I actually have two questions. The first is concerning a root canal I recently had on tooth #7. It has been five days since the procedure and I am still in immense pain. I went back to my dentist yesterday, she did a visual check of the tooth, shaved down the back of the tooth some, gave me pain killers, and said it could take up to a week to feel better. Is this normal? I’ve had another root canal before (years earlier by a different Dr.) and had no pain. Plus before this treatment my tooth had no pain (the dentist saw something on an x-ray that indicated a need for the root canal). I have never had such intense and CONSTANT tooth pain before and was looking for a second opinion as to if this sounds normal. My second question is in regards to having crowns put on the teeth that had root canal treatments. My dentist said I would need a crown put on tooth 7 and tooth 11, but I am weary of having crowns if I don’t need them. I had a root canal on tooth 11 15 years ago and it has not bother me at all. Are crowns on front teeth safe? Will it change the appearance of my smile? Are there other options? Thank you in advance for you help and advice.
Sincerely, Carrie
Carrie,
You can have an infected tooth and it doesn’t hurt. If the pulp of the tooth is dead, it can be infected, but since the nerve is dead, you won’t feel it. And you will have infection spilling out into the bone (which is probably what your dentist saw on the x-ray), but your body walls it off, and it really doesn’t hurt. But then when the dentist goes in to clean that out and seal the tooth, that can upset the equilibrium and cause a temporary flare-up like you are experiencing. Usually the flare-up heals within a few days. Reducing the occlusion so you don’t hit the tooth when you bite together is a helpful move. So the fact that this tooth hurt so badly after your root canal treatment doesn’t mean the dentist did something wrong. I’m guessing it will probably settle down in a few days. Then, when you go back in 6 months for a regular checkup, you should have this tooth x-rayed. If the bone has healed in that time, that indicates that the root canal treatment was a success.
As far as whether or not it needs a crown afterwards, your tooth #7 is your upper right lateral incisor, which is one of your four front teeth. For a front tooth it isn’t always that necessary to get a crown, unless there was a large cavity in the tooth. There is an interesting blog post about front teeth, root canals, and crowns. On that post, it says that if you don’t get a crown, you want to be sure that the dentist cleans out all the root canal filling materials from the crown of the tooth, which is the part that shows that isn’t the root. Old gutta percha and sealer cement will cause the tooth to quickly darken and be ugly, so that needs to be cleaned out. A lot of dentists don’t realize that. And then a flexible fiber post placed inside the tooth could be helpful to strengthen the tooth against breaking off.
Dr. Hall