Help or advice please!

[AG1981]

Hi,

I’ve had a bit of a journey teeth wise. I had an impacted wisdom tooth (removed in April) which damaged the molar next to it below the gum line. Long story short, I had that tooth extracted in September. This became infected and had a dry socket for almost 2 weeks.

Once that was sorted I discovered the tooth next to the extraction was cracked (I believe from the horrible extraction but obviously can’t prove this). A dentist filed the tooth down which then caused me to start grinding my teeth because my bite was so out of alignment. They then refused to help with anything until I stopped grinding, despite me saying it was because of the filed tooth. They even suggested anti depressants.

4 weeks later I saw an endodontist who said I needed a root canal because the cracked tooth was so painful with horrible taste and so on.

He did the root canal on the 4th November under sedation and placed a temp onlay. I went back 2 weeks later for the perm onlay, again under sedation. The day after I got ill with flu/covid which has given me a nasty cough that I’ve had since then. Which is also irritating the gum/tooth.

On the 28th I went back to have the onlay filed as it was clashing when I was eating & that definitely solved that issue, I was able to chew on that side fine & the pain eased for a day or two.

Now I’m still getting burning pain around the tooth/gum, other teeth feel like they’re being pressured and I feel like I need to push them with my tongue constantly. There’s no pain when I chew on the new onlay tooth & weirdly when I eat on the other side, the pain/burning kind of eases like I’m interrupting a sensation.

My mouth hurts on and off every single day. The burning feeling is intense, it’s like my mouth is cold inside, but only the left. Mostly the bottom but sometimes the top teeth react too.

I can feel a sharp edge in the gum side facing my tongue which I assume is from the extraction but I don’t think it’s that causing the issues.

Because the tooth itself isn’t hurting, could this be nerve / ligaments or could it be a failed root canal? I don’t think it’s another crack because there’s no pain when I release the bite but I just don’t know anymore.

It’s constant and I just want to know it’s going to end eventually. If someone said removing the tooth would solve it I’d pay them to take it out! Even though I’ve paid thousands on this root canal so far!

I’ve emailed the dentist today to ask for advice because I’m feeling so poorly I don’t want to travel into London if I don’t have to. Can anyone offer any advice on this? Does it sound structural or more ligaments and nerves and what can I do to ease it? I have a custom mouth guard I wear every night and there’s no pain when I wake up, it just builds during the day through stress, talking, eating - who knows!

Please can you help at all? @Gordon or any other dentists on here? I am actively trying to sort it with my dentist but while I’m waiting I’d be so grateful.

 

[Gordon]

No it doesn't sound "structural", it sounds more like some kind of soft tissue problem, but I can't really guess without knowing a lot more about you and asking questions about your medical history etc that you probably don't want to answer on a public forum.

You really need to see your dentist to get this investigated properly, sorry.

 

[AG1981]

Hi @Gordon - I'm convinced I replied to you on here to say thank you, but I clearly didn't so I'm really sorry!

I spoke to the dentist and he said it's totally normal to experience pain and discomfort at this stage after a root canal (which was at the beginning of Nov) as I'm still in the healing stage. The flu/covid was most likely straining my immune system, delaying the healing and worsening the symptoms.

The pain side of things has eased and the burning is getting less intense but I still can't really eat on that side and it's still uncomfortable in my mouth - it's so hard to explain! I don't need painkillers anymore so I'm definitely getting better in some ways, just not all of them!

If it was a failed RCT would it be more painful? I don't have hot/cold sensitivity, no discolouration or spots on my gums, everything looks ok from the outside.

I'm going to ask for a face to face appointment after Xmas if it still hasn't settled - I'm just worried about what could be going on, or rather, what it could mean I need doing! Really don't want to lose another tooth - and while it's not mind numbing pain, it's so annoying and I'd really like to be able to eat on both sides again, I've not been able to eat on the left since the beginning of September.

Any advice please?

 

[Gordon]

No worries.

A failed RCT would most likely begin by being really tender to bite on, followed by sensitivity to heat, burning feeling in your soft tissues would not be likely at all.
You don't mention if it was an upper or lower tooth that had the RCT? Unless I missed it... if it's an upper tooth then sinus problems are a possibility, given your cold/flu symptoms. Unusual for that to go on for months though.

Definitely needs looking at by your dentist when you can arrange it.

 

[AG1981]

Sorry, it’s lower 2nd molar. I had the first one removed and the 2nd was cracked during that. Then needed RCT & onlay.

Do you think it’s still soft tissue or something else? I have a custom mouth guard (top teeth) and when I wear that, it stops any discomfort in the bottom teeth!? It’s so weird. I can eat things like grapes/tomatoes on that side pain free, but anything more chewy, like cheese is a no go. It’s not excruciating just really tender.

 

[Gordon]

Really I'd be guessing here without seeing you. Possibly some kind of odd traumatic bite if the mouth guard helps it, but honestly that's just a guess.

 

[AG1981]

Hi @Gordon - so sorry to keep bothering you! I’ve got an appointment for the 5th Jan with my dentist but I just wanted to ask, if it’s a failed root canal, or the crack causing issues again, am I causing more damage having to wait that long? Sometimes it hurts to eat on that side, sometimes it doesn’t. But it always hurts to touch the sides/top.

Because it’s my first molar (second one has already been extracted, as well as the wisdom tooth) I’m really worried about it being visible if it’s also removed & I know I’d have to do an implant on it otherwise I’ll never be able to eat on that side! But is it better to just extract it rather than try and redo it?

Are there ever any other issues that cause pain and discomfort for a month after root canals/onlays?

Thank you (again!)

 

[Gordon]

if it’s a failed root canal, or the crack causing issues again, am I causing more damage having to wait that long? Sometimes it hurts to eat on that side, sometimes it doesn’t. But it always hurts to touch the sides/top.

No, it won't do any harm at all.

But is it better to just extract it rather than try and redo it?

Depends on a few different things, I can't say without looking at it/you, sorry!

Are there ever any other issues that cause pain and discomfort for a month after root canals/onlays?

Well yes, if the bite is a bit off then you can certainly have issues for a while, if the TMJ flares up due to the prolonged opening during treatment then that could do it, could even be both together

 

[AG1981]

Hi again @Gordon - Happy New Year! I wondered if you could offer any advice (or anything!) I saw my dentist on Xmas Eve in the end and he referred me for a CBCT scan. Got the results today and he’s said there’s nothing obvious that he can see, root canal looks great, no cracks or fractures, nothing that he can see would be causing the issues. He’s said it could be neurological in which case I’d have to see a specialist, but for him, the only next step would be removing the tooth which he doesn’t want to do, because I’ve already had the wisdom, and the next molar removed behind it. And I don’t want to do that either. (He also said if it is neurological removing the tooth might not help).

The tooth hurts to touch, I can’t really eat on it as it’s painful but he’s said I won’t damage it because it’s as good as it’s going to get structure wise.

What do I do? How long (is a piece of string) can these take to settle down on the bad end of things? It’s been 2 months since the root canal/onlay.

I’m gutted, I really wanted something to be obvious so it could be fixed. Not sure I can cope with permanent pain in my tooth forever. I feel like I’m a bit stuck now, I really trust the dentist, he’s a specialist and clearly knows his stuff. But where do I go from here?

Any advice would be amazing. Thank you.

 

[Gordon]

Does wearing the mouthguard still help? If yes then that points towards a TMJ/Bite problem. Otherwise I'm kind of out of ideas, sorry!

 

[AG1981]

If I wear the mouthguard (top teeth) then yes, all the other aches/pains go but there is still pain in the lower molar if I bite on the guard or push the tooth sideways.

When you say bite problem, does that include the crown/onlay not being the right shape? It still feels like it clashes wrong with my top teeth when I try and eat on that side. Like it’s extra sharp or pointed.

 

[Gordon]

When you say bite problem, does that include the crown/onlay not being the right shape? It still feels like it clashes wrong with my top teeth when I try and eat on that side. Like it’s extra sharp or pointed.

Yes. If it's a wee bit too high in the bite then the result would be a bit like wearing a too tight pair of shoes, sort of stubbing your big toe all the time. It would potentially throw your bite off and cause a bit of TMJ inflammation.

Should be fixable by adjusting the crown carefully but there's a bit of trial and error involved and it might take a few goes at it.

 

[AG1981]

He’s adjusted it once but he’s kind of said as far as he’s concerned there’s nothing else he can do, so I feel a bit lost now. He was the third, top level dentist I could see.

 

[Gordon]

Ask him to check again or try a different dentist?