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Root Canals

Do I need a root canal?

12/10/2007

Question:

Two years ago I had a bridge seated. I have not been able to eat on that side of my mouth since having the procedure done. It hurt so bad when he was seating the bridge I had to have the area numbed up. After adjusting my bite several times my dentist sent me to an endodontist to see if I needed a root canal. He did testing and didn`t think it indicated I needed a root canal at that time. My dentist suggested I see a periodontist for a crown lengthening. I had the procedure done but there was no relief. My teeth only hurt when I bite down or apply pressure on them,they really aren`t sensitive to hot or cold. This bridge has cost me more than it should have and I still can`t chew on it! I have started seeing a new dentist and he has adjusted my bite and seems to think I should have a root canal done. There was some sensitivity at the gum line of one of the teeth when the dentist was probing the bridge area. If I have the root canal done in both teeth do you think I will be able to chew on this side of my mouth after the procedure? I`m concerned about putting more money into this bridge if I`m still not going to be able to chew on it! The bridge is on the lower left side, a molar-pontic-cuspid(I think it`s a cuspid).

Answer:

Unfortunately, even with all the information you have provided, I cannot really tell you if root canals are needed or not. The fact that you are not having any thermal sensitivity may be a good sign that you don't need them, but it could also mean that the crowns are so insulating that the nerve of the teeth cannot be stimulated by the cold, or the nerves of the teeth have died. The fact that you are having continual pain only on chewing could indicate that there is some type of irritation to the ligaments around the teeth of the bridge (from a misaligned bite or an irritated nerve). The question arises if it is one tooth or both teeth? Adjusting the bite does not seem to be working so this may indicate that nerves of one or both of the teeth are irritated or possibly dying. They may be dead already. There also may be a crack in one of the roots or teeth. Cracks don't often show up on x-rays and are hard to diagnose. If there is a crack, the extent of the crack may determine if the tooth can even be saved.

You can see that there are a number of possible causes for your pain. I feel that a second evaluation by the endodontist is in order and then a decision needs to be made, by you, whether or not it is worth the effort/cost to try and see if the root canal/s could resolve your pain. They may not.

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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