Hi,

Sometimes fractures within a tooth are hard to see on a typical xray. If the xray is digital, meaning it can be reproduced on a computer screen, then the gray scale can of the actual picture can be made darker or lighter which can make the fractures more apparent. In your case as you have described this molar, the fracture will be easier to detect than if it were in a tooth that had not had the same dental history.

The root canaled molar is infected because ALL root canaled teeth have some degree of infection within the microscopic canals in addition to anaerobic bacteria which resides inside these and other canals. If this tooth was root canaled 20 yrs ago as you stated, it may also contain formocresol inside as well because that is what was used to irrigate/disinfect the large canals and this chemical cannot be removed from the tooth.

The lingering pain that you feel with cold temps indicates a fractured tooth and/or tooth decay in that molar that was just restored. You may also be told that you cannot feel pain on a root canaled tooth because it is a non vital tooth. However, because the tooth is residing in vital bone and a somewhat vital periodontal ligament, yes, you can have pain with a root canaled tooth. It is the bone and ligament that hurts, not the tooth. It is the infection from the root canaled tooth that causes necrotic changes/infection in the bone and ligament. So as long as that tooth is present, you will have pain.

All of these circumstances that I have described can cause or contribute to nerve pain within the bundles of nerves in various areas of the face. So once the original source of this pain is gone, which can be these teeth, you may still have facial pain until the affected nerves heal. This could take days, weeks or longer. It may be intermittent or chronic. It just depends on how irritated the nerves have become.

Let me clarify your description of your lower tooth problem... you wrote...

<<I had a lower molar that was showing the same symtoms as these upper molars are. It was infected & did not show up on the x-ray, once the dentist started the root canal he saw the infection...the root canal was completed, 4 days later I was still in pain I went back & wanted it pulled. Once it was pulled the dentist said it was swollen at the root. Not sure what that means..>>

THE ONGOING SYMPTOMS ARE THE SAME ON MOST ROOT CANALED TEETH DUE TO THE INFECTION. WHEN THE DENTIST OPENED THE TOOTH TO DO THE ROOT CANAL, THERE WAS BLOOD AND PUS INDICATING INFECTION. SINCE THERE IS NO WAY TO ACCESS THE MICROSCOPIC CANALS, THE INFECTION REMAINED IN THOSE AREAS AND PROLIFERATED THROUGH THE END OF THE ROOT. IN YOUR CASE IT WAS EITHER PRESENT ON THE XRAY AND NOT PICKED UP OR DURING THE ROOT CANAL, THE DENTIST PERFORATED THE END OF THE ROOT AND THE INFECTION SPILLED INTO THE BONE. THIS AREA OF INFECTION IN THE BONE IS WHAT HE WAS DESCRIBING AS...the dentist said it was swollen at the root.

I cannot tell you what to do, that choice is up to you. I have given you the information to make an informed decision and the bottom line is simply this... retaining these teeth means keeping the infection and the pain. The nerve problem may spread making it difficult to eradicate in the future.

I am going to re post a thread (after this post) that gives clear information on root canals that you can take with you to your dentist is you wanted to. Also, keep in mind that there has to be a culprit and origin to your pain and your sinus infections. Both of these teeth are unhealthy and are located in the region of your pain and sinuses.

I hope you are able to get the help that you need. Be very leery if the dentist tries to convince you that these teeth will be okay with additional treatment because they will continue to be a source of infection so long as they are present.

Bryanna



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I thought that it was difficult to see fractures on a x-ray?

As far as the teeth being infected, I hope that is the problem. Living with a life sentence of TN/ATN is not what I want.

I had a lower molar that was showing the same symtoms as these upper molars are. It was infected & did not show up on the x-ray, once the dentist started the root canal he saw the infection...the root canal was completed, 4 days later I was still in pain I went back & wanted it pulled. Once it was pulled the dentist said it was swollen at the root. Not sure what that means...

I guess I am worried they are going to say the 2 teeth look healthy-(even though they both have had extensive work on)- & should not be pulled. They could blame the pain on ATN. Should I say I want them pulled regardless?

The pain these 2 teeth begin once a breath of air hits them, when I take a drink of something...it is a lingering pain.

Thanks so much.[/QUOTE]