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Friday, March 7, 2014
Do I need a root canal?
I recently cracked the inner back cusp off of an upper molar in a skiing accident. This cracked molar was causing me a bit of pain, so I went to a dentist who, after examining the tooth, suggested the pain was not because the tooth was broken, but because the cracked portion was moving and "pinching" the gums. The dentist removed the cracked piece of tooth, and the pain did subside. The only pain I had was if something (like toothbrush bristles) got shoved into the small hole left behind after the broken segment was removed, but I did not think that this was a big deal. The dentist also suggested that I needed to have a crown placed on the tooth to strengthen it and avoid further complications. I agreed, so the dentist did perform the necessary steps for a crown. I get my permanent crown tomorrow, but I have been experiencing slight discomfort in the crowned tooth, surrounding teeth, and jaw. Furthermore, the two teeth to the front of the back molar feel loose. What is going on? Also, should my dentist have performed a root canal? He did not, and being uneducated in the ways of dentistry, I was not aware that I may need a root canal, but since having the work for the crown, many friends/family are telling me that the dentist should have performed a root canal.
Most teeth that require a crown do not need a root canal before getting the crown done. In your case it sounds like you sheared off one of the cusps of your tooth, and the sensitivity you were experiencing after the removal of the fractured segment was due to the exposure of the dentin of the tooth. It is quite normal for that to be sensitive to thermal changes and tooth brushing.
The crown was recommended because there really is no long-term filling that could replace the broken part of your tooth.
Unfortunately, I really can't tell you what the other pain you are experiencing is coming from. There may be more damage to other teeth from your skiing accident, and those symptoms are just now expressing themselves. Be sure to tell your dentist about these symptoms so that he/she can evaluate them.
John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University