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Pain after root canal. Fractured?

Help!

I had a root canal a few months ago. Pain improved - but returned a few weeks later. DDS reluctantly re-opened the tooth, removed (gutta percha) filling and found what he thought was more live tissue, which he removed. This time, he left the canals unfilled, but closed tooth with a temp. filling. Pain subsided, but again returned a few weeks later. The endo suspected fracture, although no sign of tissue granulation or other visual indication of fracture. After he cleaned out the canal, pain went away - but it's back again!

Here's my question: Would pain caused by a fracture be relieved by root cana;l therapy - even temporarily? I'm almost ready to accept that the tooth is fratured, except I can't understand why the tooth always improves after he re-treats it.
This is not a tooth a can easily afford to lose - since I had several teeth extractedyears ago following what we thought was failed root canals; turns out I had facial neuralgia. I doubt this is the case this time - because its happening on the other side - and when it WAS neuralgia, no dental treatment of any kind relieved the pain (a low dose of Elavil eventually controlled the pain until it went away completely).

Any endo experts out there?  Thanks!
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Avatar universal
my tooth had a root canal and crown and after 6 years it still hurts sometimes. i have a root fracture (it doesnt show up on xrays but there is no other diagnosis) with no infection. my dentist keeps his eye on it so if it gets infected i can pull it before bone loss occurs. sometimes its sensitive to hot/cold sometimes pressure. another poster mentioned pain after flossing, sometimes i get that too.  most of the time its a barely there ache and other times everything causes a lot of pain. i will keep it as long as the pain isnt constant and its not causing damage. those are for the most part he only options for a root fracture..... live with it or pull it.
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Avatar universal
I could not agree more!!!
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Hi Randidandy,

could you please recommend a good periodontist and prosthodontist in the NY area? I am having terrible biting pain after a root canal and suspect that the tooth may be cracked but my dentist cannot help me and is not giving me any answers. I am so frustrated and don't know what to do. I do not want to get the tooth pulled if it can be saved. When you say that the pain went away immediately, what did they do to help it? You said that your periodontist saw the fractures in the tooth but what did they do about it? Thanks so much!
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Avatar universal
Hi! I know that you created your posts eight years ago but I was wondering if you were able to finally get your tooth fixed? I am having the same trouble as you did. A piece of my molar chopped off so I went to the dentists who drilled through the tooth and said that I would need a root canal and a crown because the tooth was basically rotten and he would not be able to put a filling in it. I agreed and had a root canal done 3 weeks ago. But the pain  (biting and chewing pain) is still there. I had six appointments already to do a root canal, then insert a post, and then do a temporary crown. The pain is still there though and I cannot chew on that side of my mouth. It hurts when I push on the sides of that tooth. I am supposed to get a permanent crown installed next week but what is the point if the pain is still there? My dentist is not giving me any answers. I am also suspecting that the tooth may be cracked (or whatever is left of the tooth, to be exact). I am so frustrated. If you had your problem resolved, please-please-please let me know what you ended up doing as it may help me shed some light on my problem. Our symptoms are virtually identical. My email is ***@**** if you'd like to PM me instead. Thank you so much!
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Avatar universal
I just want to make you people aware that I was walking around for twenty years with three fractured root on root canal teeth undiagnosed.  Kept complaining to the dentist and went to several dentists over the years for opinions even three endodontists   I had on and off pain and have TMJ so dentist kept taking pressure off with night guard.  I finally found a new prosthodontist and had periodontist open up the gum flap and sure enough he finds fractures.  Just because  endontists say scan looks good does not mean they are always right when doesn't show on ct scan.  Pain went away immediately!!  Don't suffer like I had to see a competent periodontist and prosthodontist.  If you need someone in  New York area respond and I will reply.
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Avatar universal
After further research into the matter I found this comprehensive answer.


This is perhaps the most plausible answer ever. In addition this answer is talking about 4 roots so mine on the x-ray had only 3 visible and treated. I am going for a third opinion to a another doctor.

Q: I recently had to have a root canal done on a tooth that the dentist had just done a crown on. This was not my first root canal, but it was extremely painful and had an infection in it. It took a while before I was pain free. Now, three months later, I am having pain in the tooth again. What could cause this?
— Jane, Rhode Island
A:
The current pain you are experiencing in the tooth that previously had root canal therapy may be caused by the following:

1. The tooth has an extra canal that was not cleaned out and filled. This means there is an extra physical root.

2. The tooth has an accessory canal, which is a tiny piece of nerve that is rarely cleaned out and filled. These accessory canals are hard to see on X-rays but are small branches of the nerve trunk.

3. The tooth may be fractured, since root canal teeth do get dried out internally.

4. The root canal has become reinfected.

The process of performing root canal therapy is typically quite successful. Over time, however, problems can occur because the tooth no longer has internal fluids or blood supply. During root canal therapy, the tooth is cleaned out, and a rubbery material is often packed inside the canal. At any time prior to the root canal, the tooth may become fractured and go unnoticed by the dentist. A fracture or crack in a tooth may create the need for root canal therapy and the pain leading up to treatment. Once the tooth has had its root canal therapy, things may be fine for a while, but then this crack starts to trap bacteria and cause pain.

An accessory canal is a canal that is impossible to see on an X-ray, but it can leave a tiny amount of nerve tissue after a root canal is performed. These branches of the main nerve are almost impossible to fill. Oftentimes, the nerve will die, and there is no problem since it is such a small area.

There are situations in which a tooth has more roots than it is supposed to. Single-rooted teeth can have a second root, double-rooted teeth can have a third root, and multirooted teeth can have an extra root canal. Sometimes they are visible on X-rays, and sometimes they are not. A qualified root canal specialist will usually pick up this extra canal and may even find an extra third or fourth canal. There are times when even a specialist can miss these extra canals, and a few months later you feel pain from the untreated canal. I would go back to your root canal professional and see if this is the case. Sometimes the pain is just clenching and grinding on a tooth that had a root canal and no further treatment is needed except a bite adjustment. There are also other situations where the root canal can get reinfected, but these are rare.

Learn more in the Everyday Health Dental Health Center.
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Avatar universal
For all of you experiencing pain take organic olive oil and hold it on the tooth. Keep it there for as long as you can, and you'll be amazed when the pain will subside. Don't spit the oil out ingest it because it has amazing therapeutic effects. It will work wonders for everything, not only pain in your teeth.

OK I landed here because obviously I have the same problem as all of you.
I tooth with two root canals done it and still in pain.

After the first root canal, I would only experience pain on really hot foods. I was fine for two years because the pain wasn't intense. A month ago I went to put a crown on it and when the doctor opened it up I experienced pain. He did a second root canal and the tooth ached for a few days and then pain subsided. On the second root canal the doctor found a parallel canal that the previous doctor missed. He cleaned that too and he explained what happened and son on.

Last week I had something really hot and the pain came back. Same as all of you, X-rays look fine. I took another x-ray today, and I saw something on the tooth like a faint black line which looks like the a root. Treated root canals are very obvious to x-rays. But this one looks like it is not treated. The doctor looked at it and he did not tell me anything about what I noticed. The medical assistant saw the same thing. He said I might have a fracture he could not see, and recommended that I should byte the bullet and get a crown, which will help hold the tooth in place.

The last x-ray revealed healing on the tip of the roots that the second doctor discovered. However I am still concerned with this faint black line that just looks like an extra root. I mean  if get a crown and the ache is still there then the last thing is extraction. I would really suck if they take the tooth out and then they find out that in fact there was an extra root, or an additional root canal that was missed.

So that is my concern. I the mean time the olive oil worked marvels and I can barely  feel the tooth when I clench my teeth. Before I started reading this forum, I could barely chew on a freaking banana, Now I'm going to get dinner. The only part that is permanent and messed up is the uncertainty of the diagnosis. I just wish that life should have its do overs and undo's, at least three for each person. one at the age of 10, 20 and 40, or maybe one every 10 years. that would bee ******* awesome!!!! I hate this permanence!!!

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Avatar universal
hi, started getting a root canal on right back molar 1 year ago and still in the middle of redressing due to the dentist making sure that the infection is gone as i was always complaining of pain after the procedures.  Just had last dressing 4 weeks ago and there was pressure pain straight after it for two days until i thought of chewing sugar free gum on it for a day. The pain of doing that was bearable and almost soothing until the pain totally went away.  three weeks later I have pain when biting down and the gum doesn't work any more.  Thinking about pulling the thing out becuase I am so sick of this ****.  Any way my dentist says if i do this i will have no choice but to have a SINUS LIFT. So scared of this, has any one else had this procedure.
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Avatar universal
4 weeks after 2nd root canal. Pain slowly waning, but I'm not chewing on the problem side of my mouth...The consensus seems to be that pulling the tooth is the only other option if pain persists...I read your post and understand your pain and frustration.  So many others seem to be getting the same lack of concern from their dentists.  The money they charge should give them plenty incentive to treat everyone with compassion and do everything to find solutions to any discomfort the patient feels after an $1100 procedure that takes less than an hour.
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Avatar universal
HI, 50cal, sorry just read your post about your tooth, don't know how I missed it! N
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Avatar universal
Hi 50cal, I don't know your situation ( if you could give me a little info. I'd appreciate it, I'd like to hear your story)  but mine , like others I presume, is like this: Nothing shows on xrays. We are told by every dental professional that dentistry is like this, it is at times, hard to figure out what is wrong. I  don't even blame every doctor. Yes, I am upset with the oral surgeon and the endo. I don't believe the oral surgeon took the time to really help me, not even an xray. It seemed liked he made a guess and to be done with it (me) just pulled my tooth. I am a person that now has to live with this, not just an invisible patient. When you do not live in or near a big city, the chances of you getting an answer to your problem and having it fixed are slim to none in my experience and I very very much count General practioners, eye doctors etc in this. Please let us know what your outcome is.N
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Avatar universal
I had almost resigned myself to getting the problem tooth extracted until I read your last post.  I really do understand your frustration, and right now I definitely know the pain...I just researched Dental Malpractice Attornies practicing in my local area on Google...I have been very cordial with my dentist and my endo both..and they are both thousands of dollars richer because of my pain and suffering..so if I'm not getting results the "nice way", I'll try the aggressive way...and I can't believe more of us in this forum haven't done the same....This **** has got to stop...
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Avatar universal
well I wrote a reply but it disappeared. I am still having tooth problems almost 4  years later. I had the molar pulled after a crown and a root canal and thousands of lost dollars. Now I feel like **** because I have one less tooth already. Well, the tooth next to it is now sensitive to very cold and biting and my dentist want me to try a night guard since I do not have typical root canal symptoms. Which, btw, I did not have the first time either. I am so tired of this and am shocked it is so hard to figure out what is wrong with me.... Also, anyone wear a night guard? I am afraid I am going to choke on it ! N
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Avatar universal
It is well worth it to get an Endodontist to do a root canal.  Doing so may save pain, money, and maybe the tooth in the long run...see my post below:
This is about a top rear molar (second from the rear of the mouth) perforated root...  
The Dentist who performed the initial root canal told me the cause of my post procedural headaches and pain was my grinding my teeth when I slept.  After more than three years, I went to an Endodontist.  He x-rayed the tooth.  He didn't say anything about a little glob of filling material protruding from the tip of one of the roots, but he did recommend doing another root canal. He put me on Amoxicillin 500 mg three times a day for 7 days prior to the second operation and then added another seven days of the same dosage of Amoxicillin after.  After the second procedure, he did another x-ray, and I noticed that there was a larger glob of filling material protruding from the tip of the root. The Endodontist didn't make any comment about it.  He said the Dentist had missed a hairline root during the first procedure, and if the infection didn't clear up, dental surgery would be necessary. I am 62 years old and can handle the complete truth. I was so trusting, I didn't even question either one about the excess filling material at the tip of the root.  A friend who had been a dental assistant ,when hearing my story of pain after both procedures, made the comment that it sounded like the first Dentist had perforated the root tip.  It was then, that I remembered the globs of filling material in both the before and after x-rays.
Doctors and Dentists may want to be aware that full disclosure  should be considered, especially now that patients can do a Google search.  
As stated elsewhere: It would be a good idea for a patient to question everything and do his or her own research.
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Avatar universal
I fianlly got dental insurace and went to dentist back in feb.  took xrays and said i need a root canal in one of my molars.  i never had any pain or sensitivity and asked why i couldnt get it filled.  they said if they were to fill it then it would put pressure on my nerve and hurt.  stupid me i went through with it.  worst experience of my life.  i have problems and infections, swelling in cheek and gum right near tooth.  at first i thought the pain was b/c i just had my tooth worked on.  just touching with my tongue hurt like hell.  i did not eat on that side.  i went back and they gave me some presrips for infection and inflammation.  then i got ear infection- now i think it is due to tooth.  then i got bronchitis- who knows maybe infection moved to lungs- so i was on antibiotics for a while and not much pain.  then a few months pass and my tooth, gum gets inflammed and painful- i go back to dentist and they adjust my bite and give me more meds.  Now I noticed that my tooth rises when it is swollen and painfull.  last month the pain came back so bad- like someone punched me in my jaw and i wanted to pull my crown off -it hurt so bad.  of course the dentist was on vacation for 2 weeks at this time and their emergency doc didnt call me back for 2 days and left message saying that she cant do anything but write  scripts.  just so happens i got bit by nasty bug and went on antibiotocs for that and i guess it helped my tooth as well.  so now it happened again.  cheek is swollen, gumline swollen and pain.  i go unnannounced and they take xray and say-well its probably a root fracture. i ask if caused by root canal procedure and they say no way.  i dont believe them- i had no pain whatsoever before my root canal and immediately after procedure it hurts and keeps reoccuring.  i just want to know if anyone has similar situation and what they did and what they suggest i do. oh, the dentsit referred me to oral surgeon for tooth extraction that i should be responsible for (now no insurance) and then get a dental implant from them- ha.  
please any suggestion i appreciate
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Avatar universal
cracks dont show up on xrays very often. i am doubtful that a pulled muscle is your problem. it is very difficult to pull a jaw muscle. it sounds like the infection is causing your symptoms. wait and the antibiotics should make it feel better soon. remember to take all the medication even if it starts to feel okay.
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well back now the dentist i saw took an xray  and he could not see any cracks? but saw what could be an infection he told me to see my regular dentist on the 26th he gave me some antibiotics for 10 days 4 a day also got a call from my dentist office today and i was talking to the lady there and she made an apointment for the 26th at 9:30 am im wondering if may be i pulled a mucile under my jaw there cause the pain is kinda like a throbbing but if i put my finger under my jaw where the pain is it goes away ??? i got a new xray today and the dentist gave me a copy of the x ray to give my regular dentist
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good luck!
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thnks lynn  and hey my mom has your name cool i have a dentits apointment today to have him take a look at it i hope its not a fracture that will suck :( but thnk you for responding to my post i will let u know what he says cross your fingers
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Avatar universal
umm hi  if this works i just had a tooth done meaning a rootcannel done when he was doing the tooth i had some crazy pain anyway after its about 1 month i am having pain this tooth is a bottom right molor about 1 month after it was done i am having pain
at what seems like the "root" part of the tooth so the bottom of my jaw
kinda like a throbbing feeling could this be a crack ??? i have seen my dentits since
and he said there was no crack but now it has acted up again  and he is on holidays summer for 2 to 3 weeks he will be back on august 26 it is august 11th now
its monday and it started acting up again on saterday could this be a muciel that i could have pulled? under the jaw i'm hoping that's all it could be please any help would be helpful also i have a medical condition i kinda have very bad angsiaty and panic problems sorry im a bad speller please any help would be great also is there anything anyone can tell me to take for the pain ?? cause i don't do pain well at all
advil the caplets  don't really work i use the extra strength ones 400mgs  also on another note i had a tooth that had a root canel done a while ago and it had to come out i went through pain for over 5 months and was told no there's nothing wrong with the tooth i went to a dental specailest and they did x rays too and could not find anything wrong anyway long story short the tooth did come out and it was cracked it had a hairline crack in it at the root i was so scared before it came out to the point where i was freaking out  this was a dentist i no longer have as my dentist i have a new dentist now anyway that's it for now
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Avatar universal
Snowgal, I hear you! I have not eaten on the right side of my mouth in years. I do not even know if the pain is in more than one tooth. I believe more than one thing may be going on. Maybe I need a root canal in the original annoying tooth but I'll be damned if I put myself through that and get no relief. This has cause me immense, and I really mean that, stress. You would think the dentist or the endo would at least try to find another dentist endo to look at you and help you set up appts. etc to get to the bottom of this. This problem is causing me a great deal of stress every day and I am  worried and it shows physically and mentally. Please feel free to post to me any other info or gripes you may have. It is good not to feel so alone but on the other hand I feel your pain. Literally. Please let me know if you get any answers or any kind of relief. This sucks beyond words. May I ask your age? Thanks and good luck finding answers.
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Avatar universal
I cannot believe how many people have teeth pain with no answers from their dentists.  I am the same way. I have worn a night splint for 14 years, but 8 years ago I have a crown and r/c done on tooth # 16 (right upper, second last tooth).
It took along time to settle down, but I tried not to irritate it, so I would chew mostly on the other side.  2 years ago, same tooth on the other side needed crown, and then r/c on this one.
About 1 month after, the tooth on the right side that was crowned and r/c started to bother me.  It would ache, burn and occasionally jab.  Saw my regular doctor and when he tapped and blew air, all was fine.  He recommended I see the Endo who did the root canal.  Saw him, and he took ex-rays and tapped on the tooth but it didn't hurt and the ex-ray was fine.  Continued to go back to my regular dentist, and he thought maybe it could be a nerve problem.  I went to see a TMJ dentist who have me wear a day splint and a night splint.  He said have TMJ and my bite is off.  Did this treatment for 1 year but it didn't help the achy, burning tooth, which was now aching in the teeth all the way to the right front tooth, but not crossing over to the left front tooth.  I now have seen yet another dentist who recommended taking the anti-depressant Elavil.  I haven't tried it yet, I'm alittle scared of the side effects.  But don't know what else to do.  This whole thing has given me so much anxiety, and just wondered if anyone has tried Elavil and it has helped, and how were the side effects.
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Avatar universal
Good luck paddycakes. I have been suffering for 2 years and these "experts" I have paid money to, can not find a way to figure out my problem or help me. I hope you find someone who spends some time and is honest with you.
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Avatar universal
Paddycakes again -- need to clafiry something -- I spoke to my husand and he actually started with this dull throb of an achy pain after the tooth started being prepared for a crown.  The dentist did and x-ray and said it looked a little faded so maybe he'd need a root canal -- sent him to an endo who did not agree that a root canal needed to be done on 14 but wasn't sure -- so the dentist sent him to a different endo who said well " since the dentist thinks you need a root canal on 14 let's do it" and it was done and the pain still exists and is worse in some instance.  NOW WHAT DO WE DO???? i dont' want my husband to be labeled with this idiopatic facial pain bec ause people are afraid to help him -- looking for advice as to what direction to go in at the moment for some professional hlep.  
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