In pain for months after CEREC was done, root canal have not help

[Janna]

Hi,

I had CEREC onlay done in Dec. 2013 on the tooth which had deep filling and a little cavity under it. I did not experience any pain with it but my dentist told me I should fix it with CEREC to make sure cavity does not progress. Since the day Cerec was placed my life became misery.
I started to feel pain on one side of this tooth and around the gum on that side. The side where cerec is deep in the tooth. My dentist adjusted the bite and told me to wait it out. He said cerec is perfect. Then after couple of months of mild to moderate pain he told me to wait even longer. Finally he said I need a root canal. I went to the endo specialist and he said that tooth did not behave the way it would indicate it needs root canal. I went to other dentists for second option... at this point I wanted to re-do cerec.. since the pain started after the cerec was placed. They all told me it is fine and I can try root canal. On top of the pain on one side of the tooth I also get bad smell when flossing this side and the gum seems irritated. Neither dentists nor endodontist thought anything of this.
Fast forward 2 months ago I got root canal treatment and after this the pain is even stronger and the gum is even more irritated. It turned from mild/moderate to strong/sever pain after the root canal.

I was sent to periodontist and she did a deep cleaning in the area which hurts. Miracle for 2 days after this procedure I felt NO pain at all... why? how.. not sure. But today the pain is back and the bad smell is back again. I will contact periodontist on Monday. She also mentioned that when she was cleaning she was getting stuck on some kind of ledge which seems is the part of the cerec.. and this is same area which hurts, where bad smell is coming, the gum is irritated.
For the last year I have seen 5 different dentist and they all told me the CEREC is fine and does not need to be redone.... now after the root canal did not do anything good for my pain I start to think that there must be some problem with CEREC.
Can CEREC cause gum inflammation and bacteria breeding... why would my pain get even worse after root canal (it was 2 months...). I am on the end of the rope... so miserable how this stupid cerec caused my life to be ruined for more than a year and yet nothing helped so far.
Why would deep gum cleaning at this area stop the pain for two days? It was first time in months I would not have pain... I am trying to gather clues and find the way out of this misery ... please help

i have attached xray if it helps

ps: i was also checked by doctor about neuralgia and sinus problems so this is ruled out.
the pain after root canal is worse and now if I tap the tooth or bite on it, it hurts more. it hurts to tap on the tooth but it was not the case before the root canal.

 

[Dr. Daniel]

Hi,

from your story it is clear that the problem is in the gums. I think I also see on the x-ray a periodontal problem on the distal side of the tooth. More importantly: the rough spot the periodontist felt can cause the problem.
My guess is that there is that the Ceres is not that smooth and continouse with the tooth surface due to some cement left over or that the creek itself is a bit not smooth with the tooth surface.

 

[Janna]

Thank you very much for your reply! I did not see the reply until today. I am still experiencing pain and I went to see another dentist/endodontist. My pain was much less in the last week but as soon as he touched some area around the gum with the tool I felt a lot of pain and the pain came back.

He gave me a anti-bacterial chlorhexidine mouthwash to rinse the area but the pain gets much stronger after it.. I am not sure if this is normal and I have talked to him today and he said to switch to salt rinse.

I have been doing salt rinses for months so I doubt it will take all the pain away.

I am going to follow up with the periodontist in the end of the week but it is really frustrating since she said she did not see much irritation or infection. The dentist said it looked very irritated and just touching the gum made the pain come back very intensively. So the dentist does not think that it makes sense to re-treat root canal until we know that the pain really comes from there. Since there is so much pain coming from the gum it needs to be addressed. But I am not sure what can be done. The dentist thinks that the cement used to put CEREC could have irritated the gum and there is a deep pocket there now... I wish they would look into this before doing root canal.. I feel so frustrated and hopeless at this point because the pain never stops..

 

[Gillian]

Janna,
Sorry you are going through this misery! Nothing worse than an uncomfortable mouth in my opinion!

I had a lot of pain with my CEREC crown and like you, was boggled and alone. A lot of patients have pain or sensitivity after CEREC.
I still to this day do not know what specifically caused the pain. It lasted for about two years and it is better now but I've had issues with adjacent teeth ever since due to inflammation of the gums. What I have been told by my hygienist is that she hates CEREC because she sees poor margins, inflammation and excessive cement or whatever 'glue' the dentist uses.
It could be possible that bacteria has infected the ligament on that tooth which would account for some of the sensitivity/ pain when tapping the tooth. When you had the perio cleaning, a lot of the bacteria were removed in the space between gum and tooth which relieved some of the inflammation but there still may be a bacterial infection in the ligament.

I had a tooth ( think it's the same one you had your RC on) that had a root canal and some of the bacteria were not removed during the RC ( a common problem) and it infected the ligament and the bone for 30 years before I finally had to have it extracted after a failed apicoectomy to remove the tip and bacteria. A dentist should be able to see on xray an infection at the tip of the root if there is one but not always. One would have thought that a dentist would have noticed my infection in 30 years right? Especially when I was battling SEVERE pain at times and taking narcotics for the pain! It wasn't until my hygienist noticed abnormal bone loss in that area and I was getting a small painful bump above the tooth on the gum that the dentist finally tended to the problem. By then it was too late.
FYI, after the root canal ( when I was young) I never had any pain from the festering bacteria until about 8 years later. So, trust your intuition, educate yourself and talk more with your dentist about your concerns.

I really hope you find a solution and relief soon