Root Canal Treatment: Common Concerns and Solutions

Root canal treatment

I had a root canal treatment on my second-to-last upper right tooth on May 15.
I had a second treatment on May 16, and the dentist filled the cavity on May 23.
However, on May 24, that tooth was unable to bite anything, including tofu, and it was very painful.
I could still bite soft foods before this.
I returned for a follow-up on May 25, and the dentist reopened the cavity and cleaned it again, advising me to return on May 30.
(The last two upper right teeth have cavities that have been filled, but they still feel uncomfortable.
I have seen many dentists, and they all say it looks fine, but the enamel has been worn down, causing sensitivity.
They suggested monitoring it, but if it remains uncomfortable, I may need another root canal, as the second-to-last tooth has a larger cavity, which is why the dentist treated this one.)
1.
The dentist mentioned that this tooth has three root canals; one is open, one is calcified, and the other cannot be located, possibly completely calcified.
They said they can only clean it as much as possible and place medication.
If it continues to be uncomfortable, I would need to be referred to a medical center for special equipment to perform the root canal.
The dentist said they cannot see if it has been cleaned properly and can only rely on my feelings.
I find this strange—why can't the dentist see it?
2.
If I feel better in the next few days, does that mean I don't need to be referred to a medical center? I heard that using special equipment like a microscope for root canal treatment is out-of-pocket.
If I feel better, would I need to get a crown? If the treatment is done without a microscope and the dentist performs a blind procedure, is there a chance it won't be cleaned properly and will relapse soon?
3.
If the root canal is cleaned thoroughly, will this tooth no longer be sensitive to hot and cold? If there is still some sensitivity or if I occasionally feel like I am biting something foreign when eating, would it be better to undergo treatment with a microscope?
4.
After a successful root canal treatment, will the tooth still be uncomfortable in the future?

candy, 40~49 year old female. Ask Date: 2020/06/05

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Candy,
Hello! Teeth are very sensitive organs! If a cavity is too large or there is severe wear, it can lead to significant pain, and root canal treatment will be necessary.
The root canals are generally very narrow and not visible to the naked eye.
At this point, microscopic treatment is required, and it is advisable to consult a specialist in endodontics (usually found in medical centers) for management.

Basically, once the treatment is completed, there should be no symptoms, unless there is periodontal disease or damage to the root canal.
(Microscopic root canal treatment is usually out-of-pocket.) After root canal treatment, a crown is needed for protection!
Take care! Wishing you peace and success in everything!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/06/05

More Info

Root canal treatment (RCT) is a common dental procedure aimed at treating infection or damage to the pulp of a tooth. It can alleviate pain and save a tooth that might otherwise need to be extracted. However, patients often have concerns about the effectiveness of the treatment, especially when symptoms persist after the procedure. Based on your description, let's address your concerns systematically.

1. Visibility of Root Canals: It is true that during a root canal procedure, the dentist may not always be able to see all the canals clearly. Teeth can have complex root canal systems, sometimes with multiple canals that can be curved or calcified. If a canal is calcified, it can be difficult to locate and treat. Dentists often rely on X-rays to guide them, but these images may not reveal everything. If your dentist suspects that a canal is completely calcified or inaccessible, they may recommend further treatment at a specialty clinic equipped with advanced tools, such as a dental microscope, which can provide better visibility and precision.

2. Referral to a Specialist: If you notice improvement in your symptoms, it might not be necessary to transfer to a specialist immediately. However, if the pain persists or worsens, a referral could be beneficial. Specialists often have access to advanced imaging and treatment technologies that can enhance the success of root canal therapy. While some procedures may not be covered by insurance and could require out-of-pocket expenses, they can significantly improve the chances of a successful outcome.

3. Sensitivity After Treatment: After a successful root canal treatment, the tooth should ideally not be sensitive to temperature changes. If you continue to experience sensitivity, it could indicate that the canal was not completely cleaned or that there is still some infection present. In such cases, further treatment, possibly with the aid of a microscope, may be warranted to ensure all infected tissue is removed and the canals are properly sealed.

4. Long-term Comfort: Once a root canal is performed successfully, the treated tooth can function normally for many years, often for a lifetime. However, some patients may experience discomfort or sensitivity even after treatment. This could be due to several factors, including the complexity of the root canal system, the presence of additional infections, or issues with the restoration placed on the tooth after the root canal. Regular follow-ups with your dentist are essential to monitor the tooth's condition and address any emerging issues promptly.

In summary, while root canal treatment is generally effective, individual experiences can vary. If you continue to have pain or discomfort, it is crucial to communicate this with your dentist. They may recommend further diagnostic imaging or a referral to an endodontist (a specialist in root canal treatment) for more complex cases. Remember, the goal of RCT is to relieve pain and preserve your natural tooth, so don't hesitate to seek additional help if needed. Regular dental check-ups and good oral hygiene practices are also vital in maintaining the health of your teeth post-treatment.

Similar Q&A

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 Complications After Root Canal Treatment: Causes and Solutions

My mother underwent root canal treatment on her molar three months ago, which resulted in gum issues and facial nerve paralysis. After consulting various specialists, most attributed the symptoms to nerve damage. She is currently following the doctor's instructions for medic...

Dr. Xu Zhenglong reply Dentistry
1. If there is already an apical infection before root canal treatment, it can lead to complications such as cellulitis. Additionally, viral infections and prolonged exposure to cold air can potentially damage the facial area and even the nerves. 2. During root canal treatment,...

Understanding Complications in Root Canal Treatment: A Patient's Journey

Clinical Description: The upper canine tooth was treated with an observational dental cast restoration, which partially fell off after a year and a half. The patient presented without significant symptoms, so the dentist performed a permanent filling. However, a few days later, p...

Dr. Zhang Xiangyuan reply Dentistry
Dear online user, Based on your description, your upper canine tooth has undergone root canal treatment. During the course of the root canal treatment, a temporary filling material was used. The root canal treatment is completed in multiple appointments as determined by the den...

Struggles with Root Canal Treatment: Seeking Solutions for Discolored Teeth

As a child, I chipped a small corner of my tooth, and as I grew older, the color of the tooth gradually turned yellow. Feeling something was wrong, I had an X-ray taken and discovered a dark shadow. The dentist said I needed a root canal treatment. Since April, I have undergone f...

Dr. Huang Zhicheng reply Dentistry
Hello QQ: After damage to the dental pulp, bacteria can proliferate within the root canal, and toxins may extend to the apex of the tooth. This can lead to the erosion of the surrounding bone, forming a cyst, which causes the tooth to become mobile. When the lesion is significant...