What is wrong with my tooth that they had to stop root canal? (X-ray)

Discussion in 'Endodontics' started by Weronika, Jun 15, 2018.

  1. Weronika

    Weronika

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    Hello, first of all I want to point out that I speak Polish, so I may make some mistakes.
    I am 18 years old. For more than a year, my sixth tooth on the bottom is oversensitive, but I thought it was a damage to the filling (this was said from doctor in school), because this tooth is white, same as filling, gum looks normal. Since a week, I have a very large pulsating toothache, which only medications can help. First, private doctor thought it was moving eighth tooth, but I knew I have to do X-ray. Yesterday I came with this picture and in one second she knew that this sixts tooth is going to have root canal treatment (so did I), but here is the problem.. She gave me in total one and a half ampoule of anesthesia, but I haven't got feeling in my left side, BUT in my tooth still, even cold water was hurting... The doctor also said, that the damage could be to the bone, but I also don't understand this. (At first she said that this tooth supposed to be dead so we should try without anesthesia)
    Doctor gave me patch with poison and something else, but this may not help that much, because she didn't even take off all the filling. I have two weeks of taking antibiotic and then we will see..
    And my question is:
    Maybe some of you could recognize what is wrong with this tooth by this pic and what I said about the pain? Also when she gave me one of the lasts anesthesia even in one place in my gum I had the feeling of pain, when in other not..
    Please people help, in my country I could not find forum like that :( 1234.png
     
    Weronika, Jun 15, 2018
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  2. Weronika

    honestdoc Verified Dentist

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    In the US, the 6th tooth on the lower left side is tooth #19. I see suspicious shadows in both root tips. It could be normal bone trabeculae (spongy bone patterns), possible trauma from clenching your teeth (stress), or diseased pulp and root canals. I don't make my diagnosis only from x-rays but with symptoms and presentations. How intense were your sensitivities 1 to 10 being the most intense and for how long and what duration? I would also perform percussion test on a "normal" tooth on the lower right side to have you know what "normal" feels like then try it on the suspect tooth. Also palpation, cold test, periodontal probing, mobility, and bite test. Many times when people are stressed, they clench and grind on their teeth which can lead to severe teeth pain. According to experts, your teeth only touch for 20 minutes each day including all meals and function. When you exceed 20 minutes you can damage your teeth and joints (TMJ). I may recommend a hard bite (occlusal) guard.

    Lower molars can be very difficult to anesthetize especially when you feel very temperature sensitive. The nerves are overly inflammed and can be very difficult to calm them. I performed over 9000 root canals and a few times I couldn't fully anesthetize a tooth. I may have you take a mild sedative such as triazolam only if you are with an escort because you are not fully alert.

    I'm not sure if there are root canal specialists in your country. An expert with a dental microscope will adequately see inside the tooth. Using a rubber dam during the procedure is required. The procedure cannot have any microbial contamination and all efforts to clean, shape and fill the root canals are most important. A species of bacteria called Enterococcus Faecalis is resistant to 50% diluted bleach and can cause a beautiful root canal treatment to fail!
     
    honestdoc, Jun 16, 2018
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  3. Weronika

    Weronika

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    Thank you very much for your answer, I was waiting for it! I hope that the pain measure will be credible, because this is maybe US thing (like seen on movies), I am doing this for the first time ;). According to what you said:
    For a year, the pain was not constant, just unpleasant, as you said, I was more likely to touch this tooth with other tooth. Gargling my teeth caused my pain, warm and cold drinks or foods, until the temperature returned to normal, around 6/10.
    The tooth does not move. I also have a normal bite, because I wore an orthodontic appliance.
    I went to the dentist at school, there the pain during the drying of the tooth with air pressure was 7/10, felt like the pain came to the root. She could not make an x-ray, so she tried to seal the filling. Pain then was not systematic.
    More than a week ago I clenched my jaw more tightly, because it was annoying, also my gum (where sometimes I tried to stick my nails in the painful place).
    On Monday, I began to feel a strong toothache, pulsating, about 6/10 with no stop.
    To stop this hurt, I took in Listerine for 10 minutes and helped for some time (at first).
    That night, the pain was already on the whole half of my jaw and the pain was immense, around 8/10. I took the first painkiller (paracetamol) to sleep at all. The next day the drug worked for 3 hours, then in a few seconds the pain could come back with the same strength until I took the tablet again. The next few days hurts less.

    Before the root canal treatment, the doctor diagnosed which tooth hurts me, she was tapping on the tooth (I did not feel any obvious pain), but during the bite, the pain appeared very clearly, around 6/10. The private dentist used the tool dry, because it hurt more with water. The last injection in my gum also hurt (despite the remaining injections), I do not know where exactly, but the doctor sensed that the others did not hurt me anymore because of anesthesia.
    Since the return at the dentist I have a pain, but about 4/10.
    Acually, I trust my doctor, she has her clinic and she said that as long as she did not remove the filling, she does not see whether there are caries or inflammation .. But with this pain I couldn't gave myself to remove the filling. She mentioned that it may be necessary to use a microscope, but I did not seen the rubber dam durning removing the filling.
    Thank you for your time! :)
     
    Weronika, Jun 16, 2018
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  4. Weronika

    honestdoc Verified Dentist

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    When you mentioned that your dentist tapped (percussion) on your tooth, you did not feel pain. You felt pain during the bite test. Did the pain feel more intense during release from your bite? If so, you have a fracture inside your teeth. I believed you need to finish the root canal treatment. Once the tooth pain and any swelling have calmed down, you need to have a crown coverage over the tooth to protect it.

    I believe you may be grinding and clenching your teeth. Lately you may be experiencing more stress. Your filling on the x-ray did not appear close to the nerve of the tooth and I suspect you may be grinding and clenching. I do that myself and I did not realize it. I had a tooth that gave me similar pain as yours. I had pain for about 3-4 years and now it calmed down. I wear a bite guard every night to sleep.
     
    honestdoc, Jun 16, 2018
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  5. Weronika

    Weronika

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    Yes, I did not feel any pain during the percussion test, but during the bite test. The pain is the biggest during bite, then it slowly calms down.
    Recently, after visiting doctor I stopped grinding and clenching my teeth (because I know that I can't).
    I have to add that a few months ago in school anesthesia in #19 worked (she tried to fill "cavities" in this filling), probably it was less strong, which is strange for me. The doctor mentioned that it could be related to inflammation and ph which did not allow the anesthetic to work, also said that maybe this kind of anesthesia is not working for me... but hey, I could not feel my left cheek, so probably without taking off all that filling I don't know what is it. From tomorrow I am taking Clindamycin-MIP 600.
     
    Last edited: Jun 16, 2018
    Weronika, Jun 16, 2018
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