After undergoing microscopic root canal surgery and apicoectomy, the tooth has still been painful after six months of observation?
After undergoing microscopic root canal treatment and apicoectomy, if the tooth still hurts after six months, the doctor recommends further examination at a major hospital.
I would like to ask if our hospital has the necessary equipment for microscopic root canal treatment and examination? Which department should I visit for this check-up, or which doctor should I consult? Additionally, could you advise on how to manage postoperative pain? Besides tooth extraction, are there other treatment options available? Thank you.
Niming, 0~9 year old female. Ask Date: 2018/11/22
Dr. Zhu Guanyu reply Dentistry
Hello,
Generally speaking, the follow-up period for teeth after root canal treatment is typically longer.
Additionally, the tissue loss caused by apicoectomy may require an even longer recovery time.
Currently, our dental department is equipped with an operating microscope, but we do not have a specialist in endodontics.
Thank you for your message.
Wishing you peace and health,
Dr.
Kuan-Yu Chu, Attending Dentist, Taoyuan Hospital, Ministry of Health and Welfare
Reply Date: 2018/11/22
More Info
Persistent tooth pain after micro root canal treatment and apicoectomy can be a frustrating experience, and it’s essential to address it properly to avoid further complications. After undergoing these procedures, it is not uncommon for patients to experience lingering discomfort or pain. This can be attributed to several factors, including incomplete cleaning of the root canal system, the complexity of the tooth's anatomy, or the presence of additional infections.
First and foremost, if you are experiencing persistent pain, it is crucial to follow up with your dentist or an endodontist (a specialist in root canal treatments). They can perform a thorough examination, which may include imaging studies such as X-rays or a Cone Beam CT scan to assess the condition of the tooth and surrounding structures. These imaging techniques can help identify any remaining infection, missed canals, or other issues that may not have been addressed during the initial treatments.
In terms of treatment options, if the pain is due to an incomplete root canal or an undetected canal, further endodontic treatment may be necessary. This could involve retreatment of the root canal, where the dentist will remove the existing filling material, clean the canals again, and refill them. If the anatomy of the tooth is complex, utilizing a dental microscope can significantly enhance the dentist's ability to locate and treat all the canals effectively.
If the pain persists even after retreatment, or if there are signs of a persistent infection, additional procedures such as a second apicoectomy may be considered. This involves surgically removing the tip of the tooth root and any infected tissue. However, it is essential to evaluate the tooth's overall prognosis before proceeding with this option.
In some cases, if the tooth continues to be symptomatic despite multiple treatments, extraction may be the last resort. However, before considering extraction, it is worth discussing the possibility of dental implants as a replacement option. Dental implants can provide a functional and aesthetic solution, but the success of the implant can depend on the health of the surrounding bone and tissue, which may be affected by previous infections or treatments.
Regarding pain management, it is essential to communicate with your dentist about the level of discomfort you are experiencing. Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage mild to moderate pain. If the pain is severe or accompanied by swelling or fever, it may indicate a more serious issue that requires immediate attention, possibly including antibiotics to address any infection.
In summary, persistent tooth pain after micro root canal treatment and apicoectomy warrants further evaluation by a dental professional. Follow-up appointments are crucial to determine the underlying cause of the pain and to explore appropriate treatment options. Whether through retreatment, additional surgical intervention, or extraction, it is essential to work closely with your dentist to find the best solution for your specific situation. Always ensure that you are receiving care from a qualified specialist, particularly if complex procedures are involved.
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