Mirhamid Salek, DDS

Before explaining how dentists treat pulpitis, we need to know what pulpitis means. Pulpitis is inflammation of soft tissues inside of a tooth. Pulpitis can be reversible or irreversible.
Reversible pulpitis is a mild to moderate inflammation, because of superficial decay or tooth crack, or even too much pressure during grinding and clenching. This type of pulpitis can be treated just by treating the cause of the problem, like receiving restorative treatment.
reversible pulpitis is very severe inflammation, secondary to deep decays, with exposure of tooth intrinsic soft tissues to the bacteria, deep tooth cracks, or other damaging material, even chemicals which are used for filling a tooth. In this case, more aggressive treatments, like root canal therapy, may be required.
Differential diagnosis between reversible and irreversible pulpitis is not a simple task. It needs experience and knowledge of the dentist and needed equipment and technology in the dental office.
At A-Z dental care you can have all the necessary factors for getting the right answers. Dr. Salek is an experienced and knowledgeable dentist. Our office is equipped with the latest imaging technology for accurate diagnosis.

Crowns have three main roles in dental practice: First, the crown is good protection for a tooth that has been severely damaged and is on the verge of breaking, regardless of whether the tooth has received a root canal or not. Protecting the integrity of a tooth after RCT is a must, otherwise, it can easily break. A tooth with deep or large decay is prone to breakage if not protected by a crown. In these cases, there is no other option than doing a crown for the tooth, just for protection and prevention of breakage.
Secondly, teeth can get a crown as an abutment for making bridges, and replacing missing teeth. In this case, the tooth may or may not need RCT.
Thirdly, the crowning of a tooth may be considered for cosmetic reasons. Again, in this case, crowning can be done without doing a root canal depending on the tooth condition.

In some cases, after the first Root Canal Treatment (RCT), a second RCT may be necessary due to a lack of healing or the occurrence of a new infection. This second RCT is called retreatment. Since retreatment is performed on a tooth that has already been subject to RCT, no live nerve exists to cause pain. Furthermore, in all dental procedures that may cause pain, local anesthesia is administered to alleviate pain during the procedure, and prescribing antibiotics and pain medication is a common practice after many dental procedures. For these reasons, the patient should not be worried about experiencing pain during and after root canal retreatment.

Different factors can cause pain by pressure on our teeth. All these multiple factors can cause inflammation on supporting tissues, periodontium, of the tooth structure in the jaw bone. Depends on the intensity, duration, history, and eventually type of the pain, plus clinical exam, and radiologic findings, a dentist can find the causation of pain.

Read more on my webpage "Ask Your Dentist":
https://www.atozdentalcare.com/ask-your-dentist/
Sometimes this pain is because of high spot on new filling or crown. This one is the simplest factor, which can be removed by adjustment on the restoration. But some cases are very complicated, such as tooth fracture, or cracked tooth. Other than that ....

Dental bone grafting is a procedure for preservation of tooth sockets. In this procedure, the dentist will graft a section of bone from another area of the patient’s body, or use a special bone grafting material, and graft it onto jaw bone. In the past, without utilizing this technique, the patient would have experienced bone loss and shrinkage of the jaw after losing a tooth. Vertical or horizontal shrinkage of the jaw has harmful consequences, such as problems for replacing the missing teeth, or depression on the facial muscles, which can cause cosmetic problems for the patient.
Read more on my webpage "Ask Your Dentist":
https://www.atozdentalcare.com/ask-your-dentist/
It is a misconception if one assumes that bone grafting is needed only in the case of dental implant. While bone grafting is usually required before and during this procedure, but it is not limited to dental implant.....

A few years ago my wife showed up at my office with a severe pain in her upper teeth. Based on her dental history, I was sure that the pain could not be caused by damage to her teeth. After taking a panoramic x-ray to rule out other possible toothache causes, I noticed a remarkable sinus infection. Consultation with an ear-nose-throat (ENT) specialist, confirmed my initial finding of an acute sinus infection.
Read more on my webpage "Ask Your Dentist":
https://www.atozdentalcare.com/ask-your-dentist/

Toothache can cause feelings that could be associated with sinus infections and vice-versa, because they share a nerve. Patients with headaches, nose congestion and even fever, may not realize that these symptoms could be related their simultaneous toothache. Going to a dental office is the best thing to do in these circumstances. A dentist can make an accurate diagnosis based on a clinical exam and an X-Ray.

A dental implant, like many other dental procedures, should not cause pain and discomfort if done the right way and under adequate anesthesia. The first day after the procedure, however, the patient may experience some degree of mild to moderate pain. For this reason, prescribing pain medication and antibiotic, to prevent infection, is a standard practice.

More explanation is available at my website page "Ask Your Dentist" https://www.atozdentalcare.com/ask-your-dentist/

If the dental implant is performed by an experienced and knowledgeable dentist and in a dental office equipped with the state of the art technology, the unexpected consequences should be minimal or non-existent.

Placing dental implants, like other dental procedures, cannot cause any pain when patient has good anesthesia, or feeling numbness. After finishing the procedure maybe patient would feel some degrees of mild to moderate pain just for the first day. Pain medication and antibiotics should always be prescribed for the patient for pain and infection control. More info about implant is available on my website:
https://www.atozdentalcare.com/dental-service/dental-implants/
If the dental implant is performed by an experienced and knowledgeable dentist and in a dental office equipped with the state of the art technology, the unexpected consequences should be minimal or non-existent.

Before elaborating on this question, it should be made clear that TMJ is not a disorder, but one of the body’s joint like a knee or an elbow joint. TMJ is the joint hinging lower jaw (mandible) to the skull bone. Therefore, any dysfunction of the TMJ, like movement limitation, should be called a TMJ disorder or TMD.
Jaw cramps in one of the signs and symptoms of TMD. Other diagnostic symptoms of TMD include: pain, noise, deviation of jaw during opening and closing of mouth, and jaw locking.
More info on TMJ disorder is available on my website:
https://www.atozdentalcare.com/dental-service/orofacial-pain-specialty/tmj-disorders/
All of TMJ disorder symptoms should be taken seriously and the patient should be evaluated by a dentist, or by a TMJ specialist in complicated cases.

Before I answer this particular question, I want to discuss the overall possible consequences of a root canal.

Root canals, like other medical and dental treatment, can have side effects and complications, as well as very important benefits.
You can read more at my website about Root Canal:
https://www.atozdentalcare.com/dental-service/root-canal/

One of the possible consequences of a root canal is inflammation and/or pain. Actually, inflammation is one of our body’s natural immune system responses. Inflammation is a result of infection, irritation, or injury – all of which might have necessitated your root canal in the first place. Inflammation has four signs; redness, warmth, swelling, and pain. Inflammation typically begins in the ligament surrounding the tooth and spreads to neighboring tissues. Pain and discomfort when biting down or chewing foods may present itself because of inflammation of ligaments. These symptoms should go away after a few days with a dentist’s care.

The chances of this kind of complication can increase when a dentist is not as expert as they ought to be.

Before elaborating on this question, it should be made clear that TMJ is not a disorder, but one of the body’s joint like a knee or an elbow joint. TMJ is the joint hinging lower jaw (mandible) to the skull bone. Therefore, any dysfunction of the TMJ, like movement limitation, should be called a TMJ disorder or TMD.

If one poses this question to a TMJ specialist, like Dr. Salek of A-Z Dental Care in West Covina, the answer would be yes, jaw cramps in one of the signs and symptoms of TMD. Other diagnostic symptoms of TMD include: pain, noise, deviation of jaw during opening and closing of mouth, and jaw locking. All of these symptoms should be taken seriously and the patient should be evaluated by a dentist or by a TMJ specialist, in complicated cases.

During the dental procedures, nerve damage can happen, depends upon nature of procedure, or dentist’s knowledge and skill. Sometimes damage is very severe to a main branch of nerve. On the other hand, this damage can be very minor and for very terminal accessory nerve branch. Based on the damage and damaged nerve answer to this question can be different. At the same time, the way and considering golden time for treating damaged nerve is very important for getting good result, and treating patient with minimum consequences.
Therefore, as you can see, it is very hard to tell and give a timeframe for healing processes of damaged nerve. As everyone knows, prevention of a problem is always more easily, than solving a problem after happening. Even it can cause less cost and more guaranteed right outcomes and results.

Wisdom teeth infection is very serious and could even become life threatening if not properly treated.
This type of infection can quickly spread throughout the body with the circulation of blood, which will then require patient hospitalization. On the other hand, since wisdom teeth are near head and neck area, they can obstruct air way, cause brain infection, and even result in death.
People must take wisdom teeth infection very seriously and immediately seek treatment.

More explanation is available at my website page "Ask Your Dentist" https://www.atozdentalcare.com/ask-your-dentist/ 

When you need to have a consultation....

Swollen gums, secondary to inflammation or infection of the gingiva (gums), are one of the most frequent signs of gum diseases. However, there are many additional causes of swollen gums, including rare autoimmune diseases like pemphigus, pemphigoid, and lichen planus, or more common ailments like gingivitis, periodontitis, and tooth infections. Each of these diseases warrants a visit to the dentist for diagnosis and treatment because they may be indicators of dangerous local or systemic consequences, and can be a sign of an underlying systemic disease.
More explanation is available at my website page "Ask Your Dentist" https://www.atozdentalcare.com/ask-your-dentist/
Sometimes, treatment of swollen gums is not complicated. For example, a deep cleaning ....

Grinding, or other para-functions, such as chewing gum, eating hard food stuff, and clenching, can cause tension and pressure on masticatory muscles which are needed for mouth opening and closing. When someone walks or runs beyond his or her leg muscles’ capability, overwhelming muscles, soreness, activity limitation, and even pain on the relevant joints are possible. The same is possible with your mouth and jaw.

More explanation is available at my website page "Ask Your Dentist" https://www.atozdentalcare.com/ask-your-dentist/

Localized myalgia and myofascial pain are two unpleasant outcomes of overused muscles. Myofascial pain .....

Usually, extraction can cause mild to very severe pain after the procedure. Inflammation, secondary to the trauma of the procedures and the immune system reaction needed for healing, is the main reason for pain. In the case of a chronic or active infection for involved tooth, the risk of pain is higher.

More explanation is available at my website page "Ask Your Dentist" https://www.atozdentalcare.com/ask-your-dentist/ 

1-Not all extraction procedures require opioid prescriptions.
2-Opioid medication should be avoided as much as possible, because of the well-known side effects and potential consequences.

There are numerous causes of pain in our gingiva (gums). Infection, trauma, tooth problems, inflammation, and even dysfunction in the nerves (neuropathy and neuralgia). Depending upon the pain described by the patient, his or her oral health history, and intraoral or extraoral pathological changes, an expert dentist can diagnose the problem and help the patient treat or manage it.

More explanation is available at my website page "Ask Your Dentist" https://www.atozdentalcare.com/ask-your-dentist/

Sometimes the diagnosis of the source of the pain is very simple, like verifying a broken and infected tooth clinically or via an x-ray. However, sometimes the problem is not as simple as a broken tooth. For example in the case of autoimmune diseases, like lichen planus, pemphigoid, and pemphigus, some changes are rooted in patients’ gingiva, such as redness and ulceration.

Based on a great deal of research and many studies, we know that more than 30 percent of children grind their teeth. This number for adults is going up, and more than 60 percent of us grind at night (bruxism) or during the day (clenching).
More explanation is available at my website page "Ask Your Dentist" https://www.atozdentalcare.com/ask-your-dentist/
However, some signs and symptoms can help and inform you that you may grind or clench. These include sensitive teeth, pain, stiffness, as well as tiredness on the TMJ (temporomandibular joint) and masticatory muscles.

There are several reasons for getting a crown after a root canal. These include:

1-Usually, after advanced decay, a tooth needs a root canal. With huge cavities, almost all of the main part of the tooth is gone. This amount of damage to the tooth structure doesn’t let the dentist restore the tooth properly. A crown can help with the final restoration.
2-For cavity preparation, removing the roof of the pulp chamber is required. Otherwise, finding the canals and getting access for cleaning and shaping the canals is impossible. More explanation is available at my website page "Ask Your Dentist" https://www.atozdentalcare.com/ask-your-dentist/
3-Pulp chamber roof removal compromises

Almost 10% of Americans have diabetes. Diabetes has a two-way relationship with oral health. Diabetic patients should be more concerned with their oral hygiene than people who are not suffering from this disease.
1-Diabetes can increase the risk of tooth decay or cavities.
2-Diabetes can compromise immune system function. Immune system function is very important for the protection of teeth and their supporting tissues.
More explanation is available at my website page "Ask Your Dentist" https://www.atozdentalcare.com/ask-your-dentist/