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Old 07-27-2007, 03:37 AM   #1
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blahblah HB User
Failed root canal in cracked tooth

Hi, I am new to the boards, glad I found you.

Is it possible to have pain in a cracked tooth for a year and a half after a root canal without a progressive infection or abcess - or could it be referred pain from TMJD? I posted this on the TMJ board but am not getting much response there, and this also had to do with a root canal.

My TMJD began in 1/2006, at same time I had intense pain in tooth
#18 which is my lower left molar just infront of my wisdom tooth. There was a very small filling in the tooth but no present
decay. My dentist removed filling and found a small hairline fracture
that began at one side of the tooth but did not go all the way across
and did not go down as deep as gumline. She tried to bond it but that
made pain worse. (Upon biting down and releasing, sharp pain
resulted.)

It was then determined I needed root canal. The root canal was not
easy - I felt some of treatment due to inflammation from crack and
afterwards I had pain for a few days both in the tooth and jaw. My
jaw pain is on left side only - same side as tooth. My crown was
placed on tooth with temporary cement and left like that for months -
but the off and on discomfort remained. It was finally cemented in
permanently 6 months later. It is NOT same pain I experienced when it
was cracked - - it is on the sides only and almost feels like it is
loose - yet dentists have examined it and say it is not loose. Also -
most of the time when the tooth hurts, my jaw (on left only) hurts -
the pain goes back to from of ear area.
include my lower jaw.

Been to many many TMJD "specialists". (I live in the NY/NJ metro
area.) I finally found a specialist back in March who has begun to
help me. I have had two MRIs one year apart and he maintains I have
displaced discs on both sides. He started me on an $800 upper
appliance to reposition my jaw. Three months later I moved on to a
lower ($1200) appliance that is to stabilize my jaw. I am to wear
this for the next 6 months and once I am painfree - I am to get
braces.

My bite has shifted significantly in the last year and is
very bad now. However new, lower appliance hurts my tooth! By the way
when I bite down I make NO contact with tooth in question! My
dentist cut the crown off and tried to shave down the
tooth for a better fit, it did not work. He told me I must get the
tooth re-treated and to return to the Endo.

I saw Endo on Monday night and she will not retreat my root canal at
this time. After being in off and on discomfort in this one tooth I
had treated a year and a half ago she sees NO evidence of it needing
to be retreated. She xrayed it and sees NO shadows, only perfectly
filled roots. She also says for me to stay open that long will only
cause me to go into more spasm in my jaw. She said if I was not
dealing with TMJD issues she would try to retreat it - but she feels
CERTAIN the pain is associated with the jaw and is all referred
pain. If it were an infection I would have swelling and it would get
increasingly worse which it does not. My pain from the tooth
radiates back to my jaw and the masseter muscle and trijeminal nerve.

The Endo wants me to try to get the jaw issues under control first
before retreating the tooth. She does not feel it is fractured
further either - she tested the gumline etc. Now that said, there is
no way she can determine if the initial hairline fracture has gone
deeper because often hairline fractures go undetected but again she
does not believe that is the issue. She wants me back in one month to reassess the tooth.

So I continue with this discomfort in this one tooth. Very
frustrating. She said if it is pulled - I could STILL have the pain.
BUT my jaw dentist who is a general dentist and been in practice for 25 years says referred pain would NOT be in just one tooth. That he can palpate pain below the gumline in my jaw bone and that is where the roots of the tooth are- she disagrees and says he is pushing too hard there. He said something is wrong with that tooth - he recommends i see a new Endo - he also said it might be the crack that is causing the pain.

Has anyone ever heard of anything like this with the tooth pain? PLEASE help!

 
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Old 07-27-2007, 05:35 AM   #2
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Lenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB User
Re: Failed root canal in cracked tooth

I have had two cracked bicuspids root canalled, posted and crowned (MUCH money$)...I eventually lost them both.

It seems they cannot prevent leakage into these cracks from below the gumline is my guess.

(Both of mine were cracked through though.)

 
Old 07-29-2007, 04:48 PM   #3
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Join Date: Jul 2007
Location: wynnewood pa usa
Posts: 2
lynnralphie HB User
Re: Failed root canal in cracked tooth

Didn't the Endo look at tooth under microscope ? I have had two previous issues of root canal later was diagnosed as cracked or fractured tooth. One tooth actually got root cancled twice before they foun the fracture. Both times inthe past doctors kept saying it was my TMJ and that may have casued the eventual fracture. Friday I had similar problem and Endo recognized it right away as fracture and tells me it has to come out - now I'm otrn as to who to let do te extraction. But just so you know it is very common to have pain even after they declare your tooth is "dead". the last one I refused to loose and had a perio doa root resection - he took out the entire protion that was racked, unfortunatly this time its the center and the tooth has to go.

 
Old 07-30-2007, 05:26 AM   #4
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Join Date: Jul 2007
Location: US
Posts: 115
blahblah HB User
Re: Failed root canal in cracked tooth

>Didn't the Endo look at tooth under microscope ?

Yes. But apparently hairline fractures can't always be detected via microscope. In addition if the canal was not cleaned out thoroughly or if there is an air pocket at the bottom of the root that exists below the fill they use - they could not see it via microscope.

Did you have off and on pain in your cracked teeth or constant? The initial crack caused pain constantly - but after the root canal was performed I find it is not the same pain nor nearly as bad. It is not constant either - rather it is really only there if I push on sides of tooth and sometimes is worse then others.

 
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