Tooth Pain: Is It Root Canal or Wisdom Tooth Issues?

Root canal treatment

Hello, I visited the Family Dentistry at Taipei Medical University in August, and they mentioned that I might need root canal treatment for two molars.
I scheduled an appointment for October 8th to see the dentist, and in the meantime, I had the decayed teeth cleaned and temporarily filled.
I didn't experience any pain during this period.
However, since I felt it was taking too long, I went to a clinic to start treatment on one of the molars, which was not yet completed and also pain-free.
On October 8th, I had the first root canal treatment for the other molar at Taipei Medical University.
The next day, October 9th, I suddenly started experiencing severe pain.
The second root canal was scheduled for November, so I went to a nearby clinic.
They suggested that the previous treatment might not have cleaned out all the bacteria, so they performed another root canal treatment and advised me to rest at home.
However, I still felt pain and noticed slight swelling in the gum.
By October 11th, the pain persisted, and I had a sore throat, which was painful to touch, especially on one side of my face, where it was extremely painful and slightly swollen.
On October 12th, I returned to the clinic, and they performed another root canal treatment.
After returning home, before the anesthesia wore off, I started feeling pain again because the tooth still hurt.
I decided to go to a major hospital on October 13th and consulted with an oral and maxillofacial surgeon about my situation.
He examined my molar and the area around my wisdom tooth, which had been filled years ago but had not undergone root canal treatment.
He tapped on my two teeth and asked which one hurt.
He concluded that the pain was coming from my wisdom tooth, likely due to pulpitis, as it hurt when I bit down, and it was not the molar that was causing the pain from the root canal treatment.
The next day, on October 14th, I went back to the clinic and explained that my pain was likely from the wisdom tooth, not the molar.
I saw the oral and maxillofacial surgeon again, who mentioned that the nerve was inflamed and the root canal was swollen.
He noted that I had initially indicated the pain was from the molar, so he hadn't paid special attention to the wisdom tooth.
Upon examining my wisdom tooth, he said it didn't appear to be pulpitis but rather periodontal disease, and he performed periodontal treatment, mentioning that recovery would take time.
However, I still felt pain when I returned home.
On October 15th, I went back to the clinic for root canal treatment on the molar.
After finishing, the doctor pointed out that there was actually a significant cavity at the junction of my wisdom tooth and molar, which had not shown up on the X-ray.
He suggested that this might be the source of my pain and advised monitoring the situation.
Today, I feel somewhat less pain, but pressing on my face still hurts, and it seems like the gum has become more swollen.
Doctor, is my face swollen significantly? The area where the tooth hurts feels very painful and slightly swollen.
I also noticed that the gum connecting the molar to the wisdom tooth feels swollen.
So, I am completely confused about whether the issue is with the molar, the wisdom tooth, or periodontal pain.
The gum is swollen, and pressing on my face is painful.
I am very worried about the possibility of developing cellulitis, especially since I have a history of liver transplantation.

Wenwen, 30~39 year old female. Ask Date: 2015/10/15

Dr. Zeng Guanghui reply Dentistry

It is advisable to consult a dentist for further examination and treatment to prevent the infection from continuing to cause cellulitis.

Reply Date: 2015/10/15

More Info

Tooth pain can be a complex issue, especially when it involves multiple teeth and potential complications from procedures like root canal therapy or wisdom tooth extraction. Based on your description, it seems you are experiencing significant discomfort that may stem from both your molars and your wisdom teeth. Understanding the underlying causes of your pain is crucial for effective treatment.

Firstly, it’s important to recognize that root canal treatment (RCT) is performed to remove infected or damaged pulp from within a tooth. After the procedure, some discomfort is normal as the area heals, but severe pain, especially if it persists or worsens, can indicate complications. These complications may include:
1. Incomplete Cleaning: If the root canals were not thoroughly cleaned, bacteria can remain, leading to ongoing infection and pain. This seems to be a concern in your case, as you mentioned that the pain started after your first RCT and continued despite subsequent treatments.

2. Periapical Infection: If there is an infection at the tip of the tooth root (periapical area), it can cause significant pain and swelling. This may require further treatment, such as additional root canal therapy or even surgery to address the infection.

3. Cracked Tooth Syndrome: If the tooth has a crack, it can lead to pain when biting or chewing. This can sometimes be difficult to diagnose without advanced imaging techniques.

4. Adjacent Teeth Issues: Your wisdom tooth may also be contributing to your pain. If it is impacted or has decay, it can cause pain that radiates to adjacent teeth, including the molars. The inflammation of the gums around the wisdom tooth (pericoronitis) can also lead to discomfort.

5. Gum Disease: If there is gum disease present, it can cause pain and swelling in the gums surrounding the affected teeth. This could explain the tenderness you feel when pressing on the area.

Given your symptoms of swelling and pain, it is essential to follow up with your dentist or an oral surgeon. They may recommend imaging studies, such as X-rays or a CT scan, to get a clearer picture of what is happening beneath the surface.
In terms of treatment, here are some potential options:
- Further Root Canal Treatment: If the initial RCT was not successful, a retreatment may be necessary. This involves reopening the tooth, cleaning out the canals again, and sealing it properly.

- Extraction of the Wisdom Tooth: If the wisdom tooth is determined to be the source of the pain, extraction may be the best option. This is especially true if it is impacted or has decay.

- Antibiotics: If there is an infection present, your dentist may prescribe antibiotics to help control it.

- Pain Management: Over-the-counter pain relievers can help manage discomfort in the short term, but they do not address the underlying issue.

- Monitoring: If the pain subsides, your dentist may suggest monitoring the situation closely before deciding on further intervention.

Regarding your concern about the potential for cellulitis (a skin infection) or other complications, it is wise to be vigilant. If you notice increasing swelling, fever, or spreading redness, seek immediate medical attention, as these could be signs of a more serious infection.

In conclusion, the pain you are experiencing could be multifactorial, involving both your molars and wisdom teeth. It is crucial to have a thorough examination and possibly imaging to determine the exact cause of your discomfort. Open communication with your dental care provider about your symptoms and concerns will help ensure you receive the appropriate treatment.

Similar Q&A

Understanding Tooth Pain: Is It Your Molars or Wisdom Teeth?

I have a molar on the right side that has undergone root canal treatment and is capped with a crown. Recently, I've started experiencing pain in that area, and there is also a horizontally impacted wisdom tooth behind it. A few days ago, I visited the dentist and had an X-ra...

Dr. Huang Tingfang reply Dentistry
Dear Ms. Hsuan, Hello! Regarding your concerns, there should be no issues with the molar that has undergone root canal treatment and is now capped, unless there is a fracture in the root. Pain from horizontal wisdom teeth is usually due to cavities or swelling. It is important t...

Understanding Tooth Root Pain: Is It Cavities or Gum Issues?

Hello Doctor: Recently, I have noticed a slight pain in the upper right molar and the lower molar, but it is very mild and does not last continuously; it occurs intermittently. The pain is located near the root of the tooth. I initially thought it might be gum inflammation, but u...

Dr. Cao Guoqing reply Dentistry
Please visit a qualified dental clinic for examination and treatment.

Severe Tooth Pain: Causes, Treatments, and When to See a Dentist

I have been in pain for two to three days. Yesterday morning, I woke up due to the pain. Sometimes it hurts in the upper left back teeth, and other times in the lower left back teeth, feeling like it's affecting the nerves. Taking painkillers helps a bit. Do I need a root ca...

Dr. Huang Tingfang reply Dentistry
Dear Miss Xiao Na, Hello! As described, the situation is quite serious! The tooth is noticeably loose and sometimes bleeds, indicating severe periodontal disease! It causes pain that wakes you up, and there is pain in both the upper and lower teeth, suggesting the presence of re...

Chronic Tooth Pain: Seeking Solutions After Years of Discomfort

Hello Doctor: Two years ago, I had a cavity in my upper left molar, and the dentist recommended extracting my wisdom tooth before treatment. I followed their advice and had it removed. However, two days later, I experienced severe biting pain in my upper molar and the teeth below...

Dr. Huang Tingfang reply Dentistry
Dear Ms. ANN: Hello! As mentioned, you have been through a lot! The issue on the upper left may be related to your wisdom tooth, which could be causing damage to the upper first molar. The upper right seems to be a cavity issue, along with tooth sensitivity, which can truly affec...