pain after root canal

[inchicore]

i had a root canal done on my lower left second molar a little over a year ago. i didn't get a crown, just some sort of filling. about two weeks ago a piece of enamel from that tooth fell off, and i've been feeling a lot of heat sensitivity and sometimes pain while chewing in that area. my dentist said the root canal was fine and that my pain was unrelated to the enamel falling off. what should i do? is my dentist wrong, should i get a crown on that tooth?

[inchicore]

well he did use the drill on a few teeth when he was checking the dental occlusion, but i didn't feel much of a difference. anyway thanks again for all of your replies :)

[Jerome Tsang, DDS]

That's a valid approach if he can't see anything.  Obviously we don't drill without some cause for action.  Just keep an eye on it and be sure to get in as soon as possible if it worsens or new symptoms develop.

[inchicore]

just came back from the dentist. he did some tests and basically said he didnt see anything wrong and told me to just wait and see. he took a radiograph but didn't develop it while i was there. he also said i had two superficial cavities in my upper left molars but that they weren't really a problem, i should just get them treated before they get worse.

[Jerome Tsang, DDS]

With the pain, yes.  But the pain medication doesn't address the actual problem so you'll have to see what's going on.  Sometimes the tooth/nerve can start to die and result in less pain as well.  

[inchicore]

thanks again. now chewing doesn't hurt anymore, and i have very little heat sensitivity. it only really hurts with cold liquids, sharp at first then a dull ache. i called my dentist thursday and was instructed to take nimesulide (100mg) every 12 hours. i took one pill thursday night and another friday morning. i didnt feel too much pain after that so i stopped taking it. maybe they helped?

[Jerome Tsang, DDS]

Leakage of the root canal is my worry.  That means the infection/cavity has spread underneath the filling and into the root canal possibly.  Go to a root canal specialist and see if a re-treatment of the root canal may be necessary.

[inchicore]

thank you for your replies. i saved the piece of enamel that fell off. it's from the edge of the tooth, about 2mm by 1mm and mostly opaque. but it looks like there is something dark inside it, like a tiny little worm. can that be a cavity? and what kind of problems could there be with the root canal if there is or was a cavity?

[Jerome Tsang, DDS]

Judging by your description, I would recommend getting your dentist to check it again or give you a referral to a root canal specialist to evaluate the tooth. There might have been a cavity underneath the filling resulting in the tooth breaking.  If it did have a cavity, its a possibility there may be some problems with the root canal.  

[inchicore]

oh i forgot to add, i also had a root canal done on my lower left first molar about three weeks ago due to heat sensitivity. and i'm not sure it's relevant but i had all four wisdom teeth removed in mid-2009.

[inchicore]

right now anything touching my left molars makes it hurt (not ruling out the possibility of it being a nearby tooth). even cold water hurts. about five seconds after i drink it a sharp pain starts and fades to a dull ache about ten or fifteen seconds later. i know it can't be there but i swear i feel it in my lower left second molar. the same thing happened when i tried to eat some (cold) pudding. and when i eat hot, mostly solid foods, i dont think it's even the heat alone that bothers me anymore, it can hurt just from the pressure of chewing.

i'm starting to have a constant dull pain (starting to get sharper) in my lower left jaw. but sometimes i think i also feel some pain in my upper left molars and pre-molars and my left cheekbone. i have a filling on the side of my upper left first molar from around ten years ago, but that tooth has never bothered me.

i have to wait until monday to go to the dentist, i hope it doesnt get too bad until then.

[Jerome Tsang, DDS]

If there's a root canal done, there shouldn't be any sensation from the tooth itself.  There may be some pain from the gum area or a tooth nearby.  A crown probably wouldn't address the sensitivity