I have severe tooth pain after crown placement in the RCT treated tooth. Kindly help.

Question

Hello doctor,

I had an RCT done on the lower molar (number 6) two months ago. The file was left in the canal, which I did not know about. It was a mild sensation for a month or so. Then I went to fix the crown. The dentist asked to cut the gums because there wasn't enough space to fix the crown. After clearance of the gum, a crown was fixed. The pain was not subsiding even after a week. Crown has fixed it temporarily to check if it is normal for a couple of days. But the problem was out of control. The crown was removed, and the canals were cleaned again. But if the effect of the painkiller is gone, the pain used to go up again every time.

Then, I went to another dentist (endodontist) in his clinic. He performed re-RCT and said that he found another canal that was not cleaned. He did it and said that the pain would subside. But still the same situation. Even if I gently touch the tooth, there is severe pain up to the tooth's deep root.

What should be the cause of it?

Is the file left in the canal causing the issue?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

It may cause pain if the file is protruding out of the canal, but is not usually the cause. There may be a hidden canal infection. Usually, such pain is caused when more disinfectant liquid is injected into the bone beyond the canal. It should clear up when the liquid is cleared away slowly. Ask your dentist to remove the crown until the pain goes away completely. Also, get an X-ray done to see if the file is protruding out.

Strong antibiotics are also required.

I hope this information provides some clarity and reassurance.

Please feel free to reach out if you have any further questions.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I have seen the X-rays (attachment removed to protect patient identity). I think the pain will subside in a few more days. You should take antibiotics like Augmentin (Amoxicillin and Clavulanic acid) 625 mg thrice a day for a week, along with a painkiller. The broken file does not seem to be the cause of continuous pain. Do not place the crown for now until the pain is present.

I hope this information provides some clarity and reassurance.

Please feel free to reach out if you have any further questions.

Thank you.