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Dental Forum
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Tooth pain persists post root canal whether extraction and implant or crown
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By Rachel Speer
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2/2/2010 8:15:59 PM
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I've been visiting NYU Dental Clinic since April of last year over a single tooth, my #3. It started with a broken (17 year old) filling, which they replaced. When pain persisted they diagnosed me with cracked tooth syndrome, and a transilluminator revealed a fracture on the medial lingual cusp. The treatment team took a conservative approach, first reducing it with the thought of an onlay, then prepping for full crown, then when pain worsened an emergency pulpotomy right before Thanksgiving. A month ago the root canals were completely excavated of tissue, and pain persisted. Last Thursday they were shaped for filling, and the job looks "ideal" according to the endodontal specialist, but even with four shots of anaesthetic and completely numb gums, the tooth hurt severely when they tried adjusting the clamp for the rubber dam, and continues to hurt when pressed. They don't understand how I have tooth pain with the nerve long gone; they suggested that fractures under the gumline may be causing the tooth to hit nearby fibers, but they can't visualize those fractures with X-ray. I have another appt for this Thursday, and they've said it's up to me whether to proceed with the crown or opt for an extraction and implant. I don't know what would be best; they said we can wait and see if the pain resolves itself so they can proceed with the crown, but that hasn't worked so far... I had a lot of cavities as a child, but became a bit compulsive about dental hygeine when I got braces at age 10, and have had nothing but glowing dental reports since then until last spring! I use a sonicare & rinse & floss regularly. No medical issues. They say my gums are pretty healthy and the teeth all look healthy on x-ray. I'm a student without dental insurance, which is why I've been going to NYU Dental, but if you think a private practice could provide better treatment at this point, I'd be willing to pay. I don't want to do anything unecessarily invasive, but really want to be free of this pain after almost 9 months of this bother! Any advice would be greatly greatly appreciated.
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 User Comments on
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Posted By :
Dr. Ritz
on
2/2/2010 8:17:36 PM
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It is very difficult to comment without seeing the case clinically and xrays but it is always better to save the tooth, if it is possible rather than getting it pulled out. If you are not comfortable then you should take a second opinion from a private Endodontist. If the fracture line is below the gums then post and core and above that getting crown is another option. If the tooth is badly infected and the dentist feels that it is not worth saving then after pulling it out, the implant is best option. For more on root canal treatment you can check the following link in our website.. http://www.identalhub.com/articlecategory-root-canal-therapy-17.aspx
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