Root canal treatment and getting a dental crown are common procedures aimed at saving a severely damaged or infected tooth. The root canal removes the infected pulp inside the tooth, and the crown is placed to protect and restore the tooth’s function. However, it can be quite concerning when the tooth still hurts after these procedures. In this article, we’ll explore the various reasons why this might happen and what can be done about it.
Reasons for Pain After Root Canal
Incomplete Root Canal Treatment
Residual Bacteria in the Canals
One of the main reasons for pain after a root canal is that the treatment might not have been completely successful in removing all the bacteria from the root canals. The root canal system is complex, with tiny branches and curves. Sometimes, the dental instruments used to clean the canals can’t reach every nook and cranny. These remaining bacteria can continue to cause an infection, leading to pain. For example, if there’s a small side branch in the root canal that the cleaning tool missed, bacteria can thrive there and keep the inflammation going.
Inadequate Filling
Another aspect of incomplete treatment is related to the filling of the root canals. If the filling material doesn’t reach all the way to the end of the canals (under – filling), there can be a space left for bacteria to enter again. This can start a new infection, causing pain. On the other hand, if too much filling material is used and it extrudes beyond the tip of the root into the surrounding tissue (over – filling), it can irritate the tissue and cause pain. The body may treat the excess filling material as a foreign invader and mount an immune response, leading to discomfort.
Persistent or New Infections
Persistent Abscess
Before the root canal, an abscess (a pocket of pus) may have formed at the tip of the tooth’s root due to the infection. Even after the root canal, this abscess may not heal completely right away. The body is still trying to fight off the remaining infection, and this can cause pain. The abscess may need more time to drain and heal, or in some cases, additional treatment may be required to fully resolve it.
Reinfection
If the tooth is not properly sealed after the root canal, bacteria from the mouth can enter the root canals again and cause a new infection. This can happen if the filling material comes loose over time or if there’s a crack in the tooth. Also, if you have poor oral hygiene, bacteria can easily multiply and infect the treated tooth.
Issues Related to the Crown
Crown – Related Pain
High Occlusion
When the dental crown is first placed, it’s possible that it’s a bit too high compared to your other teeth. This means that when you bite down, the tooth with the crown takes more pressure than the others. Over time, this can cause pain in the tooth and the surrounding tissues. You may notice that the pain gets worse when you chew or bite down. The dentist can easily check for this by using a special paper called bite – registration paper. They will ask you to bite down on it, and the marks left on the paper will show if the crown is too high. If it is, the dentist can carefully adjust the height of the crown to relieve the pressure.
Incorrect Fit
The crown needs to fit snugly around the remaining part of the tooth. If it’s too loose, it can move around, which can irritate the tooth and the gum tissue. Food particles can also get trapped between the crown and the tooth, leading to decay and pain. On the other hand, if the crown is too tight, it can put too much pressure on the tooth, causing pain. An ill – fitting crown may need to be removed and remade to ensure a proper fit.
Gum Irritation
The edges of the crown can sometimes irritate the gums. If the crown is not properly contoured or if it’s placed too close to the gum line, it can cause the gums to become red, swollen, and tender. This can be painful, especially when you brush your teeth or eat. Good oral hygiene is important to keep the gums healthy, but if the gum irritation is due to the crown, the dentist may need to adjust the crown or provide additional treatment to soothe the gums.
Other Possible Reasons for Pain
Tooth Fracture
After a root canal, the tooth becomes more brittle because it no longer has the pulp to provide nutrients and keep it strong. Even with a crown for protection, the tooth can still fracture. This can happen if you bite down on something hard, like a nut or a piece of ice. A small crack in the tooth can be very painful, especially when you bite down. Sometimes, the crack may not be visible to the naked eye, and the dentist may need to take an X – ray to see it. If the fracture is severe, the tooth may need to be extracted.
Sinus Issues
The roots of the upper teeth are very close to the sinuses. If you have a sinus infection or other sinus problems, the pressure in the sinuses can cause pain that feels like it’s coming from your teeth. This pain may be felt in the teeth that have had a root canal and crown. You may also experience other symptoms of a sinus problem, such as a stuffy nose, headache, or facial pressure. Treating the sinus issue, usually with medications to reduce inflammation and antibiotics if there’s an infection, can often relieve the tooth – like pain.
Nerve Sensitivity
In some cases, the nerves in the area around the tooth may still be sensitive after the root canal and crown. Even though the main nerve inside the tooth has been removed during the root canal, there are other smaller nerves in the surrounding tissue. These nerves can be irritated during the procedures, and it may take some time for the sensitivity to go away. This type of pain is often a dull ache or a sensitivity to touch or pressure.
What to Do If Your Tooth Hurts
See Your Dentist
The first and most important step is to visit your dentist as soon as you notice pain. They can perform a thorough examination, including taking X – rays, to determine the cause of the pain. The dentist will check the root canal to see if there are any signs of infection or problems with the filling. They will also examine the crown to make sure it’s fitting properly and not causing any issues.
Possible Treatments
Root Canal Retreatment
If the pain is due to an incomplete root canal, such as residual bacteria or an improper filling, the dentist may need to re – open the tooth and re – do the root canal. This involves removing the old filling, cleaning the root canals again, and placing a new filling. Root canal retreatment can be more complex than the initial treatment, but it can often resolve the pain.
Crown Adjustment or Replacement
If the problem is with the crown, the dentist may be able to adjust it. If it’s too high, they can grind it down slightly to make it level with your other teeth. If it’s not fitting properly, they may be able to re – cement it or, in some cases, make a new crown.
Antibiotics
If the pain is caused by an infection, the dentist may prescribe antibiotics. Antibiotics can help kill the bacteria and reduce the inflammation. However, antibiotics are usually used in combination with other treatments, such as root canal retreatment or crown adjustment.
Analgesics
For pain relief, the dentist may recommend over – the – counter painkillers like ibuprofen or acetaminophen. In some cases, they may prescribe stronger pain medications if the pain is severe. But it’s important not to rely solely on painkillers; finding and treating the underlying cause of the pain is crucial.
Conclusion
Experiencing pain after root canal treatment and getting a crown can be worrying, but there are many possible reasons for it. Whether it’s due to incomplete root canal treatment, issues with the crown, a tooth fracture, sinus problems, or nerve sensitivity, understanding the cause is key to finding a solution. By seeing your dentist promptly and following their recommended treatment, you can get your tooth back to a pain – free state and ensure its long – term health. Remember, taking care of your teeth and reporting any unusual symptoms to your dentist is essential for maintaining good oral health.
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