Is my tooth ready for a crown...

[CuriousPoster]

Hello all,

First time poster here and seeking some advice. (Professional, if possible!)

I had root canal treatment (RCT) on my lefthand side, bottom first molar in September 2020. Prior to this, the tooth had a very significant filling and had always caused me problems. In the end, it was incredibly sensitive to anything that wasn't the usual temperature of my mouth, therefore I consulted with my dentist and a root canal was recommended.

The treatment was carried out over a couple of appointments. I got the impression throughout things hadn't gone too smoothly and the tooth was 'difficult' to work on, just from the vibes I was getting throughout the appointments. (Appointments overrunning, dentist looking flustered at times, sealing a bleed in the tooth shut with a heated up drillbit (????), me experiencing some pain from what I believe was the dentist's accidental lack of concentration during one moment and drilling too deeply etc.) Nevertheless, when all was said and done, x rays were done and I was told the treatment was a success and I was sent on my way.

I can confirm that, broadly speaking, the tooth has been considerably better to live with since. The original pain that I had has completely gone. I can chew on the tooth with no real problems. However, ever since the treatment was completed (as in, ever since day one), I've always still had some sensation in the tooth if I push against the inside wall of the tooth with my tongue or tap the tooth. This surprised me, since I understood following RCT, you should never feel anything whatsoever and anything otherwise suggests there is a problem.

Anyway, my dentist had said to me back in September 2020, to call up in the new year when they would be resuming routine appointments and I could have a crown fitted. So, I attended a check up appointment last week, the dentist acknowledged that I still had some discomfort in the tooth when it's prodded, but says that this can be normal in some instances, and that it was okay to go ahead with the process of getting a crown sorted if x rays came back okay - which they did.

I'm now booked in for my first appointment this coming Friday and I've foolishly started searching online around the process of having a crown fitted, and what constitutes a failed RCT. I've now worried myself sick that the RCT wasn't a success and the crown is going to be a bad idea.

So, I guess why I'm posting, is to ask if some sensation in a treated tooth can still be possible but not necessarily indicative of there being a problem, as my dentist has suggested? My friend also works as a dental assistant and has said to me that this isn't uncommon, and to to ahead with the crown.

As I've said, it's not what I'd describe as painful, but more a sensation and some slight sensitivity when prodded, almost like that the inner wall of the tooth is weakened or damaged perhaps.

Anyway, I throw it out to you, the dental gods, and will see what you say!

Thanks in advance.

Regards,

Daniel

 

[letsconnect]

Hi, have a look at this thread (similar thing):

Zing in one area root canal tooth

Hi I had a root canal completed on December 8th. I don’t have toothache anand I don’t have any cold or heat sensitivity in the tooth, but when flossing I’ve noticed a slight zing on one cusp of the tooth . This doesn’t happen on any other area of the tooth but one specific area gives a short...

www.dentalfearcentral.org

 

[CuriousPoster]

Hi, have a look at this thread (similar thing):

Zing in one area root canal tooth

Hi I had a root canal completed on December 8th. I don’t have toothache anand I don’t have any cold or heat sensitivity in the tooth, but when flossing I’ve noticed a slight zing on one cusp of the tooth . This doesn’t happen on any other area of the tooth but one specific area gives a short...

www.dentalfearcentral.org

Thank you so much! Puts my mind at ease somewhat.

 

[MumOfBoys1985]

I had a root canal on an upper tooth over 10 years ago and never had a crown fitted. The tooth is fine and I have had no issues or problems. Xrays every 2yrs are always perfect. Anyway, I digress, if I press in a certain spot on my cheek, sort of near my sink which is close to the root canal tooth, I get an odd sensation. Not a pain exactly, but an uncomfortable weird sort or sensation. I know our wonderful dentist Gordon also experiences a similar thing as I have asked on here previously. So what I am saying is it sounds OK and I'm sure if there was a problem your dentist would have spotted it by now so try not to worry.

 

[Niall Neeson]

Hi CuriousPoster,

To explain about the feeling you get, basically the tooth has 2 nerves. The ‘hot or cold’ nerve is inside the tooth called the pulp. This is the nerve that was inflamed with the original toothache that led to the root canal initially. This area has been cleaned, disinfected and sealed in with the root canal treatment.

The second nerve surrounds the tooth and is in what’s called the periodontal ligament. This is the nerve that allows us to pick out a fishbone or a hair in our food. It picks up on pressure. This ligament is still alive and will function.

So your root treated tooth will not (or certainly should not!) feel hot or cold, but it can still feel pressure.

Admittedly, we prefer when things settle down 100% and there are no symptoms whatsoever before proceeding with someone investing in a crown but it sounds like there’s still a good argument to proceed.

At the end of the day, when working with teeth and the human body, nothing is guaranteed. We are essentially working on probability and weighing up the risks and benefits.

To me, it sounds like the benefit of protecting a weakened root treated tooth with crown, probably outweighs the risk (over time, root treated molars that are not crowned are much more likely to break and require removal than crowned root-treated teeth). But, ultimately that is a decision that only you can make as it’s your money.

One final thing, I find that lingering issues like this can sometimes relate to clenching or grinding the teeth, or unhelpful forces being applied to certain areas when the bite is functioning. If you think any of this could be relents to you maybe just mention it to your dentist as they might be able to protect it with a splint for example.

I should clarify that obviously I have not assessed the condition of your tooth so cannot give an authoritative professional opinion on your case specifically and the suitability for a crown. I hope that this information is helpful nonetheless.

Niall

 

[CuriousPoster]

Hi CuriousPoster,

To explain about the feeling you get, basically the tooth has 2 nerves. The ‘hot or cold’ nerve is inside the tooth called the pulp. This is the nerve that was inflamed with the original toothache that led to the root canal initially. This area has been cleaned, disinfected and sealed in with the root canal treatment.

The second nerve surrounds the tooth and is in what’s called the periodontal ligament. This is the nerve that allows us to pick out a fishbone or a hair in our food. It picks up on pressure. This ligament is still alive and will function.

So your root treated tooth will not (or certainly should not!) feel hot or cold, but it can still feel pressure.

Admittedly, we prefer when things settle down 100% and there are no symptoms whatsoever before proceeding with someone investing in a crown but it sounds like there’s still a good argument to proceed.

At the end of the day, when working with teeth and the human body, nothing is guaranteed. We are essentially working on probability and weighing up the risks and benefits.

To me, it sounds like the benefit of protecting a weakened root treated tooth with crown, probably outweighs the risk (over time, root treated molars that are not crowned are much more likely to break and require removal than crowned root-treated teeth). But, ultimately that is a decision that only you can make as it’s your money.

One final thing, I find that lingering issues like this can sometimes relate to clenching or grinding the teeth, or unhelpful forces being applied to certain areas when the bite is functioning. If you think any of this could be relents to you maybe just mention it to your dentist as they might be able to protect it with a splint for example.

I should clarify that obviously I have not assessed the condition of your tooth so cannot give an authoritative professional opinion on your case specifically and the suitability for a crown. I hope that this information is helpful nonetheless.

Niall

Hi Niall

Thank you so much for taking the time to reply and in so much detail. I really appreciate it.

I understand what you're saying. Your post, together with those above, has definitely put my mind at ease. I had wrongly presumed something *must* be wrong, but can see that there is still the possibility that some sensation will remain.

Anyway, fingers crossed, and let's see how it goes on Friday!

 

[CuriousPoster]

I had a root canal on an upper tooth over 10 years ago and never had a crown fitted. The tooth is fine and I have had no issues or problems. Xrays every 2yrs are always perfect. Anyway, I digress, if I press in a certain spot on my cheek, sort of near my sink which is close to the root canal tooth, I get an odd sensation. Not a pain exactly, but an uncomfortable weird sort or sensation. I know our wonderful dentist Gordon also experiences a similar thing as I have asked on here previously. So what I am saying is it sounds OK and I'm sure if there was a problem your dentist would have spotted it by now so try not to worry.

Thanks so much for sharing this! I feel much better having heard other people's experiences.