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Root canal through a crown
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Root canal through a crown

I had a root canal completed back in September 2008 by a very skilled endodontist.  The tooth is a bottom molar that already had a crown on it from years ago.  My ordinary dentist had already performed a root canal on the tooth in April 2008, going straight through the top of the crown to preserve it.   The tooth did not settle and still had nerve pain pulsating through it every so often so I was sent to one of the best endodontists in the city.   He found nerve tissue in the tooth because I had something called calcified blockages which were very difficult for my ordinary dentist to reach.   Anyway, the endodontist completed the work back in September last year.   My problem is that when the tooth is touched, even very lightly on the front side it is very very tender, almost feels like a bad bruise.   I also have this same sensation on the top back rim of the tooth (the rim nearest my throat), although the rest of the tooth feels fine to push (except the front).   The weird thing is I have full chewing power on this tooth.   I can chew anything and have no discomfort.  So basically pushing down on the tooth with food in my mouth doesn't hurt, but pushing the front of it sideways sends me through the roof.   The endodontist has checked occlusion thoroughly and has determined everything there is fine.   He told me a root canalled tooth can be tender for a while when pushed in the "across direction" rather than the "down direction" (if that makes sense) but this has been going on for 6 months now and I really want the feeling to go away!   Even if I run my thumb over the skin on the outside of my face down there, I can feel it because it's making contact inside on the front side of the tooth.   My question is if the crown was replaced, could it help this feeling, both on the front of the molar and also on the top back rim.   Could the root canal process build up some sort of pressure in the crown which is contributing to this feeling and stopping it from going away?   Or would having a crown already on the tooth when the root canal was done have absolutely no bearing whatsoever on this bruised feeling?
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745634_tn?1243727047
What you describe sounds like an occlusal interference.  It may be perfect from a purely up and down motion (which is what most dentists check), but if you hit it heavy with eccentric movements (side to side) that would cause the exact problem you describe.  Problem is, many dentists either do not check this, or were never trained correctly how.  Occlusion is only starting to be taught correctly in the last few years, so a dentist out in practice for 10+ may not know unless he got special training.  Endodontists are worse because they do not check occlusion on a daily basis like a general dentist or prosthodontist would.

I would suggest going back to the dentist who made the crown.  Make sure he checks your bite when you grind right and left.
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530183_tn?1213087279
Problem is the crown is actually 11 years old.   The endodontist has repeatedly made me do the right to left grinding test as well as the up and down biting and he's shaved the crown down neatly to the point that he tells me it is not being hit.   Any possibility that the crown is so old that it is not doing its job of protecting the tooth and thus causing the discomfort?   I've had two other root canals done on different teeth, both of which were not crowned when the procedure was done and I've never had a day's problem with either of them.
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