Pain upon biting/previously root canaled lower molar

[Grasping]

I had a root canal on the offending tooth approximately six years ago. It received a crown immediately. I only have two molars on that side and the teeth had shifted and left just the wrong amount of space. Food would get between and I had irritation most of the time. My gums are SUPER healthy everywhere else. I was tired of fighting with that, and last year I changed dentists due to insurance and my new dentist encouraged me to get my mouth in shape to masticate food properly. I had a bridge done for the other side and it's a great thing! On the problem side my dentist suggest re-doing the crowns on the two molars and having them joined so the teeth would not shift more. At that point I was having some pain when biting but nothing showed on the x-Ray and my dentist as well as myself thought the issues were from the irritation between the teeth. Perhaps I did not stress the pain upon biting strongly enough. So I got the new crowns on, as I said, they're joined. Long story short, the gums got better, but the pain upon biting has gotten nothing but worse. I put up with it for a while, had the bite adjusted several times, did a round of antibiotics, and today I went back in. I simply cannot bite over there at all now. It hurts. He has referred me to a root canal specialist. I'm scheduled on Monday. He mentioned several possible scenarios and procedures. My question... Since the Dentist thinks it could be a fracture in the root, should the tooth just be pulled??? I have not heard a lot of success stories with fractures in the root. It stinks they are so hard to diagnose. The Endodontist suggested re-treatment on the phone, but will that work for a crack? My Dentist threw out a term I forget as a possibility but I forget the name. It had to do with going in through the gum and taking out the bottom of the root. I would appreciate any advice. I hope I've been thorough with the details. Keep in mind I'll be paying for this for years!

 

[ripply]

I think it's an apicectomy he's mentioned, where they take out the end of the root. I'm not a dentist but I know some people have managed to save a fractured tooth. It depends where the fracture is. The endodontist will be able to advise you on it.

 

[Dr. Daniel]

Hi,
Fractures are indeed not easy to diagnose and you did well by making an appointment with the endodontist.

I would suggest that the endodontist first examine your tooth before doing a re-treatment. It is true that during the re-treatment can look directly into the canals using a powerful microscope and really see whether there is a problem or not (like a fracture) but ask the endodontist first to examine the tooth clinically.

If indeed we are dealing here with a root fracture extraction is not the only option. There are great materials that can seal a fraction (depending where the fracture is, as ripply mentioned) and in more severe cases only one root is extracted or only the end of the root is being removed.

I can only speculate and it might be not relevant to your situation. Wait for Monday and listen to what the endodontist has to say.