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Painful Crown
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alhobart posted:
I had a crown put on my lower, left, second from the back molar (wisdom teeth were removed, second from back is with my existing teeth) about 2 years ago. The crown was needed because I had an old silver filling that was cracked and the tooth was decaying around the crack. This was my 3rd crown and everything was going well until my dentist hit a nerve that apparently was closer than normal to the tooth surface. The left side of my mouth was numb, but this nerve was not numbed at all. Anyway, a temp crown was put on and after 3 painful attempts at a permanent crown (the lab did not make the first two permanent crowns correctly), I had my permanent crown. One thing to note, during the first permanent crown fitting, I let the dentist know that I was in pain, so she numbed up the left side of my mouth, but the nerve that was exposed would not numb. It was the second and third fittings that she put something on the nerve directly to numb it, but it wore off within a minute of her asking me to rinse my mouth after she had to remove the adhesive and reattach the temp. crown (fitting #2) and the permanent crown (fitting #3).

Fast forward about a year and half, my tooth started aching, up until that point, the tooth was fine, only sensitive to extreme hot or cold, but no different than some of my other teeth. The aching was so bad and radiated through the left side of my mouth that I could not tell if it was the crowned tooth or the rear most lower left tooth. The tooth was very sensitive to cold and warm, not just extremes. Called the dentist, was prescribed an antibiotic (Z Pack) and pain killer (Tylenol with Codene) over the phone and had an emergency appointment. My dentist thought it was an abscess. When she saw me she saw that it was not an abscess and recommended that I stay on the antibiotic and painkiller and recommended an Endontist who treated her husband. By the time I went to see the Endontist (about 2 weeks after seeing the dentist because of scheduling issues), my pain had subsided. The Endontist tested my tooth to cold sensitivity and it responded normally. He said it was up to me if I wanted to go ahead with having root canals done to the tooth since I was not in pain. When asked if the antibiotics could have done anything, he said there was nothing, outside of an abscess, that antibiotics could be used to treat tooth problems.

Well, 6 months later, my tooth is aching again. Not as bad, but is back to being very sensitive to warm and cold. 6 Months ago, the Endontist seemed very confident that he could perform the root canals without removing the crown (I told him that if the crown comes off, the rest of the tooth comes with it, I am NOT going through any more painful fittings), even when I specifically asked about the nerve that I suspect is the cause of my pain 6 months ago and my current pain, he seemed confident he would get it. 6 months later, I am having doubts. I am afraid that I may be wasting more time and money to go with the root canals that may not solve my problem and I will end up pulling the tooth and having an implant put in. Any Dentists, Endontists and Oral Surgeons out there who want to let me know the pro's and con's of the root canals through the existing crown vs. going direct to an implant? I know my own dentist prefers to keep the original tooth as much as possible and did not like implant for molars. Are my fears about the Endontist not getting all the nerves during an root canal reasonable? Anyone who was in a similar position and what the end result was?

TIA.
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alhobart responded:
Further information which may or may not be useful:

1) Prior to the crown, I had NO pain in this tooth. The cracked filling did not cause any increase in sensitivity or any pain at all, as a matter of fact, I had no idea until the dentist mentioned it. The crown was necessary because the filling was quite large and there would not be much of the original tooth left after the new filling, so the crown was necessary to save the tooth.

2) Also, since the current pain is less than what I was going through 6 months ago, I am now 99% sure it is the crowned tooth, which I was only 75% sure 6 months ago because the pain was so bad and radiated to the other tooth, it was hard to tell which tooth was the cause of the pain, if not both.

3) My concern about rooting the nerve comes in the fact that the nerve is covered by the permanent crown and it was pretty far down on the tooth. With the temporary crown, the nerve was exposed or partially exposed so that I could not chew on the left side of my mouth for 6 months while I was going through the issues with the making of the permanent crown. I could not even brush that tooth because the bristles would hit the nerve and cause a horrible shooting pain. So, that is why I am concerned that the Endontist can even get to that nerve to remove it, without removing the crown. And that 6 month period of pain with the permanent crown fiasco is why I am so determined to eliminate the pain permanently, I refuse to live with that kind of pain again.

I probably should have had the dentist do a root canal on that nerve before getting the permanent crown, but she seemed confident with the permanent crown covering the nerve and the adhesive she used is supposed to suppress sensitivity of the nerve that I went with her suggestion and it worked for about a year and a half.


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