? Obviously the canine doesn't anymore, but if you are pushing on the bridge you also push the other abutment, so maybe it has a problem. It could also be a nonodontogenic sort of pain - if it is an electricity-like feeling, then that may not be a tooth at all but a facial pain syndrome. I really would like to help, but I would need to do an examination and so forth to even begin to give you an intelligent answer. I hope you can find someone over there who can help. I have a good friend who is a periodontist, but surprisingly don't know any endodontists in London. My friend Phil Ower has a web site, http://www.periocourses.co.uk/ which you can use to contact him and see if he can recommend someone. Cheers!

Dr. Liewehr