Ongoing problem. Need advice/help

[Aj64]

I have a had a constant dull ache in the left temple area of my head for the last 8 months now.

I have had an Mri scan and been examined by a neurologist but nothing of note was found in any of the tests.

I was even tested for giant cell arteritis despite not being in the demographic for that disease but the tests were all negative.

Thinking it might be tooth related I saw a dentist who found a deep decay in my upper 1st left molar. I had a root canal on this tooth 6 weeks ago. The dentist could only find 2 canals but sealed the tooth anyway and has basically told me he cant do any more. But the pain is still there in my temple and the root canaled tooth hurts whenever pressure from brushing or eating occurs. I am now considering having the root canaled tooth extracted...anything to end this pain.

The pain is there all the time. It varies on the pain scale from a 3/4 at its best up to a 7 or even 8 at its worse.

I am a 37 year old man. Otherwise in good health. This pain is really starting to affect my life. I cannot concentrate when the pain is particularly bad and am taking so many pain killers to just try and keep it at a reasonable level. I am hoping someone can help me figure out what is happening.

 

[Aj64]

A bit of extra info. I am very scared of having the tooth extracted. I am not too frightened by the actual procedure, but what scares me a lot is that the tooth is positioned close to my sinus and that extracting it would cause damage to the sinus itself. I am also really frightened of dry socket.

I honestly don't know what to do. I was told that the root canal looked pretty good, and that the missed canal was probably calicified meaning it wasn't apparent during the procedure. If there is a calcified canal left in there would that ever stop hurting? I have also read a lot about root fractures and am wondering if that's what happened with me? During the root canal, the dentist pushed down at one point and I felt a sharp pain. He stopped briefly and said that I shouldn't have been able to feel anything, and he was confused. Could that have been a crack?

I am currently on a 2nd dose of Amoxicillin, as the dentist said it is possible that there is still a bit of infection at the apex of the root and that hopefully antibiotics will clear that up and get rid of the pain. The pain is actually fading (I am 3 days into a 7 day course). Is it probable that the antibiotics will fix the pain from this tooth?

 

[Aj64]

How likely is sinus perforation?

I have had ongoing problems with my upper first molar on the left side. Had a root canal about 2 months ago but pain continues (there was a calcified canal that was left after permanent filling was placed). I am currently near the end of a 10 day course of antibiotics which my dentist was hoping would kill any remaining infection and save the tooth.

The antibiotics have lessened the pain but some still remains. It is seeming likely that the tooth will need extracting. I am now terrified of tearing a hole into my sinus during the extraction. The fear is giving me sleepless nights and every time I think about having the tooth taken out I feel sick.

How likely is this to happen? If it does happen how do I deal with It? Does it require an operation to fix or will it just delay my healing time?

 

[Gordon]

It does happen from time to time, but it's quite rare.

I saw 2 in 45 years of practice and I took an awful lot of teeth out.

In >95% of cases the problem sorts itself in a few days, in the remaining cases a small op is needed, basically to move a piece of skin over the hole and stitch it down to make a seal. You can do this at the extraction visit if you notice the fistula (the wee hole into the sinus) but most dentists don't because having stitches in your mouth is a major PITA for the patient and you don't really need to...

The worst effect for the patient is that you can't suck with a straw or inhale a cigarette properly, as the air pressure equalises. There's no lasting damage and it's not particularly painful.

 

[Aj64]

Thanks lots for replying Gordon. I am seeing my new dentist Monday to discuss options. (I dont trust the previous dentist any more so have changed surgery). He's suggested taking an x-ray from multiple angles to see how close the roots are to the sinus. Hopefully it's not too close and he can just whip the tooth out as a simple extraction. I'm eager for an end to this near 9 month nightmare.

 

[brit]

Hi Aj64
Just a thought in your shoes before going for extraction, I'd probably seek a second opinion from a specialist endodontist as to whether they think they could improve on the root canal despite the calcified canal - I think with the correct equipment/microscopes etc they try to navigate them despite the calcification.
Cheers
Brit

https://www.dentalfearcentral.org/faq/root-canal/

 

[Aj64]

Thanks for commenting brit. I am an nhs patient in the UK and was told an endodontist would have to be private and would cost upwards of £500. I am disabled and so don't work currently so really cannot afford that. Especially since there would be no guarantee of it working

The original dentist who did the root canal informed me after the work was finished that I was his first unsupervised molar canal patient. I really wish he had told me that before as I would have found another dentist then. My new dentist seems much better. He is a lot older and has been practicing for over 2 decades, so will be better able i think.

 

[Aj64]

Quick update. I saw the new dentist again today and he took a new x-ray and said that there's no sign of infection now. He is hoping that the antibiotics have completely resolved the problem and that the root canal will hold at least for a while.

I'm in a lot less pain now. Probably around a 1 or 2 out of 10. At its worse I was around an 8. I am praying that it will settle now and I won't need the extraction. ?

 

[Aj64]

I just don't seem to have much luck. I have now chipped a chunk off of an old filling on my lower right first molar I have been having to eat exclusively on my right side due to the problems with the upper left tooth and now I am stuck on soup as it really hurts if I chew anything on the chipped filling.

Got an appointment next Tuesday and now I'm scared that something will go wrong with this tooth as well. I'm frightened that they will find more decay under the old filling and I will need a root canal there too. I've had enough of all this. I just want to be able to eat and be free if pain again. It's been nearly 9 months of problems with my mouth now

 

[Aj64]

Okay. The root canaled tooth is very painful again now. Saw my new dentist Tuesday and he gave me another 7 days of amoxicillin 500mg. I asked if it would be possible to see an endodontist on the nhs for retreatment. Sadly the nhs no longer has endodintists except for extreme cases (such as accidents or physiological abnormalities). If I want to get the root canal retreated I will have to see a private endodontist.

I have found one who will evaluate me for £90. And approx £900 for retreatment. I am willing to take out a loan if it will save my tooth. Anything to avoid the extraction and risk of sinus damage which scares me so much I just keep crying whenever I think of it.

My dentist said that the lower right molar doesn't look too bad and the filling is stable despite the chip and he doesn't want to stir up new problems there if he can help it.

I hope I'm not making an expensive mistake. I'm so angry at my original dentist for allowing this to happen by not telling me he was inexperienced.

 

[letsconnect]

I have found one who will evaluate me for £90. And approx £900 for retreatment.

That seems pretty steep (presuming that the retreatment fee doesn't include the crown, which I highly doubt if the evaluation is £90). Might be worth seeing what other endodontists in your area are charging (if there are any others)? The British Endodontic Society's search function can be a bit temperamental, so it can be helpful to also put in other towns nearby.

 

[Aj64]

Update.

Firstly, thank you for the reply letsconnect. Sadly there are only 3 ednodontists in my area and they are all around the same price. The one I had the consultation with is a very highly respected one who teaches in endodontics in London as well as working in the surgery here.

I had the root canal retreated by the Endodontist. He did it in 2 sessions, the final one completed on wednesday 13th June. It cost a LOT of money (£1000). I am still in pain but am hoping it is just normal post operative pain, and will fade (please let it fade, I don't want to lose all that money for nothing).

I have included the xrays from the endodondist, and hoping a dentist on here can give me an opinion. The first (1) is how the tooth was after the original dentist attempted the root canal treatment, and the 2nd (2) is how it is now following the ednodontist retreatment.

The pain is around a 5/10 at the moment in the tooth and around a 7/10 in my temple. The tooth is incredibly painful when touched and brushing the tooth is very difficult for this reason. I also have some pain on touch in the neighbouring premolar.

 

[Acheygirl]

Just curious how did this turn out for you if you happen to read this. I would love to know your outcome.