JamesSmith,

Thanks for posting the xrays.

The recently root canaled tooth is #14 (using the Universal numbering system), your upper left first molar. The xray is of mediocre quality, but here is what I see:

1) The dentist instrumented and placed gutta percha in all 3 visible canals in the 3 large roots.

2) The distal root, the short one furthest to the right, is NOT filled to the apex (end) with gutta percha. There is also an infection around the root tip. Possibilities: this area of infection may have been present prior to the rc OR she may have perforated this root during the procedure. In which case the disinfectant and/or bacteria was pushed into the bone beyond the tooth. Although it is not healthy and it can become progressive... it is typical to see infections around the roots of rc teeth.

3) The palatal root, this is the longest root in the middle, appears to be filled past the apex. Meaning the root tip was perforated during the procedure and although there is currently no obvious mass of infection (like at the distal root) the same perforation issues concerning the disinfectant and bacteria are possible. Also the gutta percha that was pushed into the bone is a chronic irritant. Again, it is not a healthy scenario but a typical occurrence.

4) The center of the tooth where the pulpal chamber was is now a large open void. Although this is unfavorable, it is commonly seen in rc teeth. This void substantially weakens the integrity of this area of the root system. Putting a post in this tooth could result in a fractured root and/or a perforation of a root. This area will be prone to decay irrelevant of how well a crown were to fit over it.

Regarding the lower tooth.... you could be getting referred pain.... the ligament could be inflamed and at times it's less inflamed than others .... or there is something else going on with this tooth that you are unaware of. It would have been good to take an xray of that tooth.

Extracting this tooth would leave an open space that ideally should be filled with a replacement. If not, then the molars behind it will drift towards the open space. How far or how oddly they will drift, no one can tell you that. Sometimes the drifting of a first upper molar is not very bothersome especially when it has 2 healthy adjacent teeth.

I know again.... I'm delivering unpleasant news to you. Please consider all of the information as only you can decide as to what you feel is in your best interest for the long term.

Bryanna