Tooth Pain: Do I Need Root Canal Treatment?

Regarding cavities between the molars (the last tooth) and the second-to-last tooth?

Hello Doctor, my last tooth and the second to last tooth had a filling due to a cavity between them.
A few years later, during a check-up, the dentist found that there was decay underneath the filling, so the dentist replaced it.
The dentist mentioned that it was close to the nerve, and if it hurt after the filling, I would need a root canal treatment.
For the first three days after the filling, I didn’t experience any issues, but I felt pain when biting certain foods.
During my follow-up appointment a week later, the dentist advised me to observe for a few days to see if there was any improvement.
Over the past few days, I haven't noticed any issues with biting, but when I use a water flosser to clean the filling, it causes pain, which seems to correlate with the pressure of the water stream.
I've tested this for several days, and the pain remains the same.
I only started using the water flosser recently, so if I hadn't used it, I might not have known about this issue.
I sincerely ask the doctor: if there is no pain when biting but there is pain when using the water flosser, do I still need a root canal treatment? Thank you, Doctor.

Xiao Gao, 30~39 year old female. Ask Date: 2016/01/01

Dr. Huang Zhicheng reply Dentistry

Dear Xiao Gao,
Hello, before the dental filling, the dentist uses a high-speed handpiece to prepare the tooth, which may stimulate the pulp chamber and cause it to become hyperemic, making it sensitive to pressure, temperature, and concentration.
It is recommended to observe for 3 months post-procedure.
If you experience discomfort while chewing or even spontaneous pain, then root canal treatment will be necessary.
Wishing you safety and health.
Sincerely,
Dr.
Huang Chih-Cheng
Director, Department of Dentistry
Taoyuan General Hospital, Ministry of Health and Welfare

Reply Date: 2016/01/01

More Info

Tooth pain can be a complex issue, especially when it comes to determining whether root canal treatment is necessary. Based on your description, it seems that you have experienced some discomfort following a dental filling, particularly when using a water flosser. This raises several important considerations regarding the health of your tooth and the potential need for further treatment.

First, it's essential to understand the role of root canal treatment. This procedure is typically indicated when the pulp of the tooth becomes inflamed or infected, often due to deep decay, trauma, or repeated dental procedures. The symptoms that usually prompt a dentist to recommend a root canal include persistent tooth pain, sensitivity to hot or cold, swelling, and sometimes a visible abscess on the gums. In your case, since you mentioned that the filling was close to the nerve and you experienced pain when using the water flosser, it suggests that there may still be some irritation or inflammation present.

The fact that you do not experience pain while chewing certain foods but do feel discomfort when using the water flosser indicates that the issue may not be severe enough to warrant immediate root canal treatment. However, the pain during flossing could suggest that there is still some irritation in the area, possibly due to residual decay or an incomplete seal of the filling. Water flossers can sometimes create pressure that exacerbates underlying issues, which might not be felt during normal chewing.

Given that your dentist has advised monitoring the situation, it would be wise to follow their recommendation. If the pain persists or worsens, or if you develop new symptoms such as swelling or increased sensitivity, it would be prudent to return to your dentist for further evaluation. They may recommend additional imaging, such as X-rays, to assess the condition of the tooth and the surrounding bone structure. This can help determine if there is any infection or if the root canal is necessary.

In the meantime, here are some general recommendations to manage your situation:
1. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help alleviate discomfort. However, be sure to follow the dosage instructions and consult your dentist if you have any concerns.

2. Avoid Irritation: If using the water flosser causes pain, it may be best to avoid it until you have a clearer understanding of your tooth's condition. You can continue to practice good oral hygiene with traditional flossing and brushing.

3. Monitor Symptoms: Keep track of any changes in your symptoms. If you notice increased pain, swelling, or sensitivity, contact your dentist promptly.

4. Follow-Up: Make sure to keep your follow-up appointment with your dentist. They will be able to assess the situation more thoroughly and determine if further treatment, such as a root canal, is necessary.

In conclusion, while your current symptoms do not definitively indicate the need for root canal treatment, it is essential to remain vigilant and communicate openly with your dentist about any changes. Root canal treatment can be a valuable procedure to save a tooth and alleviate pain, but it is crucial to ensure that it is warranted based on a comprehensive evaluation of your dental health.

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