Root Canal Molar Still Sensitive after 2 months
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Dr M
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Sorry to hear about your constant inconvenience. Unfortunately, there is never any guarantee with any form of medical or dental treatment, that it will be 100% successful. I would advise however to rather have the tooth extracted. Constant chewing on one side only, will eventually start compromising those teeth as well, since the forces are not balanced. It can also affect your TM-joint and muscles on that side. If you are concerned about shifting, you can ask your dentist to make you a night time only retainer, that will prevent movement of the teeth.
I'm not a dentist, but you should definitely get a root canal retreatment. Odds of success are a little lower than for first RCT, but still high, if done by a good specialist with microscope (70/80%). For 2 reasons:
1) chronic pain begets more pain, creating a vicious cycle. so this could grow to a much bigger problem than just your tooth hurting a bit when chewing (or did you mean that besides that you're always in 2/10 pain? because that really isn't worth keeping a tooth for, even more when just endodontic retreatment has a high chance of working. And unlike the other commenter suggested, no, it's not idiopathic nerve pain, because if it started with the RCT than it's definitely related to it, and will almost certainly go away with treatment, if anything by removing the tooth and the nerves in it).
2) chewing only on one side predisposes you to develop to TMD, another real headache (no pun intended)
Even if retreatment fails, there's always extraction and implantation.
I Googled tooth sensitive to pressure after root canal and saw this explanation. I don't see "missed canal" here but I suspect it would fall under number 1 or number 2 below...in other words perhaps if the endo misses a canal then the infection remains...
Common Causes of Long-Term Post-Root Canal Pain
Several factors can contribute to long-term post-root canal pain:- Infection or Reinfection: Residual infection or a new bacterial invasion.
- Incomplete Removal: Failure to remove infected tissue entirely during the initial procedure.
- Undetected Fractures or Cracks: Hidden structural issues in the tooth.
- Nerve Irritation or Damage: Ongoing nerve irritation or damage.
- Scar Tissue Formation: Scar tissue within the tooth affects its function.
Thank you for the update. I'll share my case below as it's a bit different. My molar (tooth 19) was already diagnosed with cracked tooth syndrome prior to getting RCT.
I went to first dentist with history of mild pain when chewing on hard food for the prior several months. He tried a filling kind of randomly in between some cusps which either did nothing or made it a little worse. In retrospect I think that was a mistake as a trainee did the filling and there was a point where I felt extreme sharp pain despite being numbed. The trainee stopped at that point and it was kind of obvious to me, the assistant, and the trainee himself that he went too far.
Then I went to an endo who performed a variety of scans and tests and diagnosed me with cracked tooth syndrome. He said there was no nerve involvement and that the molar was still healthy, and that a crown would likely fix the issue.
I went to a second dentist who did a crown prep. During the prep I smelled a burning smell, and there were points where it felt hot and stinging despite being numbed. After that the molar blew up and became extremely painful all the time. Irreversible pulpitis. No infection at least.
I went back to the endo and got a root canal a few weeks later. The endo is Columbia-trained and uses advanced tech including a microscope so I trust he did a good job. He confirmed the crack didn't extend very far while he was in there. He said to avoid hard food to extend the life of it.
I went to a 3rd dentist to get a permanent crown. That went smoothly.
After the RCT and full crown I had mild symptoms for a week or so which recovered. The only symptom that remained was a mild pressure sensitivity when flossing the mesial side or when releasing my bite but only from chewing gum. It was very mild and easy to avoid (avoid gum and floss carefully) so I figured I'd give it time to improve. I've treated the tooth very carefully in the interim and stopped eating anything hard like granola as the endo advised.
I'm now 2 months out from RCT and crown. Last week I unfortunately must have clenched while sleeping one night because I woke up with some soreness. There was mild bite pain (2/10) on the molar for a day or two which then improved. However there now remains more of that pressure sensitivity I described above. It seems easier to trigger now as well. Like if I create suction in my mouth I feel it. If I press on the buccal or lingual side of the molar I also feel it. I don't think it's getting worse but also not better.
To reiterate, the sensitivity is more like a pressure than a pain. Maybe like a 0.5 or 1/10 of pain. I still have a bad feeling about it though as I feel I'll likely need an implant sooner than I thought. I hate the idea of having a ticking time bomb in my mouth, but I'm also scared of implant failures. The molar is my main chewing molar and it's also visible when I smile so I don't want to live life without it.
I don't know if I'm feeling crack progression or a sprained ligament or something else.
I have an appointment coming up with the dentist in a few weeks. Hopefully it will slowly improve or at least not get worse. He also said he'd fit me for a guard to protect from clenching as that seemed to harm it.
Incredible all this headache is from chewing something hard about a year ago and feeling a sharp pain. Prior to all of this I never had any dental issues. Brush twice, floss once every day. Healthy diet. In my 40s.
I went to first dentist with history of mild pain when chewing on hard food for the prior several months. He tried a filling kind of randomly in between some cusps which either did nothing or made it a little worse. In retrospect I think that was a mistake as a trainee did the filling and there was a point where I felt extreme sharp pain despite being numbed. The trainee stopped at that point and it was kind of obvious to me, the assistant, and the trainee himself that he went too far.
Then I went to an endo who performed a variety of scans and tests and diagnosed me with cracked tooth syndrome. He said there was no nerve involvement and that the molar was still healthy, and that a crown would likely fix the issue.
I went to a second dentist who did a crown prep. During the prep I smelled a burning smell, and there were points where it felt hot and stinging despite being numbed. After that the molar blew up and became extremely painful all the time. Irreversible pulpitis. No infection at least.
I went back to the endo and got a root canal a few weeks later. The endo is Columbia-trained and uses advanced tech including a microscope so I trust he did a good job. He confirmed the crack didn't extend very far while he was in there. He said to avoid hard food to extend the life of it.
I went to a 3rd dentist to get a permanent crown. That went smoothly.
After the RCT and full crown I had mild symptoms for a week or so which recovered. The only symptom that remained was a mild pressure sensitivity when flossing the mesial side or when releasing my bite but only from chewing gum. It was very mild and easy to avoid (avoid gum and floss carefully) so I figured I'd give it time to improve. I've treated the tooth very carefully in the interim and stopped eating anything hard like granola as the endo advised.
I'm now 2 months out from RCT and crown. Last week I unfortunately must have clenched while sleeping one night because I woke up with some soreness. There was mild bite pain (2/10) on the molar for a day or two which then improved. However there now remains more of that pressure sensitivity I described above. It seems easier to trigger now as well. Like if I create suction in my mouth I feel it. If I press on the buccal or lingual side of the molar I also feel it. I don't think it's getting worse but also not better.
To reiterate, the sensitivity is more like a pressure than a pain. Maybe like a 0.5 or 1/10 of pain. I still have a bad feeling about it though as I feel I'll likely need an implant sooner than I thought. I hate the idea of having a ticking time bomb in my mouth, but I'm also scared of implant failures. The molar is my main chewing molar and it's also visible when I smile so I don't want to live life without it.
I don't know if I'm feeling crack progression or a sprained ligament or something else.
I have an appointment coming up with the dentist in a few weeks. Hopefully it will slowly improve or at least not get worse. He also said he'd fit me for a guard to protect from clenching as that seemed to harm it.
Incredible all this headache is from chewing something hard about a year ago and feeling a sharp pain. Prior to all of this I never had any dental issues. Brush twice, floss once every day. Healthy diet. In my 40s.
I've learned some hard lessons. Don't let inexperienced/trainees "learn" on my teeth. Don't follow referrals without vetting/reading online reviews. Definitely avoid/use serious caution with hard foods (popcorn, hard candy, burnt pizza crust and so called "pitted" fruits (they often leave the pits in them). Lastly I'm trying to listen to my "gut" feelings more. When I checked in with the endo's front desk an emergency phone call had just come in. A guy was on the phone calling the endo and was in a lot of pain. I froze for a minute, then calmed down/sat down in the waiting room. Big mistake, I should have just explained I was uncomfortable and hit the door.
I hear you about listening to your gut. I've been practically brainwashed by therapists to ignore my gut feelings because they are always so full of anxiety, but the truth is sometimes the anxiety is there for a reason. My trouble is in distinguishing "spider sense" anxiety from distorted anxiety.
I will update after my dentist appointment at the end of the week. If it really is just a PDL sprain, I guess I'll continue doing my best to ignore it. Hopefully he can convince me to stop thinking of it like a ticking time bomb in my mouth. Unfortunately if I favor the other side of my mouth even for a day, the other molar starts getting sensitive. That started when I was waiting for the root canal. Went away after I started chewing on both sides again. Now I chew like every bite might have a rock in it, very gently. Incredible to think I never had dental issues before any of this, not even a cavity.
Given it's your last molar, if I were in your shoes, I might consider having it extracted and leaving it that way like your dentist mentioned. No one can see that molar unless you're trying to show them it, and I think you can chew fine without it.
In my case it's the next molar, which is my main chewing molar and also kind of visible when smiling or talking. Not from a distance but up close probably. If I were married I guess I wouldn't care as much, but I'm single. And I can't picture chewing without a tooth there. A fake tooth is an option but I can't get a straight answer on whether you can chew with them in. Some resources say no, some say yes as long as it isn't hard food, with varying definitions of "hard".
Implant is obviously the best option if it works, but I have some risk factors for that unfortunately -- bruxism and SSRIs. Also I'm on the very thin side and have stomach problems, so I worry about being able to eat enough in recovery. I also haven't been exactly lucky with dentists or dental procedures throughout this whole thing, so it's hard for me to really believe the 95% success rate applies to me.
I will update after my dentist appointment at the end of the week. If it really is just a PDL sprain, I guess I'll continue doing my best to ignore it. Hopefully he can convince me to stop thinking of it like a ticking time bomb in my mouth. Unfortunately if I favor the other side of my mouth even for a day, the other molar starts getting sensitive. That started when I was waiting for the root canal. Went away after I started chewing on both sides again. Now I chew like every bite might have a rock in it, very gently. Incredible to think I never had dental issues before any of this, not even a cavity.
Given it's your last molar, if I were in your shoes, I might consider having it extracted and leaving it that way like your dentist mentioned. No one can see that molar unless you're trying to show them it, and I think you can chew fine without it.
In my case it's the next molar, which is my main chewing molar and also kind of visible when smiling or talking. Not from a distance but up close probably. If I were married I guess I wouldn't care as much, but I'm single. And I can't picture chewing without a tooth there. A fake tooth is an option but I can't get a straight answer on whether you can chew with them in. Some resources say no, some say yes as long as it isn't hard food, with varying definitions of "hard".
Implant is obviously the best option if it works, but I have some risk factors for that unfortunately -- bruxism and SSRIs. Also I'm on the very thin side and have stomach problems, so I worry about being able to eat enough in recovery. I also haven't been exactly lucky with dentists or dental procedures throughout this whole thing, so it's hard for me to really believe the 95% success rate applies to me.
I'm gonna try to get 5 more years out of the molar-until 2030.
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