Dr. Naveen Thomas
Dentistry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I had a wisdom tooth issue for many years, and I got them removed two years back. The wisdom tooth issue was for the lower teeth, but my dentist also advised the removal of upper pairing teeth. So all four teeth were removed at the same time. After that procedure, I got recovered completely. But the actual issue I was facing before my wisdom teeth removal was that I could not bite or chew food on the right molar and sensitivity on the right molar while eating ice cream or warm food. That issue does not resolve even after my wisdom tooth removal. For the past two weeks, the sensitivity has increased, and I visited my dental surgeon, who had done my wisdom tooth removal. An X-ray of the last right molar was taken, and it showed tooth decay. I do not have that X-ray. But I have a jaw X-ray that I took for wisdom teeth removal. Last week the dental surgeon performed a root canal for the right tooth, which had developed decay. There were two sittings for the procedure.
My next appointment is in this week, but the issue which I am facing is the sensitivity issue, which was only on the last decayed tooth, but now the sensitivity has spread to the front tooth. When I gargle with water after eating, I feel the same sensitivity in the entire half of my jaw. It is a mix of pain and sensitivity, which I feel, and even in my right ear, I can feel it. But after five minutes, this sensitivity and pain go away and occurs only when I gargle with warm water again. I am not on antibiotics, and there is no swelling at the site where the root canal is done. Kindly help.
Hi,
Welcome to icliniq.com.
I had gone through the attachments (attachments removed to protect the patient's identity). The second molar has a large cavity, and it happened mostly due to the previously impacted wisdom tooth, which may have caused food impaction at the site. The second molar shown in the X-ray may require a root canal treatment. I suggest doing a root canal treatment for it as soon as possible. The sensitivity may be due to this cavity because the lesion is very near the root portion. The sensitivity of the concerned tooth and even the first molar will go away after days or a week after successfully completing root canal treatment and the complete healing of the area.
Patient's Query
Hi doctor,
I am attaching the picture before the wisdom tooth removal. Are my other teeth fine? Are they poorly placed, or are they in the correct position? Is this problem of tooth sensitivity post root canal treatment normal? I would also like to know whether the teeth sensitivity is associated with any calcium deficiency? During my early ages, like 15 or 17 years of age, I had my braces as my front teeth were protruding teeth. Kindly advise.
Hi,
Welcome back to icliniq.com.
I had gone through attachments (attachments removed to protect the patient's identity). In this X-ray also the tooth in the front of the wisdom tooth had a large cavity which required root canal treatment at that point in time itself. Thus the root canal treatment of the second molar should have been done along with the third molar removal. So the sensitivity of the area is mostly related to this second molar only. Sensitivity may be present even after root canal treatment for a few more days till the area is healed properly.
The sensitivity is not related to calcium deficiency and also not related to your braces but due to eruption of the horizontally impacted third molar.
Patient's Query
Thank you doctor for the reply,
I got RCT done for my second molar on the right side. Today at lunch, I had little hard chapattis. I had pain near the second molar, for which RCT was done when I was using that molar for chewing the chapattis. Kindly advise on this pain. I am not sure why the RCT-treated tooth is paining while chewing chapattis. Can I use the RCT-treated teeth for chewing hard food items, or should I avoid using them?
Hello,
Welcome back to icliniq.com.
Usually, there should not be any pain while chewing after two weeks, but sometimes the tooth may have high points due to the filling, which may be causing the pain. If the pain is unbearable, it may suggest a tooth fracture.
Patient's Query
Thank you doctor for the reply,
I am planning to meet my dentist today to have a check-up on my sudden tooth pain. Why do I have pain while drinking water? Why does the pain subside after drinking water? I would also like to know what questions I should ask my dentist, who performed my RCT.
Hello,
Welcome back to icliniq.com.
There is chance of tooth fracture which may sometimes cause such pain as you described, but we cannot be sure until an X-ray is taken. Consult a dentist and get an X-ray done
Patient's Query
Thank you doctor for the reply,
Today I visited my dentist, who performed my RCT. My doctor took the X-ray of both my molars which I have highlighted in the pictures. I have attached even the X-rays of both the tooth. I had taken the tablet Dolo 650 at 11 o clock in the morning and the pain reduced for a few hours, but now the pain has started again, just like yesterday.
Hello,
Welcome back to icliniq.com.
From the attached images (attachments removed to protect the patient's identity), the RCT (root canal treatment)-treated tooth has a crown over it, so there is a chance of a high point on the crown. It can be reduced. There is caries below the crown distally, so it seems the tooth has some decay below the crown in the distal root, which may be causing the discomfort.
Thank you.
Patient's Query
Thank you doctor for the reply,
The RCT-treated teeth did not have a high side when I closed my jaw. My dentist told me that it is not decay but healthy tissues. The crown that has been applied covers the entire backside of my molar. I am unsure how this decay occurred underneath the teeth after applying the crown. Is there a way to remove the decay which is underneath the crown?
Hello,
Welcome back to icliniq.com.
There is indeed some decay beneath that tooth, and it has a very poor prognosis. The decay may lead to tooth extraction in the future if pain increases.
Patient's Query
Thank you doctor for the reply,
When I initially contacted my dentist, she advised that the teeth could be saved with RCT. Was RCT the ideal solution for my problem, or should my dentist have adviced me on the teeth extraction and implant approach? I am a little confused now as I thought the RCT would fix my teeth sensitivity and pain.
Hello,
Welcome back to icliniq.com.
If the dentist is saying there is healthy tissue distally, then it might be true. The dark area may have filling material completely covering it. In the first X-ray (attachment removed to protect the patient's identity), which you sent at the start, the cavity goes below the tooth. The only thing I would have done differently is after root canal treatment, and I usually give two weeks to one month to properly heal the area and ensure there is no pain before putting a crown over it. I suggest you take the tablet Amoxycillin and consult your dentist.
Patient's Query
Thank you doctor for the reply,
I am planning to go for extraction and dental implant for my second molar, for which I got RCT done. I would like to know about the procedure.
Hello,
Welcome back to icliniq.com.
The cost of extraction varies from place to place, but the cost of the implant is usually high.
Patient's Query
Thank you doctor for the reply,
I have the following queries:
Hello,
Welcome back to icliniq.com.
All implant systems are good if done by a good, experienced, and qualified implantologist. The dentist will assess for infection and suitably tell whether the immediate placement of the implant is helpful. No periodic maintenance is required except cleaning of teeth. The duration may range between one to six months. The complications can be implant infections and implant failure if not done properly.
Patient's Query
Thank you doctor for the reply,
Does the implant cost get covered under general health insurance policies? Should I consult an implantologist to get the implants done?
Hello,
Welcome back to icliniq.com.
Usually, the implant is not covered under insurance. I suggest you consult a nearby implantologist.
Patient's Query
Thank you doctor for the reply,
Whom should I counsult for implants in my area?
Hello,
Welcome back to iclniq.com.
I do not think the cost of the implant will be covered by your insurance. You can search for good implantologists online
Patient's Query
Thank you doctor for the reply,
I got the RCT-treated teeth removed today morning. The extraction went fine, but the problem is that the doctor had put a few sutures post extraction. The problem I am facing now is the bleeding from the extraction site place has not stopped till now. I did not eat any hard food or chew from that side today. I have attached the images.
Hello,
Welcome back to icliniq.com.
Mild bleeding or blood mixed with saliva can be seen for the first 24 hours, so there is no need to worry about it. Rest, lie down, and drink cold water or juice only for the first 24 hours. If bleeding is too much, bite down on cotton, and you have to consult the dentist as soon as possible.
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Dentistry
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