Tooth Sensitivity and Pain After Biting Hard Objects - Dentistry

After biting down on chopsticks, there is a dull pain and sensitivity to hot and cold?

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Hello, Doctor: Twenty years ago, my upper right incisor was struck by my lower right canine while biting into food, causing significant pain and slight mobility with some inward displacement.
At that time, the dentist took X-rays and determined there were no fractures or cavities, recommending observation for a period.
After a month, the mobility and pain gradually subsided, but I found it difficult to bite into harder foods.
Last year, I accidentally bit into a piece of cloth with that same incisor, and a week later, I still felt soreness and sensitivity, so I visited a clinic.
The dentist took X-rays and again found no fractures or cavities.
A month later, the pain diminished, and I could eat normally, although I avoided using that tooth to tear harder foods.
This New Year's Day, I accidentally bit down on a chopstick with that incisor, causing immediate pain.
After two weeks of observation, the pain improved gradually, and I could eat normally, but I experienced persistent dull pain after eating, prompting me to seek medical attention.
The dentist took X-rays and confirmed there were no shadows at the apex of the root or cavities, and no significant cracks were visible.
The dentist then gently rocked the tooth 4-5 times, noting slight mobility but within an acceptable range.
After returning home that day, I experienced severe pain in that tooth, which persisted for 2-3 days, followed by increased sensitivity to temperature, especially to heat, which was more intense than cold.
Even drinking water caused pain, and the tooth felt dull and painful when not eating, with some soreness while brushing.
After a few days, the sensitivity and pain slightly decreased, but gentle contact with the gums and bone above the incisor and adjacent incisor caused pain, and pressing towards the nostril area resulted in a feeling of swelling.
I visited the clinic again.
The dentist took another X-ray of the incisor, finding only that the crown of the tooth and the bone were in a 1:1 ratio, suspecting this might be the cause of the temperature sensitivity.
The dentist used a periodontal probe to check for periodontal pockets, finding no severe issues, and there were no abscesses in the gums.
Additionally, the adjacent incisor was also X-rayed, showing no cavities or shadows at the root apex, and slight mechanical abrasion caused some sensitivity, but the root was not necrotic.
The dentist advised that if there was no severe pain, biting pain, or spontaneous pain, root canal treatment for the incisor was not recommended, and suggested further observation.
Thank you, doctor, for patiently reviewing my medical history.
I would like to ask you three questions and seek your advice:
Q1: After three incidents of biting (colliding) with hard objects, although I experienced pain or dull pain, I did not have any temperature sensitivity or pain upon pressing the gums.
These two symptoms only appeared after the dentist rocked the tooth.
Could this indicate periodontal ligament inflammation or periodontitis, or is it possible that a crack is causing pulp inflammation?
Q2: Currently, aside from occasional dull pain in the incisor, the adjacent incisor also experiences occasional dull pain, especially after consuming hot soup, causing both teeth to ache.
Should I continue to observe this, or should I visit a larger hospital? If I need to seek treatment, should I see an endodontist or a periodontist?
Q3: Since there is pain when lightly touching the gums and bone above the incisor, and the dentist confirmed that the tooth nerve still has sensation after slight mechanical smoothing, the dentist used another tool to make the surface smooth.
However, in the past few days, the areas that were smoothed have become sensitive to temperature and dull pain.
Is this sensitivity due to the surface smoothing of the tooth?

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MiMi, 40~49 year old female. Ask Date: 2024/01/29