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Problems after root canal
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Problems after root canal

I had a root canal 3 weeks ago and things seem worse now.
I have extreme cold sensitivity in the root canaled tooth.  Now the pain is an aching feeling through the whole back of my jaw.  Plus I have a strange ache just under my earlobe on my neck (my glands?)  I was thinking infection but the x-ray showed no sign of one.  Can an x-ray always detect an infection?  Now the Endo. wants to do an APICOECTOMY.  My last appointment with them seemed like they just didn't know why so they'll just try this next.  Any suggestions, advice, similar symptoms?  The gland symptom is what really makes me question everything.  Plus they told me over and over it would be impossible to feel cold on that tooth........then they tested it and I did.  WHAT?
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Avatar_dr_m_tn
I do not know which tooth it is, but in general I would prefer conventional endodontics over the apicoectomy.It is possible there is an infection even if there is no evidence on the x-ray.I would consider another opinion before I had the surgery.
6 Comments
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Avatar_n_tn
Three weeks after the root canal doesn't seem like long enough time for the pain to subside before the decision to do an apicoectomy is made, in my opinion.  I had severe pain after a root canal on a lower back molar that lasted for two full weeks then subsided SLOWLY after that.  One year follow up x-ray shows perfect healing since then.  But then, I've also had root canals that had almost no pain afterward.  Every tooth responds differently.

Have you had the tooth filled and crowned yet?  I had the specific root canal mentioned through an endodontist, and it was two or three weeks before my dental appointment to fill and crown it (well, re-crown it, the root canal was through a crown.)  The dentist office told me to be extremely careful on that tooth and avoid biting on that side, because it was hollowed out and would risk cracking the root or entire tooth, and they said that was also part of the reason it was still so painful when I did try to bite on it, combined with the irritated area around the root.

I did have two apicos on two other teeth, but it was almost SIX YEARS after the initial root canals.  The signs of failure were very slow.

I think getting an apico now, less than a month after the root canal, is aggressive and rushed.  I don't think waiting it out a little longer, or perhaps getting another opinion, would be a bad move.
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Avatar_n_tn
Sorry, left this out...another possibility without going full out with an apico is to re-treat the root canal.  Basically, do it over again.  They may have missed a canal or nerve the first time.  This is why it would be helpful to get another opinion.
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Avatar_n_tn
The tooth it is- back, bottum right, second from back, I believe I heard them say #30.
What do  you mean when you say "conventional" endodontics?
And if an x-ray can miss an infection how else can you test to see if one is present??
They want to do the apico. beacuse they think their might be accessroy roots that do not show up on the xray.
ALSO, they said the root was calcified- could that contribut to more pain afterwards??
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Avatar_n_tn
No I have not had a crown put on yet.  I am afraid to mess with anything until I feel confident that I understand what is going on.  But a crown is in the plans.
I have not been chewing on that side at all.  But even room temperature water will send a dull deep ache through my jaw on that side.
Did you ever have cold sensitivity after one of your root canals? (you just mention pain)
Thanks.

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Avatar_n_tn
Well, that's kind of a mixed question.  I developed odd cold "sensations" in two teeth SEVERAL YEARS after root canals that were the earliest signs of the failure that needed the apicos.  But it wasn't exactly pain.  It was like a "buzzing" sensation through the teeth in response to cold liquids and sweets, without actual pain, because the nerves were missing from the root canal.  And again, it was quite a long while after the root canals before that started to happen.

But I've never had actual cold sensitive PAIN after a root canal.

The fact that you are having actual cold sensitive pain this soon after the root canal makes me think that perhaps not all the nerves/canals were cleaned out.  Sounds like a nerve may have been missed.  I really wouldn't get an apico at this early point.  You may benefit greatly from simply having the root canal retreated.  
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Jerome Tsang, DDSBlank
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