Tooth Pain After Wisdom Tooth Extraction: Is Root Canal Needed?

Dental abscess issue?

Hello, Doctor.
I have a deep cavity in my molar that causes tooth pain when I lack sleep, usually resolving in two days.
Two months ago, I experienced tooth pain that lasted a day, with swelling near the apex of my wisdom tooth on the inner side of my mouth, which developed into a large blister the next day.
Now it has turned into a small blister that hasn't disappeared since.
When I press on the small blister, I feel sensitivity in the deep cavity of the molar.
During my visit, the dentist suggested extracting the adjacent wisdom tooth and monitoring the situation.
A month later, the small blister disappeared, but there is still a noticeable mark inside my mouth.
Pressing on it still causes sensitivity in the molar, though it's less intense than before.
Could you please advise if it is appropriate to proceed with root canal treatment on the adjacent molar one month after the wisdom tooth extraction? Thank you.

YEN, 30~39 year old female. Ask Date: 2017/06/01

Dr. Huang Tingfang reply Dentistry

Dear Mr.
Yen,
Hello! If your wisdom tooth has been extracted and the adjacent molar is not painful, it is advisable to fill it and monitor the situation.
If pain occurs, then a root canal treatment may be necessary.
Please communicate frequently with your dentist.
Thank you! Wishing you good health!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2017/06/01

More Info

Tooth pain following wisdom tooth extraction can be a complex issue, especially when there are underlying problems with adjacent teeth, such as deep cavities or infections. In your case, it seems that you have experienced swelling and the formation of a blister near the root of your molar, which indicates that there may be an ongoing infection or inflammation in that area.
When a wisdom tooth is extracted, it can sometimes lead to changes in the surrounding teeth, particularly if those teeth are already compromised due to decay or other issues. The recommendation to observe the situation for a month after the extraction is a common approach, as it allows the area to heal and any inflammation to subside. However, if you are still experiencing pain and discomfort, especially when pressing on the blister, it may indicate that the adjacent molar is still at risk of further complications.

Root canal treatment (RCT) is often necessary when there is significant decay that has reached the pulp of the tooth, or when there is an infection at the root tip. Given that you have a history of deep cavities in your molar and are experiencing ongoing pain, it is advisable to consider RCT for the affected tooth. The presence of a blister suggests that there may be an abscess or localized infection, which can lead to further complications if left untreated.

Before proceeding with RCT, it is crucial to have a thorough examination, including X-rays, to assess the extent of the decay and the condition of the tooth's root. If the tooth is still structurally sound and the infection can be managed, RCT may be a viable option. However, if the tooth is significantly damaged or if the infection is severe, extraction might be the better choice.

In terms of managing your pain and discomfort, it is essential to follow your dentist's recommendations regarding pain relief and any prescribed medications. Over-the-counter pain relievers can help alleviate discomfort, but if the pain persists or worsens, you should seek further evaluation from your dentist.
Additionally, maintaining good oral hygiene is crucial during this time. Gently brushing and rinsing with warm salt water can help keep the area clean and promote healing. Avoiding hard or crunchy foods can also minimize irritation to the affected area.

In summary, based on your symptoms and the history of your dental issues, it would be prudent to consult with your dentist about the possibility of root canal treatment for the adjacent molar. They will be able to provide a comprehensive evaluation and determine the best course of action to alleviate your pain and preserve your dental health. If you have any doubts or concerns, seeking a second opinion from another dental professional may also be beneficial.

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