Please help me diagnose my problem. Do I need a root canal?

[bjmohan]

My dentist found a deep cavity between my two upper back molars. There was a large gap between these two teeth. Dentist recommended putting crowns on both these teeth. He suggested this might protect teeth from further decay and avoid root canals for me in future. He cleaned it and put temporary crowns for both of them two weeks back.

I started having pain and sensitivity about four days later (not those first 4 days). I saw my dentist again, he referred me to an endodontist. However, endodontist said he is not so sure which tooth is needing treatment. So he asked me to wait a couple of weeks and see how the condition varies. My dentist thinks I may not need a root canal. He is afraid even if I do root canal I may still continue having pain, if the true cause of pain is not addressed.

My pain actually goes away completely (and quickly) for about 7 hours if I take Ibuprofen 200mg(Over the counter). Does root canal pain go away with just that low dosage? Not even prescription pain killer required. How can I really confirm this is a root issue or not? What else can cause pain? My endo told me I dont have an abscess or even an infection. I took Amoxicillin antibiotic prescription anyway. Completed the course but the pain keeps occurring.

Also the pain is always accompanied by headache..At some point I would say the headache is worse than the dental pain..

Can this be gum pain? Not related to root canal at all? What else can I do? I hate to undergo RCT and then realize it was not the issue and regret over a needless loss of tooth..

Endo did the tap test and hot and cold test. Not too bad. So that means the root canal is un-necessary?

I put in permanent crowns on both the two teeth yesterday. Slightly less discomfort now. But pain has not gone away completely.

What could be the cause of all this? Just wait for a few more weeks and all could be okay? Or do I need RCT?

Thanks for all help and guidance...

Ben

 

[Stress Doc]

Hi

Welcome to the forum

Based upon what you are saying it sounds like a problem with the jaw joint (TMJ) It is very possible the temp crowns are too high and this throwing off your bite. This can happen with temp crowns. When you get your permanent crowns the issue could just go away. It is worth waiting to see if that is the problem.

Ibuprofen is an anti-inflammatory and would help this issue. The good news is the endo could not find anything wrong.

There might also be some ligament pain which can take a month or so to calm down. I would wait until you get the final crowns and have them adjusted to fit your bite.

 

[bjmohan]

Thank you so much for your prompt reply....

I have the perm crown on now. Put it just two days ago. Feels more comfortable.

No much pain during daytime. But as soon as I go to sleep at night, maybe after 1 hour I wake up with sharp pain. I took Ibuprofen 200mg and the pain went away in about 10 minutes. I could sleep peacefully after that for rest of night. I keep my head elevated with double pillows..

Why is the pain appearing when I am in bed? Could sleep posture be a factor? I think your advice of it being jaw pain could be the right one. But I have had many dental treatments over last 15 yrs..Never had this pain after treatment problem before. Why now?

Does it take a week or so for the Perm crown to settle down?
Who is the specialist who can diagnose ligament, jaw pains? I dont think endo can do this..

Just for info, the two teeth my dentist crowned are 13 and 14. Upper left ones. Are they prone to creating jaw/ligament pain?

Thanks a lot! This forum is a godsend...

Ben

 

[bjmohan]

Also I dont think it is related to my bite..Dentist was very particular about this and went through throroughly to make sure my bite is correct..Bite feels very comfortable and not too high or anything.

Thanks, Ben

 

[Stress Doc]

Hi Ben

I will do my best to answer your questions. Yes, it can take a period of time for a tooth to settle down. I had one a few years ago that took about a month to "play nice."

The pain at night can come from bruxism. This is tooth grinding and jaw clenching. This usually happens at night. This can be from several sources.

The crown can be a touch high. It can be reshaped easily. A high crown can throw your bite off and cause uneven biting pressure which puts pressure on the tooth ligament.

Stress can also be a source of tooth grinding.

The fix is fairly easy. Your regular dentist can make a custom night guard to prevent this.

This is a fairly common problem. Give it a few weeks and if the problem does not resolve have your dentist do a bite test to see if the crown is high. I am sure this can be worked out fairly easily.

Blessings

 

[cakehead]

Wow. That feels just like something I've been experiencing the past two or three weeks. My bite is off thanks to worn first and second molars on one side, plus I have a slight overjet that seemed to come out of nowhere a few months ago.

When I try to lay down at night it feels like a slight cramp on one side of my face, radiating either up into my head and under the top teeth, or under the bottoms and down into my throat and tongue muscles. Changing positions and rubbing my jaw joint helps this pain, but it's really making me tired.

I'm going to the oral surgeon's soon and I'll let you know what he says, but even if your bite is slightly off somehow, I imagine it can cause this pain. Mine doesn't seem to be tooth-related at all, even though it sometimes radiates under them.