Tooth Hurts and Dentist Can’t Figure Out Why?

I had an accident while I was out of town. I had an emergency emergency dental appointment that resulted from that accident because of trauma to the tooth. I had two teeth hit. One of them was broken. The other was okay. The dentist did an emergency root canal treatment on the broken tooth. When I got home my dentist checked the work and said it was okay, then put a crown on the tooth. Now it’s been a couple of years and the tooth has really started hurting again, but the dentist cannot find anything wrong with it. There’s nothing on the x-ray and it does not hurt when he taps on it. I insisted it was hurting, so he sent me to a specialist. Unfortunately, the specialist can’t find anything wrong with it either. It is not hurting at the moment and I’m at a loss and worried I’ll lose the tooth, especially because it is a front tooth. Have you seen anything like this before?



Dear Christine,

Man holding his jaw in pain

I’m puzzled why both your dentist and the specialist, which I am assuming is an endodontist, are finding this hard to diagnose. While it is true that root canal treatments can fail, I don’t think it is likely that your front tooth did. There aren’t any surprise canals that are hard to reach on a front tooth the way there is on a molar.

You did have trauma to two teeth. My feeling is that you are having referred pain from the adjacent tooth that experienced the trauma but did not break.

Until an infection starts to spill out of the tooth, it is not unusual for nothing to show up on the x-ray with the pulp inflamed. It would not hurt when tapped at that point either.

If it is no longer hurting, that tells me that either the tooth has recovered or it is dying. If it is dying, that will eventually show up on an x-ray. The tooth will eventually start turning darker as well. I would not consider it a dental emergency, but I would keep an eye on it. You may find yourself needing another root canal treatment and dental crown at some future date. I would just keep up with your regular dental appointments and periodically have the tooth x-rayed.

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