Persistent pain

My #13 is a back anchor to a 5-piece bridge, and started becoming uncomfortable a couple of months ago. That combined with some occasional temp sensitivity, prompted me to have a root canal on the tooth. Afterward, the pain in the tooth became worse than before, and I was prescribed a round of Keflex, which eliminated the pain within a couple days. Less than 2 weeks later, the pain returned and has slowly but surely gotten worse. It has now been about two months, and my endo assures my that the procedure was slick and clean, and cannot be responsible for the discomfort. My dentist took the tooth down a bit, which provided some relief for a few days, but the pain is now as bad as ever. There is no sharp pain and no discomfort while chewing, although chewing does promt a bout of prolonged dull pain which typically starts about 10 or 15 minutes later. If I clench my teeth, I hear a small crunching noise from the tooth/bridge area about half the time. Could the bridge be loose (it does rock a little), and if so, could that be the cause? Any other ideas? Please help -- I can't take much more of this.

[Jerome Bogin, D.D.S.]

The bridge should not rock at all. If that is the case then it must be addressed and that could be the cause of some of the problems you are experiencing. See your dentist asap.

[mike1105]

sounds to me like there is a problem with the bridge, or the teeth underneath. How old is the bridge? If the dentist you are seeing now did the bridge within the last 5 years, go see another dentist and get another opinion. dentists do not like to admit that their own work has failed, possibly for a reason that could have been forseen---- not to jump to conclusions but as a general rule tooth #13 is not a great "anchor" for a bridge  (especially a longer span bridge like yours) because it usually has a slender, single root. Also,the bridge itself might not be rocking-- it might be the teeth themselves. if this is the case, you've got even more problems....periodontal problems that may have been forseeable or at least could have been noted during regular check ups (if you had them). good luck.

[BobBob7]

I believe my gums are rock-solid -- I'm a consistent flosser and have been for years. The bridge is anchored on 9-12-13 (all have had root canals), so I would hope that #13 (which does have a very long single root as noted) isn't under too much stress. The bridge also feels 'funny' when I tap it lightly with my bottom teeth -- I'm thinking it may be a loose post. The bridge is only a year old, and my current dentist is afraid to try to remove and re-cement it. I'm going to take your advice and get a second opinion from my previous dentist (I only changed dentists because I moved an hour away) -- I've always had great confidence in him.

[mike1105]

if there is no periodontal disease or loose teeth, then the bridge is rocking either because something is cracked ( a tooth or a post, as you say) or the bridge simply is loose because the cement seal has broken somewhere. either way, in my opinion it may be best to remove the bridge and see what's going on. one way for a dentist to tell if it's loose is to lightly tap on it with the crown/bridge "tapper". if it is already loose, it should come off easily without the risk of damage to the teeth or the porcelain. something you can try------ press and pull on the bridge yourself, not too hard, after wetting the area thoroughly with your saliva. as you pull and push, watch for bubbles at the gumline where your crown margins (edges) are. if you see bubbles, there is a failure of the cement seal and the bridge absolutely needs to come off. at that point, i would not want it "tapped" off unless it can be done easily because it's possible that, for example, only the seal on #9 has failed. if so, tapping it off may crack the actual teeth under #12,13 -especially because tthey have root canals (which makes teeth brittle). i would want the bridge cut off and remade. (somthing is wrong with it anyway if the cement failed after only a year---- i would not want the thin g recemented if it were me.

[BobBob7]

My previous dentist (second opinion guy in this case) adjusted my bite and declared the bridge sound. I'm still in constant pain from the RC site of roughly seven weeks ago and am opting for an apicoectomy as a last resort. I have now had the tooth taken out of contact with my lower teeth as a pain control measure. Contact and chewing on the tooth produces no sharp pain, and no immediate pain, but prolonged dull pain starts shortly thereafter. I sure hope my endo doesn't find a crack. I'd hate to go through this **** for nothing, only to lose the tooth anyway. In the meantime, I have to hold up in the face of escalating pain until Monday, when the procedure is scheduled.

[BobBob7]

OK -- it's now been 10 days since the apioectomy and the pain has gone from dull to occasionally exquisite. My endo wants to give it more time, but I'm just about ready to give up and extract this instrument of torment. It's extremely sensitive to contact (it wasn't before the procedure), and it's more uncomfortable now than it was two or three days ago. Is this worth waiting out for a while longer, or does it sound like a lost cause?

[Myteethhurt]

A related discussion, Who can you trust? was started.