Common Post-Root Canal Questions: Crowns, Pain, and Treatment Options

Post-endodontic complications

1.
Is it necessary to place a temporary crown after root canal treatment before fitting a permanent crown?
2.
Can an impression be taken on the same day after the cavity is filled following the completion of root canal treatment?
3.
After the dentist secured my permanent crown with temporary cement, they mentioned that a permanent cement would be applied in two weeks.
However, during my follow-up appointment, the dentist had to tap on the tooth at least 70 times, which was extremely painful.
Will this excessive tapping cause damage to my other teeth? The dentist also advised me to get a cleaning at another clinic.
4.
For another tooth that is close to the nerve but has not yet touched it, the dentist has filled it multiple times with different doctors.
However, I still experience sensitivity to hot and cold.
Is it necessary to perform a root canal on this tooth, or can it be treated with an inlay? Thank you, doctor.

Bei Yachi Kunrao de Wo, 40~49 year old female. Ask Date: 2023/08/25

Dr. Zeng Guanghui reply Dentistry

Dear Miss Troubled by Teeth,
1.
If there are no periodontal issues after root canal treatment, a permanent crown can be placed.
However, if there are still periodontal problems, it may be advisable to first use a temporary crown to protect the tooth.
2.
A permanent crown that is only secured with temporary cement should not come loose easily.
3.
If the tooth cannot be adequately sealed and is sensitive to hot and cold, root canal treatment may be considered.
Sincerely,
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital

Reply Date: 2023/08/25

More Info

After undergoing a root canal treatment, many patients have questions regarding the necessary follow-up procedures, pain management, and treatment options. Here, I will address your specific questions and provide additional insights based on medical knowledge.

1. Is it necessary to place a temporary crown before the permanent crown after root canal treatment?
Yes, it is generally recommended to place a temporary crown after root canal treatment. The tooth that has undergone root canal therapy is often more fragile and susceptible to fracture. A temporary crown helps protect the tooth while the permanent crown is being fabricated. It also allows for proper healing and ensures that the tooth is not exposed to bacteria or food particles that could lead to reinfection. Once the permanent crown is ready, it can be placed to provide long-term protection and restore function.

2. Can an impression be taken on the same day the root canal is completed?
In many cases, an impression can be taken on the same day as the root canal treatment, especially if the tooth is stable and the dentist feels confident in the integrity of the tooth structure. However, some dentists prefer to wait until the tooth has had time to settle and heal before taking an impression. This is to ensure that the crown fits properly and that there are no complications from the root canal procedure. It’s best to follow your dentist’s recommendation regarding the timing of impressions.

3. Is it normal to experience pain after multiple attempts to adjust the crown?
Experiencing pain during the adjustment of a crown is not uncommon, especially if the tooth has been subjected to significant pressure during the fitting process. However, if you are experiencing severe pain after multiple adjustments, it is essential to communicate this with your dentist. The repeated force applied to the tooth can potentially cause damage to the surrounding teeth or the tooth itself. If you feel that the pain is excessive, it may be worth seeking a second opinion or discussing alternative options with your dentist.

4. Regarding the tooth that is close to the nerve but has not yet touched it, is root canal treatment necessary?
If you are experiencing sensitivity to hot and cold after multiple fillings, it may indicate that the tooth is at risk of pulpitis, which is inflammation of the dental pulp. In such cases, a root canal may be necessary to prevent further complications. However, if the tooth is still vital and the nerve is not yet affected, your dentist may consider other options, such as an inlay or onlay, which can provide support and protection without the need for a root canal. Ultimately, the decision will depend on the extent of the damage and the dentist's assessment of the tooth's condition.

In summary, after root canal treatment, it is crucial to follow your dentist's recommendations regarding crowns and follow-up care. Temporary crowns are typically necessary to protect the tooth, and impressions can often be taken on the same day, depending on the situation. If you experience pain during adjustments, it is essential to communicate this with your dentist to prevent further complications. Lastly, if you are unsure about the need for a root canal or other treatments, seeking a second opinion can provide clarity and peace of mind. Always prioritize open communication with your dental care provider to ensure the best outcomes for your oral health.

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