Severe pain after root canal (going 3 months in now)

[Twister]

This is my going to be my 3rd month since I did a root canal treatment in which I believe is 1-1 or 2-1 (front)

I have experienced severe pain in my tooth since right after root canal treatment, and been to several dentists who have said there is nothing wrong and all looks ok.

Can any dentist here check my x-ray and give their opinion or see if they find anything wrong?

Pain is constant, but is knife sharp pain shooting up every time I try to bite, or apply any pressure.

Also trouble to sleep at nights, only get in about 3-4 hours per sleep at night and wake due to pain. (lasting for weeks)

On the verge to pull out the tooth myself If can't get resolved.

(Before root canal treatment, I had no pain in the tooth or infection, so I don't even know why the dentist performed a root canal on it in the first place, maybe also somebody else can tell me based on the x-ray)

 

[Dr M]

On the x-ray provided it seems like your right central incisor had a root canal done previously which looks good. Your left central incisor had a large filling, that extended into the top part of the pulp or nerve chamber, which is an indication for a root canal to be performed.
Is this x-ray taken after treatment was performed?

 

[Twister]

On the x-ray provided it seems like your right central incisor had a root canal done previously which looks good. Your left central incisor had a large filling, that extended into the top part of the pulp or nerve chamber, which is an indication for a root canal to be performed.
Is this x-ray taken after treatment was performed?

Yes this was taken ~2 months after the root canal treatment. The other 1-1 was to be next, but because I have had pain ever since my root canal treatment this has been postponed because I don't want create new problems without solving the current problems.

He did the root canal on 2-1 and 2-2 on the same time.

Do you mean these root canal fillings looks good? Because I have pain in my teeth since this was performed. (no pain before root canal treatment)

My 1-1 was even weaker then my 2-1, so I am surprised that he root canal the 2-1 and not the 1-1 which in my own knowledge needed a root canal more. (no large filling that extended into the pulp on 2-1)

But I got the 1-1 filling and into the pulp because when removal of 1-2 tooth, it also chipped off a piece on 1-1 that was left untreated for a while.

 

[Dr M]

Root canals sometimes do take a while to settle. I often prescribe a short course of antibiotics if the pain takes more than 2 months to resolve. It might also be that you have some unfilled accessory canals on the teeth that were not disinfected or filled. This can't be picked up on normal peri-apical x-rays. There is also a chance that there is a crack present.
I would try antibiotics first. If the pain does not resolve, I would go for a CBCT scan, which is a 3D scan, to rule out cracks and unfilled accessory canals.

 

[Twister]

Can central incisors have accessory canals?

 

[Dr M]

Yes, there can be some lateral canals present, which is the same as an accessory canals, and this area would then harbour additional bacteria. I assume your dentist did also check your bite for any adjustments that might have been required?

 

[Twister]

Yes he did, he also ground down both 2-1 and 2-2 so they don't touch the lower part of my teeth when biting down anymore. (milimeters) so 1-1 is some milimeter taller then 2-1.

I also have 2 additionals questions apart from the pain main cause.

1) based on the x-ray you can look at, if this tooth (2-1) wasn't already had a root canal treatment, would you say the condition of the 2-1 required and needed a root canal treatment?

2) based on the tooth's condition, and the pain I have, would getting a implant be a better choice instead? (for 2-1)

My plan was to put a crown on both 2-1 and 1-1, before I started my treatment.

 

[Dr M]

To answer your questions

1) Yes, I would say that tooth number 21 requires a root canal treatment.
2 ) It is not necessary for an implant. I think a root canal, with a post-crown should be sufficient for tooth number 21.

 

[Twister]

To answer your questions

1) Yes, I would say that tooth number 21 requires a root canal treatment.
2 ) It is not necessary for an implant. I think a root canal, with a post-crown should be sufficient for tooth number 21.

Just so i am sure which tooth is the 21, it's this one right?

 

[Dr M]

That is tooth number 11.
Tooth number 21 has not had a root canal yet, on the x-ray provided.
It is your left, upper, central incisor.

 

[Twister]

Oh okay

But i was meant to ask for 11.

would you say the condition of 11 also needed a root canal treatment (prior the root canal)
and would a crown or implant be better for 11?

 

[Dr M]

I can't comment on the condition of 11 prior to the root canal. Would need to see an x-ray to say if the root canal was indicated, but based on the size of the filling, there is a strong possibility that it did.
If there is still pain in the 11 and funds is not an issue, then an implant can be an option, if there is sufficient quality and quantity bone.

 

[Twister]

I am taking antibiotics now and while the pain have not gotten worse while taking it, the pain have slightly decreased (maybe by 5%) while I still have pain left in the tooth. I don't know if that's the antibiotics working, or if there is a painrelief substance in the antibiotics or anti-inflammatory in the antibiotics.

I think the filling on the 11 and 21 are similar, but 21 is a bit worse because of the filling near or at the pulp.

What is this black circle area in the x-ray? Is that an infection or something else?

 

[Dr M]

That is not an infection. That is part of your nasal spaces.

 

[Twister]

What about this line here?

 

[Dr M]

Difficult to see clearly, but the white line, might indicate bone, which might be part of your nasal bone

 

[Twister]

I take that back, antibiotics is not helping, today I have more pain then I have had in the last 1½ weeks.

I have reason to suspect the white line could be filling, as I found a case similar with pain after root canal

Troublesome Front Teeth

This lady had severe toothache from her troublesome front teeth. See how we relieved her pain and sorted out her dental problems.

shelbourneclinic.ie

Could this be the same as mine? is mine also filling?

 

[Dr M]

It does not look like that. But it might be extruded cement that was used, to cement the GP, that is causing the pain. Would need an image that is more clear.

 

[Twister]

What is GP?

I don't have an x-ray machine here at home otherwise I would try take some better, I would try see if my dentist can take another , or even a CBCT xray.

But I been to 2 other dentists after this who all said that the dentist who did this job (root canal) did a poor job on me, that the root canal doesn't look good. They said it needs to be re-done and that its not dense. Do you agree?

They also didn't know what the 3 white dots were in the xray.

 

[chrissgen]

The discomfort you're experiencing could indeed stem from extruded cement irritating surrounding tissues. While it may not look obvious at first glance, subtle overfills can cause lingering pain. A clearer image would definitely help in making a more accurate assessment and guiding the next steps.