Hi ellem,
Sorry it's taken me so long to reply....
I read your post and have no doubt that the hot temperature sensitivity on #3 is very real ... don't let anyone tell you that it's not. A few things could be happening and I'll give you a couple of ideas although you may not like what I'm going to say.......I'm going to tell you the truth.
One of the big myths with root canal therapy is that the root canaled tooth can no longer feel pain or sensitivity. Every day patients come in complaining of pain and/or hot temperature sensitivity in a root canaled tooth. Usually an xray will show pathology brewing in or near that tooth, but some dentists will tell the patient that it's only localized or it's scar tissue. Neither is accurate.
The first reason that myth is false is because, every tooth has millions of microscopic openings called dentin tubules or accessory canals. These curvy little crevaces have nerves in them which are not accessible. Many of these tiny nerves instantly become necrotic tissue once the blood supply is cut off during the RC procedure but some of them can remain partially alive. Any vitality within these canals will trigger a sensitivity to hot temperature. Secondly, if the tooth is fractured in an area that has some live nerve endings, this too would cause sensitivity to hot temperature.
The conventional remedy for this complaint .... an endodontist may suggest to retreat the tooth with another root canal..... but ironically there is no way to determine where the vitality is nor would there be a way to access it. Or he may suggest a surgery called an apicoectomy.....which will do nothing but cause more problems. Or he may think he knows where the problem is an suggest to amputate one of the roots..... again, only causes more problems.
Your quote: <<My endo always tells me there is no way you can feel hot or cold after a RC treatment but I am, for sure. (hot only, no cold) Whether it is the tooth or not I have no clue but it is for sure coming from #3. I think I may get a second opinion from a diff endo this week, but what could it be? Fracture?>> WHAT YOU ARE FEELING IS REAL. YOU WILL BE GIVEN THE OPTIONS OF WHAT I NOTED ABOVE. REMOVAL OF THE TOOTH IS THE ONLY TREATMENT THAT WILL CURE THE PROBLEM.
<< Could the tooth of been reinfected by bacteria from having the temp on for so long?>> THE ROOT CANALED TOOTH HAS A CHRONIC INFECTION IN IT TO BEGIN WITH. THE TEMP CROWN COULD HAVE CAUSED ADDITIONAL INFLAMMATION RESULTING IN DIFFERENT BACTERIA, BUT IT WASN'T HEALTHY TO BEGIN WITH.
<< My gums?>> SOUNDS TO ME LIKE YOU HAVE A PERIO/ENDO ISSUE GOING ON FOR A LONG TIME. THIS MEANS THAT BOTH THE TOOTH AND THE POCKET OF SURROUNDING BONE HAS A CHRONIC INFECTION GOING ON. THIS SORT OF THING SOMETIMES RESPONDS POSITIVELY (BUT ONLY TEMPORARILY) TO TREATMENT OF THE GUM AND TOOTH. THE CHRONIC PROBLEM LIES WITHIN THE TOOTH ITSELF AND THOSE ACCESSORY CANALS.
<< I feel like I have to have some idea of what I am dealing with before I meet with these people to know if they are leading me down the right path.>> THE ONLY RIGHT PATH IS WHAT YOU DECIDE IS IN YOUR BEST INTEREST. THERE ARE ONLY A FEW OPTIONS... RE-ROOT CANAL... APICOECTOMY... AMPUTATE A ROOT..... DO NOTHING UNTIL IT BECOMES WORSE.... REMOVE THE TOOTH. I KNOW YOU DO NOT WANT TO LOSE YOUR TEETH. TOTALLY UNDERSTANDABLE. HOWEVER, YOU HAVE AN ONGOING, CHRONIC INFECTION WITHIN THE TOOTH THAT CANNOT BE RESOLVED. TAKING THAT INFORMATION INTO CONSIDERATION, A BIG CONCERN ABOUT KEEPING THIS TOOTH IS THE POSSIBILITY THAT THE BONE IN THAT AREA MAY BE NOT STABLE ENOUGH TO HOLD A DENTAL IMPLANT IN THE FUTURE.
I know you are young and feel healthy. But chronic infection in the mouth causes or at minimum contributes to chronic systemic disease. Diabetes and heart disease just to name a couple....so dental infections are not something to take lightly. It's like the saying goes......... If I only knew then, what I know now, I would have done things differently.
I am here to inform you of the truth even though I know it's not at all what anyone wants to hear. The outlook on removing diseased teeth and replacing them with dental implants or removable appliances can be looked at from a positive or negative view but only you can make the best choice for you. No one can tell you what path to go down... only you can decide for yourself.
Please don't let fear of losing your teeth overwhelm you and cause you to close off the information ..... let knowledge and instinct be your guide. I know it's hard but that's really all anyone of us can do.
Please keep in touch here and know that you are definitely not alone....
Bryanna
Quote:
Originally Posted by ellem8
Not sure if you remember me but if you look down a few posts you will see that we talked about my extraction and implant on tooth #20. I have my almost 6 week post op check up tomorrow and I think things are going very well. I am having another problem though.
#20 was just the tip of the iceberg. I didn't want to bother you with my crazy dental history but now some things are popping up and your expertise would be greatly appreciated. I will start by saying that I know how you feel about root canals. Having found out this info too late there is nothing I can do about it now aside from having all my RC teeth removed and implants placed and at 35 and being as healthy as I am I just cant imagine doing that. At least not at this point.
So, I have had RC on #2, #3, and #4. All at different times, the most recent being tooth #2 which was in Jan. I had varying symptoms and problems with each tooth that lead me to the root canals that I can get into if you need me to but I will otherwise spare you the details. Here is the problem. I seem to be having some heat sensitivity on tooth #3 all of a sudden. Not cold, or warm, just hot food. Here is some history on he tooth. I had to have my perm crowns on #3 and #4 replaced in March of 09 due to the margins being off and it was causing some issues with my gums so I found a prosthdodontist and we got to work on it. My perio at the time wanted the temps to remain on for six weeks to see if my gums would heal. They did, at least I thought so and I went back to see him for my check up and he said I needed to have gum flap surgery. I proceeded to get a second and third opinion and they both told me my gums had improved tremendously and would continue to improve once I had my perm crowns placed, so I decided not to have the surgery. I finally had the perm crowns placed in Feb of this year, almost a year after we started, so I spent a year in my temps. (due to getting the opinions and deciding on the gum surgery) Now, here we go with the heat sensitivity with #3. I have had no problems until about a month ago. It is a weird sensation, like the tooth is expanding when I feel the heat, then as it cools that feeling goes away and then it becomes pressure, not bite, sensitive and begins to ache.
My endo always tells me there is no way you can feel hot or cold after a RC treatment but I am, for sure. (hot only, no cold) Whether it is the tooth or not I have no clue but it is for sure coming from #3. I think I may get a second opinion from a diff endo this week, but what could it be? Fracture? Could the tooth of been reinfected by bacteria from having the temp on for so long? My gums? (which are really healthy at this point) I feel like I have to have some idea of what I am dealing with before I meet with these people to know if they are leading me down the right path.
Sorry for the long rambling post. I know it is better for you to have more info than less. Should I start with the endo? If so do you think its a good idea to get a different opinion from a new one?
Thanks so much!!
Elle
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