The Tooth Hurts
June 3, 2010 4:58 AM   Subscribe

I had a root canal on my second molar nearly 1 year ago. The tooth is still sensitive to hot/cold and is very uncomfortable. What gives?

The tooth originally required a filling about 1.5 years ago. Once that didn't solve the pain, my dentist took a look at my x-ray and said that the filling was very close to the nerve, which was now dying. I had a root canal last summer and a crown placed on the tooth. For months the tooth has continued to hurt on and off, some days worse than others. If I tap on the tooth even gently it causes pain. I've seen 2 dentists for second opinions who have views x-rays and seen that all of the nerves have been removed from the canals. What could be causing this and what are my options for relief?
posted by Tenacious.Me.Tokyo to Health & Fitness (12 answers total) 1 user marked this as a favorite
I had that, and the nerves all hadn't been removed, something that couldn't be confirmed until the tooth was pulled entirely. X-rays showed nothing, but the pain was really bad. You may just have to have the tooth pulled, unfortunately.
posted by xingcat at 5:08 AM on June 3, 2010

I know from personal experience that root canals can fail and an infection can start under the tooth. In my case, a dark spot was showing up on the x-rays which indicated a possible infection. Multiple dentists concurred. The solution was costly; the tooth was pulled, the area was cleaned and an implant was put in its place.
posted by Jambi at 5:11 AM on June 3, 2010

It might be an infection under the tooth. Did they give you antibiotics?
posted by fleacircus at 5:15 AM on June 3, 2010

Is it an upper molar? I had a root canal on an upper tooth (although one further forward, the canine I think) and now it's sensitive to things that didn't bother me at all before. X-rays show that it now sticks into the sinus cavity a tiny bit and every time my sinuses are swollen it gets sensitive. The pain isn't actually coming from the tooth, there's no nerve so that's impossible (and mine really is all gone and there is no infection), it's referred pain from whatever the end of the root canal filling presses on. Since I have allergies and my sinus are slightly swollen most of the time it's always a bit painful to touch and cold (fun huh?). The only thing I can do is use steroid nasal spray and try to remember to take my antihistamines, and not tap on the tooth (which I just did, ouch).

A molar is probably too far back for this to happen and an infection is probably more likely. Either way the method to diagnose what's wrong is by more X-rays so another trip to the dentist may be in order. At the very least ring them up and ask if there's anything in the previous X-rays that could be causing this, like being near the sinus cavity for example (the first sign of a sinus infection is very often a sore tooth). Even if they can't see it protruding in just being right next to it can be enough, that's what mine is like. They should be able to rule this out with the images they already have then you can ask if it's worth going in for more.
posted by shelleycat at 5:28 AM on June 3, 2010 [1 favorite]

The nerves in teeth can have two roots. Perhaps more, for all I know. The first root can be removed while the second remains there and gets infected and your face swells up like a caricature of someone with mumps gargling golf balls. And the second root can be had to find, requiring ages spent in a chair while a hairy man sticks fingers in your mouth.

Why, yes, that is how I spent an afternoon last summer.
posted by Joe in Australia at 5:33 AM on June 3, 2010

Did you go to an endodontologist or a regular dentist? Sometimes a canal is hard to spot (and not at all on an x-ray) so dentists miss them. A tooth can have up to 5 canals. An endodontologist has special equipment and is trained to spot these missed canals. If this is the case they can do a new root canal treatment.

Another option is an infection on the root points but it seems unlikely that two dentists would have missed that on an x-ray.
posted by davar at 5:36 AM on June 3, 2010 [2 favorites]

IANAD yadda yadda yadda. (I am an endodontic assistant, however, so I see this stuff all day every day.)

Which hurts more, hot or cold? Is it ALWAYS sensitive to hot, or only sometimes? Can you chew on the tooth? Do you wake up in the middle of the night with spontaneous throbbing pain?

There is always the chance that it's not that same tooth, but the tooth next to it. Ask a dentist (or preferably an endodontist) to isolate each tooth with a rubber dam and test them with hot/cold water to make sure it's the same one.

There is also the possibility that the tooth is cracked, which might explain the pain to touch, but wouldn't explain the temperature sensitivity.

Either way, you should not accept analysis of an x-ray as a diagnosis. X-rays cannot give the whole story, and any dentist who shoves you off when you're in pain is not your friend.
posted by overeducated_alligator at 5:49 AM on June 3, 2010 [2 favorites]

Keep asking your dentists about it--don't let them blow you off. I've had three root canals, and two of them have left the tooth in question completely unable to feel anything, no problems, etc (and one of them was a three-rooted tooth). The third has been sensitive to hot and cold and to pressure for over a year. We're still trying to figure out the problem (like you, my x-rays show no problems), but my point is, no, root canals should not leave your tooth still sensitive.
posted by peanut_mcgillicuty at 6:02 AM on June 3, 2010

I had the same problem/question a few years ago. Actually, I've learned to live with it since no one believed me that it was hurting. They even did that isolation thing overeducated_alligator mentions. The pain ebbs and flows nowadays. Chocolate makes it worse. Oddly enough, whenever I go in for my twice yearly dental check-ups I'll ask the dentist to jiggle that tooth around, which then causes the tooth not to hurt for a good long while (like months and months).
posted by Sassyfras at 6:58 AM on June 3, 2010

i have the same issue, and here is what's going on for me:

not only is the original root canal interfering with my sinus, but the tooth next to it is about to bite the dust. so, it is twofold. i have pain when my sinuses are flaring up, and i have pain because of the tooth next door.
posted by bright and shiny at 9:44 AM on June 3, 2010

You could have a small abscess near the tooth. This might not be visible on x-rays. I agree with the others who have suggested an endodontist.
posted by parakeetdog at 10:00 AM on June 3, 2010

I just had to have a tooth pulled because of a negligent dentist not catching an infection at the site of a root canal. See an endodontist as soon as humanly possible. I probably could have kept my tooth if my dentist was better at, er, looking at x-rays.
posted by ishotjr at 8:34 PM on June 3, 2010

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