Post-Root Canal Discomfort: Tooth Sensitivity and Pain

Q: Post-Root Canal Discomfort: Tooth Sensitivity and Pain

Hello： In most cases, teeth that have undergone root canal treatment cannot withstand the same occlusal forces as before treatment, and there may still be percussion pain. <br>This is because the healing of apical lesions takes a long time. <br>However, if there is "severe aching

After root canal treatment, there may be sensitivity in the tooth and tightness or soreness in the cheek?

Hello, I have a question.
My second molar in the back has been inflamed since February, and I have visited several clinics without finding a cause.
The doctors were unsure and were afraid that the tooth might crack during treatment or that I wouldn't be able to get an appointment.
By the end of June this year, I had to undergo an emergency root canal treatment due to odontogenic sinusitis, and the doctor indicated that the inflammation was quite severe.
The root canal was completed, and a fiberglass post was placed, but I still feel a slight pressure and tightness in that tooth, with mild soreness upon touch.
However, the examining doctor stated that the root canal was clean, and I consulted other doctors in the same hospital and at another hospital, all of whom said there seemed to be no issues.

Since the root canal, I have continued to feel something, although it is not intense.
After the post and temporary crown were placed, I have experienced persistent but mild discomfort with occlusion.
I have had several adjustments, but the tooth still feels slightly sore upon touch.
Recently, I have noticed that the cheek above that tooth feels tight and sore, but touching the gums does not cause pain; only touching the tooth gives me discomfort that seems to reach the root.
Previously, the inflammation in that tooth triggered odontogenic sinusitis, so I had it checked again, but the sinuses are not inflamed.

Additionally, the discomfort from the tooth's occlusion has started to cause pain in the opposing tooth below, and I have experienced clenching at night.
I would like to ask if this means the root canal treatment was unsuccessful, or could it be due to overfilling or a crack in the tooth? The X-rays have shown no specific problems according to the doctors.
My cheek does not have sinusitis, but it feels sore and tight.
This tooth has been painful for six months now, and I have seen several doctors, from clinics to large hospitals, both experienced and younger practitioners, yet the discomfort remains unresolved...
I feel mentally and physically exhausted.

Hsuan, 20~29 year old female. Ask Date: 2017/09/17

Dr. Zhu Guanyu reply Dentistry

Hello: In most cases, teeth that have undergone root canal treatment cannot withstand the same occlusal forces as before treatment, and there may still be percussion pain.
This is because the healing of apical lesions takes a long time.
However, if there is "severe aching pain," medical attention should be sought.
Thank you for your message.
Wishing you peace and health.
Director of Dentistry, Taoyuan General Hospital, Ministry of Health and Welfare, Zhu Guanyu.

Reply Date: 2017/09/17

More Info

Post-root canal discomfort can be a frustrating and concerning experience, especially when the pain persists despite what seems to be a successful treatment. Based on your description, it appears that you have undergone a root canal treatment for your second molar due to significant inflammation, and although the procedure was completed and a fiber post was placed, you are still experiencing discomfort and sensitivity.

Firstly, it is essential to understand that some level of discomfort can be expected after a root canal treatment. This is because the procedure involves manipulating the tooth's interior, which can lead to inflammation of the surrounding tissues. However, the discomfort should gradually decrease over time. If you are still experiencing persistent pain or sensitivity, there are several potential reasons for this.

1. Residual Inflammation: After a root canal, it is not uncommon for the surrounding tissues to remain inflamed for some time. This inflammation can cause a sensation of pressure or discomfort, which may feel like a dull ache or tightness in the tooth. If the inflammation is significant, it may take several weeks or even months to resolve completely.

2. High Fillings or Overextended Material: If the filling material used in the root canal is too high, it can interfere with the bite, leading to discomfort when chewing or even when the tooth is touched. This can create a sensation of pressure or pain. If you suspect this might be the case, it is advisable to have your dentist check the occlusion and adjust the filling as necessary.

3. Cracked Tooth Syndrome: Another possibility is that there may be a crack in the tooth that is not visible on X-rays. Cracked tooth syndrome can cause intermittent pain and sensitivity, especially when biting or chewing. If your dentist suspects this, they may recommend further imaging or even a referral to a specialist.

4. Nerve Damage or Neuropathy: Sometimes, the nerves in the area can become irritated or damaged during the procedure, leading to ongoing discomfort. This can manifest as a dull ache or a sharp pain when pressure is applied.

5. Sinus Issues: Given your history of sinusitis, it is worth considering that the discomfort you feel may be related to sinus pressure or irritation, especially since the roots of the upper teeth can be close to the sinus cavities. However, you mentioned that your sinuses have been checked and are not inflamed, which makes this less likely.

6. Psychological Factors: Chronic pain can sometimes lead to anxiety and stress, which can exacerbate the perception of pain. If you are feeling overwhelmed by the discomfort, it may be beneficial to discuss this with your healthcare provider.

Given that you have already consulted multiple dental professionals and undergone various examinations, it may be time to consider a few additional steps:
- Seek a Specialist: If you haven't already, consider consulting an endodontist, a specialist in root canal treatments. They may have more advanced techniques and tools to diagnose and treat any underlying issues.

- Imaging Studies: If the discomfort persists, further imaging studies, such as a Cone Beam CT scan, may provide more detailed information about the tooth's condition and surrounding structures.

- Pain Management: In the meantime, managing your discomfort with over-the-counter pain relievers, as advised by your dentist, may help improve your quality of life.

- Follow-Up: Regular follow-ups with your dentist are crucial. Keeping them informed about any changes in your symptoms can help them adjust your treatment plan accordingly.

In conclusion, while some discomfort after a root canal is normal, persistent pain warrants further investigation. It is essential to communicate openly with your dental care providers about your symptoms and concerns to find an effective resolution. Remember, your comfort and health are paramount, and there are options available to help you manage and alleviate your discomfort.

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