Root canal pain - 5 months after it

[arondir_elf]

Hello everyone,

What is longest time a root canal will need to recover?

A bit of history. A tooth (upper molar) root-canaled 10 years ago. Never caused me any problem or pain throughout the years, but had to finally crown it (2 years ago), as it had a giant amalgam filling and no crown. So I went for a zirconium crown. Immediately after having the crown, problems with the gums started. The crown was just not right, as floss shredded and food got stuck, which caused me a lot of gum sensitivity despite flossing regularly and later on - gums recession. This is how it looked like -

5 months ago, I decided to go for a replacement of that crown which to solve my gum problems. The doctor however send me first to an endodontist because no canals was filled to the end, although no infection. "If we are redoing the crown, let's first redo the root canal.". I have no idea why I listened.

So, went to the endodontist, he works with a microscope. It was done in 2 visits. Despite anastesia I could feel pain when he poked me at the end of the root canals, which was weird. He said I have enourmously long canals, whatever that means. On the second visit I complained that now I have sensitivity to cold in the root canaled tooth, which I never had before. He only asked if I have sensitivity to biting and knocked on the tooth, I dont have sensitivity to biting. So since then I have been having sensitivity to cold, sometimes it might be to sweet things, something it is a moderate pain coming out of nowhere. As scale it is 5 out of 10 in general. This is how the tooth looks like now:

Decided to have a second opinion of another endodontist. She says it is impossible anything to be wrong with the root canaled tooth because of the reputation of the specialist I went to and that she sees a huge cavity on the neighbouring tooth from the x-ray. So she removed the crown (in order to have a new one as well), but surprise, surprise. On visual inspection there isn't any cavity there, or in other teeth.

This is a photo now without the crown:

What is your opinion? Is the 5-months pain I am having from the root canal instrumentation, and is it some neuropathy? Should I ask for redoing the root canal and what my next steps could be?

 

[Dr M]

The root canal definitely needed to be re-done initially, before placing the crown. The first root canal was done very poorly, and it was only a matter of time before it would have given you issues.
How certain are you that the sensitivity is coming from this tooth? Do some of the other teeth perhaps have some exposed dentin or tooth necks, that might cause this sensitivity to cold?
You can also ask for a CBCT scan of the tooth as it is now? There is a chance that there might be a missed canal that was not filled.

 

[arondir_elf]

Thank you for the answer, Dr M.

The neighbouring teeth have some brown spots (but not cavities for sure) where the old crown touched them. My dentist prescribed me hydroxyapatite gel for remineralization. So it shouldn't be that.

Is there a possibility the tooth has a crack and can anything be seen from the x-rays?

What is the radiation exposure from a CBCT scan? And can it be done after crowning as well, or it needs to be done now?

Thanks beforehand

 

[desrosiersdental]

Persistent pain months after a root canal could indicate an unresolved infection, a missed canal, or a tooth fracture. It’s important to see your dentist to determine the cause and find a solution. At Admire Dental Care, we specialize in diagnosing and treating post-root canal issues to restore comfort and oral health. Don’t delay; schedule a follow-up to address this concern.

 

[Dr M]

Modern CBCT scans don't emit excessive radiation, since you limit the field of view of the scan to the area in question only. It is possible to miss a crack on a 2D x-ray. A CBCT scan can be done, even if the tooth has a crown on it.

 

[arondir_elf]

Thank you all. I will wait a bit more and see if it will settle after the crown.