Persistent Pain After Root Canal and Crown: What Are Your Options?

After root canal treatment, the placement of a crown may still result in discomfort or pain?

Two years ago, I suddenly experienced severe pain in my lateral incisor.
I underwent root canal treatment and had a dental crown placed (all-ceramic), but after the crown was placed, I still experienced a dull pain.
A year later, I reported this issue to my dentist, who slightly adjusted the occlusion, but the dull pain persisted.
Two months ago, I returned to the dentist and had an X-ray taken.
The dentist said there were no issues and mentioned that if the pain continued, I might need an implant.
The persistent dull pain has been very bothersome for me.
Can I request the dentist to remove the crown and perform another root canal treatment? Who would be responsible for the costs? Or is it true, as the dentist said, that I can only consider an implant? Thank you.

DD, 30~39 year old female. Ask Date: 2015/08/12

Dr. Zhang Xiangyuan reply Dentistry

Dear online user,
Based on your description, it seems that the tooth which underwent root canal treatment two years ago is still experiencing pain and symptoms.
It is advisable for you to consult the treating dentist to evaluate whether a retreatment or other interventions are necessary, or to seek an assessment and management from an endodontist.
The fabrication of prosthetics (such as crowns or dental implants) is considered an out-of-pocket expense.
It is recommended that you discuss this with your treating dentist.
Thank you for your inquiry.

Reply Date: 2015/08/12

More Info

Persistent pain after a root canal treatment and crown placement can be a frustrating and concerning issue. In your case, it seems that despite undergoing a root canal and having a crown placed on your side tooth, you are still experiencing discomfort. This situation can arise from several factors, and understanding your options is crucial.

Firstly, it's important to recognize that persistent pain after a root canal can indicate that the treatment may not have fully resolved the underlying issue. There are several potential reasons for this ongoing discomfort:
1. Incomplete Root Canal Treatment: Sometimes, not all canals in a tooth are adequately treated. If there are additional canals that were not identified or cleaned, they can harbor bacteria, leading to persistent pain.

2. Cracked Tooth Syndrome: A crack in the tooth can cause pain, especially when pressure is applied. This can be difficult to diagnose, as cracks may not always be visible on X-rays.

3. Post-Operative Sensitivity: After a root canal, some patients experience sensitivity that can last for weeks or even months. This is usually temporary but can be exacerbated by factors such as grinding teeth or improper bite alignment.

4. Infection: There may be an infection that has developed after the root canal treatment, which can lead to pain and discomfort.

5. Crown Issues: The crown itself may not fit properly, leading to pressure on the underlying tooth or surrounding gums, causing pain.

Given your situation, here are your options:
1. Consultation with Your Dentist: It is essential to communicate your ongoing pain to your dentist clearly. Request a thorough examination, including a review of the previous root canal treatment and the crown's fit. If necessary, a referral to an endodontist (a specialist in root canal treatments) may be warranted for a second opinion.

2. Re-evaluation of the Root Canal: If your dentist agrees, you can discuss the possibility of removing the crown to re-evaluate the root canal. This may involve re-treating the root canal if any issues are found. The cost of this procedure typically depends on your dental insurance and the specific agreements you have with your dentist.

3. Consideration of a Crack: If a crack is suspected, further imaging or tests may be needed to confirm this. If a crack is found, treatment options may include a crown lengthening procedure or, in some cases, extraction.

4. Implant Consideration: If the tooth is deemed non-restorable due to extensive damage or persistent infection, your dentist may recommend extraction and placement of a dental implant. While this is a more invasive option, it can provide a long-term solution.

5. Pain Management: In the meantime, managing your pain with over-the-counter pain relievers or prescribed medications can help alleviate discomfort while you explore treatment options.

Regarding the financial aspect, if you choose to have the crown removed and undergo further treatment, the responsibility for costs will depend on your dental insurance policy and the agreements made with your dentist. It’s advisable to discuss this upfront to avoid any surprises.

In conclusion, persistent pain after a root canal and crown placement is not uncommon, and it’s essential to address it promptly. Open communication with your dentist about your symptoms and concerns is key to finding a suitable solution. Whether it involves re-evaluating the root canal, considering a crack, or discussing the possibility of an implant, there are options available to help you find relief and restore your dental health.

Similar Q&A

Persistent Pain After Root Canal: Exploring Alternatives to Tooth Extraction

I have a tooth on the lower left side that previously had a crown. Recently, due to decay, I underwent root canal treatment. Although the treatment is complete, I still experience some pain. The pain lasts for a few minutes each time and then disappears, occurring several times a...

Dr. Lin Jiayong reply Dentistry
Hello: It is recommended to take a cervical X-ray to confirm the cause of the pain, or to consult a neurologist to see if it is a trigeminal nerve issue. Only when the pain problem cannot be resolved will we consider tooth extraction.

Managing Post-Root Canal Pain: A Guide for Dental Patients

Hello, my lower right first molar underwent a failed root canal treatment last year. Today, I had a re-treatment with a microscope. After the procedure, I experienced occlusal pain with the temporary crown. I transferred to another dental clinic and had the crown replaced on Sept...

Dr. Lin Jiayong reply Dentistry
Hello: According to what you mentioned, the first, second, and third molars on the lower right side have undergone root canal treatment, indicating that the original condition of the teeth was likely not ideal. Therefore, after completing the root canal treatment, it is important...

Persistent Tooth Pain After Filling: Is Root Canal the Only Solution?

I discovered cavities in the two teeth at the ends of my mouth. After having them filled on two separate occasions, I still experience pain when biting down on hard objects (sometimes). When I returned to the dentist, X-rays were taken, and the dentist mentioned that there were c...

Dr. Zhu Guanyu reply Dentistry
Hello, "Root canal treatment," commonly referred to as "nerve extraction," involves the removal of the nerves, blood vessels, and lymphatic tissue from the root canal system. The procedure includes enlarging and debriding the root canal, followed by sealing th...

Persistent Swelling and Pain After Root Canal Treatment: What to Do?

During root canal treatment, the doctor mentioned that there was calcification. While using the instruments, I felt a lot of force being applied while working inside the nerve canal. One of the canals (there are a total of three) was very painful. The doctor said the pain would n...

Dr. Huang Zhicheng reply Dentistry
Hello: Your teeth may still have symptoms of periapical inflammation, which can cause swelling and tenderness upon percussion. After root canal treatment, inflammation outside the apex may sometimes take time to resolve. It is important to maintain close communication with your d...