Tooth Pain After Root Canal and Crown Placement

Q: Tooth Pain After Root Canal and Crown Placement

Hello： If you are really concerned about a cracked tooth, it is recommended to visit a hospital or a larger dental clinic to have a Cone Beam CT scan. <br>This will help confirm the condition of the tooth roots before discussing a treatment plan. <br>Sincerely, Lin Chia-Yung, Dep

Experiencing tooth pain after getting a crown placed following root canal treatment?

Hello Doctor, I underwent root canal treatment about a month ago and, following the doctor's advice, had a post and crown placed.
Initially, the doctor used a temporary adhesive to install the crown for adaptation, and during this period, I experienced no discomfort.
Therefore, the crown was permanently installed afterward.
However, on the day the crown was fully placed, I began to experience pain (similar to the sharp pain from a nerve exposure, even without any biting action).
When I sought help from the original clinic, the doctor only slightly adjusted some of my upper teeth to prevent occlusal contact.
Although the pain when not biting has improved, I still feel pain while chewing during normal meals (without eating particularly hard foods).
I am planning to return to the clinic for a follow-up and would like to know if the worst-case scenario could be a cracked root that requires an implant.
If I decide to switch to a larger hospital for treatment, which dental specialty should I consult? Is there a possibility that the crown may need to be redone? Thank you, Doctor, for your answers.
I really appreciate it!

Liao, 20~29 year old female. Ask Date: 2021/10/04

Dr. Lin Jiayong reply Dentistry

Hello: If you are really concerned about a cracked tooth, it is recommended to visit a hospital or a larger dental clinic to have a Cone Beam CT scan.
This will help confirm the condition of the tooth roots before discussing a treatment plan.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/10/04

More Info

Tooth pain after root canal treatment and crown placement can be a distressing experience, and it's important to understand the potential causes and solutions. Based on your description, it seems that you are experiencing significant discomfort following the completion of your root canal and the placement of a permanent crown. This situation can arise due to several factors, and I will outline them along with recommendations for further action.

Firstly, it is not uncommon for patients to experience some level of discomfort after a root canal procedure. This discomfort can be attributed to inflammation in the surrounding tissues, which may occur as a result of the procedure itself. The root canal treatment involves cleaning and disinfecting the inside of the tooth, which can irritate the surrounding nerves and tissues. However, the pain you describe, particularly the "nerve-like" throbbing pain even when not biting down, suggests that there may be other underlying issues.

One possibility is that there may still be some inflammation or infection present at the apex of the tooth root, known as apical periodontitis. This condition can occur if not all of the canals were adequately cleaned or if there is a blockage preventing proper sealing of the root canal. In such cases, a retreatment may be necessary to address the issue.
Another concern is the fit and alignment of the crown. If the crown is too high or misaligned, it can lead to discomfort during chewing or even when the teeth come together at rest. Your dentist's adjustment of the opposing teeth may have alleviated some of the pain, but if discomfort persists, further adjustments or a reevaluation of the crown's fit may be required.

In the worst-case scenario, if there is a crack in the tooth root, this could lead to significant pain and may necessitate extraction of the tooth. Cracked teeth can be difficult to diagnose, and advanced imaging techniques, such as a Cone Beam CT scan, may be necessary to assess the integrity of the tooth structure. If a crack is confirmed, extraction and subsequent options for replacement, such as dental implants, may need to be discussed.

If you decide to seek a second opinion at a larger dental facility, it would be advisable to consult with an endodontist, a specialist in root canal treatments, or a prosthodontist, who specializes in crowns and other restorations. They will have the expertise to evaluate your situation comprehensively and recommend appropriate treatment options.

Regarding the possibility of needing to redo the crown, this can depend on the findings during your next evaluation. If the crown is found to be improperly fitted or if the underlying tooth structure is compromised, a new crown may be necessary.

In summary, while some discomfort after root canal treatment is normal, persistent or severe pain warrants further investigation. It is crucial to communicate openly with your dentist about your symptoms and concerns. Seeking a second opinion from a specialist can provide clarity and help you determine the best course of action to alleviate your pain and restore your dental health. Remember, timely intervention can often prevent more serious complications down the line.

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