Hello. My first problem is the lower left second premolar. It had a filling, but the filling fell out several times. The entire crown of the tooth became sensitive to touch. The dentist decided to devitalise the tooth and cover it with a ceramic crown. Unfortunately, the tooth is now even more sensitive to touch across the whole ceramic crown. Since it was cemented, I also feel that it is too high. In addition, I have bridges in the upper jaw on both sides, and there are problems on the right that we have not been able to resolve (the bridge is supported by tooth 7 and tooth 3, while teeth 6 and 4 are missing). I have difficulty chewing, and the sensitive tooth is especially bothersome when eating. Even if I do not touch it, I feel a kind of pain although the tooth is supposed to be dead. When chewing food on the right side, I repeatedly feel as though I cannot fully bear down on my teeth and bite hard. It feels as if the prepared canine moves away when I bite, although it does not hurt. Visually, it seems to be slowly pushing the lateral and central incisors forward. I have had a slightly protrusive upper bite since childhood. Thank you for your opinion and kind regards.

Question

Accepted Answer

Dear Sir/Madam! Root-canal-treated teeth can remain sensitive to biting, tapping, or even spontaneously, despite removal of the vital part of the tooth. The source of pain is the periodontal ligament, where inflammation persists around the root tip due to bacteria still present in the root canal or to the filling material itself in the canal. With long bridges, the periodontal ligament of the supporting teeth may be overloaded during strong biting, which you perceive as pain or discomfort. I recommend repeat root canal treatment (with an X-ray before treatment), which could be supplemented with an apicoectomy if necessary. Instead of long bridges, I recommend placement of dental implants. Have a nice day!

Dentist Tomaž Rotar answers: