ongoing root canal pain 9 months
 

I had a root canal in December 2012 on a back lower molar, and have had non-stop pain since then. I've had a full re-treatment, and some additional treatments (that I don't fully understand) since then, and nothing alleviates the pain, which manifests as gum and jaw pain, sometimes radiating to the ear. Recently, a new dentist thought pain might be caused by an adjacent tooth, and so last week I had a root canal on that tooth as well. I am already worried that this tooth is about to go down the same path as the first one.

I have read some posts here which advocated extractions of root-canaled teeth. I have reached the point of pain and frustration where I am willing to consider this, but my question is why do none of the dentists I have been working with (2 dentists and 2 endodontists) not recommend this? They seem to oppose it on the grounds that they cannot see anything wrong with the tooth, or the root canal work; they say I could possibly be extracting a tooth without solving the underlying cause of the pain. But what else could this pain be? They have mentioned neuralgia (I guess TN) but have not given me a way to rule this out? Is there some definitive way to rule out TN before extracting the tooth?

I was more inclined toward extraction before the second root canal. Now I am worried that I will have to lose both teeth and get implants that I don't want and can hardly afford. But, more than anything, I want this pain to go away before it gets even worse. I'm worried that there's an infection underneath or in this tooth, but I don't understand why no one can see it. Can it really be the case that there is no empirical way to prove the tooth is bad (except by removing it and starting to feel better), and there is ALSO no way to prove that it is TN or something else. I'm at the end of my rope and cannot find an endo or dentist who can tell me anything definitive.

Is there a specialist in this sort of thing, and if so, how can I find them?

Please help!

who should perform extraction of root canaled tooth?
 

Also wanted to add that I have an appointment with a periodontist tomorrow to see if the problem I am having with the original root canal is in my gum. Every dentist I have seen keeps warning me that I could remove the tooth and still have the problem, so trying to rule out as much as possible beforehand. Just wondering if anyone has any opinion on whether it is better to have an extraction performed on a root-canaled tooth by a periodontist or an oral surgeon. The receptionist told me when I made the appointment for the periodontist that they do extractions, and that people are "amazed" by the difference in the quality when done by this periodontist.

As I am not sure whether I can have (or want) an implant, I am just curious about the best way to go about having an extraction. So far, it seems, I have made really bad choices. I would love to get some input on how to move forward with this.

Hi sadie,

I am in the dental field and can offer you some help here.

Dentists are taught to "save" teeth with root canal procedures. Unfortunately, the term "save" only indicates "retain" ... not cure. And every dentist is very aware of this fact. However, rarely will a dentist go into that explanation with a patient because endodontics is a very lucrative procedure and one that they don't want to give up.... and also dentists know that most people do not want to have their teeth extracted. So the game of endodontics is played until the tooth is so abscessed that there is no alternative.

You mentioned "some additional treatments". Did you have apicoectomies done on either of these teeth??

Without any doubt all root canaled teeth are infected as there is no access to the tiny canals that contain dead nerve tissue. So irrelevant of how many times the tooth is root canaled or apicoed.... these canals will always be diseased. There are many other things that occur in the bone surrounding these infected teeth which cause pain to develop that is often misdiagnosed as some form of neuralgia.

Infected teeth can cause or contribute to various nerve conditions in the jaw bone, some temporary and some permanent. This is one huge reason why infected and/or root canaled teeth should not be "retained" for any length of time. Most dental problems pose little to no symptoms until the problem is severe. So it is never wise to gauge a tooth infection by the limitation of symptoms.

It is without question wise to assume that all root canaled teeth have bacterial problems due to the anatomical structure of the tooth prohibiting access to the countless tiny canals preventing the tooth from being sterilized or curable.

I feel terrible that you had that other tooth root canaled as the original rc tooth was probably the source of your pain. To remove one of them simply means you have not dealt with the problem in its entirety. Unfortunately, you are not alone in this travesty. I wish dentists would inform their patients of the risks of keeping infected teeth.

The decision to remove or not remove these teeth will be yours and you may have to do some searching to find an oral surgeon to do it. You can consult with someone who is a member of the IAOMT organization as these practitioners have a clearer understanding and are more forthright in providing information to their patients.

Bryanna

Hi Bryanna,

Thanks so much for your reply. No, I did not have an apico on either tooth; my first dentist did not recommend it, and I had by that time already read a lot of very discouraging things online about the procedure. Unfortunately, I had not read about the general infection issues with root canals until recently, and had already undergone the second root canal.

The "other" procedures I'm referring to in terms of the first root-canal are various phases of re-treatment (including calcium hydroxide) and one procedure in which the dentist said he sterilized the tooth, using a laser. This did stop the percussive pain, but did not alleviate the pain around and inside the gum, which began right after the root canal and has continued unabated to this day.

Sometimes it's better and sometimes it's worse (which I don't really understand; why is it better in the morning?) but it's never felt like a healthy normal tooth since before the root canal. The frustrating thing for me is that for 9 months I have been telling two sets of dentists and two endos that the tooth is either fractured or infected or both, and they have kept me on a path of investigating other options (in addition to retreatments- replacing a year old crown,and now peridontal issues). I feel like I have made a serious commitment to this root canal, and not just a financial one (though that of course is SUBSTANTIAL). I have missed holidays and vacations (and funerals) and just day-to-day life waiting for this pain to subside, and the root canal to settle down. The fact that it will not EVER do this is heartbreaking to me, and made worse by the fact that my friends and family cannot imagine how I have been rendered so incapacitated by a *mere* root canal. Especially when all the medical professionals find absolutely nothing wrong with the tooth.

I have seen some of your other posts on here and I really appreciate your taking the time to respond to me. Just wondering if you have any additional insight about ruling out the other possibilities (TN, TMJ, violation of the biologic width of the tooth) so that I can convince my dentist to do the extraction. Also, if you have input about the difference between letting a periodontist (who does implants) and an oral surgeon do the extraction. Since I am seeing the periodontist tomorrow (and I would have to find a separate oral surgeon) it would be convenient to be able to schedule something with him, especially if I decide to do the implants. Or should I start searching for an oral surgeon who would be willing to do this?

Thank you again for all your help!

Who should perform extraction of root-canaled tooth? Oral surgeon vs. Peridontist
 

Apologies to everyone for this second post; still trying to figure out how things work on the site, and yesterday posted this question within another post. This is the first place I have received any answers that make sense to me after nine months of suffering with a root canal on a bottom molar, and I am hoping that an extraction will start the healing process. The question now is: who is most qualified to perform this extraction?

I have appointment later today with a periodontist (my dentist wants my gums checked out before he agrees to extraction) who regularly does extractions as part of his practice. The receptionist explained to me that they take extra care because their goal is to make the area as clean as possible so that they can do an implant. (That's ANOTHER question, actually, do I need to have the implant? Dentist seems to believe teeth will shift without it, or top tooth will grow down, or perhaps both with my luck. But I am not convinced yet.)

Anyway, I have little experience with any of this until now. I had my wisdom teeth removed years ago by an oral surgeon, and I suppose I always thought they were the only people who could/should pull teeth. But it did seem reasonable that someone who is preparing the area for an implant might do just as good a job as an oral surgeon. Opinions?

hi
I have merged your threads as it is best to keep all replies together when on the same topic.

Hi sadie,

Sorry I was not able to get to you earlier today.... but I just got home from working all day.

By now you have seen the periodontist. What did he say about the health of your gums?

Ideally an oral surgeon would be the one to remove your teeth. Periodontists are also surgeons and they also do extractions.... but not nearly as frequently as oral surgeons. There are some cases when a periodontist would be preferred over an oral surgeon but they are specific cases and not the norm. The choice would be up to you.

All dental surgeons are trained to remove teeth in a manner that is thorough but at the same time cause the least amount of trauma to the bone. Unfortunately not ALL perio or oral surgeons necessarily follow that training :/

Regarding the replacement of this tooth....
It is true that when a tooth is removed, other than a wisdom tooth, the adjacent teeth will shift towards the new opening. The opposing teeth either above or below the extracted tooth will naturally gravitate towards that open space. There are some cases where this movement occurs very slowly or very little. There is no way of telling what the outcome would be.

Bryanna

Thanks Bryanna. Of course, I realize that you are not available 24/7 to answer my questions; I'm just very appreciative to get your input, and I thought (or was hopeful) that I might get a chance to do at least one extraction today, so I was worried that I had to make an immediate decision.

Instead, the periodontist said that he thought there was some violation of the biologic width of the first root canaled tooth. This tooth had a Cerec crown on it that had universally criticized by every dentist and endo who subsequently saw it. It never felt like it fit in my mouth, and in fact always seemed like it was cutting into my gum. Eventually (it was less than a year old at the time of the root canal) I sort of got used to the discomfort, though never completley. Last year right before Xmas, however, the pain welled up and instead of going to my regular dentist (not the same one who made the cerec crown), I asked for a endodontist, thinking I needed to take care of it before the holidays.

After the root canal, however, the gum swelled and wouldn't calm down. Even after they fixed the pain and pressure of the tooth itself, the gum never felt right. It is this feeling that there is always something stuck under the tooth (or that I need to floss constantly because of some invisible pressure) that has been the most troubling part of this last year. He performed some minor work scraping the gum away from the tooth (here I'm slightly fuzzy on the the details) to see if the gum can start to repair itself.

More important (at least in my mind) is that he said that thought both of my root canals may have been unnecessary. He thought it was possible that my original pain may have come from the awkward placement of the cerec crown, and that the additional pain might have originated with that as well: my bite has shifted to one side, possibly from the crown and some other dental work I had done at the same time. He suspects I also now have a TMJ issue, which makes sense to me as I have been having headaches and some numbness on that side of my face.

He wants me to wait before any further procedures (i.e, extraction) to see if his gum treatment yields any benefit and also if I get any relief from some simple TMJ exercises and treatment. I can't tell you how awful it was to learn that I quite possibly had TWO root canals for no good reason, not even as you say to "retain" the teeth. It's horrible to think I spent all this time and money AND compromised my present and future health just because I thought I needed a root canal, and I found an endodontist who agreed.

I like this periodontist and despite the pain I have been in, he did manage to persuade me to wait another couple of weeks to see if the treatment he did (and the other stuff he wants me to do) will make a difference. I realize I probably still need to have the extraction, but I am so angry at having two teeth root-canaled for no reason that it is hard to make another drastic decision at the moment. It's bad enough to have a root canal when you are facing a major abscess; in my case, the endo told me only after the fact that there was no infection, just "inflammation" of the nerve. I guess that means I killed two perfectly good (or at least, not BAD) teeth.

At least I hope I know enough now not to be talked into another root canal, ever.

I know you're going to say I still need to extract the tooth (teeth). And I'm sure you're probably right, but I am going to wait until after Labor Day, since everyone on vacation until then anyway. In the meantime, I would love to get your input on this gum issue, the biologic width thing. From what little I have read online, it does seem to match up with my pain and the sensation in my gum. Also the TMJ: I kept feeling like my bite was off, and it just kept getting worse after the root canal (especially since I couldn't chew at all on that side for the last 9 months.)

And thanks again so much for getting back to me. I feel like I spent 9 months wandering in the wilderness until I found this site. THANK YOU again! I'm very grateful for your help.

Hi sadie,

I am going to re-post some of your statements and answer them in bold type.

<<<Instead, the periodontist said that he thought there was some violation of the biologic width of the first root canaled tooth. This tooth had a Cerec crown on it that had universally criticized by every dentist and endo who subsequently saw it. It never felt like it fit in my mouth, and in fact always seemed like it was cutting into my gum. Eventually (it was less than a year old at the time of the root canal) I sort of got used to the discomfort, though never completley. Last year right before Xmas, however, the pain welled up and instead of going to my regular dentist (not the same one who made the cerec crown), I asked for a endodontist, thinking I needed to take care of it before the holidays.>>>

THERE PROBABLY IS SOME VIOLATION DUE TO THE ILL FITTING CEREC CROWN.... WHICH PROBABLY SHOULD HAVE BEEN REDONE SOON AFTER IT FIRST BECAME A PROBLEM. FOR DENTISTS TO CRITICIZE THE WORKMANSHIP BUT NOT INFORM YOU THAT IT NEEDED TO BE REDONE.... HAS MOST LIKELY COST YOU THE MISFORTUNE OF HAVING HAD TWO ROOT CANALS UNNECESSARILY.
THE PERIODONTIST DEEPLY SCALED THE POCKET BETWEEN THE GUM LINE DOWN TO THE CREST OF BONE ALONG THE ROOT OF YOUR TOOTH. THIS IS DONE IN AN ATTEMPT TO REMOVE ANY GRANULATION TISSUE THAT HAD FORMED IN THAT INFLAMED SPACE DUE TO THE ILL FITTING CROWN. THE GOAL OF DOING THAT IS TO HOPE THAT THE GUM TISSUE RECEDES AWAY FROM THE MARGIN OF THE CROWN. IF THIS FAILS, YOU WILL MOST LIKELY BE TOLD TO HAVE A CROWN LENGTHENING SURGERY TO PHYSICALLY REMOVE THE INFLAMED TISSUE DOWN TO THE CREST OF BONE.
IF THIS TOOTH HAD NOT BEEN ROOT CANALED, THIS PROCEDURE WOULD HAVE MADE THIS TOOTH <PERMANENTLY> SENSITIVE TO COLD.

<<<After the root canal, however, the gum swelled and wouldn't calm down. Even after they fixed the pain and pressure of the tooth itself, the gum never felt right. It is this feeling that there is always something stuck under the tooth (or that I need to floss constantly because of some invisible pressure) that has been the most troubling part of this last year. He performed some minor work scraping the gum away from the tooth (here I'm slightly fuzzy on the the details) to see if the gum can start to repair itself. >>>

I HAVE A SUSPICION THAT THE PAIN WAS NOT TOOTH RELATED... IT WAS GUM RELATED DUE TO THE ILL FITTING CROWN. HAVING HAD THE ROOT CANAL WAS LIKE PUTTING GASOLINE ON AN ALREADY BURNING FIRE AS IT DID NOTHING TO ALTER THE PROBLEM AND JUST ADDED MORE INFLAMMATION.

<<<More important (at least in my mind) is that he said that thought both of my root canals may have been unnecessary. He thought it was possible that my original pain may have come from the awkward placement of the cerec crown, and that the additional pain might have originated with that as well: my bite has shifted to one side, possibly from the crown and some other dental work I had done at the same time. He suspects I also now have a TMJ issue, which makes sense to me as I have been having headaches and some numbness on that side of my face.>>>

WELL THERE YOU GO! THAT IS EXACTLY WHAT I AM SAYING... IT IS THE ILL FITTING CROWN THAT WAS YOUR ORIGINAL PROBLEM. SO AT THIS POINT THE CROWN STILL FITS POORLY, THE GUM IS BEING CHOKED BY THE POOR FITTING MARGIN ON THE CROWN AND THE TOOTH HAS BEEN ROOT CANALED. I KNOW YOU ARE FOCUSED ON THE GUM ISSUE, BUT THAT IS TRULY ONLY ONE ASPECT OF WHAT WILL LIKELY TURN INTO A CHRONIC TOOTH PROBLEM. I'M TELLING YOU THIS SO THAT YOU ARE MINDFUL OF THE SHORT COMINGS OF ANY OTHER TREATMENT RECOMMENDATIONS TO DEAL WITH THE "GUM PROBLEM".
IF YOUR OTHER DENTAL WORK IS NOT FITTING PROPERLY AND IS CREATING A TMJ PROBLEM.... THAT MAY MEAN THAT YOU HAVE TO REDO YOUR DENTAL RESTORATIONS BEFORE THE BITE BECOMES SO BAD THAT YOU START HAVING ADDITIONAL TOOTH PROBLEMS DUE TO THE POOR BITE.

You can only make one decision at a time. I am hoping that your gum irritation subsides..... but in the long run I think you realize that it would just be a temporary thing due to the bacteria contained in root canaled teeth.

I have seen your exact situatuon countless times...... it always breaks my heart to see people go through unnecessary dental work and pain because of crappy dentistry. One of the dentists that you had seen along the way (the endodontist especially) should have been more truthful with you and said hey..... go back to the guy who did the cerec and get him to redo it.

I am just so sorry you are going through this. Just try to stay positive and please be mindful that spending more money to treat the gum issue is not going to solve the overall situation.

Bryanna

Hi Sadie, I just wanted to say I am sorry you are dealing with this pain. I know it is hard that your friends and family don't get how much pain can be caused by the tooth but know that there are many others in the same position as you and we get it! :hug:

I am finally getting a root canal tooth extracted tomorrow at noon after having 2 dentists and a root canal specialist tell me they want to keep treating it. The pain and cost are just not worth it in the end. I hope you get things sorted soon! :)

Thanks so much for all your help, Bryanna. You are right about me feeling overwhelmed. In my original posts, I was so intent on getting to the bottom line that I omitted some important details.

For one thing, my dentist never saw the Cerec crown until after the root canal. I had been traveling when I broke the tooth, and had to have it done away from home. (I broke/cracked two other teeth at the same time, and also had those replaced by the same Cerec enthusiast, though the other two teeth have not YET- fingers crossed- caused any problems.) I'm not sure that my regular dentist ever got over the fact that I allowed someone else to do all that work on me, even though it was out of my control. He had been my dentist for over 20 years, and I trusted him completely, but as the months went by and I could not seem to get over the pain of the root canal, I began to suspect that his resentment was clouding his judgement about my treatment and I went to get a second opinion.

That dentist actually agreed with my old dentist that we should try to replace the crown with a temporary to see if that would alleviate any of the pain. I decided to start everything fresh with him, and he replaced the horrible Cerec crown about 6 weeks ago with a temp. We agree to keep the temp on as long as I neeed, to se if the root canal would calm down. Meanwhile, the adjacent tooth seemed like it was acting up. It had a 30+ year old gold crown on it, but I was sure I could feel something going on underneath it. The dentist removed that crown as well at my insistence, and said there was some decay but it didn't look too serious. He put another temp on and we waited.

To be honest, it was often hard to distinguish between the pain of one or the other teeth, especially since the worst of it seemed to be coming from between the two teeth (that gum margin/biologic width issue I suppose). I felt sensitivity to cold (especially liquids) and and some percussive pain when the tooth was tapped. But even more disturbing was a deeper pain in my jaw, and an additonal pain (like a guitar string being plucked) which recurred a few times in a row every few hours throughout the say, and seemed to run along my jawline. I wonder if this is a ligament or a nerve, but forgot to ask the perio about it. He thought that the pain that radiates to my ear several times a day was from TMJ, even though it feels like an ear infection to me. I wish I had remembered to mention this other chord plunking pain, but when your list of complaints has accumulated for 9 months, I guess it's hard to fit everything in one visit.

In any event, my dentist (#2) was puzzled and sent me to an endo for a pulp test. When I showed up at the endo, however, he told me there was no need for a pulp test, the tooth was clearly sensitive and had to be root-canaled. He had time to start it then and there. UGH. I wish I had taken the time to consider this. But I was scared (am generally just terrified at the dentist anyway) and in pain.

Anyway, that's how I ended up with two root canals and two temp crowns. Lots of time and money spent, and I am still in substantial pain. Not even sure what the cause is; is the pain from the root canal? From the violation of the biologic width? Both? What about the TMJ? DO I need to have my entire bite adjusted and who should do that? Will the pain go away if I extract the tooth? Will I still have this pain with an implant? Since the immediate pain is my immediate concern, what should be the first thing I do? It would be nice to make my future decisions without this throbbing pain in my head; it's definitely hard to think straight with this BIG pain so close to my little brain.

My tooth is still pretty sore from the perio scraping. Or maybe it's just the old soreness. The perio also wants me on a soft diet for some period of time, which I guess means REALLY soft, since I have not had anything crunchy or hard (despite some bad cravings) for 9 months.

I really appreciate all your help, Bryanna. I see all these people calling out for your help and you patiently going from thread to thread dispensing knowledge and insight. We're very lucky to have you, and I do realize you may not have time to answer all the questions I just dumped in this post. I just needed to write them all down somewhere. But if you have some "extra" time and the inclination, I'd be very grateful for some advice!

Hi Sadie
 

Bryanna is spot on. I too had my RC'd Teeth removed. Re-treatment was a money pit. Not all dentists or specialists tell you the truth. I hope all goes well for you. ginnie:hug:

thanks, Canmom
 

For some reason I just saw your post here. I guess my notifications are not working? In any event, thanks so much for saying this! It does seem (even to me sometimes) that I am losing my mind over this tooth at times. So, although I'm truly very sorry for your suffering, I'm glad there's a place here for us all to come for acknowledgement and answers.

I really hope your extraction went well. It does sound like you and I are in a very similar situation. All of the dentists I've seen act like pulling my tooth is the most horrible thing I could do; no one seems to even consider that I've had non-stop pain from that tooth since December. I will have to find your other posts to see what your exact situation is, but I hope the extraction brings an end to your pain!

Thanks again!

Yeah Sadie, they acted like me wanting the tooth gone was ridiculous, my first dentist actually laughed at me when I suggested it! :mad: It wasn't until I cried at an appointment with my new dentist that she caved and reffered me to an oral surgeon for extraction. My dentist was so dramatic saying, "it is so sad that we couldn't save the tooth...i wanted to save the tooth...i tried to save it...this is such a SHAME...i wish there was something else i could do...to have you get it pulled is such a loss...it is devastating really...i wish there was another way..." :p

Yes! They are SO disappointed- in their inability to save your tooth, but also in you and your lack of resolve to tough it out and keep treating it. My dentists/endodontists have all expressed the same frustration, as if I am giving up on life (instead of giving up on the tooth that is ruining my life). Even worse, I still haven't managed to convince anyone to do the extraction. Even after the periodontist acknowledged that both root canals were probably unnecessary. (It's funny- well, maybe not *funny*- that you had to cry to get your dentist to agree; after months of following everyone's advice and suggestions, I broke down on the phone last week with my dentist and he still doesn't want to do the extraction. It made me think that dentists must love teeth more than people. :))

I hope you're feeling better!:hug:

Now I am feeling my second, most recent (two week old) root canal start to swell up. It's sensitive to touch (I haven't bitten on that side of my mouth in months, but I assume that would be painful) and seems to be feeling the same sort of pressure I felt in the first failed root canal 9 months ago (like a pressure cooker). I was hoping the second one would remain calm at least long enough for me to deal with the first one. Meanwhile, the whole left side of my face is numb from what I suppose is TMJ. FWIW, I've switched to a soft food diet in the hope that my jaw will start to heal as well.

Very disheartening evening. No idea what to do next. Just want my face to feel again, and my tooth not to feel. Wondering if this chord plucking feeling in my jaw is the periodontal ligament and if it comes out with the tooth.

/rant

I so hope things get better for you! I can't give dental advice but I can validate your feelings. :hug:

Hang in there. :)

Sadie how about trying a TMJ Specialist. Temporal Mandibular Joint. You have had to have you mouth open for long periods of time. It possibly is not your tooth so much as the joint. Has your Dentist mentioned this? Just a thought. Good luck and best wishes for no more pain.

Hi Sadie
 

Hi Sadie, Dentists, and specialists for the most part, do NOT tell people the truth about the RC. It is a high end money making adventure for them.
The tiny canals inside the teeth, cannot be reached by any method they use. There is always some infection remaining in the tooth. Dentists may disagree with this, saying their tools and potions get rid of all the infection. They can't as the canals are too tiny. Then you wind up with a "dead" tooth, not getting any nourishment, with an infection deep inside. These RC teeth act up eventually, then you get an expensive re-do. It is a temporary fix to a problem that continues. It is to "retain" the tooth for an indefinite amount of time, that's it.

I have one remaining RC tooth in my mouth. No it doesn't hurt, and has never acted up. However as soon as I get the $ together, I will have it removed.

I have auto immune problems already, and I don't want an infected tooth to put a strain on my immune system.

I am not even sure my own doctor as good as she is, would agree with this. However, just reading the number of posts there are about this, many people have RC's teeth that act up. I had three removed last year. I have a nesbit, which works very well. Implants are out of my price range.

These specialists, that do nothing but RC's ,make a huge profit for a small amount of their time to do this procedure.
I wish you all the best Sadie. ginnie:hug:

Hi sadie,

I have re read all of your posts here regarding your two root canaled teeth. I think there may have been other things going on with these two teeth in addition to the one having an ill fitting cerec crown and the other having some decay underneath the old gold crown. You have not posted any x-rays so I can only go by your descriptions.

It is not unusual for people to be unaware of problems with their teeth. Especially if the problems were silently brewing. For example.... decay underneath a crown will often have slight to no symptoms until the decay has reached the pulp or the area swells up. Other examples would be a fractured tooth or a periodontal problem with little to no symptoms.

Also any time a tooth is drilled into, there is a risk of traumatizing the nerve resulting in infection and death of the nerve. The teeth/nerves then need time to heal and calm down. Having a crown preparation done and then shortly there after having the insult of a root canal done to that same tooth causes tremendous inflammation within that tooth, with the attached ligament and with the cells around that tooth. It also causes stress on the TMJ from all the pressure being applied to the jaw during both procedures.

It is important to keep in mind that in spite of <<some>> of the nerve tissue being removed during the rc procedure, there are countless other tiny canals that will continue to contain nerve tissue. This nerve tissue dies very quickly once the blood supply is cut off. These nerves do not dissipate or vaporize... they become diseased causing additional inflammation. Sometimes the symptoms or radio-graphic pathology of this disease process is not truly evident until the infection is severe.

That guitar string plucking thing you feel in your lower jaw could be tight ligaments ... could be spasm in the muscle..... could be a secondary inflammation from the irritation that is currently brewing with both of those teeth.

Is the gum area still sore and swollen where the periodontist curettage the other day?

Bryanna

First of all, thank you everyone, for your support and suggestions. I can't tell you how much it means to have a place like this. My friends and family are very supportive, but cannot begin to understand what this feels like, so it's great to be able to come here where people "get" it.

And an extra, very big thank you to Bryanna, for taking the time to parse all my posts for answers. I'm sorry I haven't had a chance to post this sooner, but between work and an extra long visit to the dentist yesterday (he made me a new soft nightguard), there hasn't been any time. I'm also sorry I don't have x-rays to post, but I've been reluctant to ask anyone for them, as silly as that may sound. Anyone who's seen them seems to think they look fine, with no evident areas of infection past or present.

Yes, Bryanna, my gum is still quite sore, though the dentist thinks it looks healthy. Yesterday was a full week after the curettage and the first time I think I didn't feel the additional pain of that procedure. But the original, lingering pain is still there, so I am not sure the curettage worked? That area has been especially sensitive for a long time, and I think in fact was the cause of my thinking I needed a root canal (#1). After the root canal, everything felt worse, but what I really seemed to notice was that the irritated feeling in my gum was still there and probably even more inflamed. The endodontist and my dentist both pushed for a retreatment for that issue (none of which they charged for, to be fair) and I thought maybe the retreatments would solve the problem. (They were strung out of a couple of months, with the endo going in repeatedly and cleaning out more, and using calcium hydroxide, and a third "re-treatment" where the dentist himself opened up the tooth and used used some sort of laser to "sterilize" the tooth. )

But nothing helped. In the weeks following R/C #1 (which was on tooth 18, if that helps; R/C #2 was on 19), the gum got so inflamed it felt like it was trying to physically eject the tooth. It was obviously red and swollen and the dentist recommended some deep cleaning, which did seem to calm it down a bit, at least visually. Still I always felt like it was an open wound, and very sore. It seemed like I could feel liquids (not just cold liquids) following the path of my (ostensibly removed) nerve down to the (dead) root of the tooth. This is when I began to suspect the adjacent tooth (and had the second root canal).

Now, even though they are root-canaled and officially "dead teeth" I still feel substantial soreness in the gum surrounding 18, though the tooth itself no longer hurts. Tooth #19 is still very tender to the touch, though the dentist feels it seems better since he saw me two weeks ago. (Also, seemed more irritated by the new night guard which even though is soft, still allows me to clench.) For the TMJ, which everyone seems to agree I've developed, I am taking ibuprofen (3x/day), using warm wet compresses (whenever possible), doing some jaw exercises and have changed to a soft food diet. This is the place where I've seen the most progress in the shortest amount of time, so I'm hopeful this will help.

The teeth, on the other hand, I have lost whatever hope I had. I don't want to have crown lengthening surgery on a R/C tooth. There is no guarantee it would work, from what I understand, even if I wanted to keep this tooth, which I don't. I would like to have this tooth extracted, but I am still not sure that would solve the biologic width issue. (I assume because the tooth will be gone, the gum will just re-form, but I don't fully understand why this issue is causing me so much discomfort, even after I had the cerec crown removed and a temp placed. Why didn't that help?) Also, the dentist warned me that it is possible that some of my jaw issues may have been caused by all the deep nerve blocks i have had in this area, for all those R/C's and retreatments and crown preps. I still have the plunking chord issue, running along my jaw; it happens a few times every half hour or so. I am now worried about further damage, since I realize I will probably need more blocks for the extraction. I also realize there is no way they will let me pull both 18 and 19 at once, and I don't really have the money to do it. How should I try to manage this?

Sorry for the extra long post. I know many people on this site are in similar or analogous situations, and I hope someone can get something out of this information. I wish I had thought more about all these ramifications of what seemed (each time) like a pretty straightforward decision. And I really wish I had never met an endodontist. Bryanna, I would really appreciate your help with these questions!

I left out one thing that I've been wanting to tell my dentist as well. Not sure if it's relevant to the actual condition of my tooth, but ever since the first root canal I have felt like this tooth has been a foreign object in my mouth. Last week I met a woman at the dentist who was crying about her implant, how much she hated it, how it felt like someone had just stuck something in her jaw in place of her tooth. And I realized that this was the same exact way my R/C tooth feels to me, like a completely foreign object, jammed into my VERY uncomfortable gum.

I don't know if this is how ALL root canals feel (my second R/C tooth is still inflamed so too soon to tell about about that), but I certainly hope I don't have an extraction and get an implant that feels the same way as that poor woman's.

Finding some who can do the work
 

Thank you so much Bryanna for your continued presence here and help with this subject. Do you know where I /we can find a professional who knows about bone infection and just treats them. I am again fighting with yet another oral surgeon who refuses to go there. The one person I knew who was able to help and heal me retired...Mostly he was tired of fighting with oral surgeon also. I would any where on the west coast.
:o

[/I]

Hi Sue M,

I do not personally know of anyone on the west coast. Have you tried the IAOMT organization? You would have to do a search for dentists in specific areas and then call their office and ask if they treat bone infections or if they can refer you to someone who does.

Could you try to reach the dentist that retired and ask him if he knows of someone you could go to?

Bryanna

biologic width/TMJ/PAIN!
 

I thought I may have finally talked my dentist into approving the extraction, but now have met further opposition from the periodontist, who thinks I would benefit from seeing a TMJ specialist before any "irreversible" procedures. Just have a couple of questions (Bryanna, I would really appreciate your help here!:)) before I decide to see him or get another referral:

1. Is this pain I've been feeling really caused by the biological width issue? It feels almost like teething pain (from what I can remember about teething!) and sometimes as if the gum is trying to squeeze the tooth out of my mouth. It hurts 24/7, though it does seem to feel more irritated after eating or drinking. I do think it's the reason I originally (and mistakenly) sought out the root canal.

2. If it IS pain from the biological width violation (and not, say, from the root canal per se, or from a possible fracture of the tooth below the gum line): will the extraction of this tooth solve the issue, or will the gum remain inflamed? Would taking the temporary off (temporarily) really prove that it is or isn't a biological width issue? How long would it take to work? and, if that doesn't work, and I have the extraction,would there be any complications from the gum problem if I had to get an implant in a few months?

3.Is it possible that the TMJ is actually causing this pain in my gum? It seems impossible that even as much as I clench, I am manifesting this "teething" pain in my gum. I do have many of the symptoms of TMJ, the jaw pain, earaches, headaches, numbness in the left side of my face. The soft diet has helped somewhat. Is it worth it to further delay this extraction, and seek out a TMJ specialist? (And spend even MORE money.)

4.Why does NOT ONE dentist (endo, perio, etc.) want to pull this tooth? Why does everyone suggest some other "last ditch" effort I should make beforehand? I feel like Dorothy in OZ; I have finally gotten in to see the wizard, but he makes me go chase down the witch's broomstick before he'll talk to me. I have told the last two dentists that I am ready to have the extraction, but they both have insisted I try "one more thing" before I pull the tooth. Is having an extraction really so horrible?

This is driving me crazy. I feel like that guy who was trapped under a rock by his arm and had to saw it off himself. It's as if when he was finally ready and willing to sacrifice the limb for his life, a doctor came up and suggested he instead try some massage to relax his muscle.

This tooth has been hurting me since last Thanksgiving; at this rate I will see another holiday season without any relief. I'm sure I could just find an oral surgeon online who would pull the tooth, but I'm confused about why my own dentists are so hesitant to agree that it's the best course of action. I would rather have them on board than feel that I am disregarding professional advice. (And it's not even as though these two had anything to do with the original situation.)

I don't get it.

PM Bryanna
 

Hang in there Sadie, wait for Bryanna to respond to you. You can also try to PM. her. You do have some real concerns and valid points. she can best direct you in this. Dentists in general like to "retain" a tooth, even if it is infected. Bryanna knows your history. She will be along. I know you are feeling like Dorthy in OZ, it is confusing for me too. I know how anxiety can work a person over. ginnie:hug:

Hi sadie,

I will repost your questions and answer in bold type.

<<1. Is this pain I've been feeling really caused by the biological width issue? It feels almost like teething pain (from what I can remember about teething!) and sometimes as if the gum is trying to squeeze the tooth out of my mouth. It hurts 24/7, though it does seem to feel more irritated after eating or drinking. I do think it's the reason I originally (and mistakenly) sought out the root canal.>>

YOU ARE DESCRIBING WHAT DENTISTS REFER TO AS A PERIO/ENDO PROBLEM. THIS IS WHEN THERE IS A PERIODONTAL PROBLEM WITH THE BIOLOGICAL WIDTH AS WELL AS AN INFECTION IN THE TOOTH. IT CAN BE DIFFICULT TO DETERMINE WHICH ONE ACTUALLY CAME FIRST... THE PERIO ISSUE OR THE TOOTH INFECTION.

IN THE FIRST PLACE, THE TOOTH HAD TO BE COMPROMISED TO WARRANT A (CEREC) CROWN... MEANING DECAYED, BROKEN DOWN, HEAVILY RESTORED, OR FRACTURED. PERHAPS IT WAS INFECTED AT THAT TIME AND THE DENTIST DID NOT DIAGNOSE IT AS SUCH? IN ADDITION TO THAT THE CEREC CROWN DID NOT FIT PROPERLY WHICH RESULTED IN A GUM ISSUE.
THAT SQUEEZING SENSATION YOU DESCRIBE IS INFLAMMATION. IT MAY BE BACTERIAL RELATED FROM THE TOOTH AND THE GUM POCKET.

<<<2. If it IS pain from the biological width violation (and not, say, from the root canal per se, or from a possible fracture of the tooth below the gum line): will the extraction of this tooth solve the issue, or will the gum remain inflamed? Would taking the temporary off (temporarily) really prove that it is or isn't a biological width issue? How long would it take to work? and, if that doesn't work, and I have the extraction,would there be any complications from the gum problem if I had to get an implant in a few months?...

IT IS MOST LIKELY FROM BOTH THE TOOTH AND THE GUM. ONE PROBLEM IS FEEDING OFF OF THE OTHER. BOTH ARE CAUSING INFLAMMATORY ISSUES AND THAT IS WHY IRRELEVANT OF WHAT YOU DO TO THE GUM OR THE TOOTH THE PROBLEM WILL REMAIN. EVEN IF IT WERE ORIGINALLY GUM RELATED..... THE ROOT CANALED TOOTH HAS NOW ADDED TO THE BURDEN OF INFLAMMATION WHICH IS IRREVERSIBLE. EXTRACTING THE TOOTH WOULD ELIMINATE ONE PIECE TO THE PUZZLE WHICH IN TURN STOPS THE IRRITATION WITH THE GUM TISSUE. BOTH PROBLEMS WOULD BE RESOLVED. ONCE THE GUM TISSUE IS HEALED AND THE INFLAMMATION IS GONE, THEN SO LONG AS THE BONE IS HEALTHY AND ADEQUATE TO HOLD AN IMPLANT... A DENTAL IMPLANT MAY BE A VIABLE OPTION TO REPLACE THIS TOOTH. THE ONE CONCERN REMAINING WOULD BE THAT THE IMPLANE IS BEING PLACED NEXT TO ANOTHER ROOT CANALED TOOTH WHICH HARBORS BAD BACTERIA THAT WILL EVENTUALLY SPREAD TO THE JAW BONE.

<<<3.Is it possible that the TMJ is actually causing this pain in my gum? It seems impossible that even as much as I clench, I am manifesting this "teething" pain in my gum. I do have many of the symptoms of TMJ, the jaw pain, earaches, headaches, numbness in the left side of my face. The soft diet has helped somewhat. Is it worth it to further delay this extraction, and seek out a TMJ specialist? (And spend even MORE money.) >>>

YOUR TMJ PROBLEM MAY BE RELATED TO MANY THINGS AND MAY NEED TO BE ADDRESSED MORE SERIOUSLY AT SOME POINT. HOWEVER IRRELEVANT OF HOW YOU TREAT THE TMJ YOU ARE STILL LEFT WITH TWO NON VITAL DISEASED TEETH. ANYONE THAT HAS A CHRONIC INFLAMMATION FROM A GUM OR TOOTH PROBLEM WILL TEND TO CLENCH THEIR TEETH TOGETHER AS A NATURAL REACTION TO A FOREIGN OR ABNORMAL ANNOYANCE IN THEIR MOUTH. SO VERY OFTEN PERIO PROBLEMS AND TMJ PROBLEMS GO HAND IN HAND.

<<4.Why does NOT ONE dentist (endo, perio, etc.) want to pull this tooth? Why does everyone suggest some other "last ditch" effort I should make beforehand? I feel like Dorothy in OZ; I have finally gotten in to see the wizard, but he makes me go chase down the witch's broomstick before he'll talk to me. I have told the last two dentists that I am ready to have the extraction, but they both have insisted I try "one more thing" before I pull the tooth. Is having an extraction really so horrible?>>>

BECAUSE THEY HAVE BEEN EDUCATED ON HOW TO RETAIN TEETH WITH LITTLE TO NO EMPHASIS ON THE SYSTEMIC CONSEQUENCES OF RETAINING THESE DEAD, INFECTED TEETH. ROOT CANALS ARE THE MOST PROFITABLE FORM OF DENTISTRY AND MANY DENTISTS WANT PEOPLE TO BE UNINFORMED AS THAT LIMITS THE QUESTIONS THEY HAVE TO ANSWER AND POSSIBLE LEGAL CONSEQUENCES.
YOUR SITUATION IS COMPLICATED IN THAT THERE IS MORE THAN ONE ISSUE GOING ON AND THERE ARE SEVERAL DENTISTS INVOLVED ALL OF WHOM ARE NOT WILLING TO DETERMINE OR DISCLOSE TO YOU WHAT CAUSED THE ORIGINAL PROBLEM. THEY HAVE SEEN YOUR PROBLEM COUNTLESS TIMES AND CERTAINLY HAVE THEIR SPECULATIONS BUT WILL CAUTIOUSLY SHARE THEM WITH YOU FOR FEAR OF STEPPING ON A COLLEAGUES TOES.

HAVING A TOOTH PULLED IS NOT USUALLY A BAD EXPERIENCE. HOWEVER IT IS NOT REVERSIBLE AND YOU HAVE TO BE SURE OF YOUR DECISION. I CANNOT EMPHASIZE ENOUGH THAT YOU HAVE TWO TEETH IN JEOPARDY, NOT JUST THE ONE SIMPLY BECAUSE THEY ARE BOTH ROOT CANALED.

Bryanna

Thanks again for all your help, Bryanna. I guess it's just amazing to me that they act as if this is the first time they have ever seen someone take so long to recover from a root canal/ or someone so sensitive to a breach in the gum margin/ whatever. They keep reinforcing that I may pull the tooth and not have solved the underlying issue that is causing me pain, and I guess that's why I'm fearful.

Also, the problem with the second root canal; it is still bothering me and although I understand what you're saying about it needing to be pulled, I am not sure how to go about it. I'm scared to have both teeth pulled at once, especially given my TMJ situation. I would like to have #18 pulled first and have that situation resolve somewhat (I HOPE) before I take care of the other tooth, which is still inflamed from the root canal last month. Would that be ok?

Meanwhile, I still haven't found an oral surgeon to pull this tooth, or convinced any of the dentists I've seen to refer me to one. How should I handle all this? Any ideas? Sorry to keep coming back with questions, but I am really at a loss here as to how to move forward with 2 adjacent bad R/C teeth (both hurting) and some pretty bad TMJ making it difficult to think clearly.

also
 

Just warranted to reiterate from way above in the post: I had no visible infection in either of my root canaled teeth, but when I showed up to the endodontist(s) each time, they declared the root canal necessary in spite of the lack of infection. So I guess that means that any infection I have now in these teeth is BECAUSE OF the root canal itself. I feel even worse for doing this to myself. TWICE.

Hi Sadie
 

I had two teeth removed at once. No big deal at all.... in fact I only had to heal once! I had no issue at all, and the whole process was simple and took all of a few minutes. Little pain afterwards, and a big relief mentally..... I also think you should just call around and go to a few specialists. Pick the one that treats you the best. I saw two surgeons and picked the one, that had the best personality, the most confidence, and put me at ease. I was sedated. I wish all proceedures could be so easy... Take care Sadie, this will all turn out OK. ginnie:hug:

Hi sadie,

I've been in dentistry for 35 years and worked in many dental practices. For many years I worked in more than one dental practice at a time. Although my schedule was a bit crazy, I actually preferred it because it kept things interesting and diversified.

I am telling you this because in all of my years in dentistry, I have only known and/or worked with maybe a dozen or so dentists who informed their patients directly and honestly about root canaled teeth, jaw bone infections, periodontal disease, mercury fillings, fluoride, etc. Why so few? For some dentists it is literally their lack of comprehension about systemic health as it pertains to the teeth. They think of "systemic" health as a medical issue not a dental one and it's just easier for them to not deal with those issues. These dentists choose to forgo this aspect and treat patients as if their teeth were somehow disconnected to the rest of the body and they will repetitively re treat the same tooth countless times without any hesitation about the ill affects of what they are doing. Other dentists not only payed attention to the brief course that they had on the subject in dental school but took a genuine interest in it and furthered their education in it.... why? .... because they believe they are doctors and not just tooth carpenters. These dentists are not a part of the good ole' boy community of dentists because they go against the tide and delve into being a doctor. This is often shunned upon by the other dentists because they prefer to be known as tooth carpenters, not doctors. So it can be difficult to find a qualified dentist simply because they rarely advertise differently than the norm because they need to be able to stay under the radar and avoid being ostracized or criticized by the big dental corporations.

Of course it is disheartening to me to constantly hear people say....."how come none of these dentists I am seeing are saying I have an infection in my root canaled tooth .....and how come they all tell me to re treat it... and how come they want to do other things to these rc teeth"? But this is the norm, this is unfortunately typical of what people run into every single day and basically all for the reasons that I have given you above.

I cannot tell you that your pain will go away completely if you pull these teeth. At this point you may have other issues going on. The extractions could result in additional problems as they are oral surgery. But at the same time, none of those dentists can honestly tell you that these root canaled teeth are healthy in any way, shape or form and that they are not harboring diseased bacteria. I am sorry they are misleading you and misinforming you... but this is the norm. Just read through any number of posts on this forum from hundreds of people all over the world who have or are experiencing the same BS that you are.

It is up to you to do the research and become your own advocate. Google Dr Mercola and root canals, google Dr George Meinig one of the founders of the Endodontic Society who went against the tide and exposed the truth about root canaled teeth. Read his book.

I have given you all of the information that I can. It is up to you to decide if you think you should hang onto these teeth. I cannot predict the outcome of your dental future if you remove these teeth as there are many contributing factors in the removal, the health of the bone and the replacement options for your particular anatomy. I can only inform you of the path that you are on if you retain them.

I know this is all scary for you.. I feel badly that you are enduring this pain and BS from your dentists.... but only you can search for more knowledge that will help you make the best decision for you. Check out the IAOMT organization for a biological dentist (these dentists generally are better informed and more truthful) along with looking into the other leads of information that I have provided for you.

I do wish you well... I really do.

Bryanna

Thanks for your honesty, Bryanna. I have actually been wondering about how teeth got separated from the rest of our anatomy for a while. I still don't understand why health insurance doesn't cover teeth, as if they are a foreign part of our body. Or why dentists don't have to go med school, then specialize. Like eye doctors or GI doctors. I really don't know if teeth are more complicated than eyes or intestines, maybe they are. But my point is that they are still a part of the human body, and have the ability to affect more than just their tiny enamel-encased square footage.

This one stupid tooth in the back of my mouth has made me sick for almost a year. :/

The more I think about it, the more outraged I can become. But I suppose the unfortunate bottom line is that most doctors don't care about teeth, and most dentists don't care about the rest of us. My first endodontist, when questioned about my gum pain, said, "I don't really know very much about gums." WHAT?!? I tried to imagine my shoulder surgeon saying he didn't know much about necks.

Not sure where the tooth ends, and the person begins. But as person with tooth issues this is a very troubling issue, both personally and politically. I have read many of the questions and problems posted here, and I know how much pain a tooth can cause, and how much damage it can do in a person's whole body. When do we start looking at teeth the same way we look at kidneys and lungs and eyes?

Hi sadie
 

Your post was good. You said it like it really is. The teeth are just as much a part of our bodies as eyes, etc. That remark where the dentist said he didn't know much about gums, was shocking. Not know about gums? and he is pulling teeth????? good grief, lets go back to the days of the barber, maybe we would be better off... hum.....ginnie:hug:

I saw the oral surgeon today. He saw my panoramic xray and actually took a 3d/cone beam scan. He was very nice and spent a good amount of time going over everything with me. He thinks there are a number of different issues at work here, given my tooth pain, jaw muscle pain, and numbness in the side of my face. Wants me to see a face pain specialist.

As far as the extraction, he numbed the area of the tooth and asked me if the pain went away; I suppose that's a good test of whether the extraction will get rid of the pain? It sort of helped, but when the anesthesia wore off, pain came back even worse. I think I am really sensitive to any injections in this area. But just now after I got home, I drank a glass of seltzer (which I almost never drink carbonated beverages) and I felt it very strongly in my tooth, which has been root canaled and is supposed to feel nothing. This is the same sensation I had last month before the second root canal on 19, which both the dentist and the endo attributed to that tooth (19, as 18 was already root-canaled). How can I still be sensitive to cold; does that mean that there is still living tissue in the root canaled tooth?

I want to go forward with the extraction, but don't want to complicate my situation with muscle pain. Should I wait and see yet another dentist/doctor? If I pull it, at least I will be eliminating one possible source of the pain, though even the guy who would be paid to pull it is saying it doesn't have to be pulled. Even the few injections I had this afternoon seem to irritate my jaw muscles and cause numbness, though it of course almost impossible to tell what is causing what right now.:(

Root Canal Agony
 

I had root canal treatment for the first time on Monday. As I was leaving the surgery I was given an explanatory leaflet which stated ‘you may experience slight discomfort for a few days’.

Yeah right! If you wanna see a grown man cry, come round to my place. I am in agony.

I experienced no pain after the procedure on Monday, nor the next day. By halfway through Wednesday I was in agony. I guess the local anaesthetic had worn off by then.

I started taking paracetamol, but it didn’t help a lot. I only got one or two hours sleep that night. I couldn’t do a lot on Thursday except sit there in pain. In the evening I got my wife to drive me to a pharmacy and bought some Paramol, which is a combination of Paracetamol and Codeine. I’d already had my quota of Paracetamol for the day, so I shouldn’t have taken any, but I was desperate so I took a couple. Thankfully they worked, and I fell asleep straight away. After an hour or two I awoke in agony. The pain had radiated to my ear and the side of my head. I massaged gently in front of my ear and the pain subsided. I have no idea why. The pain was now bearable, but not absent. I sat up all night watching TV, without really taking it in because of the distraction of the pain.

At 6.30 in the morning I took another couple of Paramol and fell asleep for an hour or so. The problem is, you’re only supposed to take them every four hours, but the painkilling effect only lasts for a couple of hours at most, so I am in pain for at least 50% of the time.

I phoned the dental surgery when they opened and they said they’d give me a week’s supply of penicillin. I’ve started taking those now. They also said ‘continue taking the painkillers’. As if I could survive without them!

I am well placed to assess the difference between extraction and RCT because my wife had an extraction a couple of years ago. She had been in agony with one of her teeth. The dentist had offered her a choice of RCT or extraction, and she chose extraction. She said as soon as the tooth was out the pain was gone. She now has a gap in one row of lower molars, but she says it doesn’t cause her any problems.

I was offered the same choice. Now I feel like a mug for choosing RCT, especially when extraction would have been a much cheaper option.

Is RCT a scam? Depends on your point of view. Some patients die after heart surgery, but that doesn’t necessarily mean that heart surgery is a scam. Leaving aside the Mercola vs Dental Establishment debate, I find it a little unsettling that professionals can find it within their conscience to conduct a procedure that leaves patients in such excruciating pain.

At the very least I think the professional body for orthodontists should conduct a survey, by getting their members to give patients a questionnaire to be completed say six months after the RCT. The questions should be designed to provide the following data: what percentage of patients experience severe pain after RCT, how long does the severe pain last (minimum, maximum, average). Anyone still experiencing severe pain after six months should be sent a follow-up questionnaire.

It would also be good if RCT patients could be followed up to produce data showing how long before the tooth has to be extracted anyway, shown in groups e.g. less than five years after RCT, five to ten years, over ten years.

Prospective patients could then be given a leaflet with this info to help them decide whether to risk having RCT.

Correction - I meant endodontist not orthodontist

Sorry I meant 'endodontists'.

Hi m0ssman,

I am in the dental field and can offer you some information here. I will re post some of your thread and answer in bold type to make it easier to follow.

<<I experienced no pain after the procedure on Monday, nor the next day. By halfway through Wednesday I was in agony. I guess the local anaesthetic had worn off by then.>>

THE LOCAL ANESTHETIC HAD WORN OFF A FEW HOURS AFTER IT WAS INITIALLY GIVEN TO YOU. THE PAIN THAT YOU EXPERIENCED ON THE THIRD DAY IS NOT UNUSUAL BECAUSE THE TRAUMA AND INFLAMMATION FROM THE PROCEDURE HAD TAKEN HOLD OF THE TOOTH AND THE BACTERIA THAT REMAINS IN THE TOOTH WAS BUILDING UP WITH INTENSITY.

<<I started taking paracetamol, but it didn’t help a lot. I only got one or two hours sleep that night. I couldn’t do a lot on Thursday except sit there in pain. In the evening I got my wife to drive me to a pharmacy and bought some Paramol, which is a combination of Paracetamol and Codeine. I’d already had my quota of Paracetamol for the day, so I shouldn’t have taken any, but I was desperate so I took a couple.>>

THIS IS UNFORTUNATELY WHAT OFTEN OCCURS AFTER A ROOT CANAL PROCEDURE. THE AMOUNT OF PAIN KILLERS USED TO DULL THE PAIN CAN BE TOXIC IF NOT LETHAL.

<<Thankfully they worked, and I fell asleep straight away. After an hour or two I awoke in agony. The pain had radiated to my ear and the side of my head.>>

AGAIN COMMON BECAUSE THE INFLAMMATION IS BUILDING UP AS THE REMNANTS OF NERVE TISSUE STILL RESIDING INSIDE OF THE TOOTH ARE ON FIRE.

<< I massaged gently in front of my ear and the pain subsided. I have no idea why. The pain was now bearable, but not absent. I sat up all night watching TV, without really taking it in because of the distraction of the pain.>>

THE MASSAGE SIMPLY MOVED THE INFLAMMATION AROUND TO OTHER AREAS. BUT AS YOU SAID, IT DID NOT GET RID OF THE PAIN. SO THE INFLAMMATION IS STILL PRESENT.

<< I phoned the dental surgery when they opened and they said they’d give me a week’s supply of penicillin. I’ve started taking those now. They also said ‘continue taking the painkillers’. As if I could survive without them!>>

THE ANTIBIOTIC MAY TEMPORARILY SUBSIDE YOUR SYMPTOMS AS IT ACTS TO REDUCE SOME OF THE INFLAMMATION. HOWEVER THAT WILL BE SHORT LIVED AS THE ANTIBIOTIC CANNOT NOT KILL THE INFECTION THAT IS BREWING INSIDE OF THE TINY CANALS THAT WILL CONTINUE TO HARBOR NECROTIC NERVE TISSUE. THERE IS NO ACCESS TO THESE TINY CANALS SO THE NERVE CANNOT BE REMOVED FROM THEM IRRELEVANT OF HOW MANY TIMES OR WHO PERFORMS THE ROOT CANAL.

<<I am well placed to assess the difference between extraction and RCT because my wife had an extraction a couple of years ago. She had been in agony with one of her teeth. The dentist had offered her a choice of RCT or extraction, and she chose extraction. She said as soon as the tooth was out the pain was gone. She now has a gap in one row of lower molars, but she says it doesn’t cause her any problems.>>

GLAD TO HEAR THAT YOUR WIFE HAD A POSITIVE EXPERIENCE WITH HER EXTRACTION. THE TRUTH OF THE MATTER IS THAT THE ONLY WAY TO ATTEMPT TO CURE THE INFECTION IS TO REMOVE THE SOURCE OF THE INFECTION WHICH IS THE TOOTH. ANY OTHER DENTAL PROCEDURE IS ONLY A TEMPORARY MEASURE TO "RETAIN" AN UNHEALTHY TOOTH.

<<I was offered the same choice. Now I feel like a mug for choosing RCT, especially when extraction would have been a much cheaper option.>>

WELL PRICE SOMETIMES DRIVES PEOPLE TO CHOOSE ONE TREATMENT OVER THE OTHER. IN YOUR CASE YOU WERE PROBABLY TOLD THAT THE RCT WOULD CURE YOUR PROBLEM AND THAT IS WHAT YOU OPTED TO DO. IF YOU CHOOSE TO REMOVE THIS TOOTH WITHIN A WEEK OR TWO, YOUR DENTIST WOULD MOST LIKELY REIMBURSE YOU THE MONEY THAT YOU PAID FOR THE ROOT CANAL TREATMENT. IF YOU WAIT LONGER THAN THAT, HE WILL NOT FEEL OBLIGATED.

<<Is RCT a scam? Depends on your point of view.>>

RCT IS A SCAM IN THE SENSE THAT PEOPLE ARE NOT OFTEN INFORMED OF THE RISKS OF THE PROCEDURE OR HOW THE PROCEDURE DOES NOT CURE THE INFECTION PRIOR TO HAVING IT DONE. RCT IS A DENTAL PROCEDURE THAT SHOULD BE OFFERED TO PATIENTS BUT NOT WITHOUT THE FULL DISCLOSURE OF WHAT IT IS, HOW IT'S FLAWED AND WHAT THE SYSTEMIC HEALTH RISKS ARE ASSOCIATED WITH KEEPING AN UNHEALTHY TOOTH. EVERYONE HAS THE RIGHT TO BE PROPERLY INFORMED AND ONLY THEN CAN THEY MAKE A DECISION AS TO WHAT THEY FEEL IS IN THEIR BEST INTEREST.

<< Some patients die after heart surgery, but that doesn’t necessarily mean that heart surgery is a scam.>>

WELL.... HEART SURGERY IS ACTUALLY IN A SIMILAR CATEGORY AS RCT IN THAT PATIENTS SHOULD BE INFORMED OF THE FLAWS AND RISKS ASSOCIATED WITH THE PROCEDURE. THEY SHOULD ALSO BE GIVEN INFORMATION ON OTHER TREATMENT/DIET/LIFESTYLE OPTIONS BEFORE CONSENTING TO THAT SURGERY.

<<Leaving aside the Mercola vs Dental Establishment debate, I find it a little unsettling that professionals can find it within their conscience to conduct a procedure that leaves patients in such excruciating pain.>>

IT'S BEST TO DO YOUR OWN RESEARCH AND SEEK INFORMATION FROM REPUTABLE, WELL ESTABLISHED PRACTITIONERS/EXPERTS WHO ARE WILLING TO TALK ABOUT THOSE TOPICS OF DENTISTRY THAT ARE OFTEN NEGLECTED TO BE MENTIONED BY MANY IN THE DENTAL PROFESSION.

EVERY PROFESSION, HEALTHCARE AND OTHER, HAVE SITUATIONS THAT LEAVE PEOPLE THINKING.......HOW CAN SOMEONE DO THAT TO ANOTHER PERSON? DENTISTRY IS NO DIFFERENT.

<<At the very least I think the professional body for orthodontists should conduct a survey, by getting their members to give patients a questionnaire to be completed say six months after the RCT. The questions should be designed to provide the following data: what percentage of patients experience severe pain after RCT, how long does the severe pain last (minimum, maximum, average). Anyone still experiencing severe pain after six months should be sent a follow-up questionnaire. >>

THIS WILL NEVER HAPPEN AND FOR ONE REASON. THE ANSWERS TO THOSE QUESTIONS ARE IRRELEVANT AS EVERY ENDODONTIST ALREADY KNOWS THE RCT PROCEDURE IS FLAWED SIMPLY DUE TO THE ANATOMY OF THE TOOTH NOT ALLOWING ACCESS TO THE HUNDREDS+++ OF TINY CANALS AND THE FACT THAT AN INFECTED TOOTH CANNOT BE MADE HEALTHY AGAIN. IT IS EXPECTED THAT THE PATIENT WILL HAVE PAIN EITHER WITHIN A FEW DAYS OR SOME TIME DOWN THE ROAD. IT IS EXPECTED THAT THE TOOTH WILL EVENTUALLY NEED TO BE EXTRACTED. SOME ENDODONTISTS RECOMMEND RE ROOT CANALING TEETH EVERY FEW YEARS UNTIL EITHER THE PATIENT SAYS NO MORE OR THE TOOTH IS SO DECREPIT THAT IT CRUMBLES.

<<It would also be good if RCT patients could be followed up to produce data showing how long before the tooth has to be extracted anyway, shown in groups e.g. less than five years after RCT, five to ten years, over ten years.>>

THIS FOLLOW UP WOULD BE USELESS AS THERE ARE TOO MANY BIOLOGICAL AND PATHOLOGICAL VARIABLES THAT THE PATIENT IS UNAWARE OF WHICH WOULD RENDER THE COLLECTED DATA INSIGNIFICANT.

<<Prospective patients could then be given a leaflet with this info to help them decide whether to risk having RCT.>>

DENTAL PATIENTS SHOULD BE INFORMED BY THEIR DENTISTS OF THE ORAL AND SYSTEMIC CONSEQUENCES ASSOCIATED WITH RETAINING AN INFECTED TOOTH SO THEY CAN MAKE A PERSONAL DECISION AS TO WHETHER THEY ARE WILLING TO RISK THEIR HEALTH FOR THEIR TOOTH.

I hope this information answers your questions.

Thanks for your help
 

Thanks Bryanna, the info you provided is very useful.

Update
Friday night I took some Ibuprofen. Slept quite well. Saturday I didn't need any painkillers until mid afternoon. I am no longer in agony - just discomfort / mild pain. I don't know if I'm out of the woods yet or if there will be a flare-up. I'll post updates from time to time.

Update Monday 16 June 2014
 

It's now a week since I had the RCT. Yesterday (Sunday) was my first day without any painkillers. No pain, just some discomfort in the jaw. I'm still taking the penicillin.

I'll post updates from time to time in case it helps anyone else who is going through the same experience.