Persistent pain after first part of RCT

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Mazey

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I have read here for years and managed my dental fears pretty well, especially since I found a dentist I felt was a good match for me. But currently my dental anxiety is at an all-time high.

I cracked a tooth cusp off a few months back and it was initially temperature sensitive and then calmed down, so my dentist crowned it, but I was never able to eat on it—I had the bite adjusted several times. Due to life demands,I just avoided that side for a while (which probably worsened the situation). I got it rechecked and he referred me to an Endo a week ago, who did the first step in RCT and cleaned out the nerves and packed them, I guess. I took steroids for a few days afterwards and ibuprofen every 4 hours, but my pain steadily increased to a 10/10. I went back and he adjusted the bite and gave me more steroids, which I am about to finish. Even with the steroids and ibuprofen going constantly, it’s painful. I feel pressure, throbbing, and sometimes a pulsing or zapping pain. I finish the steroids tonight and I’m afraid of how it will feel by morning. I haven’t had any solid food in a week since the procedure due to pain. Even eating soft food on the other side makes it hurt.

I will call for another recheck tomorrow. I’m anxious because when he adjusted the bite it was quite painful and he wasn’t sympathetic, so I am afraid of more pain. I’m also afraid it will need to be extracted, and the last extraction I had with just local and it was very scary for me (if I need an extraction I will ask for nitrous). Also, I think I am afraid of being told to just deal with the pain some more. I’ve had root canals before but never had any issues after the first few days. Thanks for letting me panic here!
 
FearfulInMA

FearfulInMA

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I’m not a dentist and don’t have any clear answers for you, but wanted to make sure someone responded to you. Unfortunately, when I’ve had that kind of pain it’s been either due to a dying nerve/infection or a failed root canal. It’s always possible the endo missed a canal. It’s also possible that there is an untreated infection. Either way, the endo absolutely should not require you to just deal with the pain. If you don’t get a satisfactory answer/plan when you call tomorrow, is it possible to find a different endo for a second opinion? I feel like I need to repeat that you should not have to just deal with the pain.
 
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Mazey

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Thank you so much for taking the time to respond! It helps so much to have someone hear you when you’re scared.

You’re right, I do have options. I can call my dentist and ask for another referral, or at least advice, if I am concerned or feel brushed off by the Endo.

I will keep you posted!
 
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MountainMama

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With my failed root canal, I was initially prescribed a steroid pack after three weeks, when it was still very painful. That actually seemed to make it worse. My endodontist told me that if infection is still present, steroids can make the problem worse. She ended up giving me clindamycin which took away about 90 percent of the pain. Unfortunately mine never healed, so I am getting it extracted.

I would definitely get a recheck if I were you and not play the waiting game. Maybe there is lingering infection.
 
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Mazey

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Thank you so much, MountainMama. The pain wasn’t so bad this morning but I got a zap drinking lukewarm coffee and your post helped me push to make the call.

The Endo seemed to think it’s still inflammation aggravating the bite, so he shaved it down again—which thank goodness was NOT excruciating this time—and gave me an RX for more steroids. Hopefully this does the trick.

I have an appointment next week for him to go back in and reevaluate it (and hopefully finish).

Thank you both for being here to listen. I still feel pretty anxious but not as panicked as I was. I have an appointment in the books and a few painkillers if the pain gets worse, so I feel like I have a plan. That helps manage the uncertainty a little.
 
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MountainMama

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Thank you so much, MountainMama. The pain wasn’t so bad this morning but I got a zap drinking lukewarm coffee and your post helped me push to make the call.

The Endo seemed to think it’s still inflammation aggravating the bite, so he shaved it down again—which thank goodness was NOT excruciating this time—and gave me an RX for more steroids. Hopefully this does the trick.

I have an appointment next week for him to go back in and reevaluate it (and hopefully finish).

Thank you both for being here to listen. I still feel pretty anxious but not as panicked as I was. I have an appointment in the books and a few painkillers if the pain gets worse, so I feel like I have a plan. That helps manage the uncertainty a little.

I understand completely. The uncertainty is the worst part! I hope it settles for you quickly.
 
FearfulInMA

FearfulInMA

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Mazey a thanks so much for the update. The fact that it’s starting to feel better is a very good sign. Fingers crossed for you that things continue in that direction!!

Also, glad you now have some pain meds just in case. Sometimes just having them available can help manage.

Please continue to keep us posted.
 
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Mazey

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I tapered off the ibuprofen because I’d been on it so long and I was worried about side effects and rebound pain. With just the steroids, the tooth had some ache but it was manageable. I just finished the last steroid dose and I am a little anxious about what will come next. I’m just waiting to see if any additional pain develops.

I go back in tomorrow to have the Endo take another look. I am managing the anxiety by figuring there are 2 (or 3) courses of action. Either he will go in and complete the RCT and it will be okay, or he will find an issue and recommend extraction, or he will complete the RCT and then I have continued pain and we deal with it from there. I think that’s the one that has me most scared. The pain from this has me really guarded against more.
 
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Mazey

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I’ve done the better part of the day with no OTC pain meds or steroids. The tooth feels uncomfortable at times—a sense of pressure? My brain is starting to fret about whether it needs to be calmed down more before they go back into it.

I just have to trust them to look at it and evaluate it appropriately. My goodness I’ve never had my anxiety spiral like it has during this treatment.
 
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MountainMama

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When is your appointment for finishing the root canal? It should feel much better after that appointment.

I am glad you are able to make it without the OTC meds now. When I was going through the worst of all my dental trauma, I was taking ibuprofen for 3 or 4 months straight, and ended up with an ulcer. That has healed now, thank goodness, but I also can't take ibuprofen anymore, or any NSAIDs.
 
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Mazey

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Thanks for checking in, MountainMama! I just got home from the procedure. He did finish the RCT and gave me a script for more steroids and I will start the ibuprofen again. I’d rather take the meds than risk the pain I had—but I’ll be extra careful to eat with them to try to avoid complications, yikes. Hopefully it all calms down more quickly than after the last appointment.

He said IF it is calm next week I can get the permanent filling in. I’m trying to think positively! Hopefully all the pain after the last appointment was just an anomaly. I guess I’ll see in a few hours.

Thank you all for your support. This has been so overwhelming.
 
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MountainMama

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Thanks for checking in, MountainMama! I just got home from the procedure. He did finish the RCT and gave me a script for more steroids and I will start the ibuprofen again. I’d rather take the meds than risk the pain I had—but I’ll be extra careful to eat with them to try to avoid complications, yikes. Hopefully it all calms down more quickly than after the last appointment.

He said IF it is calm next week I can get the permanent filling in. I’m trying to think positively! Hopefully all the pain after the last appointment was just an anomaly. I guess I’ll see in a few hours.

Thank you all for your support. This has been so overwhelming.

I hope it is calm for you once the numbness wears off!
 
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Mazey

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I’m updating just in case anyone later down the line has similar symptoms.

The second part seems to have gone okay. Lots of pressure and pain but it gets a little better day by day. I think I got bruised at the injection site, as that has hurt a lot and causes pain when I talk or drink through a straw. I’m managing it through ibuprofen okay.
 
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MountainMama

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I am so glad it is getting better! My endodontist said that any improvement shows healing, even if very slowly.
 
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Mazey

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I am still struggling with this. The Endo has given me several courses of steroids, during which I improve. And always, a day or two later, the inflammation and sensitivity return. I’ve also sorted out that I’m having muscle spasms and tightness on that side—it’s relieved somewhat by a heating pad. I even had pain on the opposite side where another tooth suddenly was misaligned, probably because the Endo adjusted my bite so much.

And today I woke up with the familiar soreness on the RCT tooth. I feel like at this point I need a second opinion. It is so overwhelming to be dealing with discomfort for so long.
 
FearfulInMA

FearfulInMA

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I’m so sorry you’re still dealing with this. If you can get a second opinion that might help to inform your next steps. Good luck and hang in there!
 
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MountainMama

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Ugh. A second opinion may be a good idea. My front tooth has been going through that cycle since October, where it will have a month or so of no pain, then it comes back. I finally had enough and am getting it extracted and an implant
 
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