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FAQ:  Root Canal Therapy RCT



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Question:
Need for Root Canal caused by new crown?
As I was having a crown put on my #18 tooth I felt a sharp pain that shot through my jaw as if he hit something. He continued and the pain left.

After the crown was put on I had a lot of pain in that area but I thought it was just from the process. I waited but it got worse and now causes all my teeth to hurt.

So every four hours I have to take pain reliever. I went back and he checked all my teeth around that one and said they were fine. He took an xray of #18 and said it looked like the filling was too close to the nerve.

My question is was this caused by him because the tooth had a filling in it before the crown and it was fine. Only after he worked on it did it hurt. Do I need a root canal? ...Visitor from PA

Answer:
I know it is frustrating to have a tooth protected by a crown (cap) restoration only to have it flare up and perhaps need root canal treatment.

Sometimes after a new filling or crown restoration is done the tooth hurts when you bite on it, or it becomes sensitive to hot or cold. Usually the cause is that the filling or cap is a bit high causing the opposing tooth to bang into it and hit it too hard . When this happens the root of the tooth that had the new restoration gets sore and inflamed and pain can develop under the roots of the tooth.

Remenber that when your filling or crown was placed you were most likely numb. The dentist had you tap, tap, tap on the marking paper and adjusted the new restoration to the best of his/her ability. You may have thought things felt fine, but after a week or two of banging on a high restoration or crown your tooth starts to get sore and hurt, especially when you bite down.

When this happens a patient should immediatly call their dentist so the filling or crown can be fine tuned and the bite adjusted to normal. Since the tooth was sore and inflamed, it's best to avoid eating on the tooth for a few days. It will take a week or two for the tooth to get back to normal.

In your case tooth #18 was crowned because it may have had a huge old filling in place that had started to wear and break down. A new basic silver or composite (white) filling may have caused even more tooth structure loss futher weakening the tooth.

A tooth that needs a crown, commonly has had many fillings over the years,each new filling taking away good supportive tooth structure. Patients should understand that each time a tooth has a filling or work done on it, the nerve of the tooth gets stressed.

Having the tooth prepared for a permanate crown could cause the final insult to the nerve and blood supply to the tooth, which could kick the nerve over the edge. In this case the tooth gets sensitive to hot or cold,and not only hurts to bite on, but can hurt out of the blue or at night while you are trying to sleep.

I can assure you that no dentist wants to provide a restoration, porcelain veneer, crown or filling and then have the patient return in pain. We are dealing with the human body, there is no way we can say that a tooth will never, ever have another problem with it. Most dentists try their best to provide their patients with quality, comfortable long-lasting dental care.

I think out of 100 teeth that are crowned at least 2 or 3 may need future endodontic (root canal) treatment. It's not common, but if you are one of the two or three that need futher endodontic treatment, it is a major concern to be sure!

I do not feel your dentist caused a root canal problem on purpose. If needed, a root canal can be completed through the top of your crown to get you out of pain. You will not need another crown as a small white filling can be placed in the access area.

Editorial Staff

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