Can invisalign cause tooth root pain and throbbing discomfort for months?

Hello,

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It is always advised to get all the fillings and wisdom teeth extraction (depending on the positions) done before we go ahead with the Invisalign treatment. When a cavity is removed and filling is done, exact topography is not restored by the dentist. It will vary from the original tooth shape at the occlusal level. Hence, Invisalign trays will not seat properly and treatment will be compromised. In case of wisdom teeth removal, there will be changes on the back part of the mouth with one tooth not available, the need for sutures. Another reason is, some scientists postulate that wisdom teeth put pressure on front teeth which can result in crowding and malocclusion again after orthodontic treatment is done. Hence, wisdom tooth removal is suggested. As you mentioned, everything was fine until tray eight. So, I assume it would be around three to four months till no symptoms were seen. And then another four months since the time symptoms have begun. The X-ray attached is of low-density low contrast, hence the different structures cannot be visualized properly. If the same was viewed by the dentist, it will be of no use. This X-ray is not able to differentiate between the soft tissue structures and hard tissue structures as well as density differences. This is important to localize the infection, and cavity from the normal tooth structure. Coming to your symptoms, I assume the teeth are reinfected and need treatment. As the cavity was deep, the filling would have given you temporary relief but the bacteria were not removed completely. As a result, they went further deep into the nerve of the tooth or in the root area and started the damage. Hence, initial three to four months, the body's immune mechanism fought it but it could not eliminate it. And now symptoms are seen. Invisalign does do root movements but the pressure is kept gentle so that the tooth and root move without causing harm to the patient. Even if it were due to Invisalign, it would have gone down in the initial three to four days of fresh tray placement and would return only when the new tray was placed, unlike your history where it has been four months continuous. So, Invisalign here has no role in the tooth pain experienced. I suggest getting a fresh localized X-ray (as taken previously) along with an orthopantomogram (OPG) which will show us both (a complete picture of the teeth and a more defined local area situation). There is an infection lingering around the tooth root area which could be causing referred pain. When you touch the gums area, which is near the root of the tooth, the pain is felt and it is referred up to the nose because the pain could be traveling and not getting any way to escape the area. If the fillings were not there, they would have eaten up the tooth and escaped. But the whole area is closed now and it is just traveling within trying to escape from any route possible. All the signs you mentioned about pressing and experiencing pain and walking up and down are indications that the root area has a fault and needs evaluation. Kindly get the clinical examination and radiographic tests done again and share them for further evaluation. Mostly, you would require root canal treatment on one or multiple teeth on the left side to eliminate the infections. I hope I have cleared all your doubts. Reach out for further queries or clarifications. Thank you.