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Root Canals

3 root canals in 1 tooth & still in pain

08/09/2007

Question:

I have 3 root canals in one tooth. The first, my regular dentist tried to do and ended up breaking off an instrument. It is still in there. The second was done by an endodontist, but the consistent pain is still there. The third was done by another endodist and he went through the lower part of the tooth and gum, but I still have the pain. It is not extreme (at times it needs a vicodin to calm down, but rarely...an ibuprofen usually will do the trick), but it hurts a majority of the time. I have learned to live with it, but I am afraid that even if I get the tooth pulled and get and implant (as it is the lower front tooth), it will still hurt. Any ideas or suggestions. My dentist says she has no idea why this tooth still hurts (I also have another that hurts constantly, post root canal...just not as severe). Any advice would be appreciated.

Answer:

The source of your pain may not be the tooth at all. The tooth may merely be the trigger point for your pain. The source of your pain may be neurogenic (caused by the nerves themselves either locally or in the brain). This can sometimes occur following a tooth infection, but often begins on its own. The pain can often mimic a toothache, but treatment of the tooth does not seem to resolve the pain.

I suggest you begin a log of your pain - describe when it occurs, what triggers it, describe the feeling, describe where it extends to. This may help the dentist in determining if the tooth is the source of the pain or a trigger for the pain. You may need to see a neurologist for further evaluation. Your concern about the potential of having pain after the tooth is taken out is valid. If the pain is not really being caused by the tooth, removing it will not resolve the problem.

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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