Expert: Mark Bornfeld DDS - 7/23/2006

Question
Dear Dr.
I had a cracked tooth, it was decided it needed to be capped. With tempory cap on I had quite a bit of pain. I had to constantly take pain relievers after two to three weeks just when the pain seemed to be subsiding. A root canal was done. Then I couldn't even bite on that tooth. Antibiotics were perscribed for ten days. After that it was fine. The dentist put a permenant cap on and it was fine for about three weeks. Slowly it has started hurting agian. Went back to the dentist, he took a x-ray, saw nothing checked the bite... saw nothing. Still hurting two week later and I'm going to call the Dr. tomorrow. What could be the problem? I'm a little worried because this was the first time to use this Dr. I had less problems before I did anything to this tooth.

Thank you for your time
Melinda

Answer
Dear Melinda,

There are several different things that could account for your pain. I'm not sure that it is useful for me to speculate on a cause, since your dentist will be able to provide a far more reliable assessment by using the diagnostic data that can be gathered in person rather than at a distance. Some of the things that could manifest as pain include:
-failure of the root canal therapy to eliminate infection
-cracked tooth root
-improper crown contour, leading to food impaction, which can irritate the gum
-excessive crown contour, which may subject the tooth to excessive chewing force
-periodontal (gum) inflammation due to impacted luting cement, or exacerbation of pre-existing gum disease

There are other things as well, but there's little point in providing a long list; more than likely, it is one thing that has gone wrong, and your dentist will hopefully be able to isolate the problem and provide a solution.

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY