how do I know if I need a root canal?

[Rachel_W]

Hello,

I few weeks ago I did a stupid thing and bit hard down on a date (forgetting that it still had a pit in it!).  It was a very hard impact and both my bottom and top molars at the site of impact were sensitive to cold and pressure and I also had throbbing pain after anything caused slight movement around that area of the mouth.

There was no large injury (i.e. no broken pieces or visible cracks.  Everyone told me to give it time as the mouth is very sensitive but after a week I went to the dentist.  He took x-rays (which showed no obvious damage) and tapping the teeth caused pain.  Biting down on them was painful, but pain was caused no matter what angle my tooth was pressed from, and the top tooth seemed to have swelling underneath it as it seemed raised as it was the only tooth that would touch other teeth.

The dentist said that it was possible for it to just be trauma, such as torn ligaments, and he could not tell if there was a hairline fracture.  He had me come back almost two weeks later (just under 3 weeks after the initial trauma).

The pain had continued, with a feeling of pressure after touching the tooth, sometimes painful and sometimes just a sensation of pressure and pulsating.  The bottom tooth is only slightly sore and achy as far as I can tell.

When I went back yesterday he said that as I am no longer sensitive to cold and have the throbbing then I have an abscess and will also need a root canal done at the end of the month.  He put me on antibiotics.  My questions is, how does he know the abscess is in the root and not the gum (I don't have any visible or tactile swelling except for the feeling of a raised tooth which I have had for 2.5 weeks), and couldn't the lack of sensitivity be because the dynamics of the injury has changed?  If these antibiotics clear it up, should further testing be done before a root canal is performed, or should I have it done just to be safe?  I don;'t want to lose the tooth, although he says if he finds a root fracture during the procedure he will have to extract the tooth anyway.  Also, would antibiotics sooner have helped as I did ask him the first time but he said that they were not needed at that time.

Thanks so much!

[RetiredDentalAsst]

Gluing the tooth back together would be a foolish thing to do, unless of course there were some unknown way to totally sanitize the entire tooth all the way down under the bone, and around the root of the tooth. They would still have to do a root canal. In that process they generally use bleach to disinfect the root cavity, so I suppose it might be possible to clean the entire area that way, but it would be a very risky procedure. That being said, I don't know any dentist that would do such a thing, since that is not a procedure that they are taught in dental school.

[lychee8899]

I heard that even if your tooth is cracked, they can glue it together or something.

[Rachel_W]

no need to answer now, as when they took the filling out the tooth was actually split and so they said the only option at this point was an extraction.  :(

My only advice is be careful with dates!!!

[Rachel_W]

The throbbing pain stopped, but the tooth is still sensitive to pressure after 6 weeks, and I called to see if they thought that a root canal was needed.  All the symptoms of still needing a root canal are there, such as percussion pain etc, and my tooth has a smell about it.

So I have decided to have the root canal which I am having tomorrow.

The issue is the tooth is sensitive when i push on the inside of the cusps, and I worry about a crack.  After doing this if i push the other way I hear a slight crackling noise, as if there is a crack and the tow sides of the tooth are pushing back together.

I am so worried that I have a split tooth.

I know I will find out tomorrow but I am really worried and would like to know if it is possible for the cusps on either side of the tooth to actually move if there is a crack rather than a actual split throughout the whole tooth.  My gut is telling me that movement, even though it is only slight, would only happen if there was an actual split and the two sides of the teeth were actually separated.

Please help.

[Rachel_W]

Thank you for your comments.  The dentist basically told me that because the cold sensitivity has disappeared then it must be damaged nerve/pulp, however everything that I have read says that this usually is accompanied by greater sensitivity to heat, which i do not have.  It is still unbearable to put pressure down on the tooth, and my fear is if I leave it and have a minor crack, then once I start using the tooth again it could go down into the root even if it is isn't already there.  As mentioned the x-ray did not show anything, but I know that hairline cracks usually don't show, however, I assume that if the pain goes away altogether then should this mean that the tooth is probably okay?

Thanks again.

[nerve damage]

if you need a root canal, make sure you ask what they are using.  you want gutta percha and specifically say "NO FORMALDEHYDE".  A small group of dentist use this stuff against the stance of nearly 99% of the dental community.  they don't tell their patients, sometimes even after they injure them.  Watch the news story at this website - www.worstrootcanalever.com and say "NO".  Nerve damage is the other serious injury from this stuff, but the bone infection that this lady has is horrific.  That pink stuff likely has lead and mercury in it too.

[mammo]

If all is well after you've finished  your antibiotics, I would take a "wait and see" attitude.  There is absolutely no reason to jump into getting a root canal at this point, the abcess could just be the result of trauma to the area surrounding the tooth.  There probably wasn't any reason to give you antibiotics before now since there were no signs of infection, and you don't want to take antibiotics unless you really need them.  If there is a real problem with the tooth, it will let you know and then you can decide what to do.  But I wouldn't jump into a root canl or extraction at this point.

[scottma]

Seeing an endodontist is advised.