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FAQ:  Root Canal Therapy RCT



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Question:
About four years ago I had a root canal on a lower left molar. Unfortunately, I never got a crown on it, and never had any serious follow-up checkups.

Sometime later a couple of pieces broke off the tooth, and some time after this, I had a couple instances of deep pain in the jaw, mostly at night. Meanwhile, I also began to have trouble with my left side, noticing a tremor in my left hand, experiencing muscle spasms at night, etc.

After a couple of years of this, I suddenly developed what seemed to be an inner ear infection, with headaches and a bit of vertigo and nausea. A GP did some tests, but found nothing obviously wrong. However, symptoms continued along with the fulness in the ears, and for the next couple of months I felt bad without really being sick.

Basically, I felt kind of hung over for a couple of months and couldn't figure out why. That's when I thought that I should get my root canal examined to see if it was infected, perhaps contributing to whatever was going on. The dentist did some x-rays and found that there was a chronic infection underneath the tooth. This may have been there since I first had the root canal (at least 3 or 4 years ago).

They said they could refill the tooth, re-root canal it (although one root had a pin in it so they couldn't re-do that one), or just pull it, but I don't really know what each option means.

Why would refilling or another root canal work if the infection was under the tooth? Since this was a hospital for dental students, I was put on a waiting list (which may take a while because it is exam season). So, my questions are basically three:

1) Could my earlier symptoms be related to the infection under the root canal (tremor, spasms, headaches, general feeling of tiredness, and some kind of inner ear infection)?
2) What exactly are the different options for treating the tooth?
3) How long should I wait? ... Robert in IA

Answer:
Robert, your pain symptoms may be caused by an infected tooth, but I doubt it. What you are describing is most likely a compressed TMJoint. Root canals can leak if they do not get crowned and you end up with another infection, which can be solved by redoing the root canal.

However, your symptoms just do not add up to a root canal problem. If you can re-treat the root canal, don't wait much longer. Get the treatment, if your dentist says it will be successful. Follow recommendations.

But keep an eye on your pain because what you are describing is very demonstrative of a problem with your jaw joint. You may have a hard time getting good care for this because not too many dentists know how to properly treat TMJ. But get the tooth fixed first and let me know how you feel.

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