After Braces: Discovering the Need for Root Canal Treatment

Treatment completed, braces installed, and it was discovered that there is still a tooth requiring root canal therapy?

At the beginning of January, I fractured my front tooth due to a motorcycle accident.
I received treatment and had five crowns placed in early October (which are now fixed).
Recently, I noticed that one of the teeth behind the crowns still hurts a little when it touches the crowns.
Could this require another root canal treatment? Would the fixed crowns need to be removed? If root canal treatment is necessary, would the crowns need to be redone, and would an additional crown be needed?

Xu Meinv, 20~29 year old female. Ask Date: 2018/11/12

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Hsu,
Hello! Generally, if a traumatized tooth is painful upon contact, it usually requires root canal treatment (as determined by X-ray).
After root canal treatment, a dental crown is necessary for protection.
If there is already a crown, a small hole can be drilled for the root canal treatment, and once the treatment is completed, it can be filled back in.
Please communicate with your dentist for further guidance.
Thank you! Wishing you safety!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2018/11/12

More Info

After experiencing a traumatic injury to your front tooth and subsequently getting braces, it's understandable that you're concerned about the pain you're feeling in one of your teeth. The discomfort you're experiencing could indeed indicate that a root canal treatment may be necessary, especially if the tooth has been previously damaged or if there is an underlying infection or nerve damage that has developed since your initial treatment.

When a tooth is fractured, as in your case, it can lead to complications such as pulpitis (inflammation of the dental pulp) or necrosis (death of the pulp tissue). These conditions can manifest as pain, sensitivity to temperature, or discomfort when biting down. If the pain persists, it is crucial to consult with your dentist or an endodontist (a specialist in root canal treatments) to evaluate the tooth's condition. They may perform diagnostic tests, including X-rays, to determine if the pulp is healthy or if there is an infection that requires treatment.

Regarding your braces, if a root canal treatment is necessary, it may not always require the removal of the braces. However, this depends on the specific situation and the location of the affected tooth. In some cases, the orthodontist may need to adjust the braces or temporarily remove them to allow for proper access to the tooth for treatment. After the root canal procedure, the tooth will need to be restored, typically with a crown, to ensure its strength and function, especially since it has been compromised.

If the tooth requires a root canal, the existing braces may need to be adjusted or modified to accommodate the new restoration. In some instances, a new crown may be necessary, but this can often be done without completely remaking the braces. Your orthodontist and endodontist will work together to coordinate the best approach for your treatment plan.

In summary, if you are experiencing persistent pain in a tooth after getting braces, it is advisable to seek professional evaluation as soon as possible. Early intervention can prevent further complications and ensure that your dental health is maintained. Communication between your orthodontist and the dentist performing the root canal will be essential to manage your treatment effectively. Remember, addressing dental issues promptly can save you from more extensive procedures in the future and help maintain the integrity of your orthodontic work.

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