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Root Canals

Chronic tooth ache

01/05/2008

Question:

4 months chronic aching, X-rays appear normal, Endodontial consults suggested dental work: replaced filling with inlay on molar, second molar in question cold sensitive on side, added resin after photos taken inside very dark from old silver removed 4 yrs earlier, sealed. High crown filed down and told to give time. Invisalign trays used at night after 2 years of braces. Thousands spent and still there are days that are painful. What do you suggest in treatment, tests and or time frame? Thanks

Answer:

Your problem may not be associated with the teeth; it could be pain from the temperomandibular joint (TMJ). It could also be due to neurogenic pain.

Personally, I am not in favor of placing inlays in back teeth due to the potential risk of fracture of the tooth. A bonded inlay may be okay, but I am still leery of these restorations. You may also be grinding or clenching your teeth at night. The use of the invisallign retainer may also be causing the pain (think back to your days of braces and how much your teeth hurt when they were adjusted or tightened).

Unfortunately there are quite a few potential causes for your pain. You need to try to pinpoint the source of the pain, exactly what aggravates it and when, and then have the area reevaluated by your dentist, endodontist or another endodontist. Waiting may help pinpoint the pain or it may go away on its own.

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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