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new crown pain - root canal or nerve damage?

A

A1ex

Junior member
Joined
Sep 5, 2006
Messages
4
About 2 weeks ago I got a crown because of a chipped molar. (20 year old silver filling allowed decay to weaken the tooth.) The Dentist removed the old filling and decided a root canal was not needed, only a crown.

During the crown procedure, 3 rounds of shots were needed because the anesthetic was wearing off. On shot round #4, the dentist used a longer acting anesthetic (of unknown type). On that round, on one of the shots, I felt something uncomfortable/painful as he injected me (I was still quite numb, so I was surprised to feel anything at all). After reading up things afterwards, it seems likely a nerve was hit. But I don't have any tongue issues (pain, numbness) though, so I'm not 100% certain that my symptoms back that conclusion up.

So with the temporary crown, I can provoke the tooth by drinking ice water, but the discomfort goes away after seconds and the pain is sharp and very localized. Business as usual...

The problem is there's a different type of unprovoked pain: a dull pain in the rear of my lower jaw that extends to the joint and sometimes radiates into the upper jaw. And I have a "fullness" in the ear on that side, and sometimes the pain can radiate to there too. (I tried ear plugs last night and woke up in strong discomfort [on the one side of my head] from my upper and lower jaws to my ear.) The pain is controlable with regular over-the-counter pain relief, and now there are flair-ups instead of continual pain, so I medicate when necessary. Acetaminophen seems effective, although I've tried Ibuprofin and Asprin and they are somewhat effective.

So my questions are:

1) Should I go ahead with the permanent crown at my appointment tomorrow? (Obviously I'll discuss all of this with the dentist too, but I'm looking for other points of view.)

2) If the dentist suggests a root canal and it's really nerve damage then more shots in a damaged area seems like it could be inviting big trouble. Is it best to let things heal and settle down before proceeding with anything invasive? How long should I wait?

3) Are my symptoms a classic example of root nerve problems that a RC could fix? Or is it just as likely it could be a complication of the LA administered?

4) I've read 85% of nerve damage resolves itself in time without intervention, so is there any harm in holding off further procedures and staying with the temp crown to see how things develop?

5) What are the possible negative aspects of getting an unnecessary RC? (I.e. side effects, risks etc.)

I'm trying to keep a level head about it all, but I'm definitely worried about making the right call on how to handle it. Thanks for any replies!

Alex
 
1) I probably would
2) It sounds more like TMJ pain or pain from the injection site, so I woud wait before doing RCT
3) No. Yes.
4) Nerve damage in the rest of the body, yes, nerve damage in teeth, nope. But I would probably go ahead and fit the proper crown. Slight cold sensitivity that doesn't linger too long is a sign of a fairly healthy nerve in a tooth.
5) Cost mainly.
 
Gordon - Awesome... Thanks so much for the ultra quick reply. Obviously I'll still get the dentists opinion, but now I feel far more confident going in that I'm not going to be blind-sided and asked to make decisions in unfamilar territory. The internet is a wonderful thing!

I'll post a followup after my visit so the outcome is recorded.

Thanks again!
 
Well it's been a while and here's the followup:

The pain went away after about 2 weeks, and I got my permanent crown. My dentist wasn't concerned with the symptoms at the time, but also didn't offer any explanation (definitely got the sense that time is money). So I'm thankful for the explanation provided here.

So all in all a happy ending. :)
 
Good, I'm glad to hear it all worked out OK in the end.
 
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