Root canal re treatment

[Dentalpatience]

Hi there

I don't have any xrays yet but wondering if someone could translate this for me.

My new dentist suggested I have an infection at bottom of a 20 year old root canal. She suggested root canal re treatment from a specialist.

My symptoms: At the root of root canal tooth there's sometimes slight irritation/pain. Sometimes no irritation at all (often comes on when I floss).
The tooth next to it is slightly cracked and once in a blue moon there's pain when I bite down (very rare).

I went to an endodontist. He did a 'cold test' and said (looking at X-ray): there's a slight shadow at bottom of root canal tooth which could be an infection. He also said that since there was no nerve in the tooth the pain from the 'cold test' would most likely come from the tooth next to it. He suggested there might an abcess in the tooth next to the root canal.

His treatmenttment suggestion: root canal re treatment and ask my regular dentist to do some work on the tooth next to root canal.

My question 1: If the root canal has no nerve why do I sometimes feel pain?

Question 2: Would it be possible that there is no infection and the pain I feel in root canal tooth is caused by the cracked tooth next to it?
Could the 'slight shadow' be something else?

I am asking because the root canal has always been a little sensitive and previous X-rays by previous dentists has never shown any problems before.

Any thoughts?

 

[MattKW]

1. The pain you will feel from a failed RCT would be biting pressure. Cold test will be of no use, and will be negative.
2. If the cracked tooth has a positive cold test, then it is still alive and an RCT is not needed. However, the crack may need to be fixed. Talk to your dentist.
3. Some patients report that RCTd teeth always feel a little different to live teeth, even though there is no pathology.

 

[Dentalpatience]

1. The pain you will feel from a failed RCT would be biting pressure. Cold test will be of no use, and will be negative.
2. If the cracked tooth has a positive cold test, then it is still alive and an RCT is not needed. However, the crack may need to be fixed. Talk to your dentist.
3. Some patients report that RCTd teeth always feel a little different to live teeth, even though there is no pathology.

Thank you, much appreciated.

Interesting, my failed RCT tooth has low level pain/sensitivity pretty much non stop right now. If I tap on it it hurts. Cold drinks hurt. Wondering if there's an active nerve in there somewhere.

 

[MattKW]

Cold drinks are not selective enough to determine the correct tooth. Even trying it yourself with an ice-cube can be deceptive. If I think the person is trying to anticipate my cold test, I will deceive them by saying I'm doing one tooth when really doing the other, or pretending to use ice spray when really the pellet has nothing on it. Kids especially will try and be too "helpful". There is no active nerve "somewhere" in your RCTd tooth; the biology doesn't work that way.

 

[Dentalpatience]

Cold drinks are not selective enough to determine the correct tooth. Even trying it yourself with an ice-cube can be deceptive. If I think the person is trying to anticipate my cold test, I will deceive them by saying I'm doing one tooth when really doing the other, or pretending to use ice spray when really the pellet has nothing on it. Kids especially will try and be too "helpful". There is no active nerve "somewhere" in your RCTd tooth; the biology doesn't work that way.

Thanks for explantion. I'm having root canal re treatment later this month so hopefully it will sort out the problem.