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Root Canals

Root canal failure or fracture tooth

03/06/2007

Question:

I had a root canal done #14 a couple weeks ago, currently I have a temporary crown and should be fitted for the permanent crown in the next couple weeks.

However, a three days ago molar #15 was very sore on touch and biting. This molar has had a endodontic tx done for several yrs and has been asymtomatic for several years now. When I went to see the dentist who recently did the root canal on #14 he said it was not the tooth he had worked on but the adjacent tooth. I told him the pain was ligament related and he smoothed the tooth down so it would not impact others. He said the pain should go away by the following day, but if it doesn`t it could mean that I have a fractured tooth since tooth did not have crown on it. I am very afraid to get an implant and would rather my dentist recheck the root canal.

Please tell me what a dentist must do to confirm a fractured tooth? and a tooth abscess? Thank you!

Answer:

The first thing to be checked is the temporary crown on tooth #14. Since it is the most recent work - that may be the cause. Once the bite has been checked and adjusted, then #15 can be looked at. There are a couple instruments your dentist can use to check for cracks. They consist of plastic biting surfaces than can be put on specific parts of a tooth, and you bite on it to see if it causes pain. The pain of a cracked tooth is very sharp and generally causes pain on release of the bite (in non-root canal treated teeth). There may be pain simply to biting with a treated tooth.

Another way to look for cracks in a tooth is to trans-illuminate it with a very concentrated, high intensity light. Often the cracks will reveal themselves using this device. If you are unsure about a diagnosis and wish to save the tooth versus have it removed and replaced with an implant, then have an evaluation done by a root canal specialist.

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Response by:

John M Nusstein, DDS John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University