Question:
At my last dental check up in February, my dentist said that one of my
molar roots was disappearing and that I needed a root canal. He
brought in an endodontist a couple of weeks later, and then over a
period of about 2 months, they cleaned the roots, put in the calcium
replacement, put on a temporary crown, and then the final porcelain
crown.
I've had the porcelain crown for about 3 and a half months. Initially,
it was painful, and I used painkillers. But then the pain subsided. I
was not very happy with the crown because it tends to trap in more
food on the sides, and so I have to be much more careful with
flossing.
Once, I had a bit of an inflammation (the gum was swollen), but it
disappeared after a few days. Now the gum looks fine, but I am in
pain, and it looks like there should be no reason at all for the pain.
I did have some hard cereal (Wheatabix) yesterday, but it seems like
any discomfort from that should have gone away.
I am very unhappy about the treatment I received. Are crowns supposed
to continue hurting for this long? Is my experience normal? I am
considering going to a different dentist to get it checked out. What
should I ask?
Answer:
Any specific reply would be speculation. Resorption of the roots as
you describe is not typical, and complicates the prognosis of this tooth.
The problem may be in the gum, esp. as you note you get food stuck in
between the tooth and the cap. In any case, pain at this point must be
looked into. A simple description of the pain should suffice, and any
good examining dentist should have a pretty good idea of what might be
going on. By all means, get a second opinion if you are not satisfied.
One clarification: I have no idea if food gets stuck
betwen the tooth and the cap (I'm not sure how I would find that out),
but what I did notice when I floss is that food often gets stuck
between the tooth with the cap and the next tooth (i.e. there is a
wider gap between the crowned tooth and the next one than there
normally is).
The pain is not constant. It occurs mostly after meals and is somewhat
like throbbing pain. It feels as though I have food stuck there, even
after I floss. Biting down on the tooth accentuates the feeling. Does
that mean that food somehow gets in betwen the cap and the tooth, and
this is what causes discomfort and pain?
Also, occasionally, when I press on the gum it feels very tender and
even painful.
I was told that resorption of a root can happen as a result of trauma
or stress...
From your description, it is likely the food is getting caught between the crown and the adjacent tooth.
If floss passes between these two teeth with little or no resistance, you have inadequate contact between
these teeth, and it is likely this at least contributes to the problem. Problems related to resorption of
the root sound to me less likely to be related to the problem you're having.
Root resorption is frequently caused by trauma (more usually in a front tooth), but can also be seen in
chronic pulpitis (long term inflammation of the nerve of the tooth)
