Sore tooth - mostly the gum area below

[Baz]

Last year I got my first root canal.

Thread here:
https://forums.pelicanparts.com/off-topic-discussions/1157534-im-getting-root-canal.html

The problem I mentioned in that thread has persisted and last night was so bad I thought I'd be phoning area dentists this morning to get an extraction.

I should say that most of the second half of last year and most of this year there hasn't been really any pain as much as just discomfort.

The last time it was looked at I was told there was an infection and I was prescribed antibiotics.

I took those but it didn't seem to change much.

For pain I am using mostly clove oil, Tylenol, and starting last night I started taking an antibiotic again. This morning the pain had subsided, thankfully, but I called my dentist anyway and have an appointment with them in the morning.

As much as I hate the idea of it - I may opt to have it extracted, if it makes the issue go away. Because so far no one can explain what's causing this discomfort and occasional pain.

This is the lower left back molar (2nd Molar).

We'll see what my dentist says tomorrow......

[BK911]

Something jammed down there.

[Baz]

Originally Posted by BK911

Something jammed down there.

I've had a cleaning since and nothing was discovered at that time. Plus x-rays and my dentist took a good look.

I guess that might be a possibility but seems unlikely given how much it's been looked at so far.

Thanks for your input anyway!

[LEAKYSEALS951]

why did you have the rct done last year in the first place?
decay? infection? was the tooth cracked?
Was the dentist who treated the root canal a general dentist or an endodontist?
If a general dentist did it, it might make sense to have a specialist look at it for a second opinion. They have better imaging equipment (limited field cbct) which is better than traditional radiographs, and even better than the large field cbct's some general dentist have.
Depending on the problem though, and how it shows, that might not even be necessary. Tomorrows eval could show an obvious problem.
It could be a gum issue, but the dentist should be easily able to rule that out. Also cracked teeth (or failed rcts) can cause gum issues.
Second molars are under the most stress in the mouth and are notorious for cracking.
These can be tricky to diagnose, and treat, with a guarded prognosis at best.

Usually knowing the history (what was originally wrong) and a new radiograph (what's going on right now compared to last year) can provide a lot of clues.


Good luck.
R

[masraum]

LS has clearly stayed at enough Holiday Inns to have built up points for free stays!

Sounds like he knows what he's talking about.

[LEAKYSEALS951]

Originally Posted by masraum

LS has clearly stayed at enough Holiday Inns to have built up points for free stays!

Sounds like he knows what he's talking about.

^ Yeah, but my sig lines aren't exactly confidence inspiring!

[Baz]

Originally Posted by LEAKYSEALS951

why did you have the rct done last year in the first place?
decay? infection? was the tooth cracked?
Was the dentist who treated the root canal a general dentist or an endodontist?
If a general dentist did it, it might make sense to have a specialist look at it for a second opinion. They have better imaging equipment (limited field cbct) which is better than traditional radiographs, and even better than the large field cbct's some general dentist have.
Depending on the problem though, and how it shows, that might not even be necessary. Tomorrows eval could show an obvious problem.
It could be a gum issue, but the dentist should be easily able to rule that out. Also cracked teeth (or failed rcts) can cause gum issues.
Second molars are under the most stress in the mouth and are notorious for cracking.
These can be tricky to diagnose, and treat, with a guarded prognosis at best.

Usually knowing the history (what was originally wrong) and a new radiograph (what's going on right now compared to last year) can provide a lot of clues.


Good luck.
R

Thanks for your input, Ron.

The reason for the root canal was I was told I had dying nerves inside the tooth and this would be a way to salvage the tooth.

Was originally to be done by my dentist but they didn't have any openings for a couple weeks and after the end of week one the pain was so intense I asked for an alternative s they hooked me up with an endodontist in Daytona.

A short while after that procedure things didn't feel right so I went back to them and they did more radiographs and told me they didn't see anything unusual but I probably still had an infection so gave me a script for antibiotics.

A short time later I had my 6 month checkup and cleaning by my regular dentist and after telling him about the discomfort he poked around and took new xrays and didn't see anything unusual.

So I just let it ride hoping it was just an infection that would eventually go away.

That's all I know at this point.

What I am most wondering now is should I go ahead with an extraction if it resolves the situation? How much would I miss that molar?

Thanks again!

[Baz]

Also - a cracked tooth sounds like the best candidate for the issue I'm having. That would explain all this, no?

[LEAKYSEALS951]

Originally Posted by Baz

Also - a cracked tooth sounds like the best candidate for the issue I'm having. That would explain all this, no?

Depends. Sometimes a cracked tooth would cause the nerve to die. Sometimes a large cavity/or filling can do it to.

The fact an endodontist did the rct tells me there was probably a pretty good workup. They would look for things like cracks at the time. If there was one, they would probably have told you about it, and its effect on the potential prognosis.

That doesn't mean that the tooth didn't crack since then, and I'm not saying it's a crack at all. It could be other stuff too.

I think it all boils down to how motivated you are to save the tooth. If the eval tomorrow (I'm assuming at the general dentist) doesn't show a smoking gun, you might want to go back to the treating endodontist.

If the eval tomorrow shows a big change on the radiographs, or you are just tired of dealing with it, ask your dentist how big of a deal it would be to just pull it/long term consequences.

If you are motivated in saving it, I am sure the endodontist would want to see you, since the tooth has become symptomatic since treatment.

[Baz]

OK great advice - thank you again!

Still wondering though how much losing this tooth would affect me. I guess eating being the main issue. This tooth isn't seen too much when someone smiles or talks, I guess.....

[masraum]

Originally Posted by Baz

they hooked me up with an endodontist in Daytona.

The guy said his office had caught fire the night before, and had to do the work in a lounge chair in a Howard Johnsons. He did bring his own dremel.

He also offered to plump up Baz's butt while he was there for a minimal fee. He gave him the choice of silicone caulk or 20w50.

[masraum]

Originally Posted by Baz

OK great advice - thank you again!

Still wondering though how much losing this tooth would affect me. I guess eating being the main issue. This tooth isn't seen too much when someone smiles or talks, I guess.....

You could always get an implant to replace the tooth afterwards. They are pricey, but supposed to be the next best alternative to having the OEM equipment.

[Baz]

OK, I just found an article that says losing the #2 isn't a good thing unless you replace it.....

https://burbankdentalimplants.com/last-molar-extracted-do-i-need-a-dental-implant/

[Baz]

Factor in I turn 71 in June so......

[masraum]

Originally Posted by Baz

OK, I just found an article that says losing the #2 isn't a good thing unless you replace it.....

https://burbankdentalimplants.com/last-molar-extracted-do-i-need-a-dental-implant/

I'm not saying that the article isn't correct (I know jack about teeth), but is the article written about folks that make their money by replacing teeth?

[LEAKYSEALS951]

The loss of an upper second molar is no big deal. A missing lower second molar can cause the upper molar to extrude, causing upper issues, and eventual need for the upper tooth to be extracted, but that's over a long period of time (think decades).

Also, the lower second molar area can be a tricky area to place an implant. sometimes, lack of bone, and a nerve that runs right though the area can make lower second molar implant placement very tricky. Not necessarily- but that's where your dentist can give you better advice. Each case depends.

[ramonesfreak]

Originally Posted by Baz

OK great advice - thank you again!

Still wondering though how much losing this tooth would affect me. I guess eating being the main issue. This tooth isn't seen too much when someone smiles or talks, I guess.....

Had both molars on bottom left extracted few years ago. No issues chewing etc. nobody can see it. Wouldn’t care if they did but they can’t

[LEAKYSEALS951]

Originally Posted by Baz

Factor in I turn 71 in June so......

Based on this, one thing I would ask before doing an implant, and let's just assume for a second, that the lower second molar is cracked- Is how are the other lower molars doing?, and even more importantly, how is the second lower molar on the other side of the mouth doing?- followed by- the first molar in front of the problem tooth.

If it turns out the problem tooth is cracked (again- it might be totally something else)- I would look at all the other lower molars and consider crowning them before they go down the same path (only if needed). Usually patients that crack one tooth, will crack others. Are there large fillings, craze lines, or deep plunging cusps on the upper? I'd reinforce those puppies with crowns asap (if needed) again- something you can ask your dentist. You might not need any other crowns at all. It depends.

This isn't just me saying this- I'm relaying a recent conversation from the American Association of Endodontist forums (I'm an associate member) in which they are advising their general dentist referral sources to be on the lookout for this trend and proactively treat at risk teeth before they go south. The endodontist don't make more money if the general dentist crowns the teeth, but they are seeing more and more cracked teeth (people are living longer with teeth) and dealing with the cracked teeth is a real problem and no fun for anyone.

The picture of the extruded teeth in the link is something that happened over multiple decades. Losing a second molar at 21 can be a real issue by the time you are in your 50's,60's, 70's. At 71, If it were me, I'd protect other potentially vulnerable teeth first. That upper molar is going nowhere fast.

If you have the means and bony support to place a second molar implant, go for it, but don't lose other teeth because you put all your investment in the implant basket.

This is something to discuss with your DDS pending what they find, and what they recommend in the big picture.

With all that said, I bet you go in tomorrow and it's not even cracked.

Long story short- protect the other lower molars if needed.

[Baz]

OK thanks again, Ron....this is VERY helpful! I love my dentist and trust him and her (husband and wife practice) but I also never feel I get as much practical info as I'd like to have to help me make decisions.

I will report back after the appointment - thanks again!

[LEAKYSEALS951]

Originally Posted by Baz

OK thanks again, Ron....this is VERY helpful! I love my dentist and trust him and her (husband and wife practice) but I also never feel I get as much practical info as I'd like to have to help me make decisions.

I will report back after the appointment - thanks again!

Watch it be a popcorn kernel or something!