Dr. Hall,
I had a root canal done on my lower molar a year ago, since then I’ve had pressure sensitivity and then later sensitivity to heat that would radiate. I went back, and then my dentist decided to retreat the tooth with the thought that there may be another canal. He said there was, he packed it with some medication and a temp. filling and prescribed antibiotics and I am to go back in 3 weeks for the permanent filling. Since he did this I have had pain in the tooth, pressure…nothing to hot/cold, but I can’t chew on that side. My dentist is out of town this week so I have nobody to call. I don’t know if this is “normal” or why I am having this much pain.
– Karen in Missouri

Karen,
Your pain isn’t unusual. Post-operative pain after root canal work is common. I don’t think there’s any cause for alarm, and it sounds like your dentist did everything right, but I’m sure you’d like some relief from the pain.

Pain to pressure that develops long after a root canal treatment was completed could indicate a failed root canal. But pain to cold or heat is a strong indication of another canal being present in the tooth.

There was apparently infection in the tooth. If he cleaned it out some, it’s likely that some of the infected material was pushed out of the end of the root, and this would cause that tissue to be very irritated and would cause pain until your body resolves that. If this is what is happening, the pain could be eased considerably if the tooth were adjusted to where it doesn’t hit when you clench together. Sometimes when the bite is adjusted it provides immediate and complete relief.
– Dr. Hall

Dear Dr. Hall,
I recently had a small filling placed in tooth #14. At first, the dentist thought that the small crack in the tooth was anatomy, but since I was complaining about sensitivity to cold, the dentist filled it with a small, white filling. The filling was fine for two months. One day, my tooth was sensitive to sweet and cold. A few days later, warm or hot was an isssue, too. I returned to the dentist and she suggested that I see an endodontist for a root canal. Is there no other alternative for me? Maybe a different filling? Or is this what needs to be done? Thanks in advance for your time.
– Allison from North Carolina

Dear Allison,
If your tooth is sensitive to heat, you need to see your endodontist. The tooth needs root canal treatment.

But I would also ask your regular dentist to put a good strong temporary crown on this tooth before you split it clean in two. Like I’d have her do that tomorrow. A stainless steel crown would be good. And reduce the tooth so you don’t bite on it. There’s a really good chance that you have a nasty split in this tooth. These teeth can be saved if you get a crown on them right away. See my article on saving split teeth.

Sensitive to cold and sensitive to sweets – that signals that the pulp of the tooth is irritated. Sensitive to heat – that signals that the pulp is about dead.
– Dr. Hall

Hi, my name is Carrie. I am 25 years old. I just went for a dental visit this morning. My dentist told me that I am having a tooth infection in one of my front teeth. It now causing of decoloration to that particular tooth. He recommenced to do a root canal to that tooth and place a porcelain crown over it. However, I do not feel any pain or anything. I am not sure whether to go for it. I would like to have a second opinion.

Do you suggest to go for it?

Beside root canal and crown, is there any other good alternative?

What will happen if i leave that tooth as is?

Thanks a lot!
– Carrie in Brooklyn

Carrie,
In a case like yours where the tooth is turning dark, you generally wouldn’t feel anything–no toothache, tooth pain or anything, even though the tooth is infected. I saw this a number of times when I was in practice. The inside of the tooth is dead–that’s why you can’t feel anything.

If the tooth is discolored, there has to be a reason, and an infection in the tooth is the most probable cause if you have just one discolored tooth.

And you wouldn’t have to do the crown right away, but I’d recommend doing something, if the tooth is discolored. Is the discoloration bad enough that people notice right away? So do the root canal and then do the crown maybe a few months later, to spread out the costs for you.

When the root canal is done, you’ll probably notice that you feel just a little bit better. And, the infection has probably been there for years, which means that you probably won’t feel anything when he does the root canal, because the inside of the tooth is completely dead. If you don’t do this, you just keep going on with this infection in your bone, and it’s not healthy.

To help reassure you, while you’re having the root canal done, ask the dentist to let you smell the instrument he uses inside your tooth, after he first goes inside the tooth. You’ll be disgusted at how it smells, and you’ll understand what has been going on for years in your tooth and you didn’t even feel it. I had many of these cases where the patient had no pain but they had an infected tooth. I’d always ask them to smell that instrument–it was a good education for them. What happened is that you probably had an incident years ago where you bumped the tooth really bad–maybe while you were playing sports or something, and it quietly killed the nerve to the tooth. That’s what usually makes this happen.

Dr. Hall