Pain from Root Canal - now 5 months.

[Davi]

Hi

I had a root canal 5 months ago on a lower molar that was crowned. The crown was removed and the root canal performed and left to settle. I was in incredible pain after the procedure as well for many weeks. Well it hasn't settled in 5 months and the tooth is tender to any pressure. There is a constant ache which ranges from dull to moderate and the dentist had no idea why so referrred me to the dental hospital. At the hospital they said the tooth looks okay and couldn't offer any help other than give me amitriptyline and he said it will fade in time.

I can not understand why this tooth still feels sore and it most certainly is. I have read about inflammation or injury to ligaments or even bone trauma. I have also read that in some people RCs can take a very long time to heal.

Any advice please.

 

[famv5]

I am experiencing a similar thing. I had a root canal done on a bottom molar in April. I couldn't have a crown put on until today. During that period of time, the tooth had a permanent filling on it but it started to feel tender to the touch. I could tap it from the outside or just using my toothbrush over the top of the tooth would make it feel so sore and tender.

Today at the dentist, he took an xray and said he didn't see any cracks but that doesn't mean there aren't any there. He suggested I go through the crown process and he feels that may help the tooth. Now I have a temp crown on but since the numbness wore off, I still feel that same darn pain.

I, too, would love to know why that is. I've had about five other root canals and never had this issue.

Didn't mean to take over your thread, but just wanted to share my situation because it sounds like what you are going through, too.

 

[Davi]

No worries.

My pain continues and my dentist just shrugs his shoulders. They said I have atypical toothache which has a number of causes - one being ligaments another being muscular and others that scare me. I'm in a mess with this - it's badly affecting my life. My gut feeling is a bruised tooth/ligament and if so they can take an age to heal. I get pain after talking so you can imagine how it feels.

Gutted.

 

[c247]

My wife is having a similar problem with one of her bottom molars, second from the back. And she didn't even have a root canal, just a composite filling. The top molar above it has some pressure and cold sensitivity as well. In addition to the pain, her bite feels wrong between those teeth as well. She's had it adjusted 4 times but she can still feel them hitting together wrong. They say they can't adjust it any more but how can that be if the bite still feels off? She's been avoiding chewing on that side for over 4 months now since she got the filling and it's driving her nuts. I'm going to post another message asking for advice.

 

[Davi]

My wife is having a similar problem with one of her bottom molars, second from the back. And she didn't even have a root canal, just a composite filling. The top molar above it has some pressure and cold sensitivity as well. In addition to the pain, her bite feels wrong between those teeth as well. She's had it adjusted 4 times but she can still feel them hitting together wrong. They say they can't adjust it any more but how can that be if the bite still feels off? She's been avoiding chewing on that side for over 4 months now since she got the filling and it's driving her nuts. I'm going to post another message asking for advice.

My bite feels off too and It's the same molar. I also have pain in tooth above and I can't chew on that side. I was diagnosed with aytipical toothache which is a fancy way of saying they don't have a clue. It is having a serious effect on my life and no one can help. It seems to me that RCs are hit and miss and healing can take months and months for some people.

 

[brit]

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[Davi]

Hi

My dentist is highly skilled and repected. He can't work it out.

But the RC teeth are sore to touch which tells me there is some kind of injury.

 

[famv5]

Hi

My dentist is highly skilled and repected. He can't work it out.

But the RC teeth are sore to touch which tells me there is some kind of injury.

Hi Davi....just wanted to give you an update on my tooth situation since I last posted. When I posted last, I had just had a temp crown put on. Well, the pain in that particular tooth continued. I went back to the dentist a week later and he took another xray and still couldn't see anything that looked out of the ordinary. He suggested that I go back to the endodontist that performed the root canal and get their opinion before putting the permanent crown on. I did that and the endodontist took a 3D image, as well, and he couldn't see anything unusual either. He did a second root canal on Friday (retreatment) and put some medication in the canals. I have to give it a month and if the tooth settles, then I'll get my permanent crown on. If the tooth starts to bother me again, there is nothing left to do but extract it. When he did the second root canal he looked in the tooth and said he didn't see any additional/missed canals and no cracks. (although there could be a crack not visible by the eye or xray)

So, now here I am two days later and I'm starting to feel that all too familiar pain in the tooth again. Sigh. Frustrating. I have no idea why it's doing this. I realize it hasn't even been 48 hours after the second procedure but this pain is all too familiar and I'm not thrilled about this.

So that's my update. How is your tooth doing? Still bothering you?

 

[Davi]

Hi Davi....just wanted to give you an update on my tooth situation since I last posted. When I posted last, I had just had a temp crown put on. Well, the pain in that particular tooth continued. I went back to the dentist a week later and he took another xray and still couldn't see anything that looked out of the ordinary. He suggested that I go back to the endodontist that performed the root canal and get their opinion before putting the permanent crown on. I did that and the endodontist took a 3D image, as well, and he couldn't see anything unusual either. He did a second root canal on Friday (retreatment) and put some medication in the canals. I have to give it a month and if the tooth settles, then I'll get my permanent crown on. If the tooth starts to bother me again, there is nothing left to do but extract it. When he did the second root canal he looked in the tooth and said he didn't see any additional/missed canals and no cracks. (although there could be a crack not visible by the eye or xray)

So, now here I am two days later and I'm starting to feel that all too familiar pain in the tooth again. Sigh. Frustrating. I have no idea why it's doing this. I realize it hasn't even been 48 hours after the second procedure but this pain is all too familiar and I'm not thrilled about this.

So that's my update. How is your tooth doing? Still bothering you?

Yes, both are bothering me and my anxiety about it is terrible.

I have been told I have Atypical toothache - slapped on medicines and have to wait ages for another appointment. Absolutely no idea what's causing it.

Ligament?
Masseter muscle spasms?

it isn't a nerve type pain. It's more like regular toothache.

Gutted.

 

[patiku]

I had similar issue. Had RC started in my bottom left canine and pain never settled then had some more pain on left in other teeth so had more RCs done and only got more pain. I have been diagnosed with Trigeminal neuralgia.

 

[famv5]

This is all so baffling to me. I know I updated a couple of days ago but now my mouth seems to be doing something different.

I have purposely not been touching my tooth with my tongue or finger to see what happens. Since last night, it doesn't seem so extremely sensitive to touch BUT I have aching in my jaw. It actually kept waking me up last night.

What is going on? What upsets me is that two dentists ( a general dentist and endodontist) both say the xrays look great and even the endo said he couldn't see any cracks or missed canals.

What then would cause this discomfort? I do have TMJ and do get migraines and I've been wondering if any of those are related.

Both of you mentioned being told you have either an atypical toothache or trigeminal neuralgia. I'm worried that my tooth may be fine but something else is causing this pain. My next step is to extract it and I don't want to do that unnecessarily. Neither of my dentists have mentioned any of those diagnoses as possibilities.

What are you both taking for pain? What medicine has helped? I'm taking ibuprofen every four hours when needed. How did they come to the diagnoses? Did any of your dentists suggest extractions at any point?

I just feel like they are just going through a process and if one thing doesn't work, try the next. I don't want to lose this tooth and nothing will upset me more than doing that and still having the pain afterwards.

 

[Davi]

This is all so baffling to me. I know I updated a couple of days ago but now my mouth seems to be doing something different.

I have purposely not been touching my tooth with my tongue or finger to see what happens. Since last night, it doesn't seem so extremely sensitive to touch BUT I have aching in my jaw. It actually kept waking me up last night.

What is going on? What upsets me is that two dentists ( a general dentist and endodontist) both say the xrays look great and even the endo said he couldn't see any cracks or missed canals.

What then would cause this discomfort? I do have TMJ and do get migraines and I've been wondering if any of those are related.

Both of you mentioned being told you have either an atypical toothache or trigeminal neuralgia. I'm worried that my tooth may be fine but something else is causing this pain. My next step is to extract it and I don't want to do that unnecessarily. Neither of my dentists have mentioned any of those diagnoses as possibilities.

What are you both taking for pain? What medicine has helped? I'm taking ibuprofen every four hours when needed. How did they come to the diagnoses? Did any of your dentists suggest extractions at any point?

I just feel like they are just going through a process and if one thing doesn't work, try the next. I don't want to lose this tooth and nothing will upset me more than doing that and still having the pain afterwards.

In my case the dentist referred me to the dental hospital where I was examined by a student who relayed his findings to the consultant whomin turn told me that I had 'atypical toothache'. He referred me to Oral Medicine. In the meantime I was put on Amitriptiyline and because of increasing depression an ssri antidepressant. By the way after my root canals my jaw was so aching I never felt so much pain.

I went to the oral medicine consultant who said it wasn't the tooth but the nerves around the tooth. She said that she had suffered the same and that in time it went away. I am now into my 9th month and still no relief in sight. I can't honestly say that the drugs have worked. It has affected me really badly and I'm very quiet around people.

My understanding is that Atypical Toothache is most commonly caused by trigger points in the muscles of the jaw. Next most common is tooth ligament inflammation. Then there are neurological conditions. My pain is not in keeping with neurological symptoms but rather it feels like muscular or tooth ligament. But I am in limbo land with this and no one has any idea why.

I'm the same; i touch the root canalled teeth and I feel tenderness. This tells me it is not healing.

My problem is that if I talk too much my teeth ache and this makes me very suspicious of there being muscles involved. I know for a fact that i have tender spots in my jaw muscles.

When the student checked these muscles he stroked my jaw and saud they are fine.

I'm hoping and praying for a solution because my life has changed.

 

[famv5]

Interesting.

I feel like now I don't want to rush to have an extraction done. This tooth that had the root canal retreatment seems to have gotten less sensitive over the past few days. It's no longer painful to touch BUT I am still having pain in my jaw that comes and goes. It usually flares up in the morning and then I'll take one ibuprofen and it will calm until later in the afternoon. Not sure why. I usually have to take at least three ibuprofen throughout the day because of this discomfort that just begins out of nowhere.

So they prescribed you an antidepressant for the pain? I'm not sure I would want to do that. Does it have any other side effects? I took a medrol pak for a week before my root canal retreatment and it took the jaw pain away but the tooth was still sensitive. So there was definitely inflammation of some sort that was causing the pain.

I really want to explore the atypical toothache route before just giving up on this tooth. I would be so upset if I had it pulled and the pain remained. I wish more dentists were informed about that (atypical toothache) and TMJ. I feel like my current dentist isn't. This pain could very well be muscle related or inflammation of the ligament and not the tooth itself.

How are you doing now? Has anything changed or gotten better?

I'm with you in that this is definitely affecting my life. Every day I'm dealing with this and sometimes I can't focus at work because it just consumes me. I just wish it would go way.

 

[badmouth]

Unfortunately I have a lot of experience now with atypical odontalgia, which can also go by ATN (atypical trigemnial neuralgia), TN type 2, trigeminal neuropathic pain, and I'm sure some other names.

I would NOT be taking ibuprofen or any other typical pain meds for this. The don't work very well, and actually seem to cause rebound pain and make the situation worse (I suspect they irritate the nerve more). The worst thing is opiates--they damage nerves and make it much worse. Difficult of course, as relief is so desperately needed.

I've had good luck with topical meds such as lidocaine, capsaicin and topical diazepam (Valium). Diazepam taken orally is also quite effective for me, clonazepam for burning type pain (but benzodiazepiness should not be taken on a regular basis, just occasionally). Also using gum or a mouth guard to distract the nerve.

I wish I could offer more help, this is a dreadful condition (hope I don't scare anyone!). Get as much info as you can from many doctors, and try some topicals before going into the systemic drugs if you are able.

 

[Davi]

Interesting.

I feel like now I don't want to rush to have an extraction done. This tooth that had the root canal retreatment seems to have gotten less sensitive over the past few days. It's no longer painful to touch BUT I am still having pain in my jaw that comes and goes. It usually flares up in the morning and then I'll take one ibuprofen and it will calm until later in the afternoon. Not sure why. I usually have to take at least three ibuprofen throughout the day because of this discomfort that just begins out of nowhere.

So they prescribed you an antidepressant for the pain? I'm not sure I would want to do that. Does it have any other side effects? I took a medrol pak for a week before my root canal retreatment and it took the jaw pain away but the tooth was still sensitive. So there was definitely inflammation of some sort that was causing the pain.

I really want to explore the atypical toothache route before just giving up on this tooth. I would be so upset if I had it pulled and the pain remained. I wish more dentists were informed about that (atypical toothache) and TMJ. I feel like my current dentist isn't. This pain could very well be muscle related or inflammation of the ligament and not the tooth itself.

How are you doing now? Has anything changed or gotten better?

I'm with you in that this is definitely affecting my life. Every day I'm dealing with this and sometimes I can't focus at work because it just consumes me. I just wish it would go way.

I would like to say it's improved but it's not really. I went on Amitriptyline, and for a while Diazepam and now Sertaline for the depression it has caused. I haven't had any side effects from Amitriptyline and I'll tell you that I was petrified to take them. Perhaps I felt a bit tired but nothing really to be worried about.

Atypical toothache is not neccesarily trigeminal neuralgia. In fact the two most common culprits are TJM or muscular issues and inflammatory issues around the ligaments or other tissues around the tooth. When I had my first hour long RC procedure I had a horrendous feeling of jaw tension that made mt whole teeth ache. I have a sneaky feeling that muscle tensiion/spasm is the cause of my pain because there are tight and sensitive muscles in my masseter muscle which when pressed clearly refer pain to the teeth in question.

And I am an anxiety sufferer which in the past has given me similar grief with a variety of nasty symptoms that were incredibly long lasting - like 2 years to clear a daily headache and 4 years to feel better from sinus surgery.

Unfortunately chronic pain causes stress and anxiety and personally I am affected badly because my brain won't let go and continually monitors the situation. I hate this aspect the most.

Amitriptyline is the preferred medicine for this.

 

[famv5]

My mind, too, can't let this go and is constantly monitoring the pain. If I don't feel any pain at that moment, I'll start really focusing and wondering why. Sooner or later, the pain starts. To top it all off, I have health anxiety so I'm in a constant state of worry.

I'm glad that you may have something to help you. That's a step in the right direction.

 

[Davi]

My mind, too, can't let this go and is constantly monitoring the pain. If I don't feel any pain at that moment, I'll start really focusing and wondering why. Sooner or later, the pain starts. To top it all off, I have health anxiety so I'm in a constant state of worry.

I'm glad that you may have something to help you. That's a step in the right direction.

I am the same with health anxiety and have an official diagnosis from all manner of professionals. I was doing great until this started. I'd worked incredibly hard to get better and battled 6 years of atrocious anxiety symptoms. My consultant thinks anxiety is at play with my teeth inasmuch that a genuine need for dentisty has resulted in my hypersensitivity maintaining symptoms. I'm the same with no symptoms and then I can think about it and almost generate the pain. I'm trying my hardest to chill about it but it's incredibly difficult.

Have you tried massaging the masseter? When I massage my masseter I do get the symptoms increased and it tells me it's connected.

 

[famv5]

No, I have not tried that. I do push around on the back on my jaw but it doesn't seem to do much for me. My biggest concern is the tenderness of the tooth. It seems to be worse at times than others. Today has been a super sensitive day for it so I feel it every time I talk, eat, etc. Strange that it changes so much.

The way I feel right now, I would have no problem setting an appointment for extraction. Yet, ask me that tomorrow if it feels a little better and then I would say that I don't want to rush and have that done.

 

[Davi]

No, I have not tried that. I do push around on the back on my jaw but it doesn't seem to do much for me. My biggest concern is the tenderness of the tooth. It seems to be worse at times than others. Today has been a super sensitive day for it so I feel it every time I talk, eat, etc. Strange that it changes so much.

The way I feel right now, I would have no problem setting an appointment for extraction. Yet, ask me that tomorrow if it feels a little better and then I would say that I don't want to rush and have that done.

Exactly the same with me. I'm at a complete loss, and so it seems are the dentists and consultants I have seen. This is why they diagnosed me with AT. From what I can tell the most common culprits are masseter muscle spasms/trigger points or bruised ligament - or both. I don't get nerve type pain so I'm guessing it's not anything else.

But the problem is that it's hard to live without talking or eating. Talking affects me more and it's horrible. Also, if its muscular its apparently hard to tell because it feels like toothache.

When I saw the consultant she said she suffered the same issue for a long long time before it faded. As it stands I can't see an end to this - the tooth is sensitive to pressure, which to me indicates a physical issue with that tooth.

 

[famv5]

Exactly the same with me. I'm at a complete loss, and so it seems are the dentists and consultants I have seen. This is why they diagnosed me with AT. From what I can tell the most common culprits are masseter muscle spasms/trigger points or bruised ligament - or both. I don't get nerve type pain so I'm guessing it's not anything else.

But the problem is that it's hard to live without talking or eating. Talking affects me more and it's horrible. Also, if its muscular its apparently hard to tell because it feels like toothache.

When I saw the consultant she said she suffered the same issue for a long long time before it faded. As it stands I can't see an end to this - the tooth is sensitive to pressure, which to me indicates a physical issue with that tooth.

How are you? Any improvement with your tooth?

I am due to go back to my endo since it has been one month since I had the start of the root canal retreatment. I'm not sure what they will say. I'm going to call them next week and explain what I'm feeling and find out if there is anything else possible that could be causing this and not just "well, it's cracked and needs to be extracted". I just don't feel that is the best approach at this point.

I'm thinking maybe I'll go and finish the root canal and then wait again and see how the tooth reacts. Maybe even go further and have the final crown put on, too, and see. Then at least if it still acts up I'll know that I tried everything.

Do you ever have aching in your jaw or is yours just the sensitivity? I get the aching periodically. It will just come on out of the blue and I'll take an ibuprofen and it will go away sometimes for the rest of the day. I've even just waited it out a few times and within a half hour it goes away on its own. But, I've also had situations where it continued and continued and it took a while to go away. I actually haven't had any pain since yesterday but felt a little this morning. It's all just so strange to me.

So, who knows what this could be.

I'll let you know what my endo says about all of this. Just wanted to see how things were going with you.