Tooth produces sharp pain when eating food, even after RCT

Discussion in 'Dental Archive' started by John Riddle, Jul 26, 2004.

  1. John Riddle

    John Riddle Guest

    Hi,

    I was wondering if someone could help shed some light on a problem I'm
    having with a painful tooth. I had made an appointment with my
    regular dentist to diagnose a problem I was having with a lower molar.
    It turned out to be tooth # 19, which produces a sharp pain whenever
    I bit down onto something the least bit chewy or crunchy. It is not a
    constant pain; it only occurs when I bite down on something that puts
    pressure on the tooth. It only lasts an instant: it goes as quickly
    as it comes, and sometimes is sharp enough to reverberate throughout
    my body. There is no sensitivity or hot or cold.

    My dentist tried filling a couple of divets in the tooth where it had
    been worn down (I used to grind my teeth at night as a teenager), but
    this had no effect. I went back, and she tried adjusting my bite to
    take some of the pressure off that tooth, but again, that had no
    effect.

    At this point, they suggested root canal treatment. The whole
    procedure went relatively smoothly, painless for the most part,
    although there there were a couple of sharp sensations at one point.
    (He did give me four shots of novocaine before the procedure). After
    it was done, he put on a temporary crown. He told me to take advil
    for several days afterwards.

    I avoided eating anything on that side of the mouth for a day or so,
    and took advil for several days as recommended. But there was still
    the exact same sharp pain as before. There was a continual dull ache
    from the RCT, which eventually went away.

    I called back the endo., who said that I should go back to the regular
    dentist and have my bite checked. She checked my bite and determined
    that there was too much pressure being put on #19 when I bit down,
    explaining that the tooth tends to rise up slightly after a RCT. After
    making some adjustments, my bite felt much better and #19 was
    contacting the upper tooth only slightly. The dentist advised that I
    take advil a few more days to see if the situation cleared up.

    I waited a week or so, and the sharp pain persisted, so I called back
    the endo. and told him that the original problem persisted. He used a
    tooth sleuth to verify that #19 is the painful tooth, which it is. He
    said that the only reason he could think of as to why the pain
    persisted was that the tooth could possibly have a root fracture, but
    said he didn't see any evidence of that on the X-rays or during the
    procedure. He did mention that he had a hard time performing the RCT,
    because it appeared as though the roots had started to "close up", but
    he couldn't elaborate on why. He wanted me to get a second opinion,
    so I found another endodontist, who took a few more X-rays. The
    second endo. said that all four roots had been located and that they
    had been filled perfectly, so there was no need to re-do the RCT. He
    perscribed two antibiotics, and told me to take them until they were
    used up, and wait ten days and see what happened. They had no effect.

    I called the second endo. back who said that he thought that the tooth
    would eventually get better, and repeated that there was no need to
    re-do the RTC. He did mention that my bite was slightly off.

    So now I'm back to square one. I understand that the tooth is
    essentially "dead" after RCT (assuming it is done properly), so I
    suspect that the pain is merely manifesting itself through that tooth,
    but coming from somewhere else (unless that tooth or root is indeed
    fractured?), like something that the tooth is putting pressure on when
    I chew down on something crunchy or tough. I can eat pasta or
    similarly textured/softer food without any pain. The pain has only
    ever been an instant "shot" of a sharp pain, it has never been a
    continual pain or laster more than a moment.

    Any insight anyone can provide on this, I'd greatly appreciate.
    Thanks in advance.
    John
     
    John Riddle, Jul 26, 2004
    #1
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  2. John Riddle

    W_B Guest

    On 26 Jul 2004 08:56:08 -0700, (John Riddle) wrote:

    You have a fractured tooth.

    You could try getting a crown, it is your
    best bet for holding the fractured pieces
    together. (or CEREC for Dr. Steve M)

    However, if the fracture is severe
    or deep... there may no solution except extraction.
    --

    W_B

    Take out the G'RBAGE
     
    W_B, Jul 26, 2004
    #2
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  3. John Riddle

    Dr Steve Guest

    I have seen muscle spasm mimic toothache in the area of the lower first
    molar many times.

    --
    ~+--~+--~+--~+--~+--
    Stephen Mancuso, D.D.S.
    Troy, Michigan, USA
    .....................................................

    This posting is intended for informational or conversational purposes only.
    Always seek the opinion of a licensed dental professional before acting on
    the advice or opinion expressed here. Only a dentist who has examined you
    in person can diagnose your problems and make decisions which will affect
    your health.
    .......................
     
    Dr Steve, Jul 26, 2004
    #3
  4. John Riddle

    W_B Guest


    The patient reported already having endo.
    --

    W_B

    Take out the G'RBAGE
     
    W_B, Jul 26, 2004
    #4
  5. On 26 Jul 2004 08:56:08 -0700, (John Riddle) wrote:
    Loose filling ...... or cracked cusp.

    I say its a cracked cusp, or the doc has to spend more time o nthe
    golf course studying and replacing divots.

    def. (golf) the cavity left when a piece of turf is cut from the
    ground by the club head in making a stroke

    This is the preferred spelling. It rhymes with gribbits .........
    which is the sound frogs make.

    ....while at the dentist.



    Ahahhhh. SHE? Just kidding ........

    Nature and genetics ......

    WAIT!

    It may be okay.
    Probably not. The endodontist would have taken note of that.

     
    Joel M. Eichen, D.D.S., Jul 26, 2004
    #5
  6. Uh-oh. See? Two reasonable dentists with opposite opinions ......

    JOEL
     
    Joel M. Eichen, D.D.S., Jul 26, 2004
    #6
  7. I'd say parafunction ,,,,,, if I knew what it is ... I do not but I
    have heard it enough to repeat it.

    PARAFUNCTION.


    JOEL
     
    Joel M. Eichen, D.D.S., Jul 26, 2004
    #7
  8. John Riddle

    Dr Steve Guest

    Correct. If the pain is muscle spasm in the masseter or medial pterygoid,
    the pain will persist after RCT. I saw a patient once who had pain #19.
    She had the filling re-done 2 times, then RCT. Pain persisted, so she got
    the RCT done over. Pain persisted, so she had RCT on #18 and #20. Pain
    persisted, so they did a FGC on #19. Pain persisted so they did RCT #14.
    Pain persisted so they extracted #19. Pain persisted and I got to see her
    at this point. This was before the NTI, so I made a hard horse-shoe and
    adjusted it weekly. Between 10 and 20 days, the pain was gone and never
    returned. Today, we could that in 3 days with an NTI. Then, she got the
    crown #14 and the FPD replacing #19.

    --
    ~+--~+--~+--~+--~+--
    Stephen Mancuso, D.D.S.
    Troy, Michigan, USA
    .....................................................

    This posting is intended for informational or conversational purposes only.
    Always seek the opinion of a licensed dental professional before acting on
    the advice or opinion expressed here. Only a dentist who has examined you
    in person can diagnose your problems and make decisions which will affect
    your health.
    .......................
     
    Dr Steve, Jul 26, 2004
    #8
  9. John Riddle

    W_B Guest


    WoW.
    Haven't run across a case like this.

    You must admit it is the exception and not the rule, yes ?
    --

    W_B

    Take out the G'RBAGE
     
    W_B, Jul 26, 2004
    #9
  10. John Riddle

    Dr Steve Guest

    A case like this one is the EXCEPTION. I see 2-3 people a year who think
    they have tooth pain and really have muscle pain. An NTI clears it up for
    them. You could ask me why I am wearing an NTI right this minute.

    --
    ~+--~+--~+--~+--~+--
    Stephen Mancuso, D.D.S.
    Troy, Michigan, USA
    .....................................................

    This posting is intended for informational or conversational purposes only.
    Always seek the opinion of a licensed dental professional before acting on
    the advice or opinion expressed here. Only a dentist who has examined you
    in person can diagnose your problems and make decisions which will affect
    your health.
    .......................
     
    Dr Steve, Jul 26, 2004
    #10
  11. John Riddle

    W_B Guest

    Thanks for the tip you guys.
    Will keep that in mind.



    --

    W_B

    Take out the G'RBAGE
     
    W_B, Jul 27, 2004
    #11
  12. On Tue, 27 Jul 2004 20:32:41 GMT, Steven Fawks
    Interesting ... THANKS.

    JOEL
     
    Joel M. Eichen, D.D.S., Jul 27, 2004
    #12
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