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Root Canals

Pain after root canal

07/09/2007

Question:

After one and a half years of getting a root canal done on my upper right molar, I am still experiencing pain. I had a re- treatment, been on pencillin and pain killers, and had gum surgery done yet i still occasionally still feel pain. Therefore i haven`t gotten a permanent crown on the tooth yet, do you think a permanent crown will resolve the pain and protect it from feeling hollow?

Answer:

Sometimes teeth and the surrounding tissues just don't heal as well as we would like. Although the goal is to have a tooth be completely symptom-free and totally functional, the result is not achieved because of the biologic aspect. Unfortunately healing can not be directed or controlled, and there may be residual pain or irritation after the best treatment is provided. Science is still working on that problem.

The real question is whether or not you can live with the discomfort you are experiencing. If it is affecting your quality of life, then something more needs to be done (which may mean extracting the tooth). If you are able to tolerate the occasional discomfort, then the crown should be placed. The risk of not having the crown placed on a back tooth is that the tooth can become cracked. Every year after a root canal is done and a crown is not put on the tooth increases the risk of fracture about 50%. It may be that your tooth already has a fracture in it and that is what is causing the pain.

A final evaluation should be done to check how well the bone and gums around the tooth have healed before getting the crown placed. You then have to decide whether or not you wish to invest in the crown and decrease the potential risk of cracking the tooth, or simply wait and increase the risk of fracture in the hopes that all the symptoms resolve (which they may never do).

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Response by:

John M Nusstein, DDS John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University