Lingering Pain After Root Canal Therapy
Donald R Tanenbaum, DDS, MPH
Board-Certified TMJ & Orofacial Pain Specialist at New York TMJ & Orofacial Pain
Toothache pain typically occurs due to problems associated with pupal pathology, peri apical pathology or both. In most cases (94% of the time) root canal treatment resolves the pain. But a small percentage of patients continue to experience pain that is not responsive to medications and /or surgical procedures. When this occurs a number of factors could be responsible including a tooth fracture that is undetected, untreated canals in the tooth that had not been visualized, or a persistent bacterial infection.
It does happen, however, that the lingering pain in the tooth or tooth site is due to referred pain from muscles of the jaw and neck, or referred pain from medical diseases outside the immediate tooth site region. In addition, causes of the pain may be due to nerve-related disorders, headache disorders and/or psychogenic disorders. When investigation suggests that the pain is not related to a lingering tooth or tooth site problem, the term Persistent Dentoalveolar Pain has been proposed.
When no regional medical disorder (pathology in the sinuses, pharynx, salivary glands, or thyroid glands) or distant disorder (cardiac-related) has been implicated, the pain that lingers is thought to be due to a neuropathic phenomenon.?This is when an Orofacial pain expert should direct care.
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The Risk Factors that Lead to Neuropathic Toothaches
In my practice, I have identified these risk factors leading to neuropathic toothaches. I have developed courses of treatment that lead to an easing of the pain and give the patient a chance to live life without the persistent discomfort of lingering toothaches.
If a patient is experiencing persistent tooth pain and the above factors exist, I recommend pain management be started immediately with anticonvulsant or antidepressant medications (or both) and complemented by psychological approaches including meditation and cognitive behavioral therapies. Even acupuncture has proven to be useful at times.
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11 个月Important post addressing lingering pain after root canal therapy! ??It's essential to seek guidance from a dental professional to ensure proper treatment and alleviate discomfort.?Thanks for shedding light on this common concern!?? Good work Donald R Tanenbaum, DDS, MPH
Doctor at Dental Case Presentation Management & Patient Acceptance
12 个月The so-called "Hot Tooth Syndrome" can easily be corrected by opening the tooth up and completely cleaning the inflamed pulp out. Then place formocresol on a cotton pledget and wipe out the inner surface of the pulp chamber. Remove the cotton, leaving the chamber wet. Then place a pledget of cotton saturated with dentalone ointment & with Sargenti Powder on the surface down into the pulp chamber. Dry everything off with cotton & seal the tooth with a temporary filling of IRM & take the tooth slightly out of occlusion. Wait about a week and have the patient back for a normal RCT using a standard technique. Works 100% of the time. A full crown should be placed in order to have a secure restoration.