Dr Irene Sim

If your endodontist or dentist has indicated a need for root canal treatment, it means that a tooth is infected. The tooth remains infected until a root canal treatment is completed or the tooth is extracted. If it is not treated promptly, the infection can spread and form an abscess. An abscess is an accumulation of pus (thick, yellowish fluid) that is formed naturally by the body to contain an infection and to prevent it from spreading. It appears as a pink/red swollen area and they are generally painful due to the pressure of the pus building up.

Tooth sensitivity is a brief sensation of sharp pain experienced when the dentinal layer of a tooth is exposed to stimuli; typically thermal in nature. Dentin is the yellowish layer found beneath the outermost white and hard enamel. When the protective enamel layer is lost or when the gum recedes, stimuli such as hot, cold, sticky or acidic food come into contact with the inner layers of the tooth and a signal is sent to the nerves inside the tooth. This, in turn, sends a signal to the brain and pain is felt.

Let’s draw an analogy between teeth and houses. As everyone knows, when you want to renovate a big house, like a bungalow, you will require a lot more effort and material as compared to an apartment. As a result, one can guess that it would also cost more to renovate the bungalow. With that said, it is also more time consuming and labour intensive to treat a more complex tooth. For example, molar as it can have twice, thrice, 4 times or even 5 times as many root canals as a premolar or front tooth. Hence, the fees will also be higher.

Generally, when a tooth is damaged or diseased, we will examine if it is possible to save the tooth. If it can be saved, a root canal treatment will be recommended. A root canal treatment involves the following: 1) Creating an opening into the affected tooth 2) Removing the infected contents in the canals 3) Thorough cleaning of the canals 4) Fill up the canals with a root canal filling material 4) Restore the affected tooth with an appropriate filling Following which, a dental crown may be recommended to protect against fracture and improve on the appearance of the tooth.

Since your tooth was restored with a temporary filling, it is still considered to be fragile. Here are some important after care instructions: 1) Avoid using that tooth as much as possible (especially hard/crunchy food) This is to reduce the possibility of the filling from dislodging. When a filling dislodges, it may result in re-infection and root canal treatment to fail. 2) Continue proper oral hygiene routines like brushing and flossing Brush the treated tooth gently in a circular motion. As for flossing, do it slowly.

The symptoms of a failed root canal treatment (RCT) includes: pain returning to the tooth after RCT has been completed for a period of time swelling of the face or inside the mouth discharge around the treated tooth In your case, if you are experiencing pain after 4 years, it is possible that infection has returned to the tooth. You are recommended to visit your dentist/endodontist so that he/she can do a thorough examination of your tooth. If the tooth can be salvaged, a second RCT can be done.