Question:
I went with the root canal. It was a very difficult one (on my end;
i.e; very painful, long session)(others I had before were a snap
compared to this one; this was one of those that give meaning to the
fear people feel when you utter the words "root canal"). After it was
over, I continued to feel sensitivity there. Called the endo and he
said he looked at the post-endo xray and he was sure it was fine, the
sensitivity will go away with time.
A month passes, I still feel sensitivity. Like when I tap it with my
toothbrush, it hurts, not a sharp horrible pain, but a small
uncomfortable pain. I insist on going back for him to look at it,
again. He takes another xray or two, looks at it, does some testing on
it and says it's perfect.
Meanwhile I also went to a new dentist and had this dentist look at
xrays of it. She said it looked to be a perfect root canal.
So here I am 5 months later, and this tooth STILL is very sensitive to
being hit with my toothbrush, tapped with my fingernail, spoon, fork,
etc... Granted, it's no big problem, but I keep thinking there MUST BE
SOMETHING WRONG or why would I feel something in a tooth that has no
nerve?
Am I just being a hypochondriac about this tooth? is it just normal for
a tooth to have post-root canal sensitivity for 6 months or more? (I
use sensitive toothpaste and have for a few months.)
Answer:
Root canals sometimes fail. Sometimes you find out why when you
extract the tooth; sometimes you never find out. With operating
microscopes, the incidence of missed canals is less than it was;
probably now the biggest reason for previously unexplained failure is
some occult fracture of the root system.
My wife lost an upper first molar like this just last week--it had been
bothering her for about a year and a half since having a very pretty
root canal done by and endodontist. Apicoectomy wasn't an option
because of proximity to the sinus.
So, when I explain my symptoms to the endo, and he says it's no
problem, there's nothing wrong, is he just b.s.'ing me, and he knows
there is some "occult fracture" or such and that the rct was a failure?
OR does he really think it is fine, that this is sometimes "normal"?
And are you saying that the tooth may prove to be fine, even though it
hurts a little sometimes when tapped, that it MAY not have to be
extracted or gone back into? that it may just be this way the rest of
my life, or might calm down?
Or, is it just a matter of time til it has to be extracted?
I honestly don't know. Even in my wife's case, x-ray evidence showed
that a distinct dark area at the tip of the root (presumptive infected
area) progressively faded. So there was a disconnect between x-ray
evidence and symptoms.
Some of these teeth remain symptomatic forever without showing any
other sign of problems. If the discomfort is slight, I sometimes retain
the tooth indefinitely.
If there is a crack, sooner or later things deteriorate--clinically, on
the x-ray--or both.
I would not presume B.S.--you can only see what you can see. But while
I myself would urge you to give this more time esp. if the discomfort is
mild, your discomfort should not be discounted. It should be monitored,
and any decisions should be based on both the clinical picture and your
own perception of just how much this is bothering you, and your
tolerance for waiting.
On occasion this sort of thing happens. I encounter a patient like this
on average maybe once every 3 years.
Sometimes there is an unfilled canal sometimes a fracture. Sometimes
its an adjacent tooth that is giving the pain, Sometimes its the bite
either the new crown is too high or the tooth is in a traumatic bite.
Like Dr Bornfeld says time will reveal the cause. Having a root canal
look pretty on the x-ray does not mean that the problem was solved.
I believe you should wait before considering drastic unscientific and
desperate measures such as extraction because if the problem was not
the tooth you can not put it back.
Did you have a new crown placed over the root canal? If so what type
was it? you may also want to make sure you have good contacts on either
side of the crown. You can check this with floss, the crown should
floss like your other teeth. If the contact is not as tight food
impaction can irritate your gums and give you the symptoms you describe.
