Root Canal Treatment and Tooth Sensitivity Issues

Tooth nerve extraction issues?

Hello, several years ago, I had a dental bridge consisting of three crowns placed on my lower right back teeth.
The first crown was reduced in size but did not undergo root canal treatment.
The second crown has been extracted, and the third crown underwent root canal treatment and was filled.
Recently, a small piece chipped off the side of the first crown, and I started experiencing some sensitivity to hot and cold.
I visited the dentist, who indicated that the third crown had some inflammation and infection, so the crown was removed to perform root canal treatment.
The first crown appeared to be fine, so I proceeded with the root canal treatment on the third crown and will observe the first crown for now.

The root canal treatment on the third tooth has been completed, and a post has been placed.
During this time, I have been wearing a temporary crown.
After each treatment session, I experienced soreness in the first crown for the first two to three days, especially when exposed to hot or cold or when biting down.
However, this sensitivity subsided after a few days.
When I asked the dentist, he suggested that the temporary crown might not have a good seal, allowing hot and cold liquids to penetrate, causing the sensitivity.
He mentioned that once the permanent crown is placed with a better seal, this issue should be less likely to occur.
However, he also stated that he couldn't guarantee it and suggested that if I have concerns about the first crown, I could consider having a root canal done to eliminate any future problems.
I am currently contemplating whether to have the nerve removed from the first crown.
If the first crown's root canal is fine, it should be preserved and not require a root canal, correct? However, if I do not have the nerve removed and the permanent crown is placed, but I still experience sensitivity to hot and cold, I would then need to remove the crown and undergo root canal treatment, incurring additional costs.
The dentist initially mentioned that removing the nerve would be unfortunate, as the tooth structure can regenerate (meaning it can strengthen), and this sensitivity might disappear after wearing the crown for some time.
Based on what the dentist said, if I do not have the nerve removed and after placing the crown, I avoid consuming very hot or cold foods or minimize using it for biting to avoid irritation, will the tooth structure naturally regenerate over time and resolve the issue? What do you suggest? Should I consider this further? Thank you!

Liu Xiansheng, 40~49 year old female. Ask Date: 2018/06/26

Dr. Huang Tingfang reply Dentistry

Dear Mr.
Liu,
Hello! It is best not to perform a root canal on the tooth.
However, we need to determine how much of the tooth has been ground down and how far it is from the nerve.
An X-ray may be necessary to find out! Please communicate more with your dentist.
Thank you! Wishing you safety!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2018/06/26

More Info

Understanding the complexities of root canal treatment and the associated tooth sensitivity issues can be quite challenging, especially when multiple dental procedures are involved. Based on your description, it seems you have a multi-faceted dental situation that requires careful consideration.

Firstly, it’s important to understand that root canal treatment (RCT) is performed to remove infected or inflamed pulp tissue from inside a tooth. This procedure is often necessary when a tooth has been severely decayed or has suffered trauma. After the pulp is removed, the root canal is cleaned, shaped, and filled to prevent further infection. However, even after a successful root canal, some patients may experience sensitivity or discomfort, particularly when exposed to temperature changes or pressure.

In your case, it appears that the third tooth, which underwent root canal treatment, has been causing some inflammation and sensitivity. The fact that you experienced pain in the first tooth after the treatment of the third tooth is not uncommon. This phenomenon can occur due to a few reasons:
1. Referred Sensitivity: Sometimes, when one tooth undergoes treatment, adjacent teeth can react to the changes in pressure or inflammation, leading to temporary sensitivity. This is particularly true if the first tooth is structurally compromised or has a history of dental work.

2. Temporary Crown Issues: As your dentist mentioned, if the temporary crown does not fit well, it can allow fluids to seep in, causing sensitivity. This is a common issue with temporary restorations, and once a permanent crown is placed, the sensitivity may resolve.

3. Underlying Issues: If the first tooth has not been treated and is showing signs of sensitivity, it may have underlying issues that need to be addressed. If the tooth has a history of trauma or decay, it could be at risk of pulpitis, which may necessitate a root canal in the future.

Regarding your dilemma about whether to proceed with a root canal on the first tooth, here are some considerations:
- Monitoring Symptoms: If the first tooth is not currently causing significant pain and the sensitivity is manageable, it may be worth monitoring the situation for a while. If the sensitivity persists or worsens, it may indicate that the pulp is inflamed and a root canal could be necessary.

- Preventive Measures: Avoiding extremely hot or cold foods and being cautious with biting forces can help reduce sensitivity. If you can manage the discomfort with these adjustments, it may allow the tooth to stabilize.

- Long-term Outlook: Your dentist's comment about the tooth's ability to strengthen over time is valid. Teeth can sometimes recover from mild inflammation if they are not subjected to further trauma or decay. However, if the sensitivity does not improve or if you experience pain, it may be prudent to consider a root canal to prevent further complications.

- Cost Considerations: It’s understandable to be concerned about the financial implications of dental procedures. Weighing the potential costs of a root canal against the risk of needing more extensive treatment later is important. If the first tooth does require a root canal after the crown is placed, it could lead to additional expenses.

In conclusion, it may be beneficial to keep an open line of communication with your dentist. Regular check-ups and X-rays can help monitor the health of the first tooth. If sensitivity persists or worsens, discussing the option of a root canal sooner rather than later might be the best course of action. Ultimately, the goal is to preserve your natural teeth while ensuring your overall oral health remains intact.

Similar Q&A

Understanding Tooth Sensitivity and Root Canal Treatment Options

Hello, Doctor! I originally had a sensitivity issue with my front teeth, and it's a long story. On the night of November 25, I experienced hyponatremia and was admitted to the emergency room, then spent three days in the intensive care unit. Since I was lying down for those ...

Dr. Zeng Guanghui reply Dentistry
The lower front teeth may have been subjected to excessive force, affecting the periodontal ligaments and potentially impacting the dental pulp nerves within the teeth, leading to symptoms of tooth sensitivity. If the dental examination shows no cracks, as long as excessive occlu...

Understanding Root Canal Treatment: Common Questions and Concerns

I have a dental cleaning every six months, but shortly after my last cleaning, I experienced pain in tooth #35 due to sensitivity to hot and cold. I returned to the dentist, and an X-ray revealed a cavity. The dentist indicated that I would need a root canal treatment. On the sam...

Dr. Lin Jiayong reply Dentistry
Hello: Generally, simple root canal treatments can be performed in the clinic, unless the case involves complex root canals, calcified canals, or fractured roots/instruments, in which case the patient should be referred to a dental pulp specialist at a medical center. <a href=...

Understanding Post-Scaling Tooth Sensitivity and Treatment Options

I had my teeth cleaned at the end of May, and since then, I've been experiencing severe sensitivity and pain throughout my mouth. It's been over four months, and my condition hasn't improved. I've tried using desensitizing toothpaste, but it hasn't helped...

Dr. Zeng Guanghui reply Dentistry
Hello Peter, after your teeth cleaning, if you experience sensitivity and pain, it may be due to the calcification of the tooth structure itself or gum recession, which exposes the crown or root of the tooth to the oral cavity. It is advisable to consult a dentist for further eva...

Dealing with Tooth Sensitivity: When to Consider Root Canal Treatment

I have been experiencing significant sensitivity and pain in my teeth when exposed to heat and cold for the past three weeks. I visited a nearby clinic, and the dentist indicated that I need a root canal treatment (previously referred to as "nerve extraction"). Addition...

Dr. Chen Yingfang reply Dentistry
Please discuss after the outpatient examination.