Tooth Sensitivity After Dental Treatment: Causes and Solutions

I have a constant sensation of a tooth being present?

Hello Doctor, I have a second lower molar on the right side that was filled when I was a child.
About four years ago, I noticed a black line, but after several visits to the dentist, they all said it was fine.
Last year, I started experiencing pain when biting down on harder foods, so I consulted another dentist who drilled to take a look.
The dentist indicated that the cavity was very deep and had extended to the adjacent tooth, so both teeth needed to be treated together.
On August 2nd, the decayed part was cleaned out, and due to the depth of the cavity, the dentist recommended a crown.
They placed medication in the tooth and suggested monitoring it; if there was no pain, I could proceed with the crown, but if there was pain, I would need root canal treatment.
During this time, I did not experience pain, but my tooth felt more sensitive.
On October 2nd, I underwent the procedure to repair the tooth and take impressions, which took about two hours.
Towards the end, I felt quite uncomfortable.
I received local anesthesia, but the sensitivity increased, and I experienced pain and discomfort, possibly due to the lengthy procedure (working on two teeth at once).
After the treatment, I felt psychologically distressed.
The dentist advised me to wear a temporary crown and monitor the situation.
After this treatment, I took painkillers for 2-3 days, especially at night when I felt particularly uncomfortable.
On October 13th, I returned for shade matching for the crown.
I felt uncomfortable again on the way home and took pain medication for one day (only at night).
From October until now, I occasionally feel the presence of the tooth, sometimes experiencing sharp pain or sensitivity when biting on specific areas.
I was originally scheduled to have the crown placed on December 7th, but after discussing my symptoms with the dentist, they suggested further observation.
If the issues persist, I may need to undergo root canal treatment first, as they mentioned that the fit of the crown would be better.
Due to the upcoming New Year, I have scheduled to have the crown placed in February, but I am concerned about the possibility of it being permanently cemented, as that would complicate any future root canal treatment if pain persists (I have already paid 44,000 TWD for these two teeth).
I wonder if these issues are related to the lack of a rubber dam during treatment.
I personally feel that I have been particularly uncomfortable since the October 2nd procedure.
Would you recommend proceeding directly with root canal treatment? I have been treated by this dentist since childhood, and they performed a root canal on one of my front teeth (which has been fine for 15 years), so I feel reassured by their care.
However, the two-hour dental repair left me with psychological distress, and I now feel anxious.
I am unsure if this is a psychological issue.
Thank you for your time and assistance.

Qiu~, 30~39 year old female. Ask Date: 2022/01/23

Dr. Lin Jiayong reply Dentistry

Hello, everything seems to be proceeding normally at the moment.
The doctor is very attentive and has considered many issues.
The rubber dam is indeed more likely to be used during root canal treatment.
It is advisable to follow the doctor's current instructions.
You may also remind the doctor that the previous session lasted over two hours, which exceeded your tolerance level.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2022/01/23

More Info

Tooth sensitivity after dental treatment can be a frustrating and concerning issue for many patients. In your case, it seems that you have experienced a range of symptoms following dental procedures, particularly after the treatment of your lower right second molar. Understanding the causes of tooth sensitivity and the appropriate solutions is essential for managing your discomfort and ensuring the health of your teeth.

Causes of Tooth Sensitivity
1. Dental Procedures: After dental work, especially procedures like fillings, crowns, or root canals, it is common to experience some degree of sensitivity. This can be due to the trauma inflicted on the tooth and surrounding tissues during the procedure. The sensitivity may be exacerbated if the treatment was prolonged or if multiple teeth were treated simultaneously, as you mentioned in your case.

2. Nerve Irritation: The dental pulp, which contains nerves and blood vessels, can become irritated during treatment. If the decay was deep, as in your situation, the pulp may be inflamed, leading to heightened sensitivity. This can manifest as sharp pain when biting down or sensitivity to temperature changes.

3. Gum Recession: If you are brushing too hard or have gum disease, the gums may recede, exposing the sensitive root surfaces of the teeth. This can lead to increased sensitivity, especially to hot or cold stimuli.

4. Inadequate Seal: If a temporary crown or filling is not properly sealed, it can allow bacteria to enter the tooth, leading to further decay or infection, which can cause pain and sensitivity.

5. Psychological Factors: Dental anxiety or previous traumatic experiences during dental treatment can lead to heightened sensitivity and discomfort, even if the physical cause is minimal.

Solutions and Recommendations
1. Follow-Up with Your Dentist: Given your ongoing symptoms, it is crucial to return to your dentist for a thorough examination. They may need to assess the fit of your temporary crown and check for any underlying issues, such as nerve damage or infection.

2. Use of Desensitizing Toothpaste: Your dentist may recommend a desensitizing toothpaste that contains potassium nitrate or strontium chloride, which can help block the transmission of pain signals from the tooth surface to the nerve.

3. Avoid Hard Foods: Until your sensitivity improves, it may be wise to avoid hard or crunchy foods that could exacerbate your discomfort. Stick to softer foods that require less chewing.

4. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage discomfort. However, consult your dentist before taking any medication, especially if you are on other treatments.

5. Consider Root Canal Treatment: If your symptoms persist and your dentist suspects that the pulp is inflamed or infected, they may recommend a root canal treatment. This procedure can alleviate pain by removing the inflamed pulp and sealing the tooth.

6. Psychological Support: If you feel that anxiety is contributing to your discomfort, consider discussing this with your dentist. They may suggest relaxation techniques or refer you to a professional who can help manage dental anxiety.

7. Regular Check-Ups: After your treatment, ensure you have regular dental check-ups to monitor the health of your teeth and gums. This will help catch any potential issues early.

In conclusion, tooth sensitivity after dental treatment can arise from various factors, including the nature of the procedures performed, nerve irritation, and psychological influences. It is essential to communicate openly with your dentist about your symptoms and concerns, as they can provide tailored advice and treatment options to help alleviate your discomfort. Regular follow-ups and proper oral hygiene practices will also play a significant role in maintaining your dental health.

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