Expert: Mark Bornfeld DDS - 7/25/2007

Question
Five months ago I had four deep, old fillings changed upon dentist's recommendation.  They were two molars on each upper side of my mouth.  Immediately after the novocaine wore off I started feeling sharp pain on both sides of my mouth, and face.  Few weeks later I seemed to be getting better, but no 100%.  Then again, a few weeks later, I started feeling worse.  The teeth in question were a little sensitive to bite, but I also felt as if I was punched in both sides of my face - a constant, deep pain near the the teeth, gum and cheek bones, sometimes shooting sharp sensation.  Other times it felt like a chill going through both side of my face.  Ultimately I had root canals done on all four of the teeth.  There was no infection, but all four teeth were hyper inflamed - probably from deep drillig.  However, done did not seem to have solved the problem.  I still feel the same pain and sensations on both sides of my face.  Also, the teeth seem to be recovering really slowly from the root canals, being even more sensitive to touch then before.  The dentist does not know what else to do.  The root canals, according to him, were straight forward.  I started acupuncture hoping it will help with possible nerve damage from the first procedure, but so far it has not helped, either.  Since there is no infection showing anywhere on x-rays, what would you recommend I do next?  Do you think It could be gum and bone inflammation, or infection not showing on x-rays, or some kind of nerve irritation or scaring?  

Sincerely;
Barbara LaGravinese

Answer
Dear Barbara,

Unfortunately, I can do no more than speculate in the absence of diagnostic information. Perhaps the teeth have been cracked by the filling process, or perhaps your sinuses were perforated during the root canal treatment; it may even be that the procedures precipitated a neuralgia in the sensory nerves that serve the area.

I do believe that a second opinion is particularly helpful in these cases, since a dentist that is uninvolved with treatment is in a better position to assess the quality of the root canals more critically. This is especially true if your root canals were performed by a general dentist; if this is the case, you should consider requesting a referral to an endodontist (root canal specialist) to evaluate the situation.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY