Dealing with Tooth Sensitivity: When to Consider Root Canal Treatment

Tooth sensitivity or toothache?

I have been experiencing significant sensitivity and pain in my teeth when exposed to heat and cold for the past three weeks.
I visited a nearby clinic, and the dentist indicated that I need a root canal treatment (previously referred to as "nerve extraction").
Additionally, I had braces placed about fifteen years ago, and the current treatment requires the braces to be removed before proceeding.
After the treatment is completed, I will need to have the braces reinstalled.
However, some dentists have suggested that I seek treatment at a larger hospital for advanced options such as laser therapy or other more sophisticated treatments.
I would greatly appreciate your guidance on how to proceed with my treatment.
Thank you very much!

Qiu Yu, 50~59 year old female. Ask Date: 2004/04/19

Dr. Chen Yingfang reply Dentistry

Please discuss after the outpatient examination.

Reply Date: 2004/04/19

More Info

Tooth sensitivity, especially when it involves pain in response to hot or cold stimuli, can be a sign of underlying dental issues that may necessitate root canal treatment (RCT). The symptoms you describe—sharp pain when exposed to temperature changes—are often indicative of pulpitis, which is inflammation of the dental pulp. If the pulp becomes irreversibly inflamed or infected, RCT is typically recommended to alleviate pain and save the tooth.

In your case, it’s essential to understand the rationale behind the recommendation for RCT. When a dentist suggests RCT, it usually means that the tooth’s nerve and pulp are compromised, and if left untreated, the condition could worsen, potentially leading to an abscess or tooth loss. The procedure involves removing the infected or damaged pulp, cleaning and disinfecting the root canals, and then sealing them to prevent future infections.

Regarding your previous dental work, such as the crown you mentioned, it is common practice to remove existing crowns before performing RCT. This is necessary to access the tooth structure beneath the crown. After the RCT is completed and the tooth has healed, a new crown can be fabricated and placed to restore the tooth’s function and aesthetics. If the crown is intact and undamaged, it may be possible to re-cement it after the RCT, but this depends on the condition of the crown and the tooth.

As for the suggestion to seek treatment at a larger hospital or specialized dental clinic, this can be beneficial, especially if advanced techniques such as laser therapy or other modern methods are available. These facilities often have access to more sophisticated imaging technology, such as Cone Beam Computed Tomography (CBCT), which can provide a detailed view of the tooth and surrounding structures, aiding in diagnosis and treatment planning.

When considering where to seek treatment, it’s crucial to choose a dental provider you trust. Look for a dentist or endodontist (a specialist in root canal treatment) with good reviews and a solid reputation. If you feel uncertain about the treatment plan proposed by your current dentist, seeking a second opinion can provide additional insights and help you make an informed decision.

In the meantime, managing your tooth sensitivity is important. You can use desensitizing toothpaste, which contains compounds that help block the transmission of sensation from the tooth surface to the nerve. Additionally, avoiding extremely hot or cold foods and beverages can help minimize discomfort until you receive definitive treatment.

In summary, if you are experiencing significant tooth sensitivity, it is advisable to proceed with the recommended root canal treatment. Ensure that you have a clear understanding of the procedure, the need for crown removal, and the potential for advanced treatment options at a larger facility. Prioritize your dental health by addressing these symptoms promptly to avoid further complications.

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