Can anti-biotics cure spontaneous pain after the nerve in a molar tooth has died?

[ToothPatient]

A heavily filled tooth was super sensitive to temperature, then it lost all temperature sensitivity (assuming the nerve has died).

Now there's spontaneous pain, not in the tooth, but higher in the gums, feels like higher up in the root of the tooth.

This pain feels like pulsing or shooting electrical pain, sometimes into the joint of the jaw, or into the cheek bone.

There's no signs of infection like swelling, bleeding, fever, no fistula is present around the gums, and the tooth is negative to palpation tests.
The initial pain came about as the nerve was traumatized from the drilling/filling, not infected.

Could anti-biotics settle this type of pain down?

And if they did, would it stay settled down?

And if the nerve has died, how is there still pain at all?

 

[Dr Sunali dental Solution]

While antibiotics may not be effective in this scenario due to the absence of infection signs, understanding the nature of your symptoms is crucial for appropriate treatment.

 

[dental_care]

No, antibiotics won't likely help in this case. The pain you're describing is likely from inflammation or nerve damage, not an infection. It's best to consult a dentist. They can assess the situation and recommend appropriate treatment, which might include root canal therapy or extraction. Nerve damage can still cause pain even after the nerve has died. This is because the damaged nerve fibers can continue to send pain signals.

 

[ToothPatient]

No, antibiotics won't likely help in this case. The pain you're describing is likely from inflammation or nerve damage, not an infection. It's best to consult a dentist. They can assess the situation and recommend appropriate treatment, which might include root canal therapy or extraction. Nerve damage can still cause pain even after the nerve has died. This is because the damaged nerve fibers can continue to send pain signals.

It certainly feels that way.

I had an consult with an endodontist this morning who did cold testing and used some kind of electrical test for vitality.

He said I was "slow to respond", but honestly I'm unsure I felt anything at all.

Constant pain I'm experiencing now could just be the nerve dying?
As mentioned, acute temperature sensitivity is now gone entirely.

Basically the endo I saw wants a CBCT scan (with accompanying report), which isn't cheap (350 euro with the report), to assess for possible "vertical root fracture", due to pain on releasing the bite test.

I'm undecided whether all this is worthwhile, would he not just see a crack in the tooth through his microscope when he opens it to access the root canals?

 

[Dr Sunali dental Solution]

Given your symptoms and the potential for serious underlying issues like vertical root fractures, proceeding with the CBCT scan seems prudent. It will provide valuable information that may not be obtainable through visual inspection alone and could significantly influence your treatment plan moving forward.
While it may feel like an additional expense at this moment, investing in a CBCT scan could ultimately lead to better outcomes by ensuring any serious conditions are identified and addressed promptly.

 

[ToothPatient]

Given your symptoms and the potential for serious underlying issues like vertical root fractures, proceeding with the CBCT scan seems prudent. It will provide valuable information that may not be obtainable through visual inspection alone and could significantly influence your treatment plan moving forward.
While it may feel like an additional expense at this moment, investing in a CBCT scan could ultimately lead to better outcomes by ensuring any serious conditions are identified and addressed promptly.

Is it typical for a dentist or endodontist to request the radiological report with the scan?

I was kind of shocked that report is more expensive than the scan itself.

 

[Dr M]

It is common to do this. The report is drawn up by specially trained radiologists, and charge their own fees, which might differ. Although the specialist might be able to draw his own conclusions when studying the scans, it might not be as accurate and valuable extra information might be overlooked.

 

[Dr Sunali dental Solution]

Is it typical for a dentist or endodontist to request the radiological report with the scan?

I was kind of shocked that report is more expensive than the scan itself.

It is indeed typical for dentists or endodontists to request a radiological report along with imaging scans due to its importance in diagnosis and treatment planning. While it may seem surprising that reports can be more expensive than scans themselves, this reflects the complexity and expertise involved in producing these documents.

 

[ToothPatient]

I just got to ask also;

The endodontist when reviewing this issue, used the term "zombie tooth".

He wasn't specific enough for me to know exactly what his thoughts on a treatment plan were, as he said he needed this CBCT scan and radiology review back before concluding that.

But did mention something like, "a crown might solve this problem".

He may have been referring to the tooth testing positive on the bite test.

........

But the fact the tooth now experiences continuous spontaneous pain, and is almost insensitive to temperature (where it had been crazy temperature sensitive just a few weeks ago);

There's no way more time could eventually cause the nerve to settle down, stop being painful and the tooth might actually survive/recover with the nerve intact?

Any thoughts/perspectives on this?

 

[Dr M]

If the pain disappears, it is more likely that the nerve became necrotic. A peri-apical abscess will then gradually form, and when the pressure build up is high enough, the pain will return, sometimes with swelling.
In my honest opinion, if the pain is not too severe, I would try live with it and see what happens. If the pain disappears and does not return, then great. If the pain returns, do a root canal treatment.

 

[Dr Sunali dental Solution]

While it’s theoretically possible for some teeth to recover from mild irritation without invasive treatment, your current symptoms suggest that professional intervention will likely be necessary for long-term resolution.
Given your situation continuous spontaneous pain and changes in sensitivity it’s essential to follow up with your endodontist after obtaining the CBCT results for an accurate diagnosis and appropriate treatment plan. Waiting too long could lead to further complications if an infection develops or worsens.