Post-Root Canal Treatment: Issues with Dentures and Nerve Sensitivity

Q: Post-Root Canal Treatment: Issues with Dentures and Nerve Sensitivity

Hello： Root canal treatment involves opening the pulp chamber, removing the dental pulp (commonly referred to as the nerve) from the root canal, measuring the length of the root canal, thoroughly cleaning and shaping it, disinfecting it completely, and then filling the root canal

Issues with Prosthetic Devices After Root Canal Treatment

Hello, Doctor: I would like to ask, during my root canal treatment, every time the nerve was cleaned, although the doctor said anesthesia was administered, there were always one or two instances where it felt like the nerve was being touched, causing intense pain.
I had to inform the doctor, who then increased the anesthesia, but this happened almost every time during the treatment.
Later, the doctor mentioned that he forgot to apply anesthesia in one area.
Does this mean that the doctor is unable to identify all the nerve locations? After the treatment was completed and the crown was placed, I found that the last molar crown did not fully fit with the gums, and I could feel it when drinking hot water.
I also felt like the crown was about to come off when chewing gum.
When I asked the doctor, he said that this design makes it easier to clean the back teeth.
Is this the correct approach? Is my root canal treatment not fully completed? Otherwise, why am I still experiencing sensations, and why do my gums feel a bit painful?

Eric, 30~39 year old female. Ask Date: 2005/01/13

Dr. Liu Tiancai reply Dentistry

Hello: Root canal treatment involves opening the pulp chamber, removing the dental pulp (commonly referred to as the nerve) from the root canal, measuring the length of the root canal, thoroughly cleaning and shaping it, disinfecting it completely, and then filling the root canal.
The time required for this procedure depends on its complexity; for molars, it typically takes about 3-4 hours.
If each treatment session is not lengthy, it may be necessary to administer anesthesia during the first few visits.
It is normal to experience some sensitivity when biting down within one to two weeks after root canal treatment; however, if there is no improvement after one month, a follow-up visit to the dentist is recommended.
Crown fabrication has both supragingival and subgingival margins; the former is less likely to harm periodontal health, but sufficient retention must be considered to prevent loosening.
Sincerely, Dr.
Liu Tien-Tsai, Dentist.

Reply Date: 2005/01/13

More Info

After undergoing root canal treatment, it is not uncommon for patients to experience various issues, including sensitivity, discomfort, and complications related to dentures or crowns. Your experience of pain during the nerve cleaning process, despite the administration of anesthesia, raises some important considerations regarding the procedure and the subsequent placement of your dental prosthesis.

Firstly, it is essential to understand that root canal treatment involves the removal of infected or damaged pulp from inside the tooth, which can be a sensitive area. While dentists use local anesthesia to minimize pain, the effectiveness can vary based on individual pain thresholds, the complexity of the tooth's anatomy, and the extent of the infection. In some cases, certain nerves may not be adequately numbed, leading to the sharp pain you experienced. This does not necessarily indicate that the dentist is unaware of all the nerve locations; rather, it reflects the inherent challenges in achieving complete anesthesia in certain cases.

Regarding the placement of your denture or crown, it is crucial for the prosthetic to fit snugly against the gums to prevent food particles from getting trapped and to ensure proper function. If you are noticing that the crown does not fully seal against the gums, this could lead to discomfort, sensitivity, and potential complications such as decay or gum disease. Your dentist's explanation that leaving a slight gap makes cleaning easier is somewhat valid; however, it should not compromise the overall fit and function of the crown. Ideally, a well-fitted crown should allow for easy cleaning while also providing a tight seal against the gums.

The sensitivity you are experiencing when consuming hot beverages or chewing gum could indicate that the root canal treatment may not have fully resolved the underlying issue, or it could be a sign of other complications such as:
1. Incomplete Cleaning: If the root canal was not thoroughly cleaned or sealed, residual bacteria could lead to ongoing sensitivity and discomfort.

2. Post-Operative Inflammation: After a root canal, it is common for the surrounding tissues to be inflamed, which can cause sensitivity.

3. Crown Fit Issues: If the crown is not properly fitted, it can lead to pressure points that cause discomfort when chewing or when exposed to temperature changes.

4. Nerve Damage: In some cases, the procedure may inadvertently affect nearby nerves, leading to prolonged sensitivity or pain.

Given your symptoms, it is advisable to follow up with your dentist to discuss your concerns. They may recommend further evaluation, which could include X-rays to assess the integrity of the root canal treatment and the fit of the crown. If necessary, they might refer you to an endodontist (a specialist in root canal treatments) for a second opinion.

In summary, while some discomfort and sensitivity can be expected after root canal treatment, persistent pain and issues with the fit of your crown warrant further investigation. Open communication with your dental care provider is essential to ensure that any complications are addressed promptly, allowing for a smoother recovery and better long-term outcomes.

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