My Tooth Really Hurts but My Dentist Says It’s Fine

After I had an infected tooth, I got a root canal treatment. The tooth felt better after that, but then started hurting again. I do know that there are failed root canal treatments and I worried that this happened in my case, though the pain felt more like it came from the tooth next to it. I went back to the endodontist. He did take an x-ray of the root canaled tooth as well as the ones near it and insists that everything is fine. I told him it’s not, but apparently he thinks I am absolutely nuts. In fact, he even suggested I see a neurologist. What do I do?

Angie

Dear Angie,

It is going to be hard to tell anything without examining you. I will say that there are times you can have a legitimate toothache and the tooth be perfectly fine. I’ll go over some of those and then we can talk about your options if you still think there is a problem with a tooth.

• Referred Pain: It is very common that the tooth which is hurting is actually receiving referred pain. There can be a problem with the tooth next to it. You said that he took x-rays. From those x-rays, he can tell you whether or not there was evidence of the root canal not healing properly. He should also be able to tell if the tooth and root are healthy. That being said, you did not mention whether he took any pictures of the other arch. Referred pain can be from an adjacent tooth or even from the opposing teeth on the other arch. It will go upper to lower or lower to upper, but it will not travel from one side to the other.
• Nerve Pain: There are times that nerve pain can mimic a toothache. That is probably why he suggested a neurologist. I doubt he thinks you are nuts. Though, it appears to me that he is lacking in some chairside manner.
• Sinus Problems: Our sinus cavity is very close to our tooth roots in our upper arch. You could be having sinus problems and that pain is referring to your teeth.

All of that being said, if you feel like he didn’t carefully examine the x-rays or didn’t take you the least bit seriously, it is totally okay to get a second opinion. My one word of caution would be to make it a blind second opinion. That means you do not tell them the whole back story. Just your symptoms. You also don’t tell them who the endodontist was. The dental community is a small one and you don’t want him to feel disloyal to a friend.

If the root canal treatment did fail, then you have a couple of options. You can try a root canal retreatment. Be aware the chances of a successful outcome go down with each retreatment. A second option is to extract and replace the tooth. If you do end up extracting the tooth. The best replacement option is a dental implant.

This blog is brought to you by San Antonio Endodontist Dr. Scott Janse